Search Results (2,442)

Objective: This study explored HIV testing prevalence and its associated factors among reproductive-aged women in Liberia. Study Design: A secondary and descriptive cross-sectional study was performed among Liberian women aged 15–49 years using the 2019 Liberia Demographic and Health Survey (LDHS) data set. Methods: Descriptive statistics were used to describe the characteristics of these women. Bivariate and multivariable logistic regression models were applied to determine factors associated with HIV testing. All analyses were adjusted for unequal probabilities of selection and non-response by use of survey weights. Results: Among the 8065 participants in this survey, 490 women had never had sex and were excluded, leading to the final sample size being 7575 women. The prevalence of HIV testing among Liberian women aged 15 to 49 years in 2020 was 57.17% (95% CI: 56.2 to 60.4). HIV testing among these women is associated with pregnancy history (aOR 6.40, 95% CI:4.99 to 8.22, p < 0.001), STI history (aOR 1.21, 95% CI:1.02 to 3.19, p < 0.001), knowledge of vertical transmission (aOR 1.65, 95% CI:1.23 to 2.21, p = 0.001), and highest educational level (primary (aOR 1.39, 95% CI:1.16 to 1.68, p < 0.001), secondary (aOR 2.10, 95% CI:1.73 to 2.53, p < 0.001), and higher education (aOR 6.80, 95% CI:3.75 to 12.32, p < 0.001)). Conclusions and Contribution: HIV testing prevalence of 57.17% demonstrates an unmet need for HIV testing among Liberian women aged 15 to 49 years and, thus, it is recommended that HIV testing and counseling services should mostly target these women in rural areas, with limited health services and less educated women. Full article

Background/Objectives: Dental caries is the most prevalent oral condition worldwide. Consequences of untreated dental caries (CUDC) can range from pulp damage and soft tissue ulceration due to root debris to more severe issues, such as fistulas and abscesses. Rural communities might be more vulnerable to CUDC because of lower socioeconomic status, poorer access to healthcare, and lower education levels. The objective of this study was to evaluate and compare the prevalence of CUDC in rural and urban areas in schoolchildren aged 8 to 12 years in the State of Mexico. Methods: A cross-sectional study was conducted using the PUFA index, considering the presence of pulp involvement (P), soft tissue ulcerations due to root remnants (U), fistulas (F), and abscesses (A). The independent variable was the geographic area (rural or urban), and the covariates were nutritional status, hyposalivation, having one’s own toothbrush, and having received topical fluoride in the last year. Logistic regression models were fitted, calculating odds ratios (ORs) and 95% confidence intervals (CIs). Results: The prevalence of CUDC (PUFA > 0) was 42.9% in rural areas and 25.9% in urban areas. Residing in a rural area (OR: 2.15, 95% CI 1.38–3.34, p = 0.001), hyposalivation (OR: 1.93, 95% CI 1.11–3.37, p = 0.020), and professional fluoride application (OR: 0.15, 95% CI 0.07–0.32, p < 0.001) were associated with the prevalence of CUDC. Conclusions: To prevent caries and its clinical consequences due to the lack of treatment, it is important to promote timely care seeking and access to dental care services, considering the conditions of each geographic area. Full article

Background/Objectives: Pressure injuries are a significant concern among older adults, particularly in community-based long-term care settings where prolonged immobility is prevalent. This study aimed to identify factors influencing sacral interface pressure in community-dwelling older adults, with an emphasis on support surface usage and clinical risk indicators. Methods: A total of 210 participants aged 65 years and older, all receiving long-term care services in South Korea, were enrolled in this study. Sacral interface pressure was measured in the supine position using a portable pressure mapping device (Palm Q7). General characteristics, Braden Scale scores, Huhn Scale scores, and mattress usage were assessed. Data were analyzed using descriptive statistics, t-tests, chi-square tests, and logistic regression. Results: Mattress non-use was identified as the strongest predictor of elevated sacral interface pressure (OR = 6.71, p < 0.001), followed by Braden Scale scores indicating moderate risk (OR = 4.8, p = 0.006). Huhn Scale scores were not significantly associated with interface pressure. These results suggest that support surface quality and skin condition have a stronger impact on interface pressure than mobility-related risk factors. Conclusions: The findings highlight the importance of providing high-quality pressure-relieving mattresses and implementing standardized nursing assessments to reduce the risk of pressure injuries. Integrating smart technologies and expanding access to advanced support surfaces may aid in developing tailored preventive strategies for vulnerable older adults. Full article

Background: Access to safe and reliable water and sanitation remains a critical public health and development challenge, with rural and low-income communities being disproportionately affected by inadequate services and heightened exposure to waterborne diseases. Despite global efforts and infrastructure-based progress indicators, significant disparities persist, and these often overlook users’ perceptions of water quality, reliability, and safety. This study explores the determinants of household satisfaction with drinking water in rural areas, comparing subjective user feedback with official access data to reveal gaps in current monitoring approaches and support more equitable, user-centered water governance. Methods: This study was conducted in Kazakhstan’s Atyrau Region, where 1361 residents from 86 rural villages participated in a structured survey assessing household access to drinking water and perceptions of its quality. Data were analyzed using descriptive statistics and multinomial logistic regression to identify key predictors of user satisfaction, with results compared against official records to evaluate discrepancies between reported experiences and administrative data. Results: The field survey results revealed substantial discrepancies between official statistics and residents’ reports, with only 58.1% of respondents having in-house tap water access despite claims of universal coverage. Multinomial logistic regression analysis identified key predictors of user satisfaction, showing that uninterrupted supply and the absence of complaints about turbidity, odor, or taste significantly increased the likelihood of higher satisfaction levels with drinking water quality. Conclusions: This study underscores the critical need to align official water access statistics with household-level experiences, revealing that user satisfaction—strongly influenced by supply reliability and sensory water quality—is essential for achieving equitable and effective rural water governance. Full article

Understanding the utilization patterns of nuclear medicine (NM) services is essential for optimizing resource allocation and service provision. This study aimed to address the regional evidence gap by reporting the demand for NM services by sex and age at a public hospital in Jamaica. This was a non-experimental, retrospective study of NM scans that were completed at the University Hospital of the West Indies from 1 June 2022 to 31 May 2024. While all scans were reported in the descriptive totals, for patients with multiple scans during the study period, only the data from the first visit was used in the inferential statistical analysis. This was performed with the IBM SPSS (version 29.0) software and involved the use of chi-square goodness of fit and multinomial logistic regression. A total of 1135 NM scans for 1098 patients were completed (37 patients had more than one scan); 596 (54.3%) were female and 502 (45.7%) were male, with the ages ranging from 3 days to 94 years old. Among the female patients, there was a greater demand in the ≥60 years age group for cardiac amyloid scans (χ² = 6.40, p < 0.05), while females 18–59 years had a greater demand for thyroid scans (χ² = 7.714, p < 0.05) and bone scans (χ² = 3.904, p < 0.05). On the other hand, significantly more males in the ≥60 age group presented for cardiac amyloid (χ² = 4.167; p < 0.05) and bone scans (χ² = 145.79, p < 0.01). Males were significantly less likely to undergo a thyroid scan than females (p < 0.01, OR = 0.072, 95% CI: 0.021, 0.243) while individuals aged 18–59 years were more likely to undergo this scan than patients aged 60 or older (p = 0.02, OR = 3.565, 95% CI: 1.258, 10.104). Males were more likely to do a cardiac amyloid scan (p < 0.05, OR = 2.237, 95% CI: 1.023, 4.891) but less likely to undergo a cardiac rest/stress test than females (p = 0.02, OR = 0.307, 95% CI: 0.114, 0.828). Prolonged life expectancy and an aging population have the potential to impact NM utilization, thus requiring planning for infrastructure, equipment, work force, and supplies. Cancer-related and cardiovascular indications are a top priority at this facility; hence, age- and sex-specific analysis are useful in establishing models for policy makers with regard to the allocation of economic and human resources for the sustainability of this specialized service. 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

Background: Increasing regulatory pressure for maritime decarbonization (e.g., IMO CII, FuelEU) drives adoption of low-carbon fuels and prompts reassessment of regional ports’ competitiveness. This study aims to evaluate the economic and environmental viability of rerouting deep-sea container services to regional ports in a decarbonizing world. Methods: A scenario-based analysis is used to evaluate total costs and CO₂ emissions across the entire container shipping supply chain, incorporating deep-sea shipping, port operations, feeder services, and inland rail/road transport. The Port of Liverpool serves as the primary case study for rerouting Asia–Europe services from major ports. Results: Analysis indicates Liverpool’s competitiveness improves with shipping lines’ slow steaming, growth in hinterland shipment volume, reductions in the emission factors of alternative low-carbon fuels, and an increased modal shift to rail matching that of competitor ports (e.g., Southampton). A dual-port strategy, rerouting services to call at both Liverpool and Southampton, shows potential for both economic and environmental benefits. Conclusions: The study concludes that rerouting deep-sea services to regional ports can offer cost and emission advantages under specific operational and market conditions. Findings on factors and conditions influencing competitiveness and the dual-port strategy provide insights for shippers, ports, shipping lines, logistics agents, and policymakers navigating maritime decarbonization. Full article

Background: Family caregivers are a vital yet often under-recognized part of the healthcare system. They provide essential emotional, physical, and logistical support to individuals with illness, disability, or frailty, and their contributions improve continuity of care and reduce system strain. However, many healthcare and social service providers are not equipped to meaningfully engage caregivers as partners. In Alberta, stakeholders validated the Caregiver-Centered Care Competency Framework and identified the need for a three-tiered education model—Foundational, Advanced, and Champion—to help providers recognize, include, and support family caregivers across care settings. This paper focuses on the development and early evaluation of the Advanced Caregiver-Centered Care Education modules, designed to enhance the knowledge and skills of providers with more experience working with family caregivers. The modules emphasize how partnering with caregivers benefits not only the person receiving care but also improves provider effectiveness and supports better system outcomes. Methods: The modules were co-designed with a 154-member interdisciplinary team and grounded in the competency framework. Evaluation used the first three levels of the Kirkpatrick–Barr health workforce education model. We analyzed pre- and post-surveys from the first 50 learners in each module using paired t-tests and examined qualitative feedback and SMART goals through inductive content analysis. Results: Learners reported a high level of satisfaction with the education delivery and the knowledge and skill acquisition. Statistically significant improvements were observed in 53 of 54 pre-post items. SMART goals reflected intended practice changes across all six competency domains, indicating learners saw value in engaging caregivers as partners. Conclusions: The Advanced Caregiver-Centered Care education improved providers’ confidence, knowledge, and skills to work in partnership with family caregivers. Future research will explore whether these improvements translate into real-world practice changes and better caregiver experiences in care planning, communication, and navigation. Full article

This study investigates the influence of corporate governance on reducing financial statement fraud (FSF) in Jordanian service and industrial companies listed on the Amman Stock Exchange from 2018 to 2022. To achieve this, the study employed the Beneish M-score model to assess the likelihood of FSF and logistic regression to examine the influence of corporate governance structure on fraud mitigation. The study identified 13 independent variables, including board size, board director’s independence, board director’s compensation, non-duality of CEO and chairman positions, board diversity, audit committee size, audit committee accounting background, number of annual audit committee meetings, external audit fees, board family business, the presence of women on the board of directors, firm size, and market listing on FSF. The study included 74 companies from both sectors—33 from the industrial sector and 41 from the service sector. Primary data was collected from financial statements and other information published in annual reports between 2018 and 2022. The results of the study revealed a total of 295 cases of fraud during the examined period. Out of the 59 companies analyzed, 21.4% demonstrated a low probability of fraud, while the remaining 78.6% (232 observations) showed a high probability of fraud. The results indicate that the following corporate governance factors significantly impact the mitigation of financial statement fraud (FSF): independent board directors, board diversity, audit committee accounting backgrounds, the number of audit committee meetings, family business involvement on the board, and firm characteristics. The study provides several recommendations, highlighting the importance for companies to diversify their boards of directors by incorporating different perspectives and experiences. Full article

Background: Digital transformation is increasingly present in modern logistics, especially in the context of sustainability and circularity pressures. The integration of technologies such as Internet of Things (IoT), Radio Frequency Identification (RFID), and automated platforms involves not only infrastructure but also a strategic vision, a flexible organizational culture, and the ability to support decisions through artificial intelligence (AI)-based systems. Methods: This study proposes an extended conceptual model using structural equation modelling (SEM) to explore the relationships between five constructs: technological change, strategic and organizational readiness, transformation environment, AI-enabled decision configuration, and operational redesign. The model was validated based on a sample of 217 active logistics specialists, coming from sectors such as road transport, retail, 3PL logistics services, and manufacturing. The participants are involved in the digitization of processes, especially in activities related to operational decisions and sustainability. Results: The findings reveal that the analysis confirms statistically significant relationships between organizational readiness, transformation environment, AI-based decision processes, and operational redesign. Conclusions: The study highlights the importance of an integrated approach in which technology, organizational culture, and advanced decision support collectively contribute to the transition to digital and circular logistics chains. Full article

The logistics industry faces challenges from evolving consumer expectations, technological advances, sustainability demands, and market disruptions. Logistics collaboration is in theory perceived as one of the most promising solutions to solve these issues, but here are still a lot of challenges that needs to be better understood and addressed. While vertical collaboration among supply chain actors is well advanced, horizontal collaboration among competing service providers remains under-explored. This study developed a novel methodology based on the COM-B behaviour-change framework to better understand the main challenges, opportunities, capabilities and drivers that would motivate competing companies to exploit the potential of horizontal logistics collaboration. A survey was designed and conducted among 71 logistics service providers in Slovenia, chosen for its fragmented market and low willingness to collaborate. Statistical analysis reveals cost reduction (M = 4.21/5) and improved vehicle utilization (M = 4.29/5) as the primary motivators. On the other hand, maintaining company reputation (M = 4.64/5), fair resource sharing (M = 4.20/5), and transparency of logistics processes (M = 4.17/5) all persist as key enabling conditions. These findings underscore the pivotal role of behavioural drivers and suggest strategies that combine economic incentives with targeted trust-building measures. Future research should employ experimental designs in diverse national contexts and integrate vertical–horizontal approaches to validate causal pathways and advance theory. Full article

Economic growth, especially in emerging economies, has altered the composition of international tourism. It is therefore essential to possess the skills necessary to understand the influence of culture on human behaviour, thereby enabling an appropriate response to the traveller. This research aims to develop a tool for identifying openness, flexibility, awareness, and intercultural preparedness. It focuses on the metacognitive and cognitive aspects of cultural intelligence that shape the development of empathy in customer service staff in hotels in Quintana Roo. The variables were validated and incorporated into a quantitative study using multivariate analysis and inferential statistics. A sample of 77 questionnaires was analysed using simple random sampling under a proportional design. Multiple Correspondence Analysis (MCA) was employed as a discriminatory technique to identify the most significant independent variables. These were subsequently entered as regressors into ordinal logistic regression (OLR), along with age and work experience, in order to estimate the probabilities associated with each level of the dependent variable. The results indicated that age had minimal influence on the metacognitive and cognitive variables, whereas years of experience among tourism staff exerted a significant effect. Full article

E-commerce growth has reshaped consumer behavior and retail services, driving parcel demand and challenging last-mile logistics. Existing research predominantly relies on survey data and global regression models that overlook intra-urban spatial heterogeneity in shopping behaviors. This study bridges this gap by analyzing e-commerce demand’s spatial distribution from a retail service perspective, identifying key drivers, and evaluating implications for omnichannel strategies and logistics. Utilizing waybill big data, spatial analysis, and multiscale geographically weighted regression, we reveal: (1) High-density e-commerce demand areas are predominantly located in central districts, whereas peripheral regions exhibit statistically lower volumes. The spatial distribution pattern of e-commerce demand aligns with the urban development spatial structure. (2) Factors such as population density and education levels significantly influence e-commerce demand. (3) Convenience stores play a dual role as retail service providers and parcel collection points, reinforcing their importance in shaping consumer accessibility and service efficiency, particularly in underserved urban areas. (4) Supermarkets exert a substitution effect on online shopping by offering immediate product availability, highlighting their role in shaping consumer purchasing preferences and retail service strategies. These findings contribute to retail and consumer services research by demonstrating how spatial e-commerce demand patterns reflect consumer shopping preferences, the role of omnichannel retail strategies, and the competitive dynamics between e-commerce and physical retail formats. Full article

The port logistics service innovation (PLSI) is closely associated with cross-border e-commerce (CBEC) enterprise performance, given that the port, as the spatial carrier and the joint point of goods, information, customs house affairs, etc., is essentially a key node of the CBEC logistics chain. However, the influence mechanism of PLSI on CBEC enterprise performance has still not yet been elaborated by consensus. To fill this gap, this study aims to figure out the effect mechanism integrating the probe into two variables (i.e., information interaction and environmental upgrade) in a moderated mediation model. Specifically, this study collects questionnaire survey data of logistics enterprises and CBEC enterprises in the Ningbo-Zhoushan Port of China by the Bootstrap method in the software SPSS 26.0. The results show the following: (1) PLSI can positively affect the CBEC enterprise performance; (2) information interaction plays an intermediary role between PLSI and CBEC enterprise performance; and (3) environmental upgrade can not only positively regulate the relationship between information interaction and CBEC enterprise performance, but also enhance the mediating role of information interaction with a moderated intermediary effect. Full article

Civil aviation safety remains a critical concern globally, with continuous efforts aimed at reducing accidents and fatalities. This paper focuses on the comprehensive evaluation of civil aviation safety in the Slovak Republic over the past several years, with the main objective of identifying prevailing trends and key risk factors. A comprehensive analysis of 155 accidents and incidents was conducted based on selected operational parameters. Logistic regression was applied to identify potential causal factors influencing various levels of injury severity in aviation accidents. Moreover, the prediction model can also be used to predict the probability of specific injury severity for accidents with given parameter values. The results indicate a clear declining trend in the annual number of aviation safety events; however, the fatality rate has stagnated or slightly increased in recent years. Human error, particularly mistakes and intentional violations of procedures, was identified as the dominant causal factor across all sectors of civil aviation, including flight operations, airport management, maintenance, and air navigation services. Despite technological advancements and regulatory improvements, human-related failures persist as a major safety challenge. The findings highlight the critical need for targeted strategies to mitigate human error and enhance overall aviation safety in the Slovak Republic. Full article