Search Results (868)

The rapid expansion of corporate sustainability reporting has increased transparency requirements while raising concerns about greenwashing driven by selective, narrative-based disclosure. This study assesses the credibility of Environmental, Social, and Governance (ESG) communication by comparing corporate sustainability reports with external media coverage for a sample of 204 large firms operating in Central and Eastern Europe in 2023. Using natural language processing techniques, the analysis constructs a Greenwashing Severity Index (GSI) that captures discrepancies between firms’ ESG self-representation and external public narratives. The index combines ESG-specific focus measures, sentiment analysis, TF–IDF-based term weighting, and topic modeling to quantify imbalances in ESG communication. Results indicate moderate but widespread greenwashing across countries, industries, and firm sizes, with substantial heterogeneity linked to differences in regulatory maturity and stakeholder scrutiny. Higher alignment between corporate disclosures and external narratives is observed among larger firms and in sectors subject to stronger public accountability, while finance, aviation, and online commerce exhibit higher greenwashing severity. A propensity score matching analysis further shows that firms with imbalanced emphasis across ESG dimensions display significantly higher GSI values, consistent with strategic disclosure behavior rather than substantive sustainability engagement. Overall, the findings demonstrate that transparency alone is insufficient to ensure credible ESG communication, highlighting the need for EU sustainability governance to move beyond disclosure-based compliance toward digitalized, data-driven monitoring frameworks that systematically integrate external information sources to curb strategic ESG misrepresentation and enhance corporate accountability under evolving regulatory regimes. Full article

Background/Objectives: Few studies have simultaneously evaluated spatial accessibility to both food destinations and spaces for physical activity in relation to body weight in children. The aim of this study was to determine whether spatial accessibility to food destinations and places for physical activity is associated with body weight among children, differentiating between boys and girls. Neighborhood socio-economic status and walkability were incorporated as covariates. Methods: This cross-sectional study was conducted in Valencia, Spain. The initial sample comprised a sample of 808 children. GIS-based procedures were used to evaluate access to food outlets, walkability and socio-economic status (i.e., household income) among home neighborhoods. Access to different types of food destinations and destinations where children can engage in physical activity was assessed using the Neighborhood Environment Walkability Scale for Youth (NEWS-Y-IPEN). Weight and height were objectively assessed. The body mass index (BMI) percentile was calculated. Mixed-model regression analyses were performed. Results: Being a boy was positively associated with BMI percentile (p = 0.003), whereas physical activity was negatively related to this outcome (p = 0.028) in the whole sample. None of the built environment attributes were significantly associated with BMI percentile in boys. Access to healthy restaurants (p = 0.035), as well as neighborhood income (p = 0.049), were negatively associated with BMI percentile among girls. Conclusions: The relationship between built environmental attributes and BMI varies significantly between boys and girls. Understanding these differences is key for designing effective public health interventions with the aim of reducing childhood obesity. Full article

This study proposes an indicator system for evaluating AI-assisted learning in higher education, combining evidence-based indicator development with expert-validated weighting. First, we review recent studies to extract candidate indicators and organize them into coherent dimensions. Next, a Delphi session with domain experts refines the second-order indicators and produces a measurable, non-redundant, implementation-ready index system. To capture interdependencies among indicators, we apply a hybrid Decision-Making Trial and Evaluation Laboratory–Analytic Network Process (DEMATEL–ANP, DANP) approach to derive global indicator weights. The framework is empirically illustrated through a course-level application to examine its decision usefulness, interpretability, and face validity based on expert evaluations and structured feedback from academic staff. The results indicate that pedagogical content quality, adaptivity (especially difficulty adjustment), formative feedback quality, and learner engagement act as key drivers in the evaluation network, while ethics-related indicators operate primarily as enabling constraints. The proposed framework provides a transparent and scalable tool for quality assurance in AI-assisted higher education, supporting instructional design, accreditation reporting, and continuous improvement. Full article

Patient engagement and mental workload (MWL) are often overlooked when optimising robotic-assisted rehabilitation, despite their potential impact on its effectiveness. This study aims to propose a multimodal approach to assess MWL and engagement, using electrophysiological signals and questionnaires, to explore their modulation across different assistance modalities and engaging strategies. Thirty healthy subjects were enrolled and performed repetitive upper-limb movements with a robotic device under three assistance modalities (active, passive, semi-assisted) while listening to a 1 Hz auditory stimulus (metronome or music). Electroencephalography, Electrocardiogram, the NASA Task Load Index, and the Short Stress State Questionnaire were used to assess objective and perceived MWL and engagement. Engagement increased significantly in the music condition, whereas MWL showed no significant change. The passive modality was perceived as significantly less demanding and less engaging compared to active and semi-assisted conditions. Although EEG objective indicators did not vary across modalities, the ECG objective metric was modulated significantly in agreement with the subjective measures. Overall, the auditory stimulus significantly influenced engagement, and assistance levels affected both perceived mental demand and engagement. The proposed multimodal approach is sensitive to both engagement and MWL constructs, highlighting the potential for adaptive rehabilitation systems designed to maintain engagement, prevent overload or monotony, and ultimately support better functional outcomes over the long term of robotic training. Full article

This research examines the influence of environmental, social, and governance (ESG) strategies on corporate financial performance (CFP) in China’s automotive industry, characterized by intense regulatory pressure and fast-paced technological transformation. Using an unbalanced panel dataset of A-share listed automotive firms from 2009 to 2024, this paper combines ESG scores from the Huazheng ESG index with firm-level financial data from CSMAR. CFP is measured through both accounting-based (ROA) and market-based (Tobin’s Q) indicators. Panel regression models are applied to evaluate the influence of overall ESG performance and the three individual pillars, and to assess heterogeneity across ownership types, firm type, and firm age. The results show that ESG performance is significantly and positively associated with ROA, but is insignificantly associated with Tobin’s Q. It is suggested that ESG engagement improves accounting profitability but is not fully reflected in the capital market. Among the three ESG pillars, governance shows the strongest positive link with ROA, while environmental and social performance are weakly associated with ROA. Furthermore, the heterogeneity study shows that the positive relationship between ESG and CFP is more pronounced for non-state-owned firms, vehicle manufacturers, or mature firms. Overall, this paper presents fresh evidence on whether and how ESG initiatives can facilitate sustainable value in China’s automotive sector, offering insights for policymakers and management that may help this industry achieve sustainable growth. Full article

Background/Objectives: There is still limited understanding of how psychotic symptoms and sexual risky behaviors (SRBs) are related to each other. Gaining more knowledge of the mechanisms involved in this relationship could inform interventions to reduce or prevent SRBs. This study aims to deepen comprehension of the relationship between psychotic experiences (PEs) and SRBs by examining the moderating effects of depression and childhood trauma. Methods: A web-based survey and a cross-sectional design were adopted to collect data from 466 young general population adults (aged 18–35 years) from Tunisia during the period January–March 2024. The snowball sampling technique was used to recruit participants. Results: Moderation analyses were adjusted over age, sex, household crowding index, marital status, and living situation. The interaction PEs by childhood trauma was significantly associated with SRB scores. At high and moderate levels of child abuse, higher PEs were significantly linked to higher SRBs. Furthermore, the interaction PEs by depression was significantly associated with SRB scores. At high, moderate, and low levels of depression, higher PEs were significantly associated with higher SRBs. Conclusions: Clinicians should consider including assessment of childhood trauma and depression in young adults with PEs who are engaged in sexual risk-taking behaviors. Findings may imply that strategies addressing these two factors can be effective in mitigating the association between PEs and SRBs. Full article

Background/Objectives: The present study aimed to examine how obesity and its distribution influence the relationship between healthy lifestyle habits and cardiometabolic health indicators in adolescents. Methods: This cross-sectional study included 340 adolescents (54.8% female; mean age, 16.6 ± 1.0 years) from Brazil. The cardiometabolic variables included systolic (SBP) and diastolic blood pressure (DBP), high-sensitivity C-reactive protein (CRP), and markers of lipid and glucose metabolism. Information on regular physical activity, healthy diet, reduced alcohol consumption, and non-smoking was collected via a self-reported questionnaire. Body mass index, waist circumference, and skinfold measurements were assessed to determine general obesity, abdominal obesity, and excess body fat, respectively. Multiple linear regression, adjusted for confounding factors, was employed for the analysis. Results: The adoption of ≥3 healthy lifestyle habits was directly associated with high-density lipoprotein cholesterol (up to 1.2 mg/dL) and inversely associated with triglycerides (up to −0.11 p.p.). Engaging in multiple healthy lifestyle habits was inversely associated with SBP among adolescents with general (p = 0.018) and central obesity (p = 0.004). Furthermore, the adoption of multiple healthy lifestyle habits was inversely associated with CRP in adolescents with central obesity (p = 0.037). Conclusions: Even in adolescents with obesity, it is speculated that the adoption of healthy habits may contribute to a reduction in cardiometabolic risk, given the inverse association with SBP in those with general and central obesity and the inverse association with CRP in adolescents with central obesity. Full article

Parental stress is a critical yet understudied dimension of childhood total blindness, a condition that imposes substantial developmental, emotional, and functional challenges on families. This cross-sectional study assessed parenting stress, maternal health symptoms, and children’s functional vision-related quality of life in 81 mothers of children aged 0 to 12 years with total congenital blindness. Parenting stress was assessed in the full sample using the Parenting Stress Index–Fourth Edition (PSI-4). Children’s functional vision-related quality of life was evaluated in age-specific subsamples using the Quality of Family Vision Impact (QFVI-3 for children aged 0–3 years and QFVI-7 for children aged 3–7 years). All participants also completed a sociodemographic and maternal health survey. Total Parent Stress showed moderately elevated percentile scores (mean ≈ 67), with the highest PSI-4 subdomains in Adaptability, Depression, and Health. Approximately 21% of mothers scored within the clinical range for high stress. Maternal symptoms including sadness, insomnia, headaches, forgetfulness, and musculoskeletal pain were significant (all p < 0.01). QFVI global scores indicated moderate impairments in functional vision-related quality of life across age groups. Life Stress demonstrated a small-to-moderate negative correlation with QFVI-7, suggesting that cumulative environmental stressors may adversely affect children’s functional outcomes. Several factors were associated with more favorable outcomes. Among children under three years of age, maternal engagement in physical activity was associated with higher QFVI scores, whereas among children aged 3–7 years, school attendance was associated with higher functional vision-related quality of life scores. In contrast, sociodemographic disadvantage, limited access to educational adaptations, and reduced maternal participation in work or leisure activities were associated with higher levels of parental stress. These findings highlight the importance of multidisciplinary, family-centered care incorporating psychosocial assessment, early stimulation, orientation and mobility support, and maternal mental health interventions in pediatric ophthalmology. Full article

Food waste is a persistent global concern, requiring behavioral and systemic responses from consumers. The current study investigated the effect of sociodemographic factors and digital activism on food waste prevention behavior. Data from 390 respondents living in Italy (65% females, from 18 to 75 years old, grouped into four generations) were collected through an online survey covering these sections: sociodemographic variables, digital activism, knowledge, attitudes, and food waste behaviors. A Food Waste Prevention Index (FWPI) was computed to assess self-reported adherence to waste-reducing practices, and differences across three groups identified through tertiles were tested. Women displayed higher levels of digital activism; Gen Z was the most engaged generation in seeking information about food, while interest in food issues declined with age. Gender, geographical area, and dietary orientation significantly influenced food waste prevention, with women, rural residents, and individuals adopting flexitarian or vegetarian diets tending towards more virtuous behavior (higher FWPI). According to digital activism, less virtuous waste behavior (lower FWPI) was associated with a lower social media and apps usage frequency. Furthermore, higher FWPI individuals self-reported stronger sensitivity to sustainability-related topics such as circular economy, short food chains, and ethical or environmental motivations for vegetarianism. Overall, awareness and digital activism may synergistically foster more responsible food consumption, and targeted communication and digital tools can effectively support household food waste reduction strategies. Full article

Background: Population aging has increased attention on the quality of life and successful aging of older adults. Objective: To examine urban–rural differences in subjective quality of life and self-rated successful aging, explore associations with psychosocial factors, and identify predictors of successful aging, including potential moderating effects of place of residence and chronic illness. Methods: A cross-sectional study was conducted among 403 adults aged ≥ 60 years in Eastern Croatia. Measures included a sociodemographic questionnaire, the Self-assessment of Successful Aging Scale (SSAS), and the Personal Wellbeing Index (PWI). Data were analyzed using nonparametric tests (Mann–Whitney U, Spearman’s correlation), linear regression, and moderation analyses. Significance was set at p < 0.05. Ethical approval was obtained (Class: 602-01/24-12/02; IRB: 2158/97-97-10-24-36). Results: Rural participants reported lower PWI scores (p = 0.005) and self-rated successful aging (p < 0.001) than urban participants. Active community involvement was positively associated with quality of life (Rho = 0.46; p < 0.001), whereas regret about missed opportunities and past actions was negatively associated (Rho = −0.20; p < 0.01). Regression analyses explained 48.3% of the variance in SSAS, with higher PWI scores being strongly associated with higher SSAS scores, and rural residence and chronic illness being associated with lower SSAS scores. Moderation analyses indicated that the association between PWI and SSAS was consistent across different environmental contexts and in the presence of illness. Conclusions: Older adults living in rural areas reported lower quality of life and self-rated successful aging compared with those in urban and suburban areas, with subjective wellbeing emerging as a key predictor. Promoting social engagement and addressing psychosocial barriers may enhance successful aging, particularly in rural populations. Findings suggest that social engagement and psychosocial support are associated with higher level of perceived successful aging, indicating potential areas for future community-based or healthcare interventions. Full article

This study presents a comprehensive bibliometric and science mapping analysis of research on co-creation and co-production in public administration, based on 819 publications indexed in the Web of Science (WoS). The analysis of scientific production in this field shows sparse early contributions before 2005, followed by steady growth after 2010 and accelerated expansion from 2016 onward, driven primarily by European and United States research communities. In terms of scholarly influence, the results identify a stable core of highly productive and influential authors, institutions, and countries, with strong concentration in Northern and Western Europe and Anglo-Saxon contexts. To address the intellectual structure of the field, science mapping identifies four dominant thematic clusters: (1) co-production and value creation, (2) participation and public engagement, (3) governance and policy, and (4) knowledge development, lessons learned, and evaluative insights. Examining thematic and keyword evolution over time, the findings indicate a shift from early conceptual and normative discussions toward more applied and implementation-oriented research, with increasing attention to barriers, challenges, and enabling conditions in recent years. Overall, the findings show that research on co-creation and co-production has evolved from conceptual fragmentation toward greater thematic consolidation and analytical maturity, while persistent implementation challenges remain. By systematically mapping these developments, the study provides a structured overview that supports future conceptual integration and informs both research agendas and practice-oriented discussions on co-creation and co-production in public administration. Full article

Against the backdrop of accelerating urbanisation in China, the urban-rural divide continues to widen, while cave dwellings along the Yellow River have been largely abandoned, facing the challenge of cultural erosion. This study breaks from conventional conservation approaches by empirically exploring the viability of living heritage in promoting sustainable rural revitalisation and integrated urban-rural development. Employing participatory action research, it engaged multiple stakeholders—including villagers, returning migrants, and urban designers—across 60 villages in the middle reaches of the Yellow River. This collaboration catalysed a “collective-centred” adaptive reuse model, generating multifaceted solutions. The case of Fangshan County’s transformation into a cultural ecosystem demonstrates how this model simultaneously fosters endogenous social cohesion, attracts tourism resources and investment, while disseminating traditional culture. Quantitative analysis using the Yao Dong Living Heritage Sensitivity Index (Y-LHSI) and Living Heritage Transmission Index (Y-LHI) indicates that the efficacy of collective action is a decisive factor, revealing an inverted U-shaped relationship between economic development and cultural preservation. The findings further propose that living heritage regeneration should be reconceptualised from a purely technical restoration task into a viable social design pathway fostering mutually beneficial urban-rural symbiosis. It presents a replicable “Yao Dong Solution” integrating cultural sustainability, community resilience, and inclusive economic development, offering insights for achieving sustainable development goals in similar contexts across China and globally. Full article

An early indicator of future cardiovascular risk is lower levels of nighttime blood pressure (BP) dipping from day to night. Prior work has been limited to identifying health behaviors that can promote greater dipping. This pilot study proposes that one possible set of behaviors may be engagement in self-selected leisure activities (SSLAs, or freely chosen non-work activities that are performed with the purpose of relaxation and/or mental escape), which have been linked with reduced daily stress and general daily BP control. Healthy young adult college students [N = 32; 78.1% (n = 25) female, 71.9% (n = 23) white, with an average body mass index (BMI) of 26.31 (SD = 2.46)] visited our laboratory twice within approximately one week. At each visit, the participants were fitted with an ambulatory monitor to collect BP over 24 h. On each day, participants were randomly assigned to either engage in an agreed-upon SSLA or go about their day as usual, except to refrain from engaging in assigned SSLAs; compliance was verified by daily diaries. When accounting for BMI and race/ethnicity, the results showed a higher percentage of BP dipping on the SSLA versus control day for diastolic BP (d = 0.54). SSLAs may be associated with reduced future cardiovascular disease through a nighttime BP dipping effect. Full article

Background/Objectives: Functional limitations are common among older cancer survivors and tend to increase with age and survivorship duration. Physical activity (PA) associates with better functional outcomes, but little is known about how these associations vary as time passes post-diagnosis. This study examined how years since diagnosis, three types of physical activity, and their interactions associate with functional limitations in older cancer survivors. Methods: Data drawn from the 2021 National Health Interview Survey (NHIS), representing adults aged 55+ and with a prior cancer diagnosis (n = 9356; mean age = 72.17 ± 8.5 years), were studied. A four-item self-reported difficulty index (i.e., washing/dressing, walking one block, climbing stairs, and picking up/opening objects) was summed to measure functional limitations. PA was assessed using the items aligned with the United States PA Guidelines. Hierarchical regression was used to evaluate associations between functional limitations and years since diagnosis, vigorous physical activity, moderate physical activity, and strength training. Interaction effects of years since diagnosis and each activity type were also examined. Covariates were age, sex, BMI, and educational attainment. Results: Elapsed time since cancer diagnosis positively associated with functional limitations in interaction with physical behaviors, while moderate physical activity and strength training negatively associated with functional limitations. Interactions of years since diagnosis and both moderate physical activity and strength training revealed smaller increases in functional limitations. No interaction effects were observed for vigorous physical activity. Conclusions: Among older cancer survivors, the association between survivorship duration and functional limitations differs by engagement in moderate and resistance-based physical activity. These findings support the clinical importance of promoting sustainable, non-vigorous physical activity in long-term survivorship care. Full article

Background: Narrative Medicine (NM) has emerged as a strategy to support reflective clinical practice and emotional resilience among nurses. This study examined relationships between NM practices and well-being among registered nurses (RNs) and nurse practitioners (NPs). Methods: A national sample of RNs and NPs was recruited using snowball sampling. Participants completed a NM practice survey and the Mayo Clinic Well-Being Index (WBI) survey. Data were analyzed using descriptive statistics and Pearson correlation coefficients. Results: A total of 3167 responses were analyzed (1934 RNs and 1233 NPs). Among RNs, strong statistically significant correlations were found between NM practices and well-being scores (p < 0.001). Among NPs, moderate correlations appeared in select NM practice dimensions (p < 0.05). Conclusions: Engagement in narrative Medicine practices is associated with improved well-being among nurses and nurse practitioners. NM may present a promising strategy to reduce burnout and strengthen professional resilience. Full article