Search Results (2,503)

This study aimed to explore the maternal experiences of Korean migrant working women living in the United Arab Emirates (UAE) and to gain an in-depth understanding of the meaning and essence of these experiences. In-depth interviews were conducted with 10 Korean migrant working women who had experienced pregnancy while living in the UAE and had experience raising their children while living and working in the UAE. The collected data were analyzed using Colaizzi’s phenomenological method. A total of 13 themes were identified from the participants’ maternal experiences and organized into five theme clusters. The five theme clusters were “Transition to Pregnancy and Motherhood in a Foreign Land,” “The Dual Challenges of Childbirth and Recovery in an Unfamiliar Environment,” “Struggling at the Intersection of Work and Motherhood,” “Becoming a Mother in a Foreign Country,” and “Growing into Motherhood Through Diverse Sources of Support.” The findings of this study provide an in-depth understanding of how Korean migrant working women experience and reconstruct motherhood within a migration context and provide foundational evidence for developing culturally appropriate maternal healthcare services and nursing interventions. Full article

The global polymer industry faces increasing pressure to diminish its environmental impact. However, traditional Environmental Impact Assessment (EIA) frameworks evaluate sustainability incrementally rather than as an integrated system, and empirical evidence from rapidly industrializing Gulf economies remains limited. This study investigates the Sustainable Conceptual Model for Environmental Impact Assessment in Polymer Production (SCM-EIAPP), founded on the Resource-Based View, which correlates five operational practices—Choice of Feedstock, Process Optimization, Energy Efficiency, Waste Management, and Recycling Options—with perceived EIA outcomes. Data obtained from a survey of 207 professionals within the polymer industry in the United Arab Emirates were analyzed through confirmatory factor analysis, ordinary least squares regression, partial least squares structural equation modelling (PLS-SEM), and mediation analysis. The measurement model exhibited acceptable fit and reliability. Collectively, the five practices explained approximately 39.6% of the variance in perceived EIA outcomes (PLS-SEM R² = 0.396), with the OLS estimate closely aligned at R² = 0.376. Among these, Recycling Options was the strongest predictor (β = 0.303), followed by Waste Management (β = 0.261), Process Optimization (β = 0.170), and Energy Efficiency (β = 0.168). Choice of Feedstock showed a marginal, method-dependent association (PLS-SEM β = 0.103; OLS p = 0.086). Two mediation pathways were analyzed. The hypothesized mediation of the Waste Management–EIA link via Process Optimization was not statistically significant. Conversely, Process Optimization exhibits a significant indirect effect in the Energy Efficiency–EIA relationship, with approximately 24% of Energy Efficiency’s total association operating through the process capability pathway—aligning with Resource-Based View capability spillover theory. Practices that are internally controllable—particularly Energy Efficiency—appear to be reliable levers, while material recovery practices (Recycling and Waste Management) showed the strongest overall associations for environmental improvement within resource-constrained Gulf contexts. These insights offer industry leaders and policymakers a data-driven basis for prioritizing investments in sustainability and advancing circular economy initiatives. Full article

This exploratory mixed-methods study examines self-reported perceptions of marital fidelity, marital infidelity, and digital boundary violations among adults recruited through one private university in the United Arab Emirates. Nationality or citizenship and direct socioeconomic indicators were not collected; participants are therefore described as a UAE university-affiliated sample rather than as Emirati or nationally representative. A quantitatively led design combined 156 complete questionnaires with 11 semi-structured interviews. Marital fidelity received very high endorsement (M = 4.50, SD = 0.47), and its observed association with perceived seriousness of infidelity was positive (r = 0.685, p < 0.001). Primary interpretation is limited to the strongly reliable marital-fidelity indicator and the comparatively better-supported seriousness indicator. Findings involving the three-item digital-infidelity index (alpha = 0.481), the two-item forgiveness/restoration index (alpha = 0.534), and the single boundary-clarity item are reported only as secondary exploratory analyses and are not used to support the principal conclusions. Women showed sample-specific differences on fidelity and seriousness, but no result is interpreted as behavioral or moral superiority. The observed correlation between seriousness and digital-infidelity judgments (r = 0.864) indicates substantial overlap; no correction for attenuation is presented because the dimensionality and error structure of the short indices were not established. Interview findings are reported as counts out of 11 rather than percentages. The findings are sample-bound, attitudinal, and hypothesis-generating. Full article

Background/Objectives: Sleep duration and physical activity are important lifestyle behaviors that may influence adolescents’ academic and Physical Education (PE) performance. However, evidence regarding their associations with Physical Education (PE) performance remains limited, particularly in North African populations. This study aimed to examine the relationships between sleep duration, physical activity, and academic and PE performance among Moroccan adolescents. Methods: A cross-sectional study was conducted among 439 Moroccan adolescents aged 14–20 years. Data were collected using the Arab Teens Lifestyle Study (ATLS) questionnaire. Sleep duration, physical-activity level (metabolic equivalent minutes per week [MET-min/week]), overall academic average, average grade in science subjects, and final PE grade were assessed. Pearson correlation analyses and multivariate analysis of variance (MANOVA) with follow-up univariate analyses were performed, with Games–Howell post hoc comparisons used for PE performance. Results: Sleep duration was positively associated with overall academic average (r = 0.147, p = 0.002) and final PE grade (r = 0.167, p = 0.001), but not with average grade in science subjects (r = 0.080, p = 0.099). Physical activity was positively associated with overall academic average (r = 0.169, p < 0.001) and final PE grade (r = 0.166, p = 0.001), but not with average grade in science subjects (r = −0.009, p = 0.851). Overall academic average was strongly correlated with science average (r = 0.809, p < 0.001) and moderately correlated with final PE grade (r = 0.474, p < 0.001). multivariate analysis of variance (MANOVA)revealed a significant but small overall difference in combined academic and PE performance across the four sleep-duration and physical-activity groups (Pillai’s Trace = 0.034, F(6, 870) = 2.522, p = 0.020, partial η² = 0.017). Follow-up analyses showed no significant group differences in overall academic average (F(3, 435) = 1.460, p = 0.225, partial η² = 0.010), whereas PE performance differed significantly across groups (F(3, 435) = 4.040, p = 0.007, partial η² = 0.027). Conclusions: Sleep duration and physical activity showed weak but significant positive associations with overall academic average and PE performance among Moroccan adolescents, whereas neither was significantly associated with average grades in science subjects. Combined sleep-duration and physical-activity groups differed significantly in PE performance, but not in overall academic average, with small effect sizes. These findings suggest that sleep duration and physical activity are associated with adolescent performance, although the magnitude of these associations is modest and should not be interpreted as causal. Further longitudinal research using objective measures of sleep and physical activity is warranted to clarify these relationships. Full article

Natural resource endowments are often treated as major determinants of regional competitiveness, yet institutional and rentier-state scholarship suggests that institutional architecture, reform capacity, and policy implementation may also shape competitiveness trajectories. This study examines Saudi Arabia’s competitiveness trajectory under Vision 2030 in comparison with Kuwait, the United Arab Emirates, and Qatar. The analysis covers 2022–2026, complemented by historical IMD benchmarks and independently sourced real-economy indicators, particularly economic growth and foreign direct investment (FDI). Saudi Arabia improved from 24th in 2022 to 13th in 2026, with Government Efficiency and Business Efficiency both reaching 4th globally. However, FDI remained at 1.25% of GDP, substantially below the UAE’s 7.90% and the 5.7% Vision 2030 target. Comparative evidence further indicates that neither infrastructure strength nor governance centralization alone accounts for observed competitiveness trajectories. The findings reveal incomplete correspondence between ranking improvement and real-economy transmission, supporting a conditional institutional interpretation in which reform capacity operates alongside regulatory credibility, implementation quality, and broader economic conditions. The study distinguishes reform velocity, institutional effectiveness, real-economy transmission, and institutional durability as analytically distinct dimensions of institutional transformation. Given its small-N descriptive comparative design, the study identifies theory-consistent patterns rather than causal effects of Vision 2030. Full article

Background: Lipoprotein(a) [Lp(a)] is a genetically determined, pro-atherogenic lipoprotein enriched in oxidized phospholipids and increasingly recognized as a key potential contributor to residual cardiovascular and inflammatory risk. However, data on its distribution and cardiometabolic associations in Middle Eastern populations remain limited. This study aimed to evaluate the prevalence of elevated Lp(a) and its association with type 2 diabetes (T2D), systemic inflammation, and ethnic variation in a multiethnic cohort. Methods: In this cross-sectional study, data from 2083 adults aged ≥ 18 years residing in Kuwait were collected through the Kuwait Diabetes Epidemiology Program (KDEP) at Dasman Diabetes Institute between 2011 and 2014 using random sampling. Plasma Lp(a) concentrations, cardiometabolic parameters, and high-sensitivity C-reactive protein (CRP) were measured. Elevated Lp(a) was defined as ≥ 50 mg/dL according to established clinical guidelines. Associations of elevated Lp(a) with T2D and CRP were assessed using multivariable Poisson regression models to estimate adjusted prevalence ratios. Results: The overall prevalence of elevated Lp(a) was 41.2%, exceeding global estimates. Significant ethnic variation was observed, with Arabs exhibiting the highest prevalence. After adjustment for potential confounders, individuals with T2D had a higher prevalence of elevated Lp(a) (APR = 1.166) and diabetes status significantly modified the association between CRP and elevated Lp(a) interaction (APR = 1.015), thus supporting a link between Lp(a) and systemic inflammation. Conclusions: Elevated Lp(a) was highly prevalent in this multiethnic Middle Eastern population and was independently associated with T2D and systemic inflammation. These findings support the emerging concept that Lp(a) may function as a molecular-inflammatory mediator potentially contributing to residual cardiovascular risk and highlight the importance of incorporating Lp(a) assessment into cardiometabolic risk stratification, particularly in high-risk populations. Full article

Introduction: Hepatitis B virus (HBV) genotypes exhibit distinct geographic distributions and may differ in virological expression. In low-endemic settings such as Canada, where chronic HBV burden is largely migration-driven, clinical cohorts provide a unique opportunity to characterize genotype diversity and its relationship with sociodemographic and baseline virological markers. Methods: We conducted a retrospective cohort study of patients with chronic HBV infection and available genotype results followed in The Ottawa Hospital Viral Hepatitis Program (TOHVHP) between 2001 and 2025. Results: Among 778 patients (median age 42.5 years; 52.3% male), 94.3% were born outside Canada, representing 78 countries and predominantly Asian (51.4%) and Black (34.8%). Six genotypes were identified: A (19.8%), B (25.6%), C (21.0%), D (17.4%), E (15.9%), and F (0.4%). Distribution reflected global migration patterns, with B/C predominating in East and Southeast Asia, E in West Africa, A in East Africa and the Caribbean, and D across the Middle East and North Africa, South Asia, and Europe/Central Asia. Younger age was observed among African-associated genotypes and among Black and Arab/MENA populations. Genotype-ethnicity patterns were concordant (A/E predominantly Black; B/C > 95% Asian; D heterogeneous). Genotypes B and C were independently associated with higher HBV DNA compared with genotype A. Overall, 10.7% of patients were HBeAg-positive, with genotype C showing the highest prevalence (23.7%) and an independent association with HBeAg positivity (aOR 8.3, 95% CI 2.0–34.9). Younger age and male sex were associated with higher HBV DNA and HBeAg positivity. Conclusions: In this immigration-rich Canadian cohort, HBV genotype distribution closely reflected global epidemiology and was strongly structured by country and region of birth. Baseline virological activity also differed by genotype and host factors, supporting integration of HBV genotype with sociodemographic context when characterizing chronic HBV in diverse migrant-receiving populations. Full article

Background: Mothers of children with autism spectrum disorder (ASD) play a central role in coordinating multidisciplinary interventions. This study examined quality of life (QoL) among Saudi mothers of children with ASD and its associations with caregiver burden, psychological distress, financial experiences, and perceived clarity of post-diagnosis service pathways. Methods: This cross-sectional quantitative survey included an exploratory free-text component. Of 109 survey submissions, 106 contained completed core survey data. Two brief open-ended questions were presented to 60 participants; 53 provided a post-diagnosis challenge response and 46 provided a general additional comment. These responses were reviewed descriptively as supplementary contextual observations. QoL was assessed using an adapted 22-item Arabic questionnaire derived from the Arabic WHOQOL-BREF source instrument and was analysed as an adapted QoL composite rather than as standard WHOQOL-BREF domain scores. Hierarchical linear regression used a fixed complete-case sample, and regression diagnostics and sensitivity analyses were conducted. Results: Ninety-nine mothers had sufficient valid responses to calculate the adapted QoL composite (mean = 50.65, SD = 17.32, on a 0–100 metric). The hierarchical regression included 82 participants and explained 59.3% of the variance in adapted QoL (R² = 0.593; adjusted R² = 0.536). Higher caregiver burden was associated with lower adapted QoL (B = −12.94, p < 0.001), whereas higher household income (B = 3.19, p = 0.040) and greater pathway clarity (B = 6.92, p = 0.005) were associated with higher adapted QoL. Psychological distress and perceived financial burden were associated with QoL in bivariate analyses but did not show statistically significant unique associations in the multivariable model. The free-text observations referred to caregiving demands, emotional adjustment, service-navigation uncertainty, and therapy affordability; they were not treated as formal qualitative findings. Conclusions: In this cross-sectional Saudi sample, caregiver burden emerged as the factor most strongly associated with lower adapted maternal QoL, whereas higher household income and clearer post-diagnosis service pathways were associated with better QoL. These findings highlight the importance of family-centred approaches that attend to caregiving demands, affordability, and access to clear post-diagnosis guidance. Prospective research using validated or fully documented measures should examine how caregiver and service-related factors can be addressed to strengthen maternal wellbeing over time. Full article

Background/Objectives: Community-level knowledge, food-label literacy, and consumer perceptions may shape the environment in which medically indicated gluten-free diets are followed. This study assessed prior exposure to the term “gluten,” ingredient-label literacy, perceived gluten-free product (GFP) cost, and purchasing behavior and intentions among adults in Arar, Saudi Arabia. Methods: A bilingual Arabic–English online cross-sectional questionnaire was administered to adult residents of Arar using non-probability convenience sampling. Categorical data were summarized as frequencies, percentages, and 95% Wilson confidence intervals. Association analyses were exploratory. Results: A total of 306 eligible adult respondents were included. Prior exposure to the term “gluten” was reported by 70.3% (95% CI: 64.8–75.3). Only 14.1% (95% CI: 10.6–18.4) reported always understanding ingredient terminology, whereas 35.0% (95% CI: 29.8–40.5) reported not understanding it. Most respondents (60.5%; 95% CI: 54.9–65.8) perceived GFPs as more expensive than standard products. Under a hypothetical scenario of improved affordability and availability, 34% indicated that they would definitely purchase GFPs regularly and 48.4% indicated that they would possibly do so. Reported acquaintance with someone with celiac disease or gluten sensitivity was associated with hypothetical purchase intention (χ² = 9.07, p = 0.011; Cramér’s V = 0.172). Conclusions: In this convenience sample, prior exposure to the term “gluten” coexisted with limited self-reported comprehension of ingredient terminology and perceived cost barriers. These descriptive findings do not establish market conditions, gluten-free diet adherence, or clinical outcomes, but identify community-level issues for future patient-based and retail-audit research. Full article

Photovoltaic (PV) deployment is expanding rapidly, but the climate and economic value of identical generation varies with electricity-system and market conditions. This study examines whether avoided-emission rankings align with project-level financial valuation when physical project characteristics are held constant. A documented 1.101 MWp PV project, with expected annual generation of 1592.6 MWh/year, was assessed counterfactually across seven regional electricity groupings, with Brazil as the reference case. The framework integrates generation-weighted emission factors, avoided-emission accounting, discounted cash flow, carbon-abatement costs, deterministic sensitivity analysis, Monte Carlo simulation, and exploratory Pearson and Spearman correlations with exact permutation inference. To address the physical variability of the reference asset, an auxiliary hourly PV simulation covering ten complete years (2016–2025) was additionally performed using solar irradiance, ambient temperature, and wind-speed data. The modeled annual generation averaged 1472.4 MWh/year, with a coefficient of variation of 1.44%, indicating limited interannual variability over the evaluated decade. Financial indicators were evaluated over a 20-year horizon, whereas lifetime avoided emissions and carbon-abatement costs were assessed over a 25-year technical lifetime. The Arab League presented the highest avoided emissions (1005 tCO₂/year; 6.1 times Brazil) but the weakest base-case financial result: a net abatement cost of approximately USD 7/tCO₂ and a 70.1% probability of positive NPV. The European Union achieved the highest NPV, a net abatement cost of approximately −USD 255/tCO₂, and a 100% probability of positive NPV despite lower mitigation. An inverse association between emission factor and electricity tariff further characterized this mismatch (Spearman’s $\rho =-0.786$; exact permutation $p=0.048$). The results show that physical PV production, mitigation potential, and project-level financial valuation represent distinct but complementary dimensions that should be assessed jointly when comparing PV deployment contexts. Full article

Background: Perceived social support is consistently associated with lower psychological distress among university students, but the strength of this association may vary. We examined whether help-seeking self-stigma modifies it. Methods: In a cross-sectional online survey, 507 Kuwait University students completed the Patient Health Questionnaire-4 (PHQ-4), the Multidimensional Scale of Perceived Social Support (MSPSS) and the Self-Stigma of Seeking Help Scale (SSOSH). Hierarchical linear regression tested the perceived support × self-stigma interaction, adjusting for age, sex, nationality and year of study; SSOSH structure was examined by confirmatory factor analysis. Results: Of 507 eligible students (80.9% female; mean age = 21.4 years, SD = 4.4), 458 had complete PHQ-4 data. The inverse association between perceived support and distress weakened as self-stigma increased (B = 0.003, 95% CI 0.001–0.005, p = 0.007; p = 0.040 with heteroscedasticity-consistent standard errors; ΔR² = 0.015) and was not detectable at high self-stigma. The Arabic SSOSH was not unidimensional: positively and reverse-worded items formed uncorrelated factors (r = −0.01), and the interaction was carried by the reverse-worded items. Conclusions: Help-seeking self-stigma may index variation in this association, but the finding is exploratory and constrained by the measurement properties of the SSOSH in this population. Full article

Wild-food foraging is booming across the Global North, but its meaning—and its value for plant conservation—differs sharply between settings. We compare three case studies: Denmark, an intensively cultivated country with a book- and app-led revival; Southern Scotland, a post-industrial landscape whose foragers are largely incomers with a media-sourced repertoire; and Tel Aviv–Jaffa (Israel), where Nordic-inspired “neo-foraging” coexists with an eroding Arab–Palestinian oral tradition. Pooling three independently collected ethnobotanical datasets (2012–2021; Denmark: questionnaires n = 27 and interviews n = 10; Southern Scotland: questionnaires n = 12 and interviews n = 9; Tel Aviv–Jaffa: interviews only, n = 10), we record 153 wild-food taxa—136 plants (including three macroalgae) and 17 fungi—in 51 plant families. Read through the Latvian (Riga) sociology of foraging, all three cases sit on the delocalised, “lifestyle” side of the forager spectrum. Yet, all three converge on one under-exploited fact: foraging can train ordinary urban people to see, name, track and value wild plants. The apparent contradiction between gathering plants and conserving them, we argue, is resolved by the target flora rather than by the practice itself: harvest risk is concentrated in a small minority of rare, range-edge and habitat-specialist taxa, whereas plant awareness is built through repeated encounters with the commonest species—precisely those whose gathering is demographically trivial. Where foragers anchor their teaching in this ordinary, ubiquitous flora, their role is not merely compatible with plant conservation but quintessential to it. Foragers are, thus, an underused constituency of citizen educators capable of countering plant awareness disparity (also termed “plant unawareness”), provided their enthusiasm is coupled to a stewardship ethic, and we set out how conservation actors might mobilise rather than merely regulate this potential. Full article

Background/Objectives: Fecal incontinence (FI) is an underrecognized complication of inflammatory bowel disease (IBD) and colorectal neoplasia that substantially impairs quality of life. This study translated, culturally adapted, and validated the Arabic Vaizey Incontinence Score while evaluating the burden of FI among Egyptian patients. Methods: In this multicenter cross-sectional study, 287 adults with histopathologically confirmed diagnoses were enrolled, including colorectal cancer/precancerous lesions (n = 54), IBD (n = 55), and other/no significant colorectal pathology (n = 178). The questionnaire underwent standardized translation and cultural adaptation. Internal consistency was assessed using McDonald’s omega. Structural validity was evaluated using exploratory factor analysis (EFA; n = 143) and confirmatory factor analysis (CFA; n = 144). Results: Patients with IBD had the greatest fecal incontinence burden, with the highest mean Vaizey score (9.24 ± 6.77) compared with patients with colorectal neoplasia (7.28 ± 6.03) and those with other or no significant colorectal pathology (6.68 ± 4.79). Continence-related quality of life was also poorest in IBD (median 8.0 [IQR 4–10] vs. 2.0 [IQR 1–3] and 2.5 [IQR 1–6]). EFA supported a two-factor solution explaining 48.1% of the variance (KMO = 0.691; Bartlett’s χ² = 298.61, p < 0.001). The inability-to-defer-defecation item showed negligible loading and was excluded. CFA confirmed a refined six-item model with excellent fit (CFI = 0.992, TLI = 0.985, RMSEA = 0.088, SRMR = 0.087). McDonald’s omega was 0.825 for Leakage Severity and Management and 0.869 for Functional Impact, with average variance exceeding 0.50 for both domains. Conclusions: The refined six-item Arabic Vaizey Incontinence Score demonstrated good reliability and construct validity. FI score was significantly higher among patients with IBD, supporting routine assessment using this validated instrument across Egyptian patients with colorectal diseases. Full article

Background: Adolescence is a critical period for the development of self-determination, yet little is known about how autistic adolescents experience self-determination in non-Western contexts. Objective: This multiple case study explored self-determination among four autistic adolescents in Saudi Arabia through the lens of causal agency theory. Method: Each adolescent completed the Arabic version of the ARC Self-Determination Scale, and semi-structured interviews were conducted with each adolescent, a parent, and a special education teacher. Interview data were analysed using combined inductive and deductive thematic analysis. Results: Self-determination scores varied across adolescents, but all four rated themselves highest in self-regulation and lowest in psychological empowerment. Cross-case analysis of the interviews revealed three interrelated themes: beliefs and perceptions, actions and interactions, and adolescents’ sense of self-determination. The findings show that adults’ beliefs about adolescence, autism and the value of self-determination shaped everyday actions that either expanded or restricted opportunities for autonomy, competence and relatedness. Conclusions: The study extends current research by providing a culturally grounded, multi-layered account of self-determination among autistic adolescents in Saudi Arabia. Full article

Adult vaccination is a critical component of preventive healthcare, reducing morbidity and mortality from vaccine-preventable diseases. Despite established recommendations, adult immunisation coverage remains suboptimal, particularly for vaccines beyond influenza and COVID-19. In the United Arab Emirates (UAE), limited evidence exists regarding adult vaccine uptake and determinants influencing immunisation behaviour within its diverse population. Understanding vaccine-specific coverage and associated sociodemographic, healthcare, and workplace factors is essential to guide targeted strategies that strengthen adult immunisation. A cross-sectional study was conducted among 1330 adults aged ≥ 18 years residing in the UAE. Data were collected using a structured self- or interviewer-administered questionnaire assessing uptake of recommended adult vaccines, including COVID-19, influenza, pneumococcal, herpes zoster, Tdap, and HPV. Sociodemographic characteristics, healthcare access, insurance status, workplace factors, and perceived barriers were also assessed. Descriptive statistics summarised vaccination coverage, and associations between uptake and key determinants were examined using SPSS version 30. Statistical significance was defined as p < 0.05. Overall, 71.0% reported receiving at least one adult vaccine. Uptake was highest for COVID-19 (64.9%) and influenza (57.8%), while pneumococcal, herpes zoster, and Tdap coverage remained low (12–13%). HPV uptake was 22.6% among females and 18.9% among males. Higher uptake was observed among females and adults. Social encouragement, insurance coverage, and healthcare access were associated with vaccination, whereas lack of awareness and logistical barriers hindered uptake. Although overall uptake was moderate, significant gaps persist. Integrating vaccination into routine healthcare services and addressing structural and communication barriers are necessary to improve adult vaccination coverage. Full article