Search Results (89)

Background/Objectives: Innovation capacity has become a strategic pillar for strengthening healthcare systems in the European Union, yet its effects vary considerably across countries with different levels of institutional development and technological readiness. This study examines how national innovation capacity, measured through the Global Innovation Index, influences health expenditure, healthy life expectancy, and childhood obesity across the EU-27. Methods: Using an unbalanced panel dataset for 2011–2024, we applied panel quantile regression to capture heterogeneous effects across the conditional distribution of health outcomes. Four dependent variables were analyzed: government expenditure on health, provider-level healthcare spending, healthy life expectancy at birth, and childhood obesity prevalence. GDP growth and population were included as controls. Diagnostic tests confirmed cross-sectional dependence and heteroskedasticity, supporting the choice of distributionally robust estimators. Results: Higher innovation capacity was positively and significantly associated with government health expenditure and provider-level spending across all quantiles (p < 0.001), with the strongest effects in lower-performing systems. For healthy life expectancy, innovation exhibited declining coefficients across quantiles, indicating diminishing marginal returns in more advanced systems. No stable association was observed for childhood obesity, which remained largely unaffected by national innovation capacity. Conclusions: Innovation contributes to structural improvements in health financing and population health, particularly in countries with lower baseline performance. In high-performing systems, its role shifts toward incremental efficiency gains. The absence of effects on childhood obesity highlights the dominance of socio-behavioral determinants. Findings are associative and call for future causal and sector-specific research. Full article

Tourism is a key driver of regional economies, but concerns are often raised about the effectiveness with which public resources are managed and translated into tangible outcomes. Despite its importance, research on the efficiency of public spending on tourism remains scarce and mostly confined to national scales. Therefore, this study examines how Apulian municipalities (Italy) convert public tourism expenditure into measurable tourism results, providing new evidence on the efficiency of local governance in this sector. The analysis applies a two-step econometric framework combining Stochastic Frontier Analysis (SFA) and Multiple Linear Regression to data from 247 municipalities over the period from 2020 to 2023. The results reveal generally low average efficiency levels, with only a few coastal destinations achieving high performance. The regression analysis identified key structural and territorial drivers of efficiency, including accommodation capacity, cultural production, coastal and environmental quality, and the presence of agritourism and campsites. The findings suggest that efficiency depends more on the ability of local administrations to coordinate tourism, cultural, and environmental policies than on the amount of spending. Overall, the study provides empirical evidence that an efficient allocation of tourism funds is crucial for achieving long-term sustainability goals, offering practical insights for designing more effective tourism policies. Full article

This study investigates whether public education expenditure crowds out or complements health investment in influencing life expectancy across 158 countries from 1990 to 2023. Graphical analysis shows that in high-income countries, health expenditure consistently exceeds education spending, reflecting mature complementarity between the two sectors. In contrast, in low- and middle-income countries, education spending often surpasses health expenditure, suggesting potential short-term crowding-out risks where fiscal resources are limited. Using Fully Modified Ordinary Least Squares (FMOLS), Two-Stage Least Squares (2SLS), and bootstrap estimation, the results reveal a predominantly crowding-in relationship that varies by income level. Bootstrap estimates from the life expectancy Model indicate that the coefficient of education expenditure (eexp) is −0.003 for high-income countries (HICs), 0.005 for upper-middle-income countries (UMCs), 0.045 *** for lower-middle-income countries (LMCs), and −0.010 for low-income countries (LICs). Bootstrap estimates show that the effect of education expenditure on life expectancy is insignificant in high- and upper-middle-income countries, strongly positive in lower-middle-income countries, and negative but insignificant in low-income countries. The coefficient of government health expenditure (dgghe) is 0.007 ***, 0.007 ***, 0.017 ***, and 0.035 *** for HICs, UMCs, LMCs, and LICs, respectively. Government health expenditure exerts a consistently positive and highly significant effect across all groups, strongest in low- and lower-middle-income countries. Sobel’s z-statistics (9.62, 8.70, 7.68, and 3.07) confirm a significant indirect effect of education on life expectancy through health expenditure. Health expenditure and GDP per capita enhance life expectancy, while inequality and inflation reduce it. Overall, education and health investments are mutually reinforcing but depend on fiscal capacity and governance quality, necessitating coordinated fiscal frameworks for sustainable human development. Full article

Understanding luxury tourists required a more comprehensive approach than traditional expenditure-based segmentation, which often overlooked travelers’ financial capacity. This study therefore aimed to develop and validate a new typology of luxury tourists by jointly analyzing income and expenditure patterns using the International Visitor Survey of South Korea. The study addressed the need to capture both tourists’ economic capability and consumption behavior to enhance the precision of market segmentation and support sustainable destination management. Using the Jenks natural breaks classification and logistic regression, four distinct tourist types were identified: economy, spurious, scrooge, and premier, each reflecting unique combinations of income and expenditure. The results revealed that age, nationality, occupation, and trip purpose significantly influenced tourists’ classification. Younger and middle-aged professionals from East Asia were more likely to belong to high-income and high-expenditure groups, whereas Western tourists tended to spend more relative to their income. This income–expenditure typology advanced theoretical understanding of luxury tourism segmentation and provided practical insights for destination marketing organizations. The findings offered new insights for understanding how the alignment between tourists’ financial capacity and spending behavior can redefine strategies for sustainable and inclusive tourism development. Full article

Tourism performance often depends on the joint provision of built (“hard”) and environmental (“green”) infrastructure, yet their combined effects are not well established. Using official data for Saudi Arabia’s 13 regions (2023–2024), this study constructs composite hard and green indices, estimates ordinary least squares models with heteroskedasticity-consistent inference, and probes spatial heterogeneity using geographically weighted regression (exploratory) alongside k-means/hierarchical clustering. Hard infrastructure is the strongest and most consistent correlate of overnight visitors and spending, whereas green infrastructure exhibits non-positive marginal effects over the observed range of hard capacity; a negative, statistically significant Hard × Green interaction indicates diminishing returns to greening as built capacity increases. Clustering differentiates metropolitan hubs from nature-oriented regions, underscoring place-specific policy needs. Practically, results support sequencing prioritizing foundational access and basic accommodation in under-served regions, quality upgrades and public-realm enhancement in mature centers, and targeted green interventions where marginal gains are greatest. Key limitations (cross-sectional design; coarse green metrics) motivate richer environmental indicators and longitudinal data to clarify dynamics and thresholds over time. Full article

This study analyzes the impact of research and development (R&D) investment on economic growth in Panama, an emerging economy with structural challenges in its innovation system. Using a multivariate econometric approach that included elastic net regularization and fixed-effect panel data estimation, the analysis incorporated key explanatory variables such as public education expenditure, inflation, infrastructure investment, population growth, and exports. The results indicated that both R&D and education spending have a positive and statistically significant effect on GDP growth, while inflation has a negative impact and exports show no significant effect. To ensure robustness, the study applied the augmented Dickey–Fuller test for stationarity, nonparametric bootstrapping (1000 replications), and multiple diagnostic tests, including RMSE, adjusted R², Durbin–Watson statistic, and White’s test. Scenario-based projections suggest that gradual and sustained increases in R&D investment, supported by stronger institutional coordination and absorptive capacity, could enhance Panama’s long-term productivity and innovation outcomes. The findings underscore that improving R&D funding alone is not sufficient; effective governance and coherent science, technology, and innovation (STI) policies are essential. This research contributes empirical evidence to a relatively underexplored area in the development literature and offers strategic insights for policymakers seeking to build more integrated and sustainable STI ecosystems in emerging economies. Full article

This study evaluates the operational efficiency of accredited private healthcare facilities in Italy, a sector increasingly complementing the public National Health Service. Unlike previous studies that aggregate public and private providers, this research focuses exclusively on private facilities, providing a consistent and detailed evaluation of their performance. Utilizing game-theoretic cross-efficiency Data Envelopment Analysis (DEA) combined with Classification and Regression Tree (CART) analysis, this study identifies endogenous and exogenous efficiency drivers. Results indicate that private facilities operate at high efficiency levels (mean cross-efficiency = 0.923), with smaller facilities outperforming larger ones, though resources remain underutilized. Inactive ward and bed non-occupancy rates emerge as key inefficiency factors. Regional analysis highlights minimal disparities between the north–center and south, but significant local variations persist, shaped by governance, funding allocation, and institutional frameworks. This study also identifies an “efficiency paradox”, as in deficit regions, private expenditure correlates with higher efficiency, whereas in surplus regions, greater spending does not necessarily improve performance. These findings provide actionable insights for healthcare managers and policymakers, emphasizing the need to maximize capacity utilization, optimize staffing, and structure public–private partnerships strategically. Methodologically, integrating game cross-efficiency DEA with CART strengthens accuracy, offering a robust tool for benchmarking and improving private healthcare performance. Full article

Background: Motor performance in childhood predicts physical fitness, cognitive capacity, socio-emotional development, and academic success. Parenting styles are especially important to such performance in the preschool period, as children’s gross motor abilities are shaped in part by their interactions with parents. Young children’s physical activity is also declining as they spend more time on screens. Methods: This quantitative survey-based study examined the relationships among 252 preschoolers’ gross motor skills, their tendency to become addicted to digital games, and their parents’ parenting styles. Results: The sampled preschoolers’ gross motor skill development and game addiction tendencies were both low, while the participating parents reported high levels of democratic and overprotective parenting attitudes, low levels of authoritarian ones, and moderate levels of permissive ones. Motor skills were not associated with children’s addiction tendency or parents’ democratic (also known as authoritative), authoritarian, or permissive styles. However, overprotective parenting was positively and significantly associated with gross motor skill scores. While no significant relationship was found between children’s digital game addiction tendencies and their parents’ adoption of a democratic parenting style, such tendencies were positively and statistically correlated with the authoritarian and permissive parenting styles. One dimension of such tendencies, constant gameplay, was also positively and significantly correlated with overprotective parenting. Conclusions: Although the participating children’s digital game addiction tendencies were low, the findings indicate that parents and carers should guide children to reduce their screen time and promote increased interaction with their surroundings and other people to mitigate screen time’s known negative effects on gross motor coordination. Full article

Cellular quiescence is operationally defined as a temporary and reversible cessation of proliferation. This state encompasses a wide range of physiological situations since most cells, from microbes to cells composing complex tissues, spend most of their lives non-dividing, waiting for signals to reproliferate. As such, individual quiescent cells must withstand the effects of time not only to survive but also to maintain their ability to divide. These capacities are shaped by a combination of deterministic factors relying on cell history and cumulative stochastic events linked to the environment but also to time. In addition, with time, quiescence deepens, the quiescence exit process being extended. Yet, this deepening is not necessarily sensed evenly by each individual quiescent cell, and some cells exit quiescence faster than others. Hence, time generates heterogeneity within quiescent cell populations, heterogeneity that, in turn, increases cell population resilience and robustness to time. In this review, we discuss some of the loops that link quiescence and time. Full article

Background: The COVID-19 pandemic necessitated immediate regulatory vaccine approvals to facilitate timely global access. The prevailing differences in economies and resources and the varying maturity of the regulatory systems worldwide resulted in different levels of capacity to ensure vaccine quality, safety, and efficacy. In addition to the Emergency Use Authorization or equivalent by some advanced regulatory agencies, the WHO issued Emergency Use Listings (EULs), among other tools, to streamline and expedite regulatory approvals globally. This study aimed to assess the regulatory strategies and best practices adopted during the COVID-19 vaccine approvals and gather lessons for future emergency preparedness. Methods: A mixed-method approach employing qualitative desk reviews and a cross-sectional study collected data from 194 national regulatory authorities (NRAs) across all WHO regions. Results: Three main approval processes were identified: procurement-driven, reliance-based, and independent evaluations. Wealthier countries with more mature regulatory systems were found to spend a longer time issuing approvals, primarily due to being the initial assessors of the vaccines’ quality, safety, and efficacy. Furthermore, various regulatory flexibilities and best practices centered around regulatory reliance, rolling reviews, fast-tracking reviews, and employing digital tools were identified. Notably, the WHO’s EULs were essential in facilitating the timely approval of vaccines globally, including in low- and middle-income countries. Conclusions: The findings suggest a significant turn in vaccine regulation theories and practice, emphasizing balancing speed with scientific validity. This necessitates the creation of thorough provisions for emergency preparedness, regulatory reliance, and administrative flexibility in regulatory practices worldwide. Full article

As an adsorbent, biomass activated carbon is effective at the removal of a wide range of organic and inorganic pollutants; however, its synthesis remains complex. Although spent coffee grounds (SCG) could be an effective material for the production of activated carbon, achieving a sufficient surface area has proven to be difficult. Here, this study presents a preliminary investigation into the optimal manufacturing conditions of activated-carbon adsorbents derived from SCG. SCG samples were characterized according to proximate analysis, elementary analysis, surface area, and pore volumes, then subjected to various processes (i.e., drying, carbonization, and chemical activation) with different operating parameters (temperature and time). The samples were optimized as follows: (1) Stable drying of SCG with a high moisture content of approximately 65% required consumption energy of 49 kWh/kg and drying at 105 °C for 20 h. (2) By comparing changes in the consumption energy and product yield with an increasing amount of carbon fraction, it was found that drying carbonization was more suitable than hydrothermal carbonization for SCG. The optimum drying carbonization temperature for achieving attractive biochar was 500 °C for 1 h. (3) Activated carbon with the optimum surface area (3687 m²/g) and mesopore volume fraction (approximately 70%) was achieved with a chemical activator agent ratio of approximately 3 and heating at 850 °C for 1 h. Furthermore, the butane working capacity of the activated carbon was related to the mesopore volume/surface area and reached 74.5% at a mesopore volume/surface area of 0.0004, indicating its suitability for activated carbon canisters. These findings can be used to optimize the synthesis of industrial-grade activated carbon from SCG. Full article

This study examines the impact of inward foreign direct investment (FDI) on economic growth in South and Southeast Asia from 2006 to 2022, using a comprehensive panel dataset and multiple econometric techniques. The baseline estimation employs Feasible Generalized Least Squares (FGLS), with robustness checks using Fixed Effects with Driscoll–Kraay standard errors, the Common Correlated Effects Mean Group (CCEMG) estimator, and Two-Stage Least Squares (2SLS). The results consistently show that FDI and Gross Capital Formation (GCF) significantly promote growth, while the Human Capital Index (HCI), Trade Openness (TO), and Inflation (I) have limited or adverse effects. Government spending (GS) is negatively associated with growth, suggesting inefficiencies in public resource allocation. The findings underscore the importance of enhancing absorptive capacity through investments in education, institutional quality, and trade facilitation. Policy recommendations include adopting performance-based budgeting and independent audits, drawing on Malaysia’s anti-corruption and audit reforms. To address the weak impact of human capital, this study advocates for expanding public–private partnerships in technical and vocational education, modelled on Singapore’s SkillsFuture initiative. Additionally, digital investment platforms like Indonesia’s Online Single Submission (OSS) system and infrastructure upgrades are recommended to reduce trade costs and improve the investment climate. Finally, the study calls for deeper regional integration through harmonized investment regulations under the ASEAN Comprehensive Investment Agreement (ACIA) and the development of cross-border special economic zones (SEZs). These recommendations are grounded in empirical evidence and tailored to the region’s structural characteristics, offering actionable insights for policy-makers. Full article

The competitiveness of tourism destinations is a multidimensional concept encompassing natural and cultural resources, infrastructure, accessibility, and services that cater to an increasingly discerning tourism market. Business ecosystems enhance these competitive conditions by adapting to consumers seeking high-value, differentiated experiences. This study examined the relationship between accommodation supply and tourist expenditure in the Canary Islands based on a sample of 38,071 visitors from the 2024 Tourist Expenditure Survey (EGT) of the Canary Islands Statistics Institute. Using Python and R for statistical processing, the findings revealed distinct spending patterns across accommodation types, from five-star hotels to peer-to-peer rentals, demonstrating how supply diversification influences competitiveness. The results reinforce prior research on the significance of investing in infrastructure, technology, and human capital to optimise the tourist experience. Tourist expenditure serves as an indicator of competitiveness, reflecting visitor preferences and the destination’s capacity to meet them. Accommodation choice is identified as a key determinant of spending patterns and their distribution within the local economy. This study provides an analytical basis for evaluating tourism strategies, emphasising the strategic importance of accommodation heterogeneity. It advances methodological understanding of tourist spending behaviour, offering a practical framework for destination development and strategic planning. Full article

Dar es Salaam Port, a crucial logistical hub in East Africa, faces significant challenges related to cargo handling efficiency, road congestion, and capacity constraints. The port’s performance is pivotal for regional trade, necessitating a comprehensive analysis to identify and address operational inefficiencies. This study employed Markov processes to evaluate cargo handling and delivery times, cellular automata for simulating road traffic dynamics, and max-flow models to optimize cargo flow from the port to hinterland destinations. The analysis incorporated factors such as road and rail capacities, traffic conditions, and environmental impacts. The Markov process model indicated that cargo spends 15% of its time waiting at the port, 50% in transit, and 10% delayed, with only 25% successfully delivered. The Cellular Automata simulation revealed severe congestion for heavy trucks due to poor road conditions, with an additional 10 min delay during the rainy season. The max-flow model highlighted that while the road and rail networks generally meet demand, significant bottlenecks exist, particularly for Lubumbashi, which faces a capacity shortfall of 500 t/day. The findings offer actionable insights for stakeholders. Logistics operators can leverage the framework to predict delays, optimize resource allocation, and improve delivery reliability. Policymakers can prioritize strategic investments in infrastructure upgrades, traffic management, and road maintenance to reduce delays and congestion. Scholars can adopt the integrated methodology to analyze similar systems. Together, these efforts can enhance Dar es Salaam Port’s operational efficiency, reduce transit times, and support regional trade development.. Full article

As a core and long-established part of urban blue–green infrastructure (BGI), public parks play a significant role in the sustainable development of cities. In particular, they make a major contribution to maintaining healthy ecosystems and providing multiple benefits that support human health and quality of life as a kind of nature-based solution (NBS). Still, planning, design, and management of public parks mostly rely on official standards and technical guidelines, whereas societal perspectives and the use of the ecosystem services (ES) approach (and cultural ecosystem services (CES) in particular) remain inadequately integrated. By assessing CES offered by Gorky Park in Moscow (Russia), the paper aims to bridge this gap and investigate the flow of CES and its relation to park infrastructure and the visitors’ needs. For this purpose, non-participant observation, field notes, and photographs were used in different functional park zones. By investigating visitor activities and factors affecting them, a variety of CES provided by the park have been detected. As aligned with its original idea, the park was mostly used for recreation, leisure, sports, and socializing. Moreover, the CES related to aesthetic, educational, and cultural heritage values were also partially utilized. The park was mostly attractive to the younger generation (the highest number of visitors), whereas visitors over 60 years old were hardly represented. Notably, men were more interested in sports (especially, team sports), whereas women mostly preferred walking (alone, with family, and with friends), relaxation, playing and spending time with children, picnicking, etc., which indicated certain preferences for CES among the park visitors. An interdependent relationship between the CES supply and the park infrastructure was found: the more infrastructural components were identified, the greater variety of park activities and corresponding CES were detected at certain observation points, which could ultimately lead to overcrowding and overutilization of the ES capacity. Given that the Moscow government claims integrating ES into the planning and management of urban BGI as one of the priorities in the city’s environmental policies, the related recommendations are provided. They address the recent challenges of creating integrated BGI, increasing demand for multifunctionality, and the conflicting interests of different visitor groups to maximize the benefits and diversity of CES delivered by the park. Full article