Search Results (613)

Today, ‘social sustainability’ is a key feature of many organisations’ environmental, social, and governance strategies, as well as underpinning sustainable development goals. The term refers to the implementation of targets such as reduced societal inequalities, the promotion of social well-being, and the practice of positive community relations. Building a meaningful, accountable, and quantifiable evidence-base from which to translate these high-level concepts into tangible and achievable goals is, however, challenging. The complexities of measuring social capital—often described as a building block of social sustainability—have been documented. The challenge lies in measuring the person, group, or collective in interaction with the context under investigation, whether that be a climate goal, an institution, or a national policy. Social identity theory is a social psychological approach that articulates the processes through which an individual internalises the values, norms, and behaviours of their contexts. Levels of social identification—a concept capturing the state of internalisation—have been shown to be predictive of outcomes as diverse as communication and cognition, trust and citizenship, leadership and compliance, and health and well-being. Applying this perspective to the articulation and measurement of social sustainability provides an opportunity to build an empirical approach with which to reliably translate this high-level concept into achievable outcomes. Full article

In this research report, we consider how to empower K-8 teachers as mathematics instructional leaders to initiate and sustain improvements within their schools, as a practical and sustainable model of enacting change in mathematics education more broadly by developing leadership from within. We share the theoretical framework and findings from a 5-year National Science Foundation project. We utilized a longitudinal mixed methods approach, collecting data on teachers’ knowledge, instructional practices, leadership practices, and self-perception of growth throughout the project, triangulated with focus group data from teachers’ school administrators and project leaders and logs of leadership activities. Findings indicate positive changes in teachers’ knowledge and practices and in their role as instructional leaders in their schools, districts, and the mathematics education community. We conclude by sharing factors that appeared to support teachers’ growth as instructional leaders and implications for practice and research. Full article

Background: Stigma associated with tuberculosis (TB) continues to undermine patient well-being, treatment adherence, and public health goals and objectives. This study aims to systematically review the literature to identify and synthesize TB stigma reduction interventions published between 2015 and 2025. Methods: Following the PRISMA guidelines, we conducted a comprehensive literature search across PubMed, Scopus, Science Direct, ProQuest, and Google Scholar. Eligible studies included those with qualitative, quantitative, and mixed-methods designs that focused on interventions related to TB-related stigma. We categorized the studies into three groups: (1) intervention development studies, (2) TB treatment programs with stigma reduction outcomes, (3) stigma-specific interventions. Data extraction and quality appraisal were conducted independently by two reviewers using the Mixed Methods Appraisal Tool (MMAT). Results: A total of 15 studies met the inclusion criteria. Five studies focused on co-developing stigma interventions, which incorporated multi-level and multicomponent strategies targeting internalized, enacted, anticipated, and intersectional stigma. Two studies assessed TB treatment-related interventions (e.g., home-based care, digital adherence tools) with incidental stigma reduction effects. The remaining seven studies implemented stigma-targeted interventions, including educational programs, video-based therapy, peer-led support, and anti-self-stigma toolkits. Interventions addressed stigma across individual, interpersonal, institutional, community, and policy levels. Conclusions: This review highlights the evolution and diversification of TB stigma interventions over the past decade. While earlier interventions emphasized education and support, recent strategies increasingly integrate peer leadership, digital platforms, and socio-ecological frameworks. The findings underscore the need for comprehensive, contextually grounded interventions that reflect the lived experiences of people affected by TB. Full article

Startups are often praised for their innovative power and dynamic work environments, but are also criticized for workplace cultures that perpetuate traditional masculine norms of competitiveness, workaholism, emotional resilience, and strength. This exploratory study examines the prevalence of Masculinity Contest Culture (MCC) in German startups and related gender dynamics. The Masculinity Contest Culture scale, which assesses masculine norms related to emotional resilience, physical superiority, workaholism, and aggressive competitiveness, was employed to collect data from 101 participants representing various startups. The results indicate an overall low prevalence of MCC, with slightly higher scores for strong commitment to work. Individuals from disparate gender and hierarchical status groups exhibited comparable ratings of the intensity of toxic masculinity. While the presence of female founders and supervisors did not affect MCC scores, male dominance within the work environment had a small but significant amplifying effect. Significant differences were observed based on the prevailing leadership style, indicating that a shared leadership approach is associated with the creation of a more inclusive and less toxic work environment. The results challenge commonly held assumptions about tech startups. In addition, the study highlights the need for further research into the impact of leadership dynamics on startup culture. Full article

This article describes the design and implementation of a Specialized Mental Health Clinical Pastoral Education (CPE) program for clergy and theological students of all spiritual, religious, and cultural backgrounds. Addressing the need for mental health competencies in religious leaders and chaplains, this training equips participants with specialized skills in individual and group mental health spiritual assessment and spiritual care. Program participants become effective members of a multiprofessional team, gain knowledge of mental health philosophies of concordant and discordant spiritual orienting systems, and gain greater relational capacity. The Mental Health CPE Program includes traditional and novel CPE elements: (1) clinical practice, (2) group and individual supervision, (3) didactic presentations and journal clubs, (4) verbatim (Protocols of patient encounters) and case presentations, (5) group leadership training and practica, and (6) experience of faith reflections. This article provides insights into the origins of CPE, a description of the implementation in a free-standing psychiatric hospital, and observed developmental changes of program participants. We include graduates’ anecdotal feedback about their learning experience and its impact on their leadership in chaplaincy and in religious communities. Additionally, we report on areas for future development and further study of the effectiveness of Mental Health CPE. Full article

Background: Prehabilitation programs improve postoperative outcomes in vulnerable patients undergoing major surgery. However, current screening tools such as the Malnutrition Universal Screening Tool (MUST) may lack the sensitivity needed to identify those who would benefit most. Muscle quality assessed by Computed Tomography (CT), specifically muscle radiodensity in Hounsfield Units (HUs), has emerged as a promising alternative for risk stratification. Objective: To evaluate the prognostic performance of CT-derived muscle radiodensity in predicting adverse postoperative outcomes in colorectal cancer patients, and to compare it with the performance of the MUST score. Methods: This single-center cross-sectional study included 201 patients with non-metastatic colon cancer undergoing elective laparoscopic resection. Patients were stratified based on enrollment in a multimodal prehabilitation program, either within an Enhanced Recovery After Surgery (ERAS) protocol or a non-ERAS pathway. Nutritional status was assessed using MUST, SARC-F questionnaire (strength, assistance with walking, rise from a chair, climb stairs, and falls), and the Global Leadership Initiative on Malnutrition (GLIM) criteria. CT scans at the L3 level were analyzed using automated segmentation to extract muscle area and radiodensity. Postoperative complications and hospital stay were compared across nutritional screening tools and CT-derived metrics. Results: MUST shows limited sensitivity (<27%) for predicting complications and prolonged hospitalization. In contrast, CT-derived muscle radiodensity demonstrates higher discriminative power (AUC 0.62–0.69), especially using a 37 HU threshold. In the non-ERAS group, patients with HU ≤ 37 had significantly more complications (33% vs. 15%, p = 0.036), longer surgeries, and more severe events (Clavien–Dindo ≥ 3). Conclusions: Opportunistic CT-based assessment of muscle radiodensity outperforms traditional screening tools in identifying patients at risk of poor postoperative outcomes, and may enhance patient selection for prehabilitation strategies like the ERAS program. Full article

Background: The leadership style employed by those in positions with authority could significantly impact employees’ work behavior, either positively or negatively. Objectives: The aim of the study was to examine the impact of engaging leadership on quiet quitting and work engagement among nurses. Methods: A cross-sectional study was conducted in Greece with a convenience sample. Data collection occurred throughout October 2024 via an online survey. We utilized Google forms to create an online version of the study questionnaire, which was subsequently shared in Facebook groups for nurses. We used validated tools to measure our study variables, namely, the “Engaging Leadership Scale-12” for engaging leadership, the “Quiet Quitting Scale” for quiet quitting, and the “Utrecht Work Engagement Scale-3” for work engagement. We applied univariate and multivariable linear regression analyses to identify the association between engaging leadership, quiet quitting, and work engagement. p-values less than 0.05 were considered statistically significant. Results: Our multivariable models showed a negative association between engaging leadership and quiet quitting. Moreover, we found a positive association between engaging leadership and work engagement after the elimination of confounders. Conclusions: Our findings suggest that higher levels of engaging leadership reduce quiet quitting and improve work engagement. Nurses’ managers should adopt engaging leadership to improve nurses’ motivation and, thus, clinical outcomes. Full article

Medicaid is a vital public health program, serving over 70 million Americans from many backgrounds. Understanding how Medicaid spending varies by political leadership and demographic factors can inform policy discussions and advocacy efforts. We conducted a cross-sectional descriptive analysis of state Medicaid spending using publicly available data. Our findings show that individuals identifying as White comprise the largest single racial group of Medicaid beneficiaries both nationally and in most states. While the 2020 Census Diversity Index correlated strongly with total Medicaid spending, no significant association was found with per enrollee spending or the federal share of Medicaid funding. States led by Democrats had higher total Medicaid spending when compared to Republican-led states. However, Republican-led states received a larger proportion of federal Medicaid funding. Among political leadership levels, Senate representation showed the strongest relationship with Medicaid spending trends compared to gubernatorial leadership and presidential voting history. In conclusion, we demonstrate that Medicaid spending impacts all racial groups and both major political parties. However, funding structures and political representation reflect distinct spending patterns. Given the evolving demographic and political landscape, ongoing policy discussions should ensure that Medicaid remains a public health program that remains effective at safeguarding human health. Full article

Young people are frustrated and disheartened with the lack of adult leadership and action to address the climate crisis. Although youth representation in global, regional, and local decision-making contexts on climate change is steadily growing, the desired role and effect of youth in environmental and climate decision-making has shifted from a focus on having youth voices heard, to having a direct and meaningful impact on policy and action. To meaningfully integrate youth perspectives into climate policies and programs, intergenerational approaches and youth–adult partnerships are key. This paper explores strategies to support youth action and engagement as adult partners by investigating youth perspectives on what adults and adult-led organizations should consider when engaging young people in climate-related work. This qualitative research study introduces a revised version of the 7P youth participation framework, developed through focus groups with high school youth. This paper provides reflective questions and practical recommendations for participants engaged in youth–adult partnerships to help guide engagement beyond token representation and create meaningfully participatory conditions for youth agency in climate organizing spaces. Full article

Background/Objectives: This study protocol outlines the implementation of a professional development programme (ProDeveloP) designed to support newly graduated nurses (NGNs). NGNs often experience inadequacy and face challenges in developing their professional competence. Healthcare organisations can ease this transition through introduction programmes. However, effective implementation strategies in local healthcare settings remain unclear. This study aims to develop, implement, and evaluate a programme that enhances role clarity, task mastery, social acceptance, stress reduction, and recovery, contributing to increased job satisfaction and retention. Methods: ProDeveloP will be implemented at a regional hospital in mid-Sweden. This study will include a convenience sample of 110 NGNs from both the previous and the new introduction programmes, 20 dialogue facilitators involved in the programme, and 10 managers responsible for NGNs participating in the programme. Data will be collected throughout the ProDeveloP using questionnaires, individual interviews, and focus groups. The data will be analysed using both qualitative and quantitative analyses. Conclusions: This study has the potential to improve NGNs’ work-related health, job satisfaction, and retention while contributing to competence development. By offering structured reflection, mentorship, and organisational support, this research project addresses knowledge gaps in understanding the long-term impacts of introduction programmes and structured reflection, contributing to evidence-based improvements in nursing practice and healthcare leadership. Clinical trial number: NCT06742047. Registered in ClinicalTrials.gov, 19 December 2024. Full article

Organizational behavior examines the interactions of individuals and groups within businesses, while human resource management (HRM) focuses on enhancing workforce efficiency through recruitment, training, and employee relations. The success of an organization depends on the relationship between employee engagement and performance, as engaged individuals enhance productivity and innovation. This study aims to conduct a comprehensive bibliometric analysis of the academic research on the relationship between artificial intelligence (AI), employee engagement, and performance. This study highlights trends, countries, sources, and keywords in this field. The authors analyzed 11,291 articles in the first phase, 42,358 articles were analyzed in the second phase, and 606 articles were analyzed in the third phase. This study highlights the growth of the research in this area and identifies the most productive years and regional contributions. The citation analysis is used to identify the relevant research and renowned authors. This study also addresses ethical concerns related to the implementation of artificial intelligence (AI) in the workplace. This study indicates theme variations among national contributions, highlighting differing socio-cultural and theoretical perspectives on AI adoption in HRM, from behavioral leadership models to efficiency-oriented frameworks. In summary, this bibliometric study provides valuable insights into the evolution of the research topics related to AI’s impact on employee engagement and productivity, spanning multiple disciplines, such as psychology, organizational behavior, and computer science. It is relevant for the researchers, practitioners, and businesses interested in understanding and utilizing AI in the workplace. Full article

This study investigates how inclusive leadership, mentorship, and digital tools shape conflict prevention and social cohesion within the Greek public sector. Employing a cross-sectional quantitative design, data were collected from 203 employees across municipalities, ministries, regional, and decentralized administrations. The survey instrument captured four dimensions: leadership and mediation for social cohesion, mentorship for the empowerment of vulnerable groups, use of digital tools, and the perceived social impact of inadequate conflict management. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) to test direct and indirect effects, evaluate the explanatory and predictive power of the model, and explore the mediation mechanisms linking leadership, mentorship, and digital tools to social cohesion. The results demonstrate that both leadership and mentorship are positively perceived and significantly interrelated, jointly enhancing workplace cohesion and trust. Mentorship emerged as a critical predictor of digital tool adoption, highlighting its role as a bridge for digital inclusion and organizational innovation. In contrast, digital tools, despite their high importance in the model, remain underutilized and require further investment in training and integration. Poor conflict management is perceived as a major organizational risk, strongly linked to increased stress, diminished trust, and a deteriorated workplace climate. These findings highlight the value of integrating mentorship and inclusive leadership with mediation and digital technologies, supporting the development of hybrid strategies for conflict management. The study enriches theoretical debates on organizational resilience and social cohesion, while offering practical recommendations for modernizing public administration through participatory leadership, targeted mentoring programs, and the thoughtful adoption of digital solutions. Full article

Background/Objectives: Assessing oral intake in patients with disease-related malnutrition (DRM) and sarcopenia remains a clinical challenge. This study aimed to evaluate the relationship between oral intake adjusted to nutritional requirements and the presence of sarcopenia in patients with DRM. Methods: This was a prospective observational study involving 118 outpatients with DRM, diagnosed according to Global Leadership Initiative on Malnutrition criteria. Sarcopenia was assessed using the European Working Group on Sarcopenia in Older People criteria. A 3-day dietary intake record was collected at the beginning of nutritional follow-up. Caloric (kcal/day) and protein (g/day) intakes were calculated. Energy needs were estimated using the Harris-Benedict equation with stress factors, and protein needs were set at 1.5 g/kg/day. Intake was categorized based on whether energy and protein intake exceeded or fell below 70% of requirements. Results: The mean age was 62.2 years, and 58.8% were female. Sarcopenia was present in 42% of patients. No significant difference was found in body mass index between patients with and without sarcopenia. Mean caloric intake was 29.6 kcal/kg/day and protein intake was 1.3 g/kg/day. Average fulfilment was 78.3% for energy and 86.8% for protein. Patients with sarcopenia had significantly lower intake of calories and macronutrients. Sarcopenia was more prevalent in those with <70% fulfilment of caloric and protein requirements. Multivariate analysis showed increased risk of sarcopenia (Odds ratio (OR): 4.27; 95% Confidence Interval (CI): 1.30–14.03; p = 0.017) and severe malnutrition (OR: 5.17; 95% CI: 1.63–16.42; p < 0.01) in patients with low protein intake. Conclusions: In patients with DRM, insufficient intake of calories and protein was associated with a higher prevalence of sarcopenia. There was an increased risk of sarcopenia and severe malnutrition in patients with lower protein intake. Full article

Background: Fundamental movement skills (FMS)—including muscular strength, endurance, and mobility—are linked to better health-related quality of life and higher physical activity in children. Rural children often score lower on FMS tests than urban peers due to resource limitations rather than ability. Thus, increasing access to FMS activities in under-resourced rural areas is essential. The primary objective was to test the feasibility of Hoosier Strength in a rural middle school sample, and the secondary objective was to observe the preliminary changes in FMS-related outcomes pre- to post-intervention and at follow-up. The exploratory objective was to explore how participants responded to different coaches on the Hoosier Strength coaching team (i.e., gender, coaching style during activities). Methods: This study used a Hybrid Type 3 design to evaluate feasibility and FMS outcomes, integrating qualitative and quantitative data. The four-week intervention included a test group (n = 24; 14 females, 10 males; mean age: females 12.4 ± 0.5 years, males 12.7 ± 0.4 years) and a control group (n = 12; 8 females, 4 males; mean age: females 12.9 ± 0.3 years, males 12.7 ± 0.3 years). Data analysis included descriptive statistics for feasibility indicators (Acceptability of Intervention Measures [AIM], Intervention Appropriateness Measure [IAM], and Feasibility of Intervention Measure [FIM]), linear regression for mobility and muscular endurance changes, t-tests for psychological need satisfaction and frustration, and regression analysis for squat knowledge and post-intervention confidence. Results: (1) There was high feasibility across the 4-week Hoosier Strength intervention and at follow-up; (2) there were no statistically significant changes in squat performance; (3) participants’ confidence in their ability to squat at the end of the intervention was significantly predicted by their squat knowledge at baseline; and (4) participants prioritized leadership and team management over tactical analysis, highlighting a preference for coaches who foster teamwork. Conclusions: The findings offer a transparent approach for evaluating the feasibility and preliminary outcomes of the Hoosier Strength intervention in an under-resourced rural middle school, thereby encouraging further investigation into strength training interventions in rural schools. Full article

Travestis and transgender women in Brazil face a disproportionate burden of mental health conditions, exacerbated by structural discrimination, violence, and social exclusion. This narrative review synthesizes evidence on the prevalence of depression, anxiety, suicidality, and substance use among travestis and transgender women in Brazil, and examines intersecting social and health disparities. We searched PubMed, Embase, and PsycINFO in April 2025, identifying peer-reviewed studies in English or Portuguese reporting mental health outcomes or associated social determinants of health in this population. Thirty-one studies across twelve different cities (n = 7683) were included and grouped into two thematic domains. Reported prevalence ranged from 16–70.1% for depression, 24.8–26.5% for anxiety, and 25–47.3% for suicidality. Substance use was also highly prevalent, with studies reporting high rates of alcohol (21.5–72.7%), tobacco (56.6–61.6%), cannabis (19–68.9%), and cocaine/crack (6–59.8%) use. Discrimination, violence, economic hardship, and HIV were consistently associated with psychological distress and barriers to care. These findings underscore the urgent need to integrate mental health, gender-affirming care, and HIV services into Brazil’s Unified Health System (Sistema Único de Saúde–SUS), strengthen anti-discrimination and violence-prevention policies, and adopt inclusive public health strategies that prioritize the leadership and lived experiences of transgender, nonbinary, and gender diverse people, particularly amid rising political threats to gender-affirming care. Full article