Search Results (42)

Background: This study aims to evaluate the cost-effectiveness of providing the 23-valent pneumococcal polysaccharide vaccine (PPV23) free of charge versus self-paying vaccination among adults aged 60 years and older in Nanning, Guangxi, China. Methods: A decision tree–Markov model was developed to compare three strategies (government-funded free vaccination, self-funded vaccination, and no vaccination) over a 5-year time horizon. The model incorporated local epidemiological data and cost parameters, applying a 3% discount rate. Sensitivity analyses were conducted on key parameters, including vaccine effectiveness against pneumonia and pneumonia treatment costs. Results: The benefit–cost ratios for free and self-funded vaccination were 0.075 and 0.015, respectively, both below the cost-effectiveness threshold of 1. However, the free vaccination strategy resulted in a higher net benefit (USD 399,651.32) compared to the self-funded strategy (USD 222,594.14), along with a lower Incremental Cost-Effectiveness Ratio (ICER) (USD 1.47 per USD 0.14 of avoided disease cost). Although both strategies yielded benefit–cost ratios far below the conventional threshold of 1, the free strategy demonstrated relatively greater economic efficiency. Sensitivity analyses confirmed that vaccine effectiveness against pneumonia and treatment costs were key drivers of economic outcomes. Conclusions: While neither vaccination strategy achieved conventional cost-effectiveness benchmarks in this setting, the free PPV23 vaccination program demonstrated relatively greater economic efficiency compared to the self-funded approach; although neither strategy met the conventional cost-effectiveness thresholds, they should be considered for inclusion in regional health policy for older adults. Full article

Human papillomavirus (HPV) is a leading cause of several cancers, most notably cervical cancer, but also anal, penile, vulvar, vaginal, and oropharyngeal malignancies. While vaccines and screening technologies offer highly effective prevention, the global burden of HPV-induced cancers remains disproportionately high in low- and middle-income countries (LMICs). This literature review provides a comprehensive synthesis of the types, mechanisms, treatments, and prevention strategies associated with HPV-related cancers, while also highlighting regional disparities in healthcare access and infrastructure. It critically examines the barriers LMICs face in adopting life-saving interventions, such as limited healthcare infrastructure, vaccine hesitancy, funding gaps, and cultural stigma. The review further explores recent scientific and policy advances—including single-dose vaccination, self-sampling HPV tests, and senolytic therapies—that have the potential to reduce global health inequities. By connecting molecular biology with public health systems, this paper underscores the need for interdisciplinary solutions and equity-centered approaches to combat HPV-induced cancers worldwide. The findings emphasize that eliminating cervical cancer and other HPV-related diseases is not only a scientific goal but also a moral imperative requiring global collaboration and local action. Full article

Tropical pasture degradation represents a major challenge for global food security and environmental conservation, particularly in Brazil, where up to 60% of pastures are degraded. This study evaluates the economic viability of recovery of degraded pastures using an integrated crop–livestock–forest (ICLF) system. A representative 2-hectare system in the Brazilian Cerrado was analyzed, featuring native Dipteryx alata trees interplanted with pasture for cattle grazing. A deterministic financial model was developed to simulate annual cash flows over a 20-year period under various financing scenarios, including self-financing and multiple subsidized rural credit lines (e.g., Pronaf and Pronamp programs, and ABC Ambiental). The analysis shows that subsidized credit lines with low interest rates and extended grace periods significantly improve project profitability, yielding positive NPVs and robust internal rates of return, while self-financing and high-cost credit options (such as Pronaf Mulher) result in negative NPVs. The dual cash flow strategy—where borrowed funds are immediately invested in secure fixed-income instruments—further enhances economic performance. The findings demonstrate that ICLF-based pasture recovery is economically viable when supported by appropriate financing, offering a scalable model for sustainable agriculture that delivers both economic and environmental benefits. Full article

Background: Charitable crowdfunding platforms have become widely used tools for raising funds to support social and humanitarian causes. As participation in these platforms is voluntary, understanding the influence of individual motivations and cultural values is essential, particularly when engaging donors across culturally diverse regions. Within the framework of Self-Determination Theory (SDT), this study explores whether consumers’ cultural orientations influence their motivations and levels of engagement in charitable crowdfunding. Methods: Data were collected through an online survey using the Computer-Assisted Web Interviewing (CAWI) method from 680 participants recruited via Amazon Mechanical Turk. Structural equation modeling was employed to analyze the effects of three cultural dimensions—collectivism, power distance, and uncertainty avoidance—on charitable giving behavior, including their interactions with intrinsic and extrinsic motivations. Results: Collectivism was found to positively predict charitable giving, while uncertainty avoidance had a negative effect. Power distance showed a mixed influence, depending on the underlying motivational factors. Comparative analysis revealed significant regional differences, particularly between respondents from the Americas and Europe, in the strength and nature of these relationships. Conclusions: The findings underscore the importance of integrating cultural factors into digital fundraising strategies and offer new insights into how individual cultural values shape prosocial behavior in online crowdfunding environments. Full article

Background and Objectives: Cervical cancer remains a critical public health challenge in Eastern Europe and Central Asia (EECA), where systemic barriers have hindered prevention efforts. This descriptive regional study evaluates progress toward achieving Target 1 of the WHO Global Strategy for Cervical Cancer Elimination—vaccinating 90% of girls by age 15—in 17 countries and territories. The research is situated within the context of the Regional Alliance for Cervical Cancer Prevention in EECA, a multi-stakeholder platform launched by UNFPA in 2021 to accelerate regional progress toward WHO targets. The Alliance supports countries through technical collaboration, shared learning, and political engagement. Therefore, as a secondary endpoint, the study explores possible correlations between national achievements and the post-2021 scale-up efforts supported by the Alliance. Methods: A standardized questionnaire, consolidated by United Nation Population Fund (UNFPA) technical experts, was disseminated in November 2024 to 17 national focal points, yielding 19 responses due to disaggregated submissions from Bosnia and Herzegovina. The survey collected data on HPV vaccination policies, delivery models, vaccine type, target populations, and coverage. Results: By late 2024, six countries had implemented HPV vaccination before 2021, while six more launched programs after the Regional Alliance’s formation in 2021. Coverage varied widely, from 0.2% in Brčko District to 99.3% in Uzbekistan. Most countries targeted girls aged 9–14, with increasing male inclusion and catch-up cohorts. Gardasil 4 was the most used vaccine, though Gardasil 9 is gaining ground. School-based and hybrid delivery strategies were associated with significantly higher coverage (p = 0.0121). Inferential analysis also showed significant variation by vaccine type (p = 0.0067) and a positive correlation with program maturity (ρ = 0.52, p = 0.067). However, findings should be interpreted considering limitations including reliance on self-reported country data and absence of independent validation. Conclusions: The results offer actionable insights into delivery models, gender inclusion, and regional disparities—supporting efforts to close the gap toward 2030 elimination targets in EECA Countries. Full article

Developing teacher self-efficacy can be supported through coaching, a process that guides and supports teachers in enhancing their confidence in teaching and learning skills. This study, part of the CONNECT project funded by the European Union and implemented in various countries, investigates how coaching improves teacher performance and self-efficacy within the context of open schooling for sustainability. The coaching process underpinned by the CARE-KNOW-DO framework focused on 45 coaches supporting a total of 790 teachers in the UK, Brazil, Romania, and Spain. A multilanguage digital platform provided resources, guidelines, video, and best practices on open schooling integrated with the Sustainable Development Goals for teachers’ educators and teachers. Through a qualitative study analyzing CARE-KNOW-DO practices in one-on-one dialogue-based strategies, collaborative participatory research, webinars, workshops, and professional development courses, our findings reveal both challenges and catalysts in coaching. Key features of the coaching model that boosted teachers’ self-efficacy included working with mixed-ability classes (UK), overcoming curriculum pressure (Spain), and addressing complex teaching challenges (Romania). Pedagogical changes involved the adoption and co-creation of open schooling materials, along with integrating CARE-KNOW-DO principles and the EU DigComp framework for green digital skills. These insights demonstrate that coaching in open schooling environments for sustainability can significantly enhance teachers’ self-efficacy and the quality of open schooling experiences by increasing teachers’ awareness of challenges, strategies, and outcomes, focusing on meaningful practices, enhancing teaching and learning competencies, and fostering collaborative personal development. Full article

This article theorizes the role of local and indigenous culture in its intersection with development initiatives. It argues that Communication for Development and Social Change (CDSC), through a cultural studies framework, strengthens the potentiality of democratization and participation within community-based development and social change settings. We advocate that applied cultural studies can facilitate agency (through voice and self-representation) in social interventions. This is a cultural studies approach that has been recontextualised from the Birmingham origin as read through Marxist development studies, first adapted and mobilized during the anti-apartheid struggle in developing cultural strategy, and more recently with efforts to indigenise research practices with research participants in the southern Kalahari. We draw on an example of the community-owned, state-funded, and privately operated !Xaus Lodge cultural tourism asset. We illustrate how CDSC strategies, influenced by applied cultural studies, can work with an agentic imperative to effect development and mutual understanding in a defined geographical area, where multiple stakeholder agendas, cultural backgrounds, and ontologies are to be negotiated. Full article

Background/Objectives: A late HIV diagnosis represents a significant public health concern in Poland, with approximately 50% of patients being identified as late presenters (LPs), resulting in the delayed initiation of treatment. This study assesses the potential of HIV self-testing (HIVST) to enhance early detection, particularly among heterosexual individuals, and evaluates its advantages and limitations within the Polish context. Methods: This study examines the advantages and disadvantages of HIVST by analyzing data from various studies. It focuses on the acceptability, sensitivity, and specificity of HIVST, comparing blood-based and oral fluid-based tests. Moreover, the economic impact and potential public health benefits of HIVST in Poland are evaluated. Results: HIVST is well-accepted, especially among key populations; it can reduce stigma and enhance privacy. The results of studies conducted in Poland indicate that heterosexuals are more inclined to use self-testing methods than traditional diagnostic procedures. On the other hand, HIVST has the potential for false-negative results due to the serological window and the possibility of missed diagnoses of other sexually transmitted infections (STIs). Moreover, the cost of HIVST remains a significant barrier, as it is not publicly funded in Poland. Conclusions: Despite its limitations, HIVST offers a number of significant benefits, including increased rates of testing and earlier detection, which could prove vital in reducing the transmission of HIV in Poland. This study proposes that increased funding, the integration of HIVST into public health strategies, and further research to enhance its implementation, alongside education and support for its effective use, should be prioritized. Full article

Entrepreneurship Education (EE) is renowned for developing students’ managerial aptitudes, skills, and ideas for self-reliance. The inclusion of digital technology and innovation in EE is necessary to enhance Entrepreneurial Intention (EI) and Entrepreneurial Motivation (EM) for technological revolution and economic development. The aim of the systematic literature review is to (i) identify the current study on digital technologies, innovation, EE, EI, and EM, (ii) highlight how digital technology and innovation shape EE to achieve EI and motivation among students, and (iii) offer new advice on the future EE in a digital era. A search strategy was instituted to ascertain the required publications from Scopus, Web of Science, DOAJ, IEEE, ProQuest, SAGE Journals, Taylor & Francis, and Wiley. The publications were between 2010 and 2024, with no language restrictions. Out of the 108 identified publications from the search, 69 publications representing 54 separate papers were used in the review. Digital transformation in EE requires significant studies to determine its role in economic development and job creation. This review identified several themes in the publications, such as innovation, motivation, skills development, digital technology, EE’s impact, and factors of EE. The sustainability and future expectations of EE through digital technology and innovation are highlighted in the review. The study identified several findings, such as factors depriving EE, such as experience, investment, teachers, infrastructure, technology, market size, government, competition, culture, and funds. Further findings are a strategic vision of EE through policies to embrace innovation and digital technology practices and to achieve EM and EI. Also, the selected papers for the review are current publications at 61.1%, the quantitative method at 42.3% and journal articles at 88.9%. It is prudent to review EE’s appropriateness in a digital and innovative environment and to identify the impact on EM and EI among students. Full article

Rarely do so many areas of society change as quickly as now. This study analyses the disruptive transformation of HR/qualification in small and medium-sized enterprises (SMEs) in the leading sectors of mechanical and plant engineering and the automotive industry in Lower Franconia, Bavaria. More precisely, this study is about the Mainfranken region. Administratively, it comprises the two independent cities of Würzburg and Schweinfurt as well as seven administrative districts. This paper researches the long-term transformation of the world of work in terms of skill shortages, procurement strategies and employee performance. This study is based on quantitative and qualitative findings from the funding project transform.RMF in the form of an overarching literature review, a commissioned online survey, stakeholder workshops to identify regional trends and self-conducted expert interviews. Unsurprisingly, the shortage of skilled labour is a serious problem for regional SMEs. Managing directors are aware of the need to act in the acquisition and retention of recruited specialists. This includes in-house benefits, New Work models and competitive acquisition strategies. We must overcome the biggest obstacle to transformation—a lack of qualified personnel—together, structurally. Based on our insights, we create recommendations for action and connecting the potential in the network. In the future, the aim will be to intensify cooperation between society, business, science and politics at the regional level—transform.RMF’s mission in the interests of its members. Full article

The capacity of schools to address behavioral health concerns presents an emerging challenge, exacerbated by major shortages in the workforce. Schools across the U.S. are struggling to hire licensed behavioral health professionals, with additional barriers encountered when seeking to hire practitioners with experience in educational settings. In 2023, a school district in the suburbs of Columbus, Ohio, partnered with The Ohio State University to launch a “grow your own” policy pilot. The priorities focused on addressing workforce shortages and leveraging the experiences of current teachers/staff to support growing needs related to student mental health and well-being. More specifically, the district utilized COVID-19 relief funds to recruit, train, and transition 25 teachers/staff into school mental health positions by underwriting the costs of each professional’s Master of Social Work (MSW) degree. Here, we (a) describe the district–university partnership and the processes guiding the implementation of the “grow your own” model, (b) distill preliminary findings about district needs regarding behavioral health, and (c) explore facilitators, barriers, and outcomes associated with learning among participants in the program. The findings from a district-wide staff survey indicated a high level of need for individual counseling, crisis intervention, and small group interventions. Additionally, qualitative interviews revealed that learning among the program’s participants was facilitated by effective classroom strategies and specific learning experiences integral to the program’s design. These facilitators supported key learning outcomes, including general social work knowledge, self-awareness, and therapeutic skills that are foundational for engaging with students, parents/families, teachers/staff, and the broader school community. This innovative policy pilot and training model demonstrate how universities and local educational agencies can partner to address workforce development challenges at the intersection of behavioral health and education. Full article

Adopting Industry 4.0 (I4.0) is inevitable for Thailand’s manufacturing sector to remain competitive because global markets increasingly demand higher quality, faster delivery, and greater customization. While firms need to enhance productivity and optimize resource utilization, they also need to reduce operation costs, which require advanced technologies and data-driven operations. However, successful adoption requires skilled human resources, which is challenging for small and medium-sized enterprises (SMEs). This research explores factors driving and facilitating the implementation of Industry 4.0 (I4.0) in Thai manufacturing firms among SMEs and large firms. We employed qualitative analysis using semi-structured interviews with SMEs and large manufacturing firms in Thailand. Five key factors emerged as crucial for I4.0 adoption: awareness of I4.0, strong and proactive support from top management, self-funding capabilities, and effective human resource development strategies. While large multinational enterprises (MNEs) possess more significant resources and capabilities to adopt I4.0 technologies, SMEs face considerable challenges. They require a strategic approach tailored to their unique needs and resources to develop a feasible I4.0 roadmap. Additionally, governments and industry associations can play a significant role by providing training, funding, and other resources to empower SMEs to embrace I4.0. Full article

There is a lack of rapid dietary assessment tools to screen for compliance with guidelines for cancer prevention, such as those issued by the World Cancer Research Fund and the American Institute for Cancer Research. Our aim was to develop and validate a short screener (Nutri S-Can) to evaluate adherence to these recommendations, with the potential to be used in cancer prevention strategies. Four stages were defined: development, pilot study, refinement and validation study. The Nutri S-Can captures several domains of the WCRF/AICR recommendations: body composition, physical activity, diet, alcohol consumption, and breastfeeding. A first version was piloted in n = 100 PREDIMED-Plus study participants, for which comprehensive dietary, physical activity, and anthropometric measurements were available (+/− 6 months). Nutri S-Can was retested 6 months later in a subsample of 60 participants. Its validity was evaluated by comparing total and individual domain scores of the screener to those obtained from validated methods (breastfeeding not validated), and its reproducibility was measured comparing the first to the second administration (Pearson correlation). The first version of the Nutri S-Can included 15 questions distributed across five domains. Each question had three possible answers to determine whether participants meet (1 point), partially meet (0.5) or do not meet (0) the recommendations (score range: 0–7). Participant’s average age was 71.4 ± 5.03 y (41 women, 59 men), taking an average of 6.9 min to complete the screener. The total average score was 4.9 ± 0.9 vs. 3.5 ± 0.9 using data from validated questionnaires (high correlation; r = 0.51). Individual domains presented a high and significant correlation (r = 0.25–0.85) when comparing Nutri S-Can to validated assessments, except for processed foods (r = 0.15). A high correlation (r > 0.3) was observed when comparing Nutri S-Can before and after 6 months for individual dimensions and overall score. The refinement study aimed to increase preciseness and accuracy: two additional questions were included (total: 17 questions) to reduce the under-estimation of processed foods and improve self-classification of physical activity, and the nº of answers available was increased to six. This final version is being validated in two different populations (university students (n = 100) and PREDIMED-Plus participants (n = 117)) with the aim of having a validated screener that can be used in clinical settings at the individual level. Full article

Global Navigation Satellite Systems (GNSSs) are nowadays the prevailing technology for positioning and navigation. However, with the roll-out of 5G technology, there is a shift towards ‘hybrid positioning’: indeed, 5G time-of-arrival (ToA) measurements can provide additional ranging for positioning, especially in environments where few GNSS satellites are visible. This work reports a preliminary analysis, the processing, and the results of field measurements collected as part of the GINTO5G project funded by ESA’s EGEP programme. The data used in this project were shared by the European Space Agency (ESA) with the DICA of Politecnico di Milano as part of a collaboration within the ESALab@PoliMi research framework established in 2022 between the two organizations. The ToA data were collected during a real-world measurement campaign and they cover a wide range of user environments, such as indoor areas, outdoor open sky, and outdoor obstructed scenarios. Within the test area, eleven self-made replica 5G base stations were set up. A trolley, carrying a self-made 5G receiver and a data storage unit, was moved along predefined trajectories; the trolley’s accurate trajectories were determined by a total station, which provided benchmark positions. In the present work, the 5G data are processed using the least squares method, testing and comparing different strategies. Therefore, the primary goal is to evaluate algorithms for position determination of a user based on 5G observations, and to empirically assess their accuracy. The results obtained are promising, with positional accuracy ranging from decimeters to a few meters in the worst cases. Full article

(1) Background: The present study aimed to examine the relationship between physical activity (PA), screen time (ST), maximal oxygen uptake (VO₂max), Mediterranean diet (MD) adherence, self-esteem (SE) and academic performance (AP) in primary education students. In order to address this aim, an explanatory model was developed to examine the existing relationships between PA, ST, VO₂max, MD adherence, SE and AP. Further, the proposed structural model was examined via multi-group analysis as a function of sex and school type. (2) Methods: A non-experimental, descriptive, comparative and cross-sectional study was designed with a total sample of 269 Spanish students (11.29 ± 0.62). Validated questionnaires were administered to collect data on study variables. (3) Results: Relative to boys, girls reported better academic grades and showed a stronger positive relationship between MD adherence and AP, MD adherence and PA, and VO₂max and SE. Likewise, girls showed a stronger negative relationship between ST and VO₂max, and ST and MD adherence. At the same time, mixed funding school (MFS) students reported higher PA engagement than state school (SS) students. However, SS students reported better MD adherence, ST and AP than MFS students. Further, a stronger positive relationship was found in SS students between MD adherence or VO₂max and SE than in MFS students. Also, within the former group, ST was more negatively related to MD adherence and VO₂max. (4) Conclusions: Scientific and educational communities must develop future strategies that consider potential determinants in order to target more desirable outcomes. Full article