Search Results (796)

This study investigates how gender-inclusive leadership and trade integration shape environmental sustainability in China, addressing a key gap in the literature where most prior work has focused on aggregate governance, finance, or growth without considering how gender representation in leadership and trade openness jointly relate to environmental outcomes. China provides a particularly relevant setting because it is both a leading global emitter and one of the world’s most trade-integrated and rapidly growing economies, so changes in leadership structures, financial deepening, and external openness can have sizable environmental consequences. Given the nonlinear and non-normal nature of the variables, the analysis relies on nonlinear econometric tools, specifically quantile-on-quantile ARDL and Quantile Granger Causality, applied to quarterly data from 1998Q1 to 2024Q4. The results show that the impact of gender-inclusive leadership on environmental sustainability is state-dependent, with improvements at lower environmental pressure but a predominantly negative long-run association at mid to upper quantiles, while financial development tends to support sustainability, and economic growth and trade openness are generally linked to lower sustainability across much of the quantile range. By narrowing the research gap on gender-inclusive leadership and explicitly motivating China as a critical case, this study offers context-specific evidence that can guide policies aimed at fostering inclusive leadership and greener finance while carefully managing the environmental consequences of rapid growth and deeper trade integration. Full article

Women play a key role in Greek olive cultivation, a sector at the heart of local economies currently facing increasing pressures from climate change. This study explores gender roles, responsibilities, and access to resources shaping the adoption of sustainable agriculture practices. Through in-depth interviews with female farmers on the island of Crete, the results show that women face limited access to training and financial services as well as gender-based discrimination and the hidden caregiving and house working tasks. However, they manifest a strong openness towards sustainable practices, driven by environmental values, even among those lacking decision-making authority. Despite these challenges, women show a positive attitude toward learning and innovation, calling for more institutional support and training opportunities. This study sheds light on the need for recognition of women’s roles in agriculture, particularly in the context of climate adaptation, and offers practical recommendations to improve gender roles within the olive sector. 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

Mangrove ecosystems underpin coastal livelihoods and biodiversity in Mozambique, yet gendered patterns of resource use and their implications for management remain underexplored. This study explores how artisanal fishing and shellfish collection differ between men and women on Inhaca Island (Maputo Bay), focusing on how these gender-specific practices shape livelihood outcomes, spatial use of mangroves, and perceptions of ecological change. To address this question, we combined structured interviews (n = 35; 51.4% men, 48.6% women) and camera-trap monitoring in two mangrove areas during September 2024 to document fishing practices, catch characteristics, spatial patterns, and ecological perceptions. We found pronounced gendered divisions of labor and space use: men, using boats and nets, harvested a median of 15 kg of fish per day for commercial sale, generating cash income, whereas women collected a median of 3 kg of shellfish by hand, primarily for household consumption. Camera traps confirmed pronounced spatial segregation in mangrove use: women foraged in targeted areas, and men traversed broader zones, both synchronizing their activities with tidal and daylight cycles. By integrating social and ecological data, the study revealed nuanced gender roles and resource pressures, with 82.9% of participants reporting declines in fish and shellfish stocks, emphasizing mangroves’ critical role in livelihoods, biodiversity, and climate resilience. Our findings highlight the value of mixed-method approaches for understanding socio-ecological dynamics and advocate for gender-sensitive conservation policies, strengthened Community Fisheries Councils, and infrastructure investments to regulate resource use, enhance mangrove management, and promote equitable livelihoods in Mozambique’s coastal communities. Full article

Background: Burnout, a syndrome of emotional exhaustion, cynicism, and reduced personal accomplishment, is a significant concern among dental students because of the intense demands of their academic and clinical training. This study aimed to determine the prevalence of burnout and its related dimensions among dental students at King Khalid University, Abha, Saudi Arabia. Methods: A cross-sectional study was conducted among 300 dental students (147 males, 153 females) from the 4th year to the internship level, selected via simple random sampling. A 12-item survey called the Burnout Clinical Subtype Questionnaire-12-Student Survey (BCSQ-12-SS) was validated for use with students. Burnout was assessed across three domains—Overload, Lack of Development, and Neglect. Descriptive statistics, Mann–Whitney U tests, and Kruskal–Wallis analyses were employed to explore gender- and year-based differences. Results: Overload and Lack of Development were the most prominent burnout dimensions, with more than half of participants reporting excessive academic pressure, personal sacrifices, and dissatisfaction with developmental opportunities. Neglect demonstrated the lowest prevalence. Female students exhibited significantly higher total burnout scores (p = 0.005). Burnout varied across academic years, peaking among fourth-year students (p < 0.001). Internal consistency for all domains was acceptable to excellent (α = 0.62–0.89). Conclusions: Burnout is highly prevalent, particularly in the domains of Overload and Lack of Development. Female and mid-program students represent high-risk groups. Institutional reforms, curricular enhancement, workload redistribution, structured support systems, and early mental-health interventions are crucial to mitigate burnout and promote student well-being. Full article

With the promotion and development of anime, manga, and video games in Japan and beyond, a substantial number of fans have been attracted. These people began to dress up as their favorite characters. Cosplay has found applications in different fields. This essay argues that cosplay has played a positive role in promoting gender expression, enhancing mental health, and fostering cultural consumption that transcends mere escapism. Cosplay provides a safe environment for gender expression, challenging traditional gender norms, embracing diversity of gender expression, and allowing cosplayers to showcase their gender identities. Cosplay helps cosplayers not only overcome mental pressure in real life by enabling them to play superheroes and build their resilience, but also brings them a sense of achievement and cultivates their problem-solving abilities through the creation of costumes. Cosplayers utilize these characters for cultural consumption, promoting the cosplay-related economic industry in Japan. Cosplayers, audiences, and organizers of anime conventions form a sustainable consumption cycle by making or purchasing costumes, spending money on merchandise, and organizing comic conventions. Cosplay has driven economic benefits in the catering, photography, and venue rental industries by incorporating anime themes and catering to the demands of three major consumer groups. Full article

Background/Objectives: Body self-image interacts with young adults’ health behaviors in complex ways, yet its role in shaping supplement use is not well defined. This study examined young adults’ body self-image and their use of dietary supplements commonly marketed to enhance physique, fitness, and weight outcomes. Methods: College students (N = 122; 18–28 years) completed the Body Self-Image Questionnaire-Short Form to assess body self-image and answered three dichotomous questions related to general dietary (DS), performance-enhancing (PES), and weight-loss (WLS) supplement use. Student scores were calculated across nine psychological subscale groups and ranked as high, moderate, or low percentile within our study sample. Chi-square analyses examined supplement prevalence in student responses ranked within the highest and lowest tertiles; middle tertile data were excluded as part of the extreme-group design. All responses were included in the logistical regression analysis. Results: Higher scores for the Investment in Ideals and Health-Fitness Evaluation subscales observed significantly higher PES use; both subscales and the male gender were significant predictors of PES use. Higher scores for the Fatness Evaluation, Negative Affect, and Social Dependence subscales observed significantly higher WLS use; Fatness Evaluation and age were significant predictors of WLS use. Subscales were not significantly associated with general supplement use in chi-square or logistical regression analyses. Conclusions: Our findings suggest that internalized appearance ideals, emotional distress, and social approval pressures are linked to weight- and physique-driven supplement behaviors in college students. Targeted, inclusive campus wellness initiatives are needed to address psychological drivers of weight-management practices, including potentially high-risk supplement use. Full article

Background/Objective: Emerging evidence indicates that temporomandibular disorders (TMD) patients may present features of nociplastic pain (NP), characterized by central sensitization (CS)-related symptoms. This study aims to identify factors associated with CS-related symptoms and pain sensitivity in patients with TMD and NP-related features. Methods: In this cross-sectional study, 43 TMD patients were assessed for CS-related symptoms (CSI), proximal, distal, global pressure pain threshold (PPTs, algometer), orofacial pain intensity (VAS), jaw impairment (FAI), maximal isometric strength of four muscle groups (dynamometer), resting heart rate (RHR, chest band), kinesiophobia (TKS-11), physical activity level (IPAQ), anxiety (HADS), and sleep quality (PSQI). Associations were analyzed using linear regression models adjusted for gender, age, and symptoms duration. Results: Multivariate analysis showed that higher CSI was significantly associated with greater jaw impairment (Estimate 0.09, 95% CI 0.01 to 0.18) and higher pain intensity (Estimate 0.26, 95% CI 0.14 to 0.38). Lower PPT was significantly associated with lower grip strength (Proximal: Estimate 0.03, 95% CI 0.01 to 0.05; Distal: Estimate 0.07, 95% CI 0.01 to 0.14; Global: Estimate 2.44, 95% CI 0.57 to 4.31), and proximal PPT with higher RHR (Estimate −0.02, 95% CI −0.03 to 0). Conclusions: Association was found between CS-related symptoms and pain intensity and jaw impairment, while lower PPTs were related to decreased maximal isometric grip strength and elevated RHR, thus highlighting the need for multimodal treatment in TMD patients. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease worldwide. It greatly increases hepatic cirrhosis and cancer, cardiovascular disease, and chronic kidney disease. Despite the rising frequency of MASLD in Saudi Arabia, public understanding of its management is lacking. Objective: This study seeks to evaluate public knowledge, attitudes, and management barriers related to MASLD, thereby informing future educational and preventive strategies. Methods: A cross-sectional study was conducted from November 2023 to October 2024, involving 502 participants across Saudi Arabia, employing a modified self-administered online questionnaire. Data was analyzed using SPSS 25. Descriptive statistics and Chi-square tests were used to investigate correlations between knowledge or attitude levels and demographics, with a significance threshold of p < 0.05. Results: Less than half of the respondents who took part (47.2%) had heard of MASLD. Of them, 24.9% had good knowledge, 38.2% had fair knowledge, and 36.9% had low understanding. There were strong links between knowledge and age, education, and job status, but not between knowledge and gender (p = 0.514). People were somewhat aware that being overweight (48.4%) and having high cholesterol (51.8%) were risk factors, but they often had wrong ideas regarding diabetes and high blood pressure. Only 7.8% of those surveyed said they had been formally diagnosed, and 74.4% of those who had been were given advice on how to change their lifestyle. Barriers to management included the idea that lifestyle change alone suffices (46.7%), the absence of medical advice (46.7%), and insufficient disease awareness (33.3%). Conclusions: The research shows that many Saudis are unaware of MASLD and have misconceptions about it. Targeted health education programs, greater provider–patient communication, and primary care MASLD knowledge are needed to close these gaps and promote disease prevention and management. Full article

Background: Non-communicable diseases (NCDs) such as cardiovascular diseases, diabetes, obesity, and cancer are the leading cause of mortality globally and in Saudi Arabia, accounting for more than 70% of all deaths. Despite national initiatives offering free preventive services, screening uptake remains low. This study aimed to describe the demographic and clinical characteristics of individuals participating in community-based NCD screening campaigns in the Eastern Province of Saudi Arabia and to evaluate screening uptake, compliance, and diagnostic outcomes. Methods: A retrospective cross-sectional analysis was conducted among 3106 adults screened at volunteer-driven community campaigns held between January 2023 and December 2024. Screening included anthropometric measurements, blood pressure assessment, and glucose testing, followed by eligibility evaluation for osteoporosis and cancer screening. Uptake and compliance were verified using electronic health records. Descriptive and inferential statistical analyses were applied. Results: Participants were 64% male and 36% female, with a mean age of 41.4 ± SD years. Obesity, hypertension, and diabetes were identified in 32%, 31%, and 12% of participants overall. Gender-stratified prevalence showed higher obesity among females at 36% (95% CI 32.3 to 38.1) and higher hypertension and diabetes among males at 36% (95% CI 34.0 to 38.2) and 14% (95% CI 12.1 to 15.2), respectively. Uptake among eligible individuals was 51% for dual-energy X-ray absorptiometry (DEXA), 47% for fecal immunochemical testing (FIT), 43% for Pap smear, and 39% for mammography. Diagnostic findings demonstrated substantial undetected disease burden, including osteoporosis in 41% (95% CI 26.0 to 56.8) of DEXA scans, a FIT positivity rate of 5% (95% CI 1.5 to 10.3), abnormal Pap cytology in 3% (95% CI 1.1 to 7.5), and BI-RADS 0 mammograms in 19% (95% CI 11.9 to 29.5), reflecting incomplete assessments requiring further evaluation. Conclusions: Community-based campaigns can effectively resolve limited engagement in health promotional activities and detect substantial burdens of undiagnosed NCDs. However, improvements in referral tracking, follow-up systems, and culturally tailored health education are essential to enhance screening compliance and early detection outcomes. These results can be utilized to inform public policies by extending screening services to additional areas, increasing investment in preventive health campaigns, and enhancing the capacity of the health system. Full article

Background: Iodine deficiency remains a significant public health concern worldwide and may contribute to metabolic disorders beyond thyroid dysfunction. Emerging evidence suggests that nutritional factors, such as vitamin A, may influence the health effects of iodine deficiency, yet population-based evidence remains limited. This study aimed to investigate the associations between iodine deficiency and cardiometabolic risk factors (blood pressure, glucose, and lipids) and to explore whether these associations are different between adults with different vitamin A levels. Methods: A total of 4723 adults (1895 males and 2828 females) were included in this cross-sectional study. Participants were categorized based on iodine status and serum vitamin A levels. Demographic, anthropometric, and biochemical indicators were assessed through standardized examinations. Multivariable linear and logistic regression models were used to evaluate the associations between iodine deficiency and continuous (systolic blood pressure [SBP], diastolic blood pressure [DBP], fasting blood glucose [FBG], total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], triglycerides [TGs]) and binary outcomes (hypertension, hyperglycemia, and dyslipidemia), with stratified analyses by gender, age, and vitamin A status. Results: Iodine deficiency was significantly associated with higher SBP (β = 2.89, 95% confidence interval [CI]: 2.00–3.77), DBP (β = 1.08, 0.55–1.60), FBG (β = 0.06, 0.01–0.12) and TC (β = 0.05, 0.00–0.10). The odds of hypertension (odds ratio [OR] = 1.41, 1.23–1.63) and hyperglycemia (OR = 1.39, 1.17–1.65) were also increased. Stratified analyses indicated that these associations were more pronounced among participants with vitamin A deficiency than those with sufficient vitamin A. In this subgroup, iodine deficiency was positively associated with FBG (β = 0.14, 0.03–0.25), TC (β = 0.08, 0.00–0.15), and hyperglycemia (OR = 1.35, 1.04–1.76). Conclusions: The findings suggest that the association of iodine deficiency with adverse cardiometabolic risk factors may be stronger in individuals with concurrent vitamin A deficiency. This highlights the potential value of integrated nutritional assessments and supports the need for longitudinal studies to confirm these interactions and assess the effects of combined micronutrient supplementation. Full article

Ecosystems provide essential services to local communities, which in turn offer incentives for the preservation of natural resources, as these resources are crucial to the sustainability and evolution of human societies. So, this study examined the demand for ecosystem services among communities surrounding the Luki Biosphere Reserve in the Democratic Republic of Congo. Data were collected through semi-structured interviews with 361 randomly selected individuals and focus group discussions in 18 villages, complemented by field observations on local resource use (agriculture, charcoal production, wood harvesting, and tree felling). The services provided by the reserve were identified according to citation frequency, perceived usefulness, and level of agreement among respondents. Results indicate that agricultural products (28.5%), charcoal (19.1%), non-timber forest products (17.5%), and firewood (10%) are the most requested. The Chi-square test showed significant associations between dependence on ecosystem services and socio-economic variables such as gender (p = 0.014 < 0.05), education level (p = 0.033 < 0.05), and annual income (p = 0.000 < 0.05), while age was not significant (p = 0.504 > 0.05). Poverty and rapid demographic growth were identified as key drivers of demand and factors contributing to growing pressure on natural resources. The study emphasizes feedback loops between changes in ecosystem service supply and community responses, as well as trade-offs between services and actors. It recommends integrating ecosystem values into agricultural and forestry policies, while raising awareness and educating local communities to promote sustainable resource management. Full article

Modern romantic relationships face increasing internal and external pressures that may leave partners emotionally depleted and overwhelmed, yet empirical tools for assessing relationship burnout remain limited, mononormative, and psychometrically underdeveloped. Across two studies, we developed and validated the Antecedents of Relationship Burnout Scale (ARBS), a multidimensional measure grounded in the Job Demands–Resources (JD–R) model and designed to capture the relational demands and resource deficits that precipitate burnout. Study 1 generated and evaluated an initial 51-item pool using a sample of 175 partnered adults. Exploratory factor analysis revealed a clear and robust two-factor structure: Relationship Depletion and Exhaustion (e.g., emotional detachment, diminished appreciation, unmet emotional/sexual needs) and Relational Overload (e.g., external stressors, partner demands, role strain). Study 2 sought to confirm this structure and establish the ARBS’s psychometric validity via a sample of 288 adults. A confirmatory factor analysis supported a 36-item two-factor model with strong internal consistency, full measurement invariance across gender, and theory-consistent associations with relationship satisfaction, therapy participation, and infidelity urge, demonstrating both convergent and predictive validity. Together, these studies introduce the ARBS as the first comprehensive, theoretically grounded measure of the antecedents of relationship burnout, offering a rigorous foundation for future research, assessment, and intervention. Full article

This study describes the developed special prototype of a wearable measuring device based on a photoplethysmography (PPG) sensor. It contains also a humidity sensor and a thermometer to measure skin moisture and temperature, and a force-sensitive (FSR) element to sense a contact pressure between the measuring probe and the skin surface. All parts of the multi-sensor are shielded, to be applicable in a weak magnetic field environment. After the basic sensor’s functionality verification inside the magnetic resonance imaging tomograph, a set of experiments was performed. Comparative measurements by an oximeter confirm good correspondence with heart rate values determined from PPG (HR_PPG) and FSR (HR_FSR) signals—the mean absolute error lies below 0.5 min⁻¹ for both types. The sensing of PPG signals on wrists was realized for Normal, Dry, and Wet skin. In comparison with normal skin conditions, drying decreases the PPG signal range by 7% and the systolic pulse width by 8%, while moistening increases the signal ripple by 3% and decreases the correlation between HR_PPG and HR_FSR values by 5%. The detailed analysis per hand and gender types yields differences between male and female subjects, while the results for left and right hands differ less. Full article