Search Results (4,994)

Sustaining Ghana’s construction workforce requires more than expanding training as it requires integrating apprenticeships into a coherent skills system that links education, industry, and employability. This study tests how institutional integration, practical training, and industry collaboration jointly shape the effectiveness of apprenticeship training as a pathway to a sustainable construction workforce. Using survey data from 212 students, 36 instructors, and 129 industry and policy stakeholders, the study applies Confirmatory Factor Analysis (CFA) and Structural Equation Modelling (SEM) to validate a latent construct of Effective Apprenticeship Strategies and quantify how its components explain training and workforce outcomes. A first-order measurement SEM was estimated to examine the causal relationships between the latent strategy construct and its observed indicators across the three respondent groups within a single analytical framework. The model shows strong construct validity (CFI = 0.904; RMSEA = 0.032) and reveals that structured workplace learning, institutional support, SME engagement, and technology-oriented training are the most influential components of effective apprenticeship integration, together explaining a substantial proportion of variance in apprenticeship quality and workforce readiness. The results further reveal a highly gender-polarised training pipeline (87.7% of students and 94.4% of instructors are male), indicating that current apprenticeship structures risk constraining Ghana’s future skilled labour supply and undermining long-term workforce sustainability. The study demonstrates that apprenticeship integration is not merely a training reform but a workforce sustainability mechanism. By empirically identifying which integration strategies matter most and showing how gender exclusion limits future labour capacity, the study provides a quantitative basis for redesigning Ghana’s apprenticeship system toward a more inclusive, industry-aligned, and sustainable construction workforce. Full article

Background: The majority of cleft palate patients have been reported to suffer from otitis media with effusion (OME). The improvement of velopharyngeal function (VPF) after palatoplasty might be evidence for the improvement of the function of the Eustachian tube. The improvement of the function of Eustachian tube by palatoplasty has been reported to be effective for the treatment of OME simultaneously with the insertion of a ventilation tube into the tympanic membrane. There are only a few reports that clearly show the association between improvement of VPF and improvement of OME after palatoplasty. In this study, we discussed whether the improvement of VPF after palatoplasty in cleft palate patients with OME improved OME. Methods: Twenty-six patients with cleft palate were included in the study. We retrospectively extracted the information of cleft type, gender, surgical technique, and presence of OME risk factors from electronic medical records. We also investigated the recurrence of OME and the improvement level of VPF at 36 months postoperatively. OME was assessed based on the otolaryngologist’s findings in electronic medical records, with a good prognosis group with no symptom of OME, or a recurrence group with prolonged or recurrent OME. Results: At 36 months after palatoplasty, 19 of 23 patients (82.6%) were in the OME good prognosis group and four (17.4%) were in the OME recurrence group. The rate of patients with recurrent OME did not differ significantly by the degree of improvement of VPF. This study indicated that clear association between other risk factors for OME and OME recurrence could not be shown. Conclusion: We observed that most patients with cleft palate who underwent palatoplasty showed a good prognosis for OME at 36 months after surgery. However, further studies are needed to investigate the impact of different surgical techniques on the improvement of OME and the degree to which VPF improves, as well as the effect of each OME risk factor. Full article

Children with autism spectrum disorder (ASD) frequently struggle with emotion regulation, which can be influenced by parental practices and the supportive role of siblings in encouraging emotional and social development. The study aimed to examine the relationship between parenting practices and emotional regulation of children with ASD and to explore the mediating role of the prosocial behavior of siblings between parenting practices and emotional regulation in children with ASD. Additionally, this study investigated the moderating role of sibling gender in the relationship between prosocial behavior and emotional regulation. A total of 600 parents/caregivers aged 25–40 years (M = 32.91, SD = 4.23) of children with ASD were selected from special education institutes in Lahore, Pakistan, using a non-probability, purposive sampling method. Although the majority of respondents were mothers (94.5%), the term parenting practices is used to reflect a family-level caregiving construct rather than exclusively maternal behavior. Data were interpreted through IBM SPSS Statistics 23 and PROCESS macros, revealing that authoritative parenting had a significant positive relation with emotional regulation in children with ASD. Results also indicated that the prosocial behavior of siblings partially mediated the relationship between authoritative parenting and emotional regulation in children with ASD. Furthermore, sibling gender significantly moderated the indirect effect, with female siblings showing stronger facilitation of emotional regulation through prosocial behaviors compared to male siblings. Full article

Objective: The primary objective of this study is to investigate the prevalence of unexpected findings requiring treatment after routine histological examinations following tonsillectomy, tonsillotomy, adenotomy, or conchotomy (TTAC) in a retrospective study and to discuss whether routine histological examination is useful in patients without clearly defined risk factors or whether it would be better to reduce unnecessary costs and resource utilisation. Materials and methods: The present retrospective study encompasses 5709 patients who underwent routine histological examinations following TTAC and were treated as inpatients at the University Medical Center Freiburg, Department of Otolaryngology, Head and Neck Surgery, between 2011 and 2021. The data was collected based on patient characteristics, including date of birth, gender, age of patients at the time of surgery, date of surgery, indication for surgery, tissue examined, and histological result. Results: Of a total of 6687 patients who underwent TTAC, 5709 with routine histological examinations were included in the analysis, of whom only four showed abnormal findings, corresponding to an overall prevalence of 0.07%. Three of these four patients were adults. These included two cases of granulomatous inflammation, one instance of Burkitt lymphoma, and one instance of chronic lymphocytic leukaemia/small cell B-lymphoma. Following the exclusion of tuberculosis and sarcoidosis, and the lymphoma board’s decision to adopt a watch-and-wait approach in the case of chronic lymphocytic leukaemia/small cell B-cell lymphoma, only n = 1/0.0175% of patients were found to require treatment. Conclusions: The study demonstrated that only four abnormal histological findings occurred in 5709 inpatient TTACs, of which only one, namely Burkitt lymphoma, ultimately required treatment. Consequently, it can be concluded that routine histological examinations following TTAC are not beneficial in patients without clearly defined risk factors, such as blood in the saliva, history of smoking or alcohol consumption, unexplained pain, previous cancer, mucosal changes, or tissue asymmetries. However, in instances where clinical or anamnestic suspicion of malignancy is present, a histological examination should be conducted. Full article

Background: Non-small cell lung cancer (NSCLC) is the most prevalent form of malignancy and the leading cause of cancer-related fatalities. In clinical practice, metastatic sites are identified on a case-by-case basis. ALK rearrangements are detected in 3–5% of NSCLC cases and are known to have a tendency (tropism) to metastasize to the brain. Methods: Data from 81 ALK-positive and 91 ALK-negative metastatic NSCLC patients were retrospectively analyzed. Systemic markers, including HALP score, NLR, PLR, LMR, and LDH, were calculated from blood tests at the time of metastasis. Optimal cut-off values were determined using ROC analysis. Survival outcomes and prognostic factors were assessed using Kaplan–Meier and Cox regression analyses. Results: ALK-positive patients were significantly associated with female gender (p = 0.002), non-smoking status (p = 0.001), adenocarcinoma histology (p = 0.001), and a higher incidence of brain metastases (p = 0.001). In univariate analysis, age, time to metastasis, liver metastasis, and NLR were prognostic for survival. Crucially, multivariate analysis identified liver metastasis as an independent predictor of poor prognosis (HR = 1.618; 95% CI: 1.050–2.494; p = 0.029), indicating a 61.8% increased risk of death or progression. While inflammation markers (NLR, HALP, PLR, LMR) did not predict metastasis to specific sites, elevated LDH levels were significantly associated with liver metastasis (p = 0.007). Conclusion: ALK-positive NSCLC demonstrates a marked CNS tropism; however, liver metastasis remains a more critical adverse prognostic factor than brain metastasis in real-world settings. While routine inflammation markers showed limited utility in predicting site-specific metastasis, LDH levels correlated significantly with liver involvement. Aggressive management strategies are warranted for ALK-positive patients presenting with liver metastases. Full article

For listed companies, board diversity is often associated with improved decision-making, sustainability and financial performance. However, prior studies have neglected the interplay between board diversity and executive remuneration, especially in developing countries, over extended time horizons, and at the level of individual executives. This study addressed this gap by examining the evolution of board diversity and executive remuneration in South African listed companies from 2002 to 2017. Specifically, it investigated trends in board diversity and the determinants of executive remuneration, with particular attention to gender and ethnic pay gaps. Descriptive and regression analyses were conducted on a dataset comprising 8835 executive-level observations. Findings reveal a steady increase in female and non-white executive representation, possibly to align with societal expectations and remain legitimate. However, persistent gender and ethnic pay gaps were also noted, which might indicate that white and/or male executives are more entrenched and able to extract additional remuneration in line with the managerial power theory. The study contributes to the literature by documenting long-term trends in diversity and remuneration, providing empirical evidence on the influence of demographic attributes on remuneration outcomes, and offering insights for regulators, investors and non-executive directors seeking to advance equity and effective governance. Full article

Background: Sleep quality (SQ) and physical activity (PA) are among the strongest behavioral determinants of healthy aging, while dietary behavior and psychological factors act as complementary modulators of these relationships. Although each domain has been studied extensively, their combined influence on subjective life expectancy (SLE)—an individual’s perceived likelihood of living to an advanced age—remains largely unexplored. Methods: This narrative review synthesizes evidence from sleep science, exercise physiology, behavioral medicine, and psychological aging. Literature published between January 2015 and 15 December 2025 was examined across PubMed, Scopus, and Web of Science using integrative keyword strategies. Studies addressing SQ, PA, circadian rhythms, psychological health, SLE, or aging-related outcomes were included. Results: The review identifies several converging pathways linking sleep and PA to aging trajectories. Sleep architecture, circadian stability, metabolic regulation, inflammatory balance, and autonomic function represent key biological mechanisms. PA contributes through improvements in mitochondrial efficiency, VO₂max, muscle metabolism, and anti-inflammatory signaling (IL-6 as a myokine). Across studies, both sleep and PA strongly influence psychological health, health perception, and future-oriented expectations, within a broader lifestyle context supported by nutritional status and dietary quality. SLE emerges as a central psychological mediator that shapes motivation, adherence to health behaviors, and long-term health outcomes. Contextual moderators—including age, gender, socioeconomic status, cultural norms, and wearable technology engagement—further influence these relationships. Conclusions: SQ and PA form the core behavioral components of a dynamic system that is further shaped by dietary behavior and psychological well-being and centered on SLE. Our proposed integrative model positions SLE as a key psychological link between lifestyle behaviors and longevity. This framework is hypothesis-generating and requires empirical validation through future longitudinal and interventional studies, underscoring the need for multidomain research integrating behavioral, biological, nutritional and psychological indicators of aging. Full article

Background: While COVID-19 vaccination significantly reduces acute disease severity, its impact on the incidence of long COVID remains debated, with some observational studies paradoxically suggesting higher symptom rates among vaccinated individuals. This study aimed to resolve this controversy by distinguishing between the protective effects of prior immunity and the confounding influence of reverse causality. Methods: We conducted a retrospective cohort study of 627 adults hospitalised for COVID-19 in London. Participants were stratified into two analytical cohorts based on vaccination timing: a “prevention cohort” (vaccinated ≥ 14 days pre-infection) and a “post-acute cohort” (vaccinated post-infection). Multivariable Bayesian logistic regression was employed to estimate Adjusted Odds Ratios (aOR) for long COVID, controlling for age, gender, BMI, comorbidities, and acute length of hospital stay (LoS). Results: In the prevention cohort, prior vaccination demonstrated a non-significant protective trend against long COVID (aOR 0.81; 95% CI 0.45–1.42; p = 0.45), with no significant difference observed between homologous and heterologous regimens. The post-acute cohort exhibited a strong, significant positive association (aOR 3.41; 95% CI 2.23–5.52; p < 0.001), indicating substantial indication bias, with symptomatic individuals more likely to seek vaccination. The strongest independent predictors of long COVID were comorbidities (aOR 2.78) and prolonged acute hospitalisation (≥4 days; aOR 1.82). Conclusions: Vaccination administered prior to infection demonstrates a protective trend against long COVID, whereas the strong association observed with post-infection vaccination reflects indication bias, with symptomatic survivors being more likely to seek immunisation. Clinical strategies to mitigate post-acute sequelae should prioritise reducing acute disease severity and managing comorbidities, which were identified as the dominant independent predictors of risk in hospitalised patients. Full article

Background/Objectives: Rural communities in Guatemala face a growing double-burden of malnutrition. Women of reproductive age are a key population to address, as their health and nutritional status influence not only their own well-being but also that of their children and families. However, they often experience greater exposure to nutritional risks due to gendered inequalities in access to resources, education, and health care. This small-scale observational study aimed to describe the dietary habits and nutritional status of a sub-group of women living in a rural area of Bárcena Villa Nueva, Guatemala. Methods: An observational study was conducted between March and April 2025 among women aged ≥18 years from two rural communities. Dietary data were collected through structured interviews, 24 h dietary recall (24-hR), and a validated food frequency questionnaire (FFQ). Anthropometric and biochemical measurements were also collected. Results: A total of 22 women were included (mean age: 41.3 ± 16.3 years). The prevalence of obesity and central obesity was 45.5% and 86.0%, respectively. Quantitative dietary assessment based on the 24 h recall showed a mean energy intake approximately 35% higher than the recommended values, with a high contribution from fats and carbohydrates and an excessive sodium intake. In contrast, intakes of potassium, zinc, and folic acid were below the recommended levels. The qualitative analysis of the food frequency questionnaire indicated a dietary pattern characterized by high consumption of carbohydrates, animal-based protein sources, traditional energy-dense foods, and ultra-processed products, alongside a limited intake of vegetables and fruits. Datary diversity was low (4.9, SD: 1.1). Conclusions: This small-scale observational scale study provides a preliminary overview of dietary patterns and nutritional status among women living in a rural community in Guatemala. Although the findings are not generalizable, they suggest the coexistence of excessive energy intake, suboptimal micronutrient intake, and low dietary diversity. These results underscore the need for further research using larger and more representative samples and may help inform the development of context-specific nutrition education initiatives in similar underserved settings. Full article

As China’s demographic transition deepens and fertility rates continue to decline, childbearing has shifted from a private family matter to a salient public issue. Social media platforms have become key arenas in which fertility-related concerns are articulated, negotiated, and publicly constructed. This study analyzes fertility-related user-generated content (UGC) from three major Chinese platforms—Sina Weibo, Douyin, and Toutiao—collected between 30 June and 31 December 2024. Using BERTopic-based topic modeling, sentiment quantification, and cross-platform comparison, the study examines how fertility discourse is thematically organized and emotionally expressed across different platform environments. The results reveal clear platform differentiation. Douyin primarily foregrounds individualized and relational narratives embedded in everyday family life, Toutiao emphasizes gender-neutral, macro-social and policy-oriented interpretations, while Sina Weibo centers on gender relations, institutional arrangements, and rights-based debate. Sentiment analysis indicates that fertility discourse on all three platforms exhibits an overall negative emotional orientation, though with varying intensity. Rather than reflecting uniformly pessimistic fertility attitudes, this negative bias is interpreted as a product of platformized public discourse. The study proposes an emotional filtering mechanism to explain how fertility-related emotions are selectively distributed across communicative spaces: problem-oriented and conflict-laden expressions are more likely to gain visibility in open public platforms. By integrating a platformization perspective, this study demonstrates how platform-specific communication logics shape both the thematic configuration and emotional structure of fertility discourse, offering new insights into the mediated construction of fertility concerns in contemporary China. Full article

University dormitories, as crucial living spaces for students, significantly influence their physical and mental health based on the quality of spatial design. However, whether the use of an upper bunk (UB) or lower bunk (LB) induces differential physiological and psychological effects remains unclear. This study aimed to measure participants’ physiological and psychological responses in UB and LB environments to explore the differential impact of bunk bed positions on student comfort. A crossover experiment was conducted with 28 participants (14 male, 14 female). Dormitory scenes were recreated using point cloud scanning and virtual reality technology, and a crossover experimental design was implemented. Physiological and psychological responses during the use of UB and LB spaces were measured via heart rate variability (HRV), electroencephalography (EEG), and the Profile of Mood States (POMS). Key findings indicated that the UB space promoted a state of deeper relaxation, evidenced by significantly higher Delta activity (p = 0.039) and lower heart rate (p = 0.042) compared to the LB. Psychologically, participants reported significantly higher vitality (Vigor, p = 0.032) and lower total mood disturbance (TMD, p = 0.038) in the UB. Conversely, the LB environment tended to trigger neural alertness, with significantly elevated High Beta waves (p = 0.009). Furthermore, gender significantly moderated emotional responses, particularly for Vigor (p = 0.045). Overall, from the perspective of promoting physical and mental health, the UB space provided greater comfort than the LB. These findings offer empirical evidence to inform the optimization of dormitory spatial design. Full article

Active and healthy ageing has become a strategic objective in European and national policy agendas, grounded in grounded in internationally recognised definitions and policy frameworks such as the Madrid International Plan of Action on Ageing (MIPAA) and the European Innovation Partnership on Active and Healthy Ageing (EIPAHA). In Italy, the translation of this paradigm has taken place within a fragmented welfare system characterised by strong regional autonomy and persistent social and territorial inequalities, particularly along regional and gender lines. This scoping review has a twofold aim: (1) to map the Italian scientific and grey literature on active and healthy ageing, identifying dominant dimensions, priorities and gaps, and (2) to examine how policies and interventions frame, address or overlook social, territorial and gender inequalities across the life course Following established scoping review methodological frameworks and PRISMA-ScR guidelines, the review systematically identified, selected and synthesised Italian scientific studies and institutional documents published between 2012 and 2024. An inductive thematic analysis was conducted across four main areas—health and wellbeing; social inclusion and participation; indicators and measurement tools; and governance and public policies—with specific attention to the explicit and implicit treatment of inequalities. The analysis reveals a heterogeneous and regionally unbalanced policy landscape. While some territories have developed more integrated approaches linking prevention, participation and social inclusion, others remain largely confined to sectoral and fragmented interventions. Gendered patterns of unpaid care, differential access to programmes and services, and uneven territorial distribution of resources emerge as key dimensions of inequality shaping opportunities for active ageing. A partial discontinuity can be observed after 2019, with the introduction of national coordination mechanisms, although substantial differences in regional implementation capacity persist. The findings highlight the need for more coherent and equity-oriented strategies capable of integrating health, social and educational dimensions through a life-course and intersectional perspective. Strengthening multi-level governance and explicitly addressing social, territorial and gender inequalities as structural determinants—rather than residual variables—appears crucial to enhancing both the effectiveness and the fairness of active and healthy ageing policies in Italy. Full article

This study explores gender-based perceptions of diversity, equity, and inclusion (DEI) within the Australian construction industry, drawing on data from an exploratory mixed-methods investigation of construction practitioners. Australia provides a relevant case context due to sustained national attention to organisational culture, employee well-being, and work–life balance in construction. Adopting an exploratory mixed-methods design, the study integrates survey responses from construction practitioners (n = 40), examined separately for male and female participants, with qualitative analysis of open-ended responses to explore perceptions of workplace culture, leadership opportunities, organisational policies, work–life balance, and technology. Quantitative data were analysed using descriptive cross-tabulations and Fisher’s Exact Tests to identify indicative patterns, while qualitative insights provided contextual depth. Given the modest sample size, findings are interpreted descriptively rather than as statistically generalisable. Results indicate broad recognition of progress toward more inclusive workplace practices across both genders, alongside persistent concerns regarding leadership diversity, access to mentoring, and the visibility and communication of flexible work arrangements. Qualitative findings further emphasise the importance of transparent promotion processes, leadership accountability, and organisational support mechanisms in shaping gender-equality experiences. Overall, the study offers exploratory, practitioner-level insights into a sector undergoing gradual cultural transition, highlighting areas for continued organisational and policy attention. Full article

Background: Early evidence from a nursing home in Yepes (Toledo, Spain) indicated that antihistamines combined with azithromycin prevented deaths and hospitalizations during the first COVID-19 wave. Subsequent data from the Consorci Sanitari de Terrassa (CST) showed that patients chronically taking antihistamines had significantly reduced hospital admissions and mortality. However, a concerning rise in long COVID incidence (2–5%) after the third infection and a doubling of thrombosis rates in patients over 60 were observed. Objective: This study aimed to determine whether chronic antihistamine prescription is associated with a reduction in long COVID syndrome and thrombotic events. Methods: We analyzed anonymized data from the CST population (n = 192,651 as of March 2025). Variables included age, gender, chronic antihistamine use, number of chronic treatments (nT), COVID-19 vaccination status, SARS-CoV-2 infection history, long COVID (LC) incidence, and aggregated thrombotic events. Odds ratios (OR) were calculated using chi-square tests. Results: The prevalence of LC increased progressively with successive infections in the non-antihistamine group. No significant differences were found with the antihistamine group, which presented no LC cases among the 52 patients with three documented infections. Thrombotic events were significantly less frequent in antihistamine users with at least one chronic prescription (p < 0.0001). Conclusions: Results suggest a protective effect of antihistamines against thrombotic events. While confirmation via multicenter, randomized trials is needed, a pragmatic approach using antihistamines could be considered for symptomatic patients in the early stage of infection. Full article

This paper investigates travellers’ intentions, with regard to preferences for a green and/or ethical hotel, boycotting hotels accused of extreme environmental damages or over-exploitation of workers, and sharing relevant information on social media. Questioning the claim that intentions to prefer a green hotel are based mainly or even solely on practical criteria, this study focuses on examining the influencing power of values. The Values-Beliefs-Norms model was employed and modified as the New Environmental Paradigm was replaced by climate change risk perception. Personal interviews were conducted with consumers in the urban area of Thessaloniki, Greece, using a structured questionnaire for data collection. Area sampling, in combination with quota sampling, in terms of gender and age, was used. Results provided that egoistic and altruistic values were excluded from the final structural model, and just biospheric values indicated a statistically significant positive relationship with Risk Perception. The other hypothesised consecutive relationships between Biospheric Values (BV), Risk Perception (RP), Awareness of Consequences (AC), Ascription of Responsibility (AR), Personal Norms (PN) and Intentions (Int) were found to be statistically significant and positive. Overall, 80.9% of the variance in Intentions was explained, while Personal Norms indicated the stronger impact on Intentions among all other relationships in the chain. Eventually, theoretical and practical implications, as well as future research directions, are suggested. Full article