Search Results (548)

Introduction: This prospective descriptive study explored the disparities in perceptions and experiences regarding healthcare services between providers and users during the COVID-19 pandemic, with a specific focus on the impact of the digital divide on access to and quality of care. The study revealed significant inconsistencies in the experiences of healthcare providers and patients, particularly regarding the effectiveness of digital health interventions. Methods: This study was a prospective descriptive analysis conducted to evaluate and compare the use of electronic healthcare services between healthcare employees (HΕs) (N = 290) and consumers (Cs) (N = 263) from December 2024 to May 2025, utilizing an electronic survey after the COVID-19 pandemic. To ensure the statistical validity of the sample size, a power analysis was performed using G*Power 3.1.9.2 software. A questionnaire was developed to evaluate the readiness of healthcare employees and consumers for electronic healthcare services. It was validated to ensure reliability within this population and comprised 49 questions. Results: The response rate of the participants was 89.19%, and the Cronbach’s alpha for the questionnaire was 0.738. The study revealed notable differences in perceptions regarding health-related information and digital health technologies across genders and age groups. Specifically, 28.8% of females and 27.3% of males considered it important to be well-informed about health issues (χ² = 8.83, df = 3, p = 0.032). Conclusions: This research contributes to filling a gap in comparative analyses of provider and user perspectives, offering a comprehensive view of how digital health was adopted and experienced during a global crisis. Practically, it provides an evidence base to guide future interventions aimed at fostering more equitable, resilient, and user-friendly digital healthcare systems. Full article

Farming is a uniquely demanding occupation, with family and work often deeply intertwined. Whilst this integration is common amongst the agricultural sector in Ireland (99.7% farms classified as family), it can lead to a conflict of responsibilities, but this has not been examined to date. Therefore, this study aimed to examine work–family conflict (WFC) in farmers in Ireland, and if WFC differs based on socio-demographic factors, mental health, social support and farm-specific stressors. A cross-sectional study examined WFC in 446 farmers in Ireland. Depression, anxiety, stress, suicidality, general mental health, psychological flexibility, cognitive fusion, self-experience, perceived social support, farm stress and attachment were also measured. Participants reported moderately high levels of WFC (25.1 ± 7.2). Being younger, male, having children aged 5 years or less, higher reported working hours on the farm, higher farm-specific stressors, and lower psychological flexibility contributed to higher WFC. In addition, lower social support, mental health and psychological skills were significantly associated with higher WFC. Future research should consider the integrated nature of work and family in farm life and use a qualitative approach to further understand gendered experiences of WFC. Full article

Environmental contaminants exhibit heterogeneous neurotoxicity profiles, yet systematic comparisons between legacy neurotoxicants and emerging pollutants remain scarce. To address this gap, we implemented an integrative transcriptome meta-analysis framework that harmonized eight transcriptomic datasets spanning in vivo and in vitro neural models exposed to two legacy neurotoxicants (bisphenol A [BPA], 2, 2′, 4, 4′-tetrabromodiphenyl ether [BDE-47]) and polystyrene nanoplastics (PSNPs) as an emerging contaminant. Our analysis revealed a substantial overlap (68% consistency) in differentially expressed genes (DEGs) between BPA and PSNPs, with shared enrichment in extracellular matrix disruption pathways (e.g., “fibronectin binding” and “collagen binding”, p < 0.05). Network-based toxicogenomic mapping linked all three contaminants to six neurological disorders, with BPA showing the strongest associations with Hepatolenticular Degeneration. Crucially, a sex-stratified analysis uncovered male-specific transcriptional responses to BPA (e.g., lipid metabolism and immune response dysregulation), whereas female models showed no equivalent enrichment. This highlights the sex-specific transcriptional characteristics of BPA exposure. This study establishes a novel computational toxicology workflow that bridges legacy and emerging contaminant research, providing mechanistic insights for chemical prioritization and gender-specific risk assessment. Full article

Autism Spectrum Disorder (ASD) encompasses various neurological disorders with symptoms varying by age, development, genetics, and other factors. Core symptoms include decreased pain sensitivity, difficulty sustaining eye contact, incorrect auditory responses, and social engagement issues. Diagnosing ASD poses challenges as signs can appear at early stages of life, leading to delayed diagnoses. Traditional diagnosis relies mainly on clinical observation, which is a subjective and time-consuming approach. However, AI-driven techniques, primarily those within machine learning and deep learning, are becoming increasingly prevalent for the efficient and objective detection and classification of ASD. In this work, we review and discuss the most relevant related literature between January 2016 and May 2024 by focusing on ASD detection or classification using diverse technologies, including magnetic resonance imaging, facial images, questionnaires, electroencephalogram, and eye tracking data. Our analysis encompasses works from major research repositories, including WoS, PubMed, Scopus, and IEEE. We discuss rehabilitation techniques, the structure of public and private datasets, and the challenges of automated ASD detection, classification, and therapy by highlighting emerging trends, gaps, and future research directions. Among the most interesting findings of this review are the relevance of questionnaires and genetics in the early detection of ASD, as well as the prevalence of datasets that are biased toward specific genders, ethnicities, or geographic locations, restricting their applicability. This document serves as a comprehensive resource for researchers, clinicians, and stakeholders, promoting a deeper understanding and advancement of AI applications in the evaluation and management of ASD. Full article

The MAM domain-containing glycosylphosphatidylinositol anchor 1 (MDGA1) gene, which encodes a protein involved in synaptic inhibition, has been identified as a potential risk gene for restless legs syndrome. A recent study in the Chinese population described increased MDGA1 methylation levels in patients with idiopathic RLS (iRLS) compared to healthy controls. In this study, we investigated the possible association between the most common variants in the MDGA1 gene and the risk for iRLS in a Caucasian Spanish population. We assessed the frequencies of MDGA1 rs10947690, MDGA1 rs61151079, and MDGA1 rs79792089 genotypes and allelic variants in 263 patients with idiopathic RLS and 280 healthy controls using a specific TaqMan-based qPCR assay. We also analyzed the possible influence of the genotype frequencies on several variables, including age at the onset of RLS, gender, a family history of RLS, and response to drugs commonly used in the treatment of RLS. The frequencies of the genotypes and allelic variants of the three common missense SNVs studied did not differ significantly between RLS patients and controls, neither in the whole series nor when analyzing each gender separately; were not correlated with age at onset and the severity of RLS assessed by the International Restless Legs Syndrome Study Group Rating Scale (IRLSSGRS); and were not related to a family history of RLS or the pharmacological response to dopamine agonists, clonazepam, or gabaergic drugs. Our findings suggest that common missense SNVs in the MDGA1 gene are not associated with the risk of developing idiopathic RLS in Caucasian Spanish people. Full article

Tourist satisfaction models typically assume that service performance dimensions carry the same weight for all travelers. Drawing on Bourdieu, we reconceptualize age, gender, and region of origin as demographic capital, durable resources that mediate how visitors decode service cues. Using a SERVPERF-based survey of 407 international travelers departing Quito (Ecuador), we test measurement invariance across six sociodemographic strata with multi-group confirmatory factor analysis. The four-factor SERVPERF core (Access, Lodging, Extra-hotel Services, Attractions) holds, yet partial metric invariance emerges: specific loadings flex with demographic capital. Gen-Z travelers penalize transport reliability and safety; female visitors reward cleanliness and empathy; and Latin American guests are the most critical of basic organization. These patterns expose a boundary condition for universalistic satisfaction models and elevate demographic capital from a descriptive tag to a structuring construct. Managerially, we translate the findings into segment-sensitive levers, visible security for youth and regional markets, gender-responsive facility upgrades, and dual eco-luxury versus digital-detox bundles for long-haul segments. By demonstrating when and how SERVPERF fractures across sociodemographic lines, this study intervenes in three theoretical conversations: (1) capital-based readings of consumption, (2) the search for boundary conditions in service-quality measurement, and (3) the shift from segmentation to capital-sensitive interpretation in emerging markets. The results position Ecuador as a critical case and provide a template for destinations facing similar performance–perception mismatches in the Global South. Full article

This article examines the impact of everyday life infrastructure on well-being through the lens of feminist economics, with a specific focus on gender disparities within the European context. Combining the capability approach (CA) and subjective well-being (SWB) theory, this study introduces a gender-sensitive well-being budget indicator, the Well-being and Infrastructure by Gender Index, or just WIGI, to assess the differential impacts of public expenditures on women and men. Drawing on feminist critiques of infrastructure planning, it highlights how gendered patterns of access and use shape experiences of well-being. The literature review synthesizes recent contributions on well-being measurement, gendered capabilities, and the role of public infrastructure in supporting everyday life. The research utilizes the Benefits of Gender Equality through infrastructure Provision (BGGEIP) survey from the European Institute for Gender Equality (EIGE) from 28 EU member states in 2015 to evaluate the contribution of key public services—such as transport, childcare, and healthcare—to individual capabilities and subjective well-being outcomes. The findings underscore the importance of integrating gender-sensitive methodologies into infrastructure planning and public policy to promote social inclusion and equitable well-being outcomes. This article concludes by advocating for feminist economics-informed policies to enhance the responsiveness of public investments to the lived experiences of women and men across Europe. Full article

Healthcare-associated infections (HAIs), also referred to as nosocomial or hospital-acquired infections, are a significant cause of death worldwide, with hand hygiene being the most powerful means to tackle them. The present study had a twofold aim: first, to assess the level of knowledge and the degree of compliance with hand hygiene practices based on healthcare workers’ self-reports; second, to evaluate whether behavioral economics techniques, specifically a poster combining an image and an informational message, designed according to the published literature, can increase the level of healthcare workers’ compliance with hand hygiene. Factors that potentially affect compliance were also examined. This study involved distributing a questionnaire to healthcare workers in Greek public hospitals, from which 314 completed responses were collected during the last quarter of 2023. Participants were randomly and evenly assigned to an intervention group that received a nudging poster or to a control group, which did not. Self-reported compliance with hand hygiene practices was high, based on two latent variables derived through exploratory factor analysis, although knowledge of germ transmission was moderate, as reflected in the relevant knowledge question scores. However, nudging had no statistically significant effect on hand hygiene behavior. Compliance was associated with several factors, including gender, age, work experience, profession, perceived adequacy of available hygiene-related resources, and perceived consequences of nosocomial infections on patient outcomes. Full article

Background: Pulmonary arterial hypertension (PAH) is a rare and severe condition characterized by increased pulmonary arterial pressure and vascular resistance. Women are more susceptible to PAH yet have higher survival rates than men, a phenomenon called the “estrogen paradox”. This study aims to investigate the sex-based differences in PAH using plasma untargeted metabolomics. Methods: Plasma samples were collected from 43 PAH patients and 37 healthy controls. The samples were analyzed using two complementary analytical techniques: gas chromatography–mass spectrometry (GC-QqQ/MS) and liquid chromatography–mass spectrometry (LC-Q-ToF/MS). The metabolic differences between male and female PAH patients and controls were identified using multivariate statistical analyses. Results: Our results show changes in the lipid, fatty acid, and amino acid metabolism in both sexes. Women presented additional changes in the carbohydrate, bile acid, and nucleotide metabolism. The metabolites affected by PAH in women included decreased threonine, tryptophan, and lipid intermediates and elevated bile acids. Men were found to have additional changes in the heme catabolism, cholesterol synthesis, and lipoxygenase pathways. The metabolites affected by PAH in men included decreased branched-chain amino acids and increased bilirubin, phospholipids, and oxidized fatty acids. Conclusions: The gender differences observed in the development of PAH are likely multifactorial. While estrogens and potentially other sex hormones have been implicated in modulating relevant biological pathways, their exact role in disease progression and pathogenesis remains to be fully elucidated. The specific metabolic changes in women and men point to distinct disease mechanisms, potentially explaining the differences in prevalence, prognosis, and treatment response of patients with PAH. The obtained results should be validated with the use of targeted quantitative analyses and larger numbers of patients. Full article

Carotid stenosis is a common pathology in clinical practice and unfortunately carries a high risk of serious cerebrovascular events. The early recognition of carotid plaque and, consequently, a careful analysis by means of multimodal imaging are the necessary steps to undertake a correct management pathway, aimed at preventing or, if not possible, reducing the risk of atherogenic phenomena responsible for cerebral infarction. In particular, the presence or absence of clinical symptoms, understood as the occurrence of events such as TIAs in the last 6 months, non-disabling strokes or repeated episodes of amaurosis fugax, and the degree of carotid stenosis, are certainly the most studied parameters, and as reported by several international guidelines, can lead to the best therapeutic strategy: whether to rely on conservative medical therapy or to resort to mechanical revascularization of the carotid stenosis. According to the recommendations of the European Society of Vascular Surgery, mechanical revascularization is recommended for stenosis > 50% in symptomatic patients and stenosis > 60% in asymptomatic patients. In contrast, the latest findings on plaque vulnerability have focused attention on individual patient characteristics and clinical comorbidities that may be responsible for plaque inflammation and should therefore be taken into consideration to decide if revascularization treatment is needed even in those subjects who present stenosis with less degree than reported as critical value. Moreover, further radiological investigations are fundamental to finding the presence of entities such as plaque ulceration, plaque neo-vascularization, fibrous caps, and intraplaque lipid core that are responsible for increased vulnerability. Medical therapy involves interventions aimed at eliminating cardiovascular risk factors by administering drugs that control the comorbidities responsible for worsening carotid stenosis. Recent studies are also evaluating the effectiveness of new plaque-modifying drugs or targeted anti-inflammatory agents in reducing the risk of plaque development and complications. Revascularization therapies, on the other hand, include surgery (CEA), the endovascular technique (CAS), and a new hybrid technique (TCAR): they are all valid alternatives for the treatment of carotid stenosis, each with specific technical difficulties, but on the whole with comparable safety profiles and risk rates of postoperative complications, although some recent emergencies have focused attention on possible short- and long-term gender-dependent outcome differences. The aim of this manuscript is to present the state of the art in the management of patients with carotid stenosis and to take a closer look at revascularization options. In our opinion, the choice of one strategy over another should therefore depend on gender, anatomical features of the patient, preoperative comorbidities, and last but not least, the experience of the center and the multidisciplinary team involved in the management of the patient. Full article

The latest Relationships Education, Relationships and Sex Education, and Health Education (RSHE) Draft Guidance seeks to reduce the inclusion of LGBT themes in English schools. Additionally, the Gender Questioning Draft Guidance for Schools and Colleges and the Cass Review overlook the rights of trans and non-binary young people, further intensifying the heated debates surrounding their lives. In response, the author draws upon research conducted in a primary school in Greater London in 2021, when statutory RSHE, including LGBT content, was first introduced. The research aimed to understand how teachers felt about teaching RSHE and to collaborate with them to enhance pupil learning within and beyond the RSHE curriculum. This paper critiques lesson observations and teachers’ reflections on their lessons using a Framework for Sexuality Education and Queer Theory. The researcher’s call to rethink how RSHE is taught should not be taken to mean it should not be taught. To the contrary, the findings suggest a need for the school to broaden its curriculum, teaching methods, and strategies to become a truly ‘LGBT-inclusive’ environment. However, the paper also illuminates the apprehensions these primary school teachers experienced, which in turn influenced pedagogical decisions. The article concludes by recommending specific whole-school approaches and effective pedagogical practices for RSHE in the school, which could be beneficial to other primary school settings. Effective teaching of LGBT themes requires clear support for educators, especially within the complexity of a primary school setting and given the changing political and social climate. Full article

Environmental tobacco smoke (ETS) exposure is a public health concern linked to neurodevelopmental disorders like attention deficit hyperactivity disorder (ADHD). Prior studies link ETS to ADHD, but gaps remain regarding gender differences, critical exposure windows, and dose–response relationships. This study assessed ETS exposure’s association with ADHD-like behaviors in Chinese preschoolers, evaluating overall risk, critical periods, dose–response relationships, and gender differences. Analyzing data from 64,472 preschoolers, ETS exposure (prenatal; infancy, 0–1; and early childhood, 1–3 years) was assessed via parent questionnaires, and ADHD-like behaviors were measured using the Conners’ Parent Rating Scale-Revised, with associations examined via logistic regression. ETS-exposed children had a 49% higher ADHD-like behavior risk (AOR = 1.49, 95% CI: 1.38–1.62, p < 0.001), with dose–response effects: The risk increased from AOR = 1.25 (95% CI: 1.10–1.40) at low exposure to 2.24 (95% CI: 1.63–3.01) at high exposure. Prenatal (AOR = 1.42, 95% CI: 1.17–1.71) and infancy exposures (AOR = 1.43, 95% CI: 1.05–1.90) showed the strongest associations, while early childhood exposure (1–3 years) was non-significant (AOR = 1.04, 95% CI: 0.82–1.29). No gender-specific differences were observed. Early-life ETS exposure, particularly prenatally and in infancy, elevates ADHD-like behavior risk in preschoolers, demonstrating dose–response trends without gender disparity, highlighting the need for universal strategies to reduce such exposures. Full article

Proclamation of the gospel is a perennial practice of congregational leadership demanding responsiveness to issues, trends, and events impacting congregations, their local and regional communities, and the challenges of the world. How do congregational leaders equip themselves for the important and ever-changing task of preaching? Lifelong learning, the fastest-growing and least-resourced aspect of theological education in North America, provides this opportunity. Through a 2024 survey, this quantitative study provides insight into the lifelong learning needs of Methodist preachers, including differences based on gender and race/ethnicity. Time for additional learning is the major perceived obstacle for preachers desiring to improve their craft. Thus, lifelong learning programs must make the case for how the required time and energy will benefit the preacher participating in such programs. Specifically, the activities of reviewing recordings of sermons (both one’s own and those of other preachers), receiving constructive feedback on sermons, and realizing the collaborative potential of preaching must be structured in ways that prove the value of these investments for preachers. This data on the lifelong learning needs of Methodist preachers has implications on multiple levels: conceptual, institutional, congregational, and personal. Full article

Background: Atherosclerotic cardiovascular disease (ASCVD) is often perceived as a male-dominant condition, yet recent European data show that more women live with and die from it. Gender disparities have been reported in the management of dyslipidemia, with women less likely to receive high-intensity lipid-lowering therapy and to reach low-density lipoprotein cholesterol (LDL-C) goals. This study aimed to assess sex-specific differences in response to and tolerance of PCSK9-targeted therapies—monoclonal antibodies (evolocumab, alirocumab) and small interfering RNA (inclisiran)—as well as LDL-C goal attainment according to current ESC guidelines. Methods: We conducted a prospective registry of patients initiating PCSK9-targeted therapy at a specialized lipid center between April 2018 and June 2024. Baseline lipid profiles were recorded and monitored over follow-up. Results: Of the 341 patients, 122 (35.8%) were women and 219 (64.2%) were men, with a mean age of 66.4 ± 12.6 years for the women and 63.9 ± 11.8 years for the men. The women more frequently had heterozygous familial hypercholesterolemia (HeFH) (61.5% vs. 38.4%, p < 0.001) and a lower prevalence of previous cardiovascular events compared to the men (62.3% vs. 84.5%, p < 0.001). A higher proportion of the women were classified as high cardiovascular risk compared to the men (37.7% vs. 15.5%, p < 0.001). Risk categories were assigned according to ESC guidelines, with LDL-C targets of <70 mg/dL for high-risk patients and <55 mg/dL for very high risk patients, along with a ≥50% LDL-C reduction for both categories. In the very high risk group, fewer women achieved LDL-C targets at the first two follow-up visits (first follow-up: 50.0% vs. 76.6%, p = 0.008; second follow-up: 55.3% vs. 68.1%, p = 0.049). Although treatment prescription and tolerance were similar between sexes, women showed smaller LDL-C reductions at the first follow-up (51.7 ± 23.9% vs. 57.3 ± 24.9%, p = 0.044). Conclusions: PCSK9-targeted therapies were effective in both sexes at third follow-up, although women showed a tendency toward a delayed response and lower target attainment, indicating the potential need for more personalized management strategies. Full article

Background/Objectives: Parental emotion socialization is a key influence on children’s emotional regulation and psychosocial development. This study examined how supportive and non-supportive parental responses to children’s negative emotions are associated with internalizing and externalizing problems and social competence among Greek children aged 6–12 years. Methods: A non-experimental, cross-sectional correlational study using convenience sampling was conducted with 100 Greek parents who completed the Coping with Children’s Negative Emotions Scale and the Child Behavior Checklist. Correlation and multiple regression analyses were used to examine associations between parenting responses and child outcomes, controlling for child age, child gender, and parent gender. Results: Minimization/devaluation responses were significantly associated with higher internalizing problems (β = 0.396, p = 0.009), externalizing problems (β = 0.264, p = 0.048), and total problems (β = 0.320, p = 0.012). Punitive responses significantly predicted externalizing (β = 0.383, p = 0.003) and total problems (β = 0.304, p = 0.004). Supportive strategies (e.g., emotion-focused and problem-focused responses) did not significantly predict lower problem scores but were positively correlated with social competence (e.g., problem-focused response: ρ = 0.25, p = 0.017). Parent gender predicted minimization/devaluation responses, with mothers scoring higher than fathers (β = 0.308, p = 0.006). Conclusions: Non-supportive parental responses—especially punitive and dismissive behaviors—are robustly associated with increased behavioral and emotional difficulties in children. While supportive strategies may contribute to social competence, their benefits appear diminished in the presence of negative parenting practices. These findings highlight the importance of culturally sensitive interventions tailored to Greek family dynamics. Despite limitations such as the use of self-report measures and a non-representative sample, this study contributes valuable insights into emotion socialization and child adjustment in a specific cultural context. Full article