Search Results (1,093)

This study explores the migration intentions of university students—representing the potential creative class—in Erzurum, a medium-sized city in eastern Turkey experiencing shrinkage. Within the theoretical framework of shrinking cities, it investigates how economic, social, physical, and personal factors influence students’ post-graduation stay or leave decisions. Survey data from 742 Architecture and Fine Arts students at Atatürk University were analyzed using factor analysis, logistic regression, and correlation to identify key migration drivers. Findings reveal that, in addition to economic concerns such as limited job opportunities and low income, personal development opportunities and social engagement also play a decisive role. In particular, the perception of limited chances for skill enhancement and the belief that Erzurum is not a good place to meet people emerged as the strongest predictors of migration intentions. These results suggest that members of the creative class are influenced not only by economic incentives but also by broader urban experiences related to self-growth and social connectivity. This study highlights spatial inequalities in access to cultural, educational, and social infrastructure, raising important questions about spatial justice in shrinking urban contexts. This paper contributes to the literature on shrinking cities by highlighting creative youth in mid-sized Global South cities. It suggests smart shrinkage strategies focused on creative sector development, improved quality of life, and inclusive planning to retain young talent and support sustainable urban revitalization. Full article

Background/Objectives: The two major subtypes of inflammatory bowel disease (IBD)—Crohn’s disease (CD) and ulcerative colitis (UC)—are known to increase the likelihood of developing colorectal cancer (CRC). While this relationship has been well studied in Western populations, evidence from East Asia remains limited and inconsistent. Using nationwide cohort data, this study explored the potential connection between IBD and CRC in a large Korean population. Methods: We conducted a retrospective cohort study using data from the Korean National Health Insurance Service–National Sample Cohort from 2005 to 2019. A total of 9920 CRC patients were matched 1:4 with 39,680 controls using propensity scores based on age, sex, income, and region. Overlap weighting and multivariable logistic regression were used to evaluate the association between IBD and CRC. Subgroup analyses were conducted to assess effect modification by demographic and clinical factors. Results: IBD markedly increased the likelihood of developing CRC (adjusted odds ratio (aOR) = 1.38; 95% confidence interval (CI): 1.20–1.58; p < 0.001), with the association primarily driven by UC (aOR = 1.52; 95% CI: 1.27–1.83). CD appeared unrelated to heightened CRC risk overall, though a significant association was observed among low-income CD patients (aOR = 1.58; 95% CI: 1.15–2.16). The UC–CRC association persisted across all subgroups, including patients without comorbidities. Conclusions: Our findings support an independent association between IBD—particularly UC—and increased CRC risk in Korea. These results underscore the need for personalized CRC surveillance strategies that account for disease subtype, comorbidity burden, and socioeconomic status, especially in vulnerable subpopulations. Full article

By 2050, it is estimated that approximately 200 million people will be displaced due to the impacts of climate change. Vulnerability to climate change is shaped not only by environmental factors but fundamentally by systemic power relations and structural conditions present at both the places of origin and destination. In Latin America, climate-displaced persons predominantly settle in marginalised neighbourhoods, where widely accepted informality facilitates their rapid arrival but obstructs genuine progress and full integration as urban citizens. This paper critically examines the prevailing myths that justify the persistence of informality, revealing the socioeconomic challenges faced by climate migrants in the region. These four dominant myths are (1) Latin America’s inherently low productivity levels; (2) concessions by the ruling class enabling excluded groups to merely survive; (3) the perceived privilege of marginalised neighbourhoods to generate income outside formal legal frameworks, which supports their social capital; and (4) the limited benefits associated with formalisation. Debunking these myths is essential for developing effective public policies aimed at reducing informality and promoting inclusive urban integration, ultimately benefiting both climate migrants and host communities. Full article

Background: Breast cancer remains a major public health challenge in Latin America, where access to personalized risk assessment tools is still limited. This study aimed to evaluate the implementation of a polygenic risk score (PRS)-based stratification model combined with remote genomic counseling in Colombian women with sporadic breast cancer and healthy women. Methods: In 2023, an embedded mixed-methods observational study was conducted in Medellín involving 1997 women aged 40–75 years who underwent clinical PRS testing. The intervention integrated PRS-based risk categorization with individualized risk factor assessment and lifestyle recommendations delivered through a remote counseling platform. Results: PRS analysis classified 9.7% of women as high risk and 46% as low risk. Healthier lifestyle patterns were significantly associated with lower PRS categories (p = 0.034). Physical activity showed a protective effect (OR = 0.60, 95% CI: 0.5–0.8), while prior smoking, elevated BMI, and sedentary behavior were associated with higher risk. The counseling model achieved high delivery (93%) and satisfaction (85%) rates. Qualitative insights revealed improved understanding of genomic risk and greater engagement in preventive behaviors. Only one new case of breast cancer was detected among intermediate-risk participants, with a diagnostic lead time of 12 months. Conclusions: These findings support the feasibility, acceptability, and potential impact of integrating PRS and genomic counseling in cancer prevention strategies in middle-income settings. Full article

Background: Type 2 diabetes (T2D) is a growing public health concern, particularly in low- and middle-income countries. Although prediabetes is a major risk factor for T2D, it remains largely underdiagnosed and untreated. Structured lifestyle interventions have proven effective in preventing diabetes, but their feasibility within the Brazilian public health system remains unclear. Methods: This multicenter pilot randomized controlled trial assessed the feasibility of a culturally adapted lifestyle intervention (PROVEN-DIA) across the five regions of Brazil. A total of 220 adults at high risk for T2D were randomized to an intervention group or a control group (usual care) and followed for three months. Both groups received similar educational content on healthy eating and physical activity, but the intervention group participated in a structured and personalized lifestyle program with regular follow-up sessions. The primary outcome was adherence to dietary recommendations, assessed using the BALANCE Index—a validated dietary score (range: 0–40) based on the Brazilian Cardioprotective Diet that classifies foods into color-coded groups according to nutritional quality—along with engagement in moderate-to-vigorous physical activity (MVPA). Secondary outcomes included diet quality (DQIR), anthropometric and metabolic parameters. Results: Feasibility was demonstrated by a 93.2% retention rate (n = 205). There was no significant difference in the primary outcome (simultaneous improvement in diet and MVPA). However, the PROVEN-DIA group exhibited significantly greater improvements in diet quality, with a 2.8-point increase in the BALANCE Index (vs. 0.5 in the control, p = 0.03), and a significant improvement in the DQIR (p < 0.001). No significant differences between groups were observed in MVPA, HbA1C, glycaemia, or body weight. Conclusions: The PROVEN-DIA intervention proved feasible within the Brazilian public health context, resulting in significant improvements in dietary quality among individuals at high risk for T2D. A larger trial with longer follow-up is warranted to evaluate its effectiveness in preventing the progression to diabetes. However, to enhance physical activity outcomes, specific adaptations and targeted strategies may be required to better support participant engagement in exercise. Full article

More than 50 years ago, children were viewed as naturally resilient and often labeled invulnerable or invincible. Resilience is now understood to be the result of dynamic interactions between individual, familial, social, and environmental systems, decentralizing the focus from the individual to the global society. Experiences with adversity may emanate from the youth’s family environment, their community, the school system, and larger structural challenges related to poverty, discrimination, health disparities, and educational inequities. Youth experiences with adversity, trauma, and tragedy have the potential to negatively impact youth well-being, with consequences manifesting across the lifespan. Children and adolescents generally hold limited power to change their circumstances and are often ill-equipped to resolve the adverse or traumatic experiences occurring within their ecosystem. The value of social supports in the young person’s ability to be resilient has been affirmed. This understanding is particularly important for children growing up in poverty or in Low- and Middle-Income Countries (LMICs) where significant challenges occur as a result of economic and social disadvantage. Resilience at the individual level is unlikely to eliminate macrolevel issues. Developing and deploying strategies to enhance the ability of youth to rebound from adversity represents a positive step at the micro level, but the larger issues of economic and social disadvantage are unlikely to change without macro-level interventions. Glancing toward the future, traumatized youth may grow into traumatized adults without appropriate interventions and changes in social policies, programs, and protections. Full article

Saudi Vision 2030 seeks to improve social sustainability in the Kingdom through comprehensive economic and social reforms. This study investigates whether these reforms are associated with changes in subjective well-being (SWB), commonly understood as individuals’ experienced quality of life. Using Gallup World Poll data from 2013 to 2023 on Cantril ladder scores and affect balance in Saudi Arabia, we find increases in SWB following the implementation of Vision 2030 reforms, particularly for the affective component of SWB. While positive changes in SWB are observed across the entire population, the gains in affective well-being are especially pronounced among women. Blinder–Oaxaca decompositions show that improvements are associated with enhanced community basics, followed by greater income sufficiency, improved perceptions of social life, and an increased sense of personal freedom. Full article

Although intracranial hypertension (ICH) has traditionally been framed as simply a numerical escalation of intracranial pressure (ICP) and usually dealt with in its clinical form and not in terms of its complex underlying pathophysiology, an emerging body of evidence indicates that ICH is not simply an elevated ICP process but a complex process of molecular dysregulation, glymphatic dysfunction, and neurovascular insufficiency. Our aim in this paper is to provide a complete synthesis of all the new thinking that is occurring in this space, primarily on the intersection of glymphatic dysfunction and cerebral vein physiology. The aspiration is to review how glymphatic dysfunction, largely secondary to aquaporin-4 (AQP4) dysfunction, can lead to delayed cerebrospinal fluid (CSF) clearance and thus the accumulation of extravascular fluid resulting in elevated ICP. A range of other factors such as oxidative stress, endothelin-1, and neuroinflammation seem to significantly impair cerebral autoregulation, making ICH challenging to manage. Combining recent studies, we intend to provide a revised conceptualization of ICH that recognizes the nuance and complexity of ICH that is understated by previous models. We wish to also address novel diagnostics aimed at better capturing the dynamic nature of ICH. Recent advances in non-invasive imaging (i.e., 4D flow MRI and dynamic contrast-enhanced MRI; DCE-MRI) allow for better visualization of dynamic changes to the glymphatic and cerebral blood flow (CBF) system. Finally, wearable ICP monitors and AI-assisted diagnostics will create opportunities for these continuous and real-time assessments, especially in limited resource settings. Our goal is to provide examples of opportunities that exist that might augment early recognition and improve personalized care while ensuring we realize practical challenges and limitations. We also consider what may be therapeutically possible now and in the future. Therapeutic opportunities discussed include CRISPR-based gene editing aimed at restoring AQP4 function, nano-robotics aimed at drug targeting, and bioelectronic devices purposed for ICP modulation. Certainly, these proposals are innovative in nature but will require ethically responsible confirmation of long-term safety and availability, particularly to low- and middle-income countries (LMICs), where the burdens of secondary ICH remain preeminent. Throughout the review, we will be restrained to a balanced pursuit of innovative ideas and ethical considerations to attain global health equity. It is not our intent to provide unequivocal answers, but instead to encourage informed discussions at the intersections of research, clinical practice, and the public health field. We hope this review may stimulate further discussion about ICH and highlight research opportunities to conduct translational research in modern neuroscience with real, approachable, and patient-centered care. Full article

(1) Background: This study used latent profile analysis (LPA) to investigate family patterns of paternal and maternal responses to adolescents’ discrete emotions (happiness, sadness, and anger) and examined the relationship between these profiles and demographic factors, as well as adolescents’ emotion adjustment (emotion regulation and depressive symptoms). (2) Methods: A sample of 666 adolescents reported parental responses and their emotional adjustment; their mothers provided family information. (3) Results: (a) The LPA identified four profiles for adolescent happiness, including high enhancing but low dampening and neglect from both parents (Consistent Supportive); low enhancing but high dampening and neglect from both parents (Consistent Unsupportive); low to moderate scores on each response from both parents (Consistent Disengaging); and high maternal dampening and neglect but relatively low scores on the paternal response (Inconsistent). There were two profiles for sadness (Consistent Supportive, Consistent Unsupportive) and three for anger (Consistent Supportive, Consistent Unsupportive, Consistent Disengaging). (b) Parents with boys, higher incomes, better education, and greater marital satisfaction were likely to be classified into the Consistent Supportive profile across emotions. (c) When adolescents perceived their parents with the Consistent Supportive profile, they would show the best emotional adjustment; while for parents with the Inconsistent profile (for happiness) and the Consistent Unsupportive profile, the adolescents had the poorest outcome. Interestingly, adolescents who perceived their parents as fitting the Consistent Disengaging profile (especially for anger) exhibited comparatively less adverse adjustment. (4) Implications: A person-centered approach highlights different patterns of emotion socialization, underscores the importance of fostering parental cooperation and supportive responses to adolescents’ happiness, and suggests that joint disengagement from anger may promote healthier emotional development. Full article

This study investigates the influence of monthly income level (low, medium, and high) on consumer behavior regarding a newly launched cream cheese product enriched with berry by-products. A panel of 345 participants was surveyed, and data were analyzed using the Kruskal–Wallis and Mann–Whitney tests. Most consumers were environmentally aware, recognizing the impact of personal food waste and expressing support for food products incorporating by-products. Respondents also favored the use of renewable energy and reducing greenhouse gas emissions in the food industry. Higher income levels were associated with greater health awareness and increased acceptance of cream cheese with berry by-products, with the high-income group showing a greater willingness to pay a premium. Health benefits and the product’s natural character were the main advantages identified. Individuals with lower incomes were more open to trying unfamiliar foods when ingredient details were not provided, while higher-income respondents expressed greater hesitation and distrust toward new products. Willingness to try novel items decreased with income level. Statistically significant differences (p < 0.05) were found between income groups for label reading, support for mountain dairies, and the influence of product origin, health benefits, nutrient diversity, pricing concerns, and consumer confidence in purchasing cream cheese with berry by-products. These findings are important for understanding how income affects consumer perceptions and willingness to consume innovative, sustainable food products like berry-enriched cream cheese, highlighting key areas for targeted marketing and product development. Full article

Background/Objectives: Weight loss and its subsequent regain pose significant challenges for those dealing with overweight and obesity. This study explores weight loss strategies among adults in Saudi Arabia and evaluates factors linked to weight regain. Methods: This cross-sectional study focused on adults residing in Jazan, located in southwest Saudi Arabia. Data collection was conducted using a self-administered questionnaire that assessed participants’ demographics, medical history, perceptions of body weight, weight loss methods, and the incidence of weight regain. Logistic regression was used to determine whether there were statistically significant differences related to the occurrence of weight regain. Results: A total of 368 participants reported efforts to lose weight over the past 3 years. The average age of these participants was 32.7 years (standard deviation: 11.3), and the gender distribution was almost equal. The majority of the sample (65%) voiced dissatisfaction with their body weight. Some participants employed a combination of weight loss methods, with exercise, reduced food intake, and intermittent fasting being the most frequently mentioned. The findings also indicate that a minority sought professional help, whether from a physician or a nutritionist. Over 90% claimed to have successfully lost weight at least once during their attempts, but more than half (139 individuals) experienced weight regain following their weight loss efforts. Within the univariate logistic regression, higher odds ratios of weight regain were detected among men, older participants, those living in rural areas, individuals with higher levels of education, employed persons or business owners, those with higher monthly incomes, smokers, khat chewers, and those diagnosed with a chronic condition (p values < 0.05). However, the multivariate logistic regression revealed that only residence, monthly income, smoking status, and being diagnosed with a chronic disease remained statistically significant as predictors of weight regain after adjusting for other variables (p values < 0.05). Conclusions: These findings highlight the significance of incorporating weight regain prevention into body weight management for individuals dealing with overweight and obesity. Further research is needed to evaluate specific dietary, physical activity, and psychological factors that may increase the risk of weight regain in certain participants. Full article

In a global context characterized by budgetary pressures, aging populations, and accelerated economic transitions, the capacity of countries to mobilize stable and sustainable tax revenues represents a crucial pillar for maintaining macroeconomic stability and social cohesion. This research investigated the determinants of total tax revenues in the developed economies of the G7 group (Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States) during the period 2000–2022, employing both static and dynamic panel econometric approaches. The estimated model considered total tax revenues as the dependent variable, while the explanatory variables encompassed the main categories of government revenues: direct taxes (personal and corporate income), indirect taxes (consumption, trade, and other taxes), social contributions, grants, other non-tax revenues, and institutional quality indicators (regulatory quality and control of corruption). The empirical findings revealed that all tax components analyzed exert a positive and significant influence on total tax revenues, with particularly strong effects observed for consumption taxes, social contributions, and personal income taxes. Based on these results, the study provides policy recommendations aimed at diversifying revenue sources, balancing direct and indirect taxation, and broadening the tax base equitably. The study advances the literature on international taxation by offering an integrated and comparative analysis of the revenue structures in advanced economies, while also identifying relevant pathways for sustainable tax reforms in a dynamic global environment. Full article

Background/Objectives: Trace minerals (TMs), both essential and toxic, are integral to human physiology, participating in enzymatic reactions, oxidative balance, immune function, and the modulation of chronic disease risk. Despite their importance, imbalances due to deficiencies or toxic exposures are widespread globally. While low-income countries often face overt deficiencies and environmental contamination, middle- and high-income populations increasingly deal with subclinical deficits and chronic toxic metal exposure. This review aims to explore the relevance of serum as a matrix for evaluating TM status across diverse clinical and epidemiological, geographic, and demographic settings. Methods: A narrative literature review was conducted focusing on the physiological roles, health impacts, and current biomarker approaches for key essential (e.g., zinc, copper, selenium) and toxic (e.g., lead, mercury, cadmium, arsenic) trace elements. Particular emphasis was placed on studies utilizing serum analysis and on recent advances in multi-element detection using inductively coupled plasma mass spectrometry (ICP-MS). Results: Serum was identified as a versatile and informative matrix for TM assessment, offering advantages in terms of clinical accessibility, biomarker reliability, and capacity for the simultaneous quantification of multiple elements. For essential TMs, serum levels reflect nutritional status with reasonable accuracy. For toxic elements, detection depends on instrument sensitivity, but serum can still provide valuable exposure data. The method’s scalability supports applications ranging from public health surveillance to individualized patient care. Conclusions: Serum trace mineral analysis is a practical and scalable approach for nutritional assessment and exposure monitoring. Integrating it into clinical practice and public health strategies can improve the early detection of imbalances, guide interventions such as nutritional supplementation, dietary modifications, and exposure mitigation efforts. This approach also supports advanced personalized nutrition and preventive care. Full article

The drastic and historic fall in natural rubber prices has prompted many smallholders around the world to abandon rubber plantations in favor of other survival alternatives. In the Lomela and Lodja territories of Sankuru Province (Democratic Republic of Congo), where a historical absence of a rubber market prevails, local communities have conserved rubber plantations inherited from the colonial era (dating back to 1955). Data collected from 401 households enabled us to identify the perceptions and determinants of rubber plantation conservation. The results show that households are highly dependent on forest ecosystem services. Agriculture is the main activity for 81.3% of respondents, in the context of extreme poverty where daily incomes amount to 0.33 USD/person. The patriarchal system favored men, who inherited 97% of the plantations. Men perceived the conservation of the plantations as beneficial, while women perceived it as serving external project interests. Perceptions were significantly influenced by gender, age, social and legal organization, geographical origin, mode of acquisition, main activity, diversification of income sources, membership in a tribal mutuality, access to the informal mutual aid networks, membership in an association and contact with extension services. Conservation was positively and significantly correlated with geographical origin, membership in an association, contact with extension service, consideration of plantations as natural heritage and the ecosystem services provided. These results underline that rubber plantations cannot be understood only in terms of rubber production, but also in terms of their socio-ecological and heritage dimensions. Full article

Tourism is recognized as one of the key enabling industries driving Thailand’s strategic transition toward the Thailand 4.0 economic model. This paper presents the development of a national technology roadmap to support the transition toward sustainable tourism in Thailand, conducted between January and October 2024. The primary objective is to promote tourism growth that is environmentally responsible, economically viable, and socially inclusive. The roadmap was developed through a combination of a literature review, statistical data, and group discussions with tourism professionals. The roadmapping process focused on aligning external drivers, strategic goals, and the current capabilities of Thailand’s technological ecosystem. The key drivers identified include environmental concerns, the advancement of digital platforms, the growing trends of an aging population, diversity, and inclusion, political instability, and the emergence of middle-income nations. The resulting roadmap outlines a strategic vision for Thailand’s tourism sector from 2024 to beyond 2030. It emphasizes the transition linking sustainability and eco-design principles to smart tourism, metaverse applications, and personalized travel experiences. Priority areas include the adoption of green technologies, sustainable practices, and advanced digital platforms. This study further recommends research and development (R&D) initiatives in sustainability, biodiversity conservation, Data Analytics, Cybersecurity, and E-Tourism solutions. Ultimately, this roadmap provides actionable guidance for tourism stakeholders in defining their roles, responsibilities, and contributions toward achieving a sustainable tourism future in Thailand. Full article