Search Results (1,065)

Refugees identifying as lesbian, gay, bisexual, transgender, queer, and intersexual (LGBTQI) may experience discrimination not only prior to and during flight but also within the host country, including stigmatisation by other refugees. Such experiences can severely affect mental health, making LGBTQI refugees a particularly vulnerable group. To date, however, quantitative data on homonegativity within refugee populations remain scarce. In this cross-sectional survey, 70 adult refugees in Germany reported interpreter preferences across three everyday settings. Homonegativity was operationalised as the consistent rejection of an LGBTQI-identifying interpreter across all settings. Sixteen participants (22.9%) showed consistent rejection. This proportion exceeds estimates of negative attitudes towards homosexuals reported for the German general population. Consistent rejection was associated with higher religiosity and was more common among participants who identified as Muslim, with higher rates among refugees from Syria compared with those from Afghanistan. No significant associations were found for age, gender, or length of stay. While the majority of participants did not reject LGBTQI-identifying interpreters, a substantial minority did so consistently. These findings underscore the importance of considering subgroup-specific preferences in interpreter assignment practices and indicate potential risks of discrimination against LGBTQI refugees within shared accommodation settings. Full article

In sub-Saharan Africa, the sustainability of smallholder farming systems is threatened by climate change. Women farmers are often disproportionately affected. These disproportionate impacts are linked to gender-based inequities like limited decision-making power and resource constraints, which limit women’s adaptive capacity. Previous research has examined inequities in agriculture generally, as well as women farmers’ adaptation to climate change. However, relatively few studies have explicitly focused on the experiences of women who are the primary farmers. Intersectional research is also limited. This paper presents the results of a scoping review to identify how climate change affects women smallholder farmers and how they adapt. The review identified 41 studies between 2014 and 2024. The most frequently identified vulnerability factors were access to credit, social and cultural norms, and land issues (e.g., tenure issues). Few studies took an explicitly intersectional approach. The findings suggest the need for support that targets the challenges faced by women smallholders. More intersectional research is needed to examine how gendered impacts are shaped by other forms of inequality and inhibit sustainable livelihood options. The review revealed a pervasive patriarchal assumption in which dual-headed households are often described as “male-headed”. Revising such discourses can support women’s adaptive agency in the face of future climate challenges. These findings have direct implications for the sustainability of smallholder farming systems and rural livelihoods in the region, emphasizing the need for gender-responsive approaches to sustainable development in sub-Saharan Africa. Full article

Building inclusive, high-density cities requires understanding vulnerable groups’ public space usage. While green exposure significantly impacts urban health, existing research frequently overlooks females’ specific needs regarding streetscape visual quality, green space structures, and daily travel experiences. To address this, the study investigates spatial disparities in Suzhou’s historic district. Utilizing multi-source data and mixed modeling strategies, including Partial Least Squares and Ordinary Least Squares (PLS-OLS) and eXtreme Gradient Boosting (XGBoost), the research analyzes how streetscape perceptions and green space characteristics affect female life satisfaction and expressed sentiment. Results indicate three main findings. (1) Streetscape visual features fundamentally drive subjective evaluations. Safe significantly enhances well-being, whereas boring and lively negatively impact life satisfaction, reflecting females’ acute sensitivity to environmental oppressiveness during daily travel. (2) Park diversity elevates expressed sentiment, while patch density positively influences life satisfaction, demonstrating the vital value of fragmented greenery for daily public space usage. (3) Boring precipitously diminishes life satisfaction after surpassing a specific threshold, while park diversity elevates expressed sentiment only after crossing a critical interval. The study establishes an integrated analytical framework linking visual perception, green space structure, emotional response, and satisfaction. These findings provide targeted strategies for enhancing inclusive urban design and optimizing green space allocation to improve streetscape safety and alleviate visual oppressiveness, thereby advancing gender social justice for vulnerable groups in historic districts. Full article

Drug use, mental health, and gender identity are complex phenomena influenced by multiple social, psychological, and cultural factors. Previous research indicates that the university stage represents a period of vulnerability for mental health, especially among students whose gender identity differs from the traditional categories of man or woman. This study aimed to examine the association between gender identity, drug use, and symptoms of anxiety and depression among students at a public university in Mexico. A cross-sectional correlational study was conducted through a public invitation survey among undergraduate students enrolled in a public university in Mexico. Data were collected using the Drug Use Questionnaire for University Students administered through the LimeSurvey platform. Variables included sociodemographic characteristics, gender identity (man, woman, and other identity), drug use, and symptoms of anxiety and depression. The results indicate that students who identified with another gender identity showed a higher likelihood of using the substances analyzed compared with those who identified as women, particularly prescription drugs and marijuana. Additionally, they presented higher odds of reporting anxiety and depressive symptoms compared with those who identified as men. These findings highlight the need for targeted prevention and support strategies to improve mental health among students with diverse gender identities. Full article

Children in residential care constitute a particularly vulnerable group at high risk of developing emotional and behavioral difficulties as a consequence of adverse experiences and dysfunctional family environments. Identifying risk and protective factors is essential for designing interventions tailored to their needs; however, the available research remains limited and does not always provide the evidence required to guide effective programs within the child protection system. The aim of this study was to examine the prevalence of emotional and behavioral problems among children in residential care and to analyze the role of family factors, sex, and age in these difficulties. The sample consisted of 210 children aged 6 to 18 years institutionalized in residential care centers and supervised apartments. A cross-sectional design was employed, administering the Strengths and Difficulties Questionnaire (SDQ) along with an ad hoc questionnaire to collect socio-family variables. The results reveal a high prevalence of emotional and behavioral difficulties. The multivariable models explained between 8.1% and 29.4% of the variance in emotional and behavioral functioning and showed that age, sex, exposure to gender-based violence, parental substance use, and parental intellectual disability were associated with specific emotional and behavioral dimensions. The study highlights the need to develop and implement educational and therapeutic programs aimed at strengthening children’s emotional regulation, addressing behavioral difficulties, and considering family-related adversity in intervention planning. Full article

Background: Thromboembolism is a serious complication in acute lymphoblastic leukemia (ALL). This systematic review and meta-analysis evaluated thrombosis incidence and risk factors across populations receiving asparaginase-based therapy. Methods: From 214 studies (1994–2026), 58 met inclusion criteria, totaling 23,655 adult, pediatric, and mixed-population patients. Searches included Ovid MEDLINE, Embase, Cochrane CENTRAL, PubMed Central, and Google Scholar. Eligible studies were observational cohorts or clinical trials reporting thrombosis in ALL patients treated with asparaginase. Risk factors assessed included study design, asparaginase formulation, immunophenotype, gender, treatment phase, corticosteroid use, mediastinal mass, ABO blood group, body weight, and age. Random-effects models were used for meta-analysis, and risk of bias was assessed using ROBINS-I and RoB-2. Results: Adults had significantly higher thrombosis rates than children (p < 0.0001). Study design, asparaginase formulation, immunophenotype, and treatment phase differed significantly across age groups (p < 0.0001). T-cell ALL showed higher thrombosis rates than B-cell ALL (p < 0.0001). Significant pediatric risk factors included age ≥ 10 years, mediastinal mass, non-O blood type, and overweight/obesity (all p ≤ 0.0004). Gender and corticosteroid use were not significant predictors. Findings were limited by substantial heterogeneity across included studies. Conclusions: Thrombosis risk was multifactorial. Adults and older children had higher risk, and pediatric patients with overweight/obesity, mediastinal mass, or non-O blood type were particularly vulnerable. Thromboprophylaxis is advised for high-risk groups. This review was not registered and received no external funding. Full article

Background/Objectives: Grief following the death of a partner is a complex psychosocial process associated with an increased risk of prolonged grief, depression and suicidal ideation. Among lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ+) individuals, these risks are exacerbated by stigma, relational invisibility and family rejection, often resulting in unrecognized or disenfranchised grief. This scoping review aimed to map the available evidence on the experiences of bereavement following the death of a partner among LGBTIQ+ individuals between 2016 and 2026, identifying study types, recurring themes and knowledge gaps relevant to nursing practice. Methods: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) extension and the methodology of the Joanna Briggs Institute. Searches were planned in PubMed/MEDLINE, Scopus, CINAHL, PsycINFO and Web of Science (2016–March 2026) using combined terms for grief, partner and LGBTIQ+ populations. Primary qualitative, quantitative and mixed-methods studies, as well as selected grey literature that explicitly addressed grief following the death of a partner in LGBTIQ+ individuals were considered. Results: The search identified 1032 records; after removing duplicates (n = 356), 676 titles/abstracts were screened, and 94 full texts were assessed. Eighteen studies were included, mainly qualitative, and conducted in high-income countries. Key themes included invisibility and lack of recognition of the relationship, managing the disclosure of sexual orientation and gender identity, social isolation and the role of chosen families, and intersectional vulnerabilities in subgroups such as older adults, bisexual people and trans people. Conclusions: The available evidence reflects specific bereavement experiences among LGBTIQ+ individuals that are not adequately captured in traditional models of bereavement care. Significant gaps remain, particularly in Spanish-speaking contexts and in the design and evaluation of nurse-led interventions. This scoping review provides a conceptual basis for future research and for the development of culturally safe clinical practices in supporting LGBTIQ+ individuals through bereavement. Full article

This study assesses improved maize variety (IMV) adoption, as well as yield effects among smallholder farmers in Benue State, Nigeria, having implications for sustainable crop management and resource-use efficiency. Benue state is commonly known as the “Food Basket of the Nation,” but the average maize yield remains less than 2 t/ha, compared to 7–10 t/ha when achieved under improved technologies, and it shows a key sustainability challenge for food security and land-use efficiency. With primary cross-sectional survey data from 205 smallholder farmers with 107 adopters and 98 non-adopters, selected across Local Government Area (LGAs) in Benue State, this study adopts Propensity Score Matching (PSM) for controlling selection bias and estimating the Average Treatment Effect on the Treated (ATET). Nearest Neighbour Matching acts as a primary estimator through robustness checks while using Radius and Kernel Matching. However, the logit model shows that IMV is greatly determined by gender, use of fertilizer, formal education, cooperative membership, access to irrigation, and extension contact, highlighting the crucial parts of human capital, complementary inputs, and institutional support in promoting sustainable adoption of technology. Following the control for observable differences across matching, a 0.399 log-unit yield gain was achieved by adopters, which is equivalent to approximately 49% higher output per hectare compared to non-adopters, an effect that is robust throughout alternative matching algorithms, and it surpasses the 38.7% national-level yield increase, indicating a regional sustainability premium in Benue State. The gains in productivity can promote land-use efficiency, decrease pressure for agricultural intensification on vulnerable lands, and enhance the case for integrated crop management. But adoption remains limited by access to quality seeds, complementary inputs, credit, and sustained gender barriers. Improving input supply chains, extension services, and institutional support is therefore crucial for developing productivity, resource-use efficiency, and food security across smallholder farming systems. Full article

The Singaporean government’s Green Plan 2030 aims to “galvanize a whole-of-nation movement and advance [its] national agenda on sustainable development,” transforming the Garden City into a City in Nature. The state’s #OneMillionTrees campaign, which intends to plant a million trees over a decade, seems less focused on climate adaptation, given Singapore’s unresolved environmental issues such as oil refinement, terraforming, and hyperconsumption. Instead, it appears to superficially address deeper socioenvironmental wounds inflicted on the postcolonial people and land. In this article, I explore the visual culture of Singapore’s ableist-nationalist greening campaigns alongside artworks such as Marvin Tang’s A Guide to Tree Planting and History of 39 Cuttings—Hybrids, and Woong Soak Teng’s Ways to Tie Trees and Rules for Photographing a Scoliotic Patient. I argue that Tang and Woong highlight adaptation issues in the face of eco-ableist sustainability in Singapore, challenging simplistic notions of climate adaptation by attending to vulnerable, sexed and gendered more-than-human bodies. The field of art history has an opportunity to probe ableist visions of ecological sustainability—within an emerging discourse between environmental justice and disability studies—by historicizing and interpreting such art, as it speaks to enduring, more-than-human impairment and climate adaptation. Full article

Nuclear contamination challenges assumptions that harm can be contained through technological control, political borders, or bodily separation. Across the Asia-Pacific, radioactive exposure moves unevenly through racialised, gendered, and colonial histories, rendering some bodies more vulnerable to ecological violence than others. Nuclear regimes continue to depend upon theological logics of purity, sacrificial exclusion, and protected innocence. This article develops a spirituality of fermentation through Asian eco-feminist theology and the Korean practice of sakhim. Fermentation becomes a practice of sustaining wounded life through endurance, permeability, and communal care. From this spirituality of fermentation, I develop the concept of Vital Fluidity as an ethical and theological framework for understanding how life continues through shared vulnerability, where bodies, nourishment, and histories remain deeply entangled. The article contributes to intersectional debates in theology, religion, gender, and ecology by approaching contamination through relation rather than separation. Under nuclear conditions, ethical responsibility emerges through practices that hold grief, contamination, memory, and nourishment together within shared existence. Fermentation therefore becomes a practical theological model for living with nuclear bodies. Full article

Background/Objectives: The performance of musical wind instruments imposes significant neuromuscular and biomechanical demands on the stomatognathic system. Depending on the mouthpiece type, wind instruments are divided into four classes, which may have distinct impacts on the instrumentalists’ quality of life. This study aimed to evaluate musicians’ self-perception regarding the impact caused by wind instruments practice on oral health-related quality of life (OHRQoL), jaw functional limitations, and chronic pain. Methods: A cross-sectional observational study was conducted among 71 wind instrumentalists (52% female; mean age 24.16 years; mean practice history of 12.8 years) using the Oral Health Impact Profile-14 (OHIP-14), the Jaw Functional Limitation Scale (JFLS), and the Graded Chronic Pain Scale (GCPS). Data were analyzed using the Statistical Package for the Social Sciences (SPSS), with statistical significance set at p < 0.05. Results: Musicians in Class 1 (clarinet/saxophone) and Class 4 (transverse flute) reported the worst OHRQoL and chronic pain scores. Orofacial pain in the jaw, temple, or ear was reported by 66% of the participants. Joint sounds (36%) and closed jaw locking (26%) showed a significant association with female gender; however, this relationship is highly confounded by the strong female clustering in Class 4 (85%) and Class 1 (63%). Behavioral and practice habits significantly influenced outcomes: higher daily study duration (mean 170.31 min), the absence of relaxation exercises, and a willingness to endure physical discomfort for technical progress (73.2%) were significantly associated with lower quality of life and greater functional limitations (mastication and mobility). Performance anxiety, warm-up exercises, and practice intensity peaks showed no significant relationships with OHRQoL. Conclusions: Wind instrument practice severely impacts jaw function and musicians’ well-being. These findings underscore the need for interdisciplinary preventive interventions, including targeted ergonomic training, structured rest protocols, and jaw relaxation exercises, alongside oral public health initiatives that recognize wind musicians as an occupationally vulnerable group. Full article

Climate change represents one of the defining global health challenges of the 21st century, with far-reaching implications for population health, health systems, and health equity. The acceleration of environmental change, evidenced by record-breaking global temperatures, extreme weather events, and ecological degradation, poses a direct threat to achieving Sustainable Development Goal 3 (SDG 3), which aims to ensure healthy lives and promote well-being for all. This manuscript presents a narrative review and policy analysis of the intersection of climate change and global public health in light of the outcomes of the 2025 United Nations Climate Change Conference (COP30) in Belém, Brazil. Drawing on peer-reviewed literature, major institutional reports, and relevant policy documents, we explore how climate change exacerbates communicable and non-communicable diseases, undermines health system resilience, and disproportionately affects vulnerable populations worldwide. Particular attention is given to heat-related morbidity, infectious disease expansion, air pollution, food and water insecurity, displacement, gender inequities, antimicrobial resistance, and mental health impacts. The paper highlights the significance of the Belém Health Action Plan (BHAP), which is treated here as a COP30-associated action framework that places health more centrally within climate policy discussions. However, major challenges remain, including its voluntary orientation, the absence of dedicated financing mechanisms within the framework itself, and limited clarity on accountability arrangements, as identified through our synthesis of the available policy and evidence base. We argue that achieving SDG 3 is no longer feasible without integrating climate adaptation and mitigation into health systems and policies, and that progress will depend on translating global commitments into context-specific country strategies, governance arrangements, and implementation pathways. Full article

Background: Problematic social media use (PSMU) has been increasingly conceptualized as a form of behavioral addiction, characterized by loss of control and continued engagement despite negative consequences. Adolescents with psychiatric disorders may represent a particularly vulnerable group, yet clinical evidence remains limited. This study examined the prevalence of PSMU in help-seeking adolescents and investigated how psychological vulnerabilities influence social media (SM) engagement, platform selection, and content preferences. Methods: A cross-sectional study was conducted on 265 adolescents (12–18 years) undergoing psychiatric evaluation. Participants completed validated measures of PSMU (Social Media Disorder Scale-9) and perceived stress, along with items assessing screen time, platform usage, engagement style (active vs. passive), and content preferences. Diagnostic data were retrieved from clinical assessments. Results: PSMU prevalence was 14.4%, rising to 19.2% among adolescents with internalizing disorders. Female and gender-diverse adolescents showed significantly higher PSMU scores. PSMU was associated with greater screen time (OR = 2.41) and nearly threefold higher odds of intensive TikTok use. Overall, SM engagement was predominantly passive, particularly among adolescents with depressive disorders, while those with neurodevelopmental disorders more frequently engaged actively. Higher stress levels were linked to greater SM use, especially on TikTok and Instagram. Conclusions: PSMU appeared to be relatively prevalent among adolescents receiving psychiatric care, particularly those with mood and anxiety disorders and high stress levels. Findings highlight the importance of assessing PSMU in these groups of adolescents and analyzing qualitative patterns of SM engagement to identify at-risk youth and inform targeted clinical interventions. Full article

Background: Functional Neurological Disorder (FND) is a common and disabling condition at the interface of neurology and psychiatry, characterized by motor, sensory, seizure-like, or cognitive symptoms that are incongruent with recognized neurological disease but associated with substantial impairment. Despite its frequency and marked female predominance, FND remains underdiagnosed and often misunderstood. Methods: This narrative review synthesizes evidence from neurobiological, biomarker, and treatment studies, with attention to predictive coding, salience network dysfunction, impaired sense of agency, stress-related mechanisms, and sex- and gender-related vulnerability. Results: Current evidence supports a model of FND as a disorder of distributed brain network dysfunction involving abnormal interactions among salience, limbic, motor, and self-monitoring systems. Predictive coding and impaired agency models provide clinically useful frameworks for understanding symptom generation, although they remain mechanistic hypotheses rather than definitive causal explanations. Candidate biomarkers, including functional connectivity alterations, autonomic dysregulation, and HPA axis measures, offer pathophysiological insight but remain insufficiently validated for routine diagnosis. Female predominance likely reflects interacting biological, psychological, and sociocultural mechanisms rather than a single neuroendocrine pathway. Conclusions: This review contributes an integrated, clinically oriented framework linking neurobiology, biomarkers, sex/gender vulnerability, and treatment in FND. Current evidence supports multidisciplinary care combining diagnostic communication, specialized physiotherapy, psychotherapy, and coordinated follow-up, while future research should prioritize standardized phenotyping, longitudinal designs, and multimodal biomarker validation. Full article

College students often maintain poor dietary habits, notably low fruit and vegetable intake. Common barriers include limited time, cost, and lack of nutritional knowledge. This study examined dietary behaviors, barriers, and factors influencing Healthy Eating Scores (HES) among college students. Participants (N = 224; age = 20.3 ± 2.5 years, BMI = 23.9 ± 4.1 kg/m², 78.9% female, and 91.3% white) completed an online survey. Results indicate meat overconsumption with underconsumption of water, fruits, and vegetables. Limited time and healthy options were the primary perceived barriers. Tests of between-subject effects identified gender (F = 4.38, p = 0.04) and living situation (F = 4.42, p < 0.01) as independent HES predictors. Backward stepwise linear regression (adj. R² = 0.22, p < 0.001) further indicated that being male, an athlete, living off-campus, and cooking at home were significantly associated with higher HES. Conversely, non-athlete females living on campus emerged as the most vulnerable group for low HES. These findings suggest that future interventions should target specific demographic vulnerabilities to improve dietary outcomes and mitigate barriers in the college population. Full article