Search Results (7,499)

Implementing effective cycling mobility requires infrastructure that enhances safety and reduces travel time. A common metric for tracking progress is the total length of dedicated cycling infrastructure. However, this does not always correlate with increased cycling usage. For instance, in Italy (2008–2015), cycling infrastructure grew by 48%, but ridership remained unchanged. Design quality and behavioral and contextual factors all influence this dynamic. This study analyzes a 16-year time series (2009–2024) of monthly cyclist flows surveys in Bologna, Italy. It focuses on flows, gender, and bike lane usage. It represents the most detailed and longest series of its kind in the country. The findings show a positive correlation between infrastructure growth (meters per inhabitant) and cyclist flows, though this weakened significantly after COVID-19 and the extensive introduction of non-exclusive bike lanes on mixed-use roads from 2020. Regression analyses reveal that new bike flows per new meter/inhabitant of infrastructure were 3 times greater before 2020. This study identifies two likely causes: the insufficient perceived safety of the newly introduced mixed-traffic lanes from 2020 and the lack of attractivity of cycling for the female population, as highlighted in the decreasing trend in the usage of bike infrastructure by female riders after 2020. Full article

Objectives: To assess intra-session reliability of isometric and isotonic shoulder external rotation (ER) strength tests and to compare their outcomes. Methods: Thirty-eight healthy subjects (19 females; 19 males; 25.7 ± 6.0 years; 175 ± 9 cm; 70.3 ± 11.4 kg) completed a shoulder ER strength assessment including Prone and Standing ER Isometric tests and Seated 5 repetition maximum (RM) ER tests. Normality was checked with the Shapiro–Wilk test. Reliability was assessed using the CV and ICC (3, k, 95% CI). Linear mixed models examined sex and dominance effects. Correlations and multiple regression tested associations between tests (p < 0.05). Results: All tests performed displayed “excellent” reliability scores (CV from 1.9 to 3.1% and ICC from 0.970 to 0.994). No significant effect of dominance was observed in any strength test. Males showed significantly higher values than females in both Prone (3.8% higher, p < 0.001) and Standing (2.7% higher, p = 0.003) isometric ER strength tests. Prone and Standing isometric tests were moderately correlated (r = 0.62, 95% CI [0.46, 0.74], p < 0.001). A regression model explained 52.4% of the variance in Seated 5 RM ER strength (R² = 0.524, p < 0.001), with Prone isometric strength emerging as a significant predictor (β = 0.612, p < 0.001). Conclusions: This study provides previously unreported 5 RM shoulder ER strength values in healthy adults, with all included tests showing excellent reliability. Isometric measures did not fully capture isotonic ER strength. Males outperformed females in isometric tests, but no gender difference was observed in Seated 5 RM strength. Full article

Background/Objectives: As precision medicine advances, attention to sex and gender determinants across epidemiological and clinical domains has intensified. However, in the audio-vestibular field, knowledge on sex- and gender-related aspects remains relatively limited. The main aim of this review has been to analyze the available gender medicine-based evidence in vestibular disorders. In particular, our investigation considered the following: (i) pathophysiology and clinical presentation, including differences in predominant signs and symptoms, diagnostic modalities and findings, underlying biological mechanisms associated with vestibular disorders across sex-specific groups; (ii) prognostic variables, including response to treatment, recovery rates, and long-term functional outcomes; (iii) the potential role of sex- and gender-specific diagnostic and therapeutic approaches in the management of vestibular disorders. Methods: Our protocol was registered on PROSPERO (CRD42025641292). A literature search was conducted screening PubMed, Scopus and Web of Science databases. After removal of duplicates and implementation of our inclusion/exclusion criteria, 67 included studies were identified and analyzed. Results: Several studies reported a higher incidence of vestibular dysfunctions among females, with proposed associations involving hormonal fluctuations, calcium metabolism and vitamin D. Estrogen receptors within the inner ear and their regulatory effects on calcium homeostasis have been proposed as potential mechanisms underlying these sex-specific differences. Furthermore, lifestyle factors, comorbidities and differential health-seeking behaviors between males and females may also modulate disease expression and clinical course. Conclusions: Gender-specific variables could not be independently analyzed because none of the included studies systematically reported gender-related data, representing a limitation of the available evidence. Current evidence suggests the presence of sex-related differences in the epidemiology and clinical expression of vestibular disorders, but substantial gaps remain regarding mechanisms, outcomes, and clinical implications. Future research should prioritize prospective, adequately powered studies specifically designed to assess sex and gender influences, integrating biological, psychosocial, and patient-reported outcomes, and adopting standardized sex- and gender-sensitive reporting frameworks. Full article

We examine complex inequities that emerge when race, gender, and first-generation college status are treated as interdependent, rather than independent statuses, for assessing student outcomes at Hispanic-Serving Institutions (HSIs). Drawing on student-level administrative data from two public HSIs in the U.S. Southwest, we analyze four-year graduation and placement in developmental English and mathematics. Using continuing-generation college white women as the reference group, we estimate marginal effects and then construct linear combinations for twenty intersectional social locations defined by race, gender, and first-generation college status. Our findings show that first-generation American Indian men, first-generation college Black men, and first-generation college Hispanic men experience some of the largest achievement gaps in both graduation and developmental placement, gaps that would remain obscured in conventional reporting by race, gender, or class alone. We argue that quantitative intersectionality, grounded in critical race and intersectionality scholarship, offers a value-added approach to state-based institutional analytics that can inform equity metrics, accountability systems, and resource allocation at HSIs and beyond. We conclude with recommendations for redesigning data infrastructures, reporting practices, and equity initiatives to better align HSI servingness with the lived realities of structurally marginalized students. Full article

Background: Sexual dysfunction (SD) affects up to two-thirds of individuals with early-onset Parkinson’s disease (PD), yet it remains underexplored in developing countries where stigma, depression, and treatment side effects may worsen its burden. This study investigated the magnitude and correlation of SD in early-onset PD. Methods: A cross-sectional study included 74 individuals with PD onset at ≤55 years of age. SD was assessed using the Medical Outcomes Study Sexual Functioning Scale, alongside interviews on sexual experiences after initiating PD medication. Prevalence was estimated descriptively, and Spearman’s correlation identified correlates of SD. Results: Half of participants reported SD, including lack of sexual interest (52.7%), difficulty relaxing or enjoying sex (52.7%), and impaired arousal (50%). Among men, 48% experienced erectile problems, while 44% of women reported difficulty achieving orgasm. After starting anti-Parkinson’s medication, 16% noted markedly reduced sexual desire, whereas nearly 10% reported increased desire. In men, SD correlated with levodopa dose (r = 0.411, p < 0.01). In women, SD correlated with stigma (r = 0.389, p < 0.05), depression (r = 0.529, p < 0.01), and anxiety (r = 0.629, p < 0.01). Conclusions: One in two individuals with early-onset PD experiences SD, independent of gender. Findings highlight the need for routine sexual health assessment and careful monitoring of treatment side effects. Interventions targeting stigma, depression, and anxiety are critical to improve sexual well-being in this population. Full article

The development of generative artificial intelligence tools, including large language models, opens new opportunities for adult education while simultaneously posing the risk of deepening inequalities resulting from differences in digital competences and individual dispositions. The aim of this article is to examine how digital skills (DS) and personal innovativeness (PI) shape differentiated and advanced use of ChatGPT (UC) among adult learners in Poland, with particular attention to the moderating role of gender. The study was conducted using the CAWI method on a nationwide sample of 757 adult ChatGPT users engaged in upgrading their qualifications. Validated scales of DS, PI, and UC were applied, along with confirmatory factor analysis (CFA) and structural equation modeling (SEM) using the WLSMV estimator, as well as multigroup SEM for women and men. The results confirm that both digital skills (β ≈ 0.46) and personal innovativeness (β ≈ 0.37) significantly and positively predict advanced use of ChatGPT, jointly explaining approximately 41% of the variance in UC, with stronger effects observed among men than women. Attention is therefore drawn to the need to incorporate a gender perspective in further research on the use of GenAI in adult education The findings point to a stratification of GenAI use in adult education and underscore the need to incorporate critical digital competences and AI literacy into sustainable education policies in order to limit the reproduction of existing inequalities. Full article

Background: Physiotherapy University students frequently experience psychological challenges such as depression, anxiety, and stress. These issues are shaped by various individual, health-related, and social factors. Understanding these influences is essential for identifying vulnerable subgroups and guiding effective support strategies. Aim and Objectives: This study aims to assess the prevalence and severity of depression, anxiety, and stress among physiotherapy students. Specific objectives include (1) analyzing mental health variations across demographic variables such as gender, nationality, marital status, and year of study; (2) evaluating the impact of physical and mental health conditions on psychological distress; and (3) investigating the protective role of perceived social support from family, friends, and faculty. Methods: A cross-sectional study was conducted among 282 physiotherapy students at Kuwait University, focusing on students from the Physical Therapy Department in the College of Allied Health Sciences, of whom 89% were aged 18–22 years and 10% were aged 23–27 years. Participants were selected through purposive and convenience sampling, including second-, third-, and fourth-year students. Data were collected using the DASS-21 scale along with demographic, health, and social support information. Descriptive statistics and ANOVA tests were used to analyze associations between psychological outcomes and the studied variables. Results: Anxiety was the most prevalent condition, with 39.4% of students reporting extremely severe levels. Depression and stress affected 14.2% and 11.3% of students at the same severity level, respectively. Gender differences were examined among the participants (259 females and 23 males), with female students showing significantly higher stress levels than males and second-year students reporting greater depression and stress compared to their senior peers. Students who received support from family and friends exhibited lower levels of psychological distress. Conclusions: This is the first study in Kuwait to examine mental health among physiotherapy students, revealing a high prevalence of depression, anxiety, and stress in this group. The findings highlight the unique academic and clinical pressures faced by physiotherapy students, including intensive coursework, frequent assessments, physically demanding clinical placements, close patient interaction, and the need to integrate theoretical knowledge with hands-on clinical practice, while also emphasizing the protective role of social support. These insights call for targeted mental health strategies and support systems within physiotherapy education to promote student well-being and foster a healthier learning environment. Full article

Background: This study aimed to investigate the association between occlusal splint use and several key parameters, including body position perception, tongue pressure, temporomandibular joint dysfunction (TMD) severity, jaw functional limitation, and neck muscle endurance. Methods: A total of 157 individuals diagnosed with bruxism were screened, and 52 eligible participants were enrolled and divided into two groups: occlusal splint users (n = 26) and non-users (n = 26). Body position perception was assessed with a digital inclinometer, tongue pressure was measured using the Iowa Oral Performance Instrument (IOPI), and neck muscle endurance was evaluated by the Cranio-Cervical Flexion Test (CCFT). TMD severity and jaw functional limitation were assessed via the Fonseca Anamnestic Questionnaire and Jaw Functional Limitation Scale-20, respectively. Gender-based analyses showed higher TMD severity and mandibular limitation scores in females using occlusal splints than in males. Results: No statistically significant differences were found between the splint and non-splint groups in body position perception, tongue pressure and neck muscle endurance (p > 0.05). However, significant differences were observed in the Jaw Functional Limitation Scale (CFKS) subscales. Splint users reported higher functional limitations in chewing, mobility, and expression compared to non-splint users (all p = 0.000), with small effect sizes (d = 0.23–0.29). Conclusions: Occlusal splint use was not associated with better proprioception, orofacial muscle function, or TMD-related symptoms compared with non-splint users. However, splint users were associated with higher mandibular functional limitation based on CFKS subscale scores. Full article

Little attention has been paid to whether an instructor’s hand-pointing gestures or use of a mouse-guided arrow can mitigate the attentional loss caused by an instructor’s happy facial expressions or can enhance the social benefits of these expressions in instructional videos. The goal of the present study is to determine whether social cues in an instructional video affect learning processes and outcomes. The participants were 57 female students from a university. We employed a 2 × 2 mixed experimental design. The instructor’s facial expression was a within-subject variable, while the type of pointing cue was a between-subject variable. Students who had the smiling instructor rather than the bored instructor gave higher ratings of the perceived positive emotion of the instructor, felt more positive emotion, and had more motivation to learn. Eye-tracking technology showed that students who learned with the smiling instructor spent more time looking at the content on the slides than those who learned with a bored instructor. Students who learned with the smiling instructor scored higher on a learning outcome post-test than those who learned with the bored instructor. Among female Chinese students, this pattern is consistent with the five steps posited by the positivity principle, which concludes that people learn better from instructors who exhibit positive social cues. Pointing with a human hand was not superior to pointing with an arrow, suggesting that in this case hand-pointing was not a strong social cue and did not moderate the effects of facial expression. Given the exclusively female sample, future research should examine whether these effects generalize across genders. Full article

Objective: To conduct a scoping review of the global trends of adolescent health inequities and their social determinants from 2000 to 2024 and establish an evidence base for developing targeted intervention strategies. Methods: Guided by the rainbow model, we conducted a bibliometric analysis of 171 peer-reviewed articles related to adolescent health inequalities and their social determinants from the Web of Science Core Collection using CiteSpace 6.3.1 to summarize empirical evidence on how social determinants of health (SDOH) influence adolescents’ health behaviors (e.g., drinking) and health outcomes (e.g., overweight). Results: First, results showed a progressive increase in publications addressing social determinants of adolescent health from 2000 to 2024. Journals in public health and preventive medicine accounted for the highest proportion of articles, with the United States contributing the largest national share (21.05% of global output). Second, an analysis of keywords showed that previous studies mostly focused on the effects of socioeconomic status, family affluence on adolescent health (e.g., physical activity, mental health, and overweight). Third, inequalities in adolescent health were prevalent globally. Health behaviors (e.g., diet, oral health, and smoking) have received widespread attention and are influenced by socioeconomic status, family environment, and gender, whereas various indicators of adolescent health outcomes (e.g., obesity, mental health, and suicide) were highly correlated with family socioeconomic status. Conclusions: To reduce adolescent health disparities, it is important to deepen interdisciplinary research, consider the impact of emerging societal (e.g., digital environments) and environmental factors (e.g., climate change), and develop systematic and comprehensive intervention strategies that encompass the individual, family, school, community, and national levels. Full article

Background: Identifying factors associated with cognitive impairment among older adults is critical. This study investigates both concurrent and longitudinal associations between sleep quality, sleep duration, and cognitive performance among older adults in China, with particular emphasis on the moderating role of fruit and/or vegetable intake (FVI), a factor rarely examined in previous research. Methods: We pooled five waves of a specially designed nationwide sample of adults aged 65 years or older (N = 64,690; mean age: 86.3 years; men: 43.5%) in 2005, 2008, 2011, 2014, and 2018 in China. Cognitive impairment was assessed by the Mini-Mental State Examination. Among the sample, 10.7% were cognitively impaired. FVI was dichotomized into frequent (almost daily) versus infrequent (other low frequencies). Sleep hours were grouped into short (≤6 h), normal (7–9 h), and long (≥10 h) durations. Both concurrent and cross-lagged analyses were performed after adjusting for a wide set of covariates (demographics, socioeconomic status, family/social connections, health practices, disability, self-rated health, and chronic conditions). Analyses were further stratified by gender, age group, and urban–rural residence. Results: When all covariates were present (the full model), good sleep quality was associated with 22% lower odds of the prevalence of cognitive impairment, whereas the long sleep duration was associated with 24% higher odds as compared with the normal sleep duration. Although the short sleep duration was not associated with the prevalence of cognitive impairment in the full model, it was associated with 8% higher odds of cognitive impairment when health condition was not controlled for. Interaction analyses revealed that frequent FVI buffered the adverse cognitive effects of poor sleep quality and both short and long sleep durations. Subgroup analyses further show similar patterns across subpopulations, with more pronounced protective associations in older women and the oldest-old. Conclusions: Good sleep quality, normal sleep durations, and frequent FVI jointly contribute to better cognitive functioning at older ages. While the observed relationships are largely concurrent rather than causal, promoting both healthy sleep and dietary habits may be important for cognitive health among older adults. Full article

As China’s population ages and the sustainability of the public pension system is at risk, personal savings become crucial. As such, the quality of financial planning for retirement (FPR) has been recognized as a key to safeguarding financial well-being during retirement. This study examines the relationships of two predictors (future time perspective and risk tolerance) and a mediator (subjective financial literacy) in shaping financial planning for retirement, with particular attention to potential gender differences. Using survey data retrieved from respondents aged between 23 and 60 years old, overall sample and gender-based multigroup analysis were used to examine whether gender moderates these relationships. The results reveal that both future time perspective and subjective financial literacy positively influence financial planning for retirement across all gender groups. Notably, we found no significant gender gap in retirement planning behavior. Subjective financial literacy serves as a significant mediator linking both future time perspective and risk tolerance to retirement planning, though the indirect effect of risk tolerance through financial literacy differs significantly between genders. Academically, theoretical propositions related to retirement planning can be accounted for by both genders. Practically, standardized policy can be tailored to address retirement issues across genders. The study emphasizes that financial planning for retirement in China shows no gender gap, and this provides meaningful guidance to policymakers and financial institutions to develop measures to encourage individuals to take financial actions in retirement planning. Finally, the combined interpretation of a strong effect of subjective financial literacy and an insignificant effect of risk tolerance raises concern that adult income earners in China are affected by financial literacy bias when practicing financial retirement planning. Full article

Social competence in early childhood is a foundational, multifaceted construct and a strong predictor of academic and behavioral outcomes. Difficulties in this domain are often linked to challenges in forming positive peer relationships. The present study investigates the association between children’s social competence and peer exclusion, while examining the effect of gender in both domains. Participants were 312 children (3–5 years old) from 39 early childhood education and care classrooms in Greece. Construct validity for the adapted version of the Social Behavior Scale was initially established, supporting its proposed three-dimensional structure, comprising emotional competence, social engagement, and aggressiveness. Measurement equivalence across gender was also confirmed at all levels. Structural Equation Modeling revealed moderate associations between peer exclusion and two dimensions of social competence (i.e., emotional competence and aggressiveness). Gender effects were identified only for aggressiveness, with boys exhibiting slightly higher levels of aggressive behavior. Mediation analysis further revealed that gender exerted an indirect effect on peer exclusion through aggressiveness. The findings highlight the importance of addressing specific behavioral patterns, rather than gender alone, when designing interventions to foster positive peer relations and support children’s social development in early childhood education and care. Full article

Background: Existing evaluations of large language models (LLMs) largely emphasize linguistic and factual performance, while their psychometric characteristics and behavioral biases remain insufficiently examined, particularly beyond English-language contexts. This study presents a systematic psychometric screening of LLMs in German using the validated Big Five Inventory-2 (BFI-2). Methods: Thirty-two contemporary commercial and open-source LLMs completed all 60 BFI-2 items 60 times each (once with and once without having to justify their answers), yielding over 330,000 responses. Models answered independently, under male and female impersonation, and with and without required justifications. Responses were compared to German human reference data using Welch’s t-tests ($p<0.01$) to assess deviations, response stability, justification effects, and gender differences. Results: At the domain level, LLM personality profiles broadly align with human means. Facet-level analyses, however, reveal systematic deviations, including inflated agreement—especially in Agreeableness and Aesthetic Sensitivity—and reduced Negative Emotionality. Only a few models show minimal deviations. Justification prompts significantly altered responses in 56% of models, often increasing variability. Commercial models exhibited substantially higher response stability than open-source models. Gender impersonation affected up to 25% of BFI-2 items, reflecting and occasionally amplifying human gender differences. Conclusions: This study introduces a reproducible psychometric framework for benchmarking LLM behavior against validated human norms and shows that LLMs produce stable yet systematically biased personality-like response patterns. Psychometric screening could therefore complement traditional LLM evaluation in sensitive applications. Full article

University students worldwide experience considerable health challenges. We examined health inequalities in a nationwide, gender-balanced sample of 1105 German students, considering negative (stress, depression, burnout) and positive health outcomes (self-rated health [SRH], well-being) alongside vertical (subjective social status [SSS], parental academic background) and horizontal (gender) determinants. Analyses used bivariate statistics, multivariate regressions, and interaction terms. Higher SSS was associated with better SRH (β = 0.322) and well-being (β = 0.355), and lower stress (β = −0.154), depression (β = −0.127), and burnout (β = −0.219). First-generation students reported highly significant poorer SRH and well-being than students with one (β = 0.114; β = 0.112) or two academic parents (β = 0.162; β = 0.192). Students with two academic parents showed lower stress (β = −0.087, p = 0.007) and burnout (β = −0.099, p = 0.002). Interactions suggest a protective effect of higher SSS on depression (β = −0.219, p = 0.026) and burnout (β = −0.264, p = 0.006), more pronounced among male students, who additionally benefited more from an academic household regarding SRH (β = 0.100, p = 0.044). These findings underscore intersectional and multifaceted inequalities among German students and the need for interventions. Full article