Search Results (1,908)

The purpose of this study was to examine vegetable consumption and its relationship with lifestyle characteristics among children and adolescents. Data from a health survey administered to a representative sample of 177,091 schoolchildren between the ages of 8 and 17 were employed in this observational, cross-sectional investigation. Physical activity level, screen time, and sleeping patterns were assessed using self-completed questionnaires. Vegetable consumption and dietary habits were analyzed using the Mediterranean Diet Quality Index for Children and Adolescents. Participants consuming vegetables more than once daily were categorized as consumers vs. non-consumers. Physical education teachers measured anthropometric and physical fitness factors. Descriptive statistics and binary logistic regression analysis were conducted, and the odds ratio with the corresponding 95% confidence interval was calculated and adjusted for confounders. Vegetables were consumed once or more times a day by more females than males (25.5% vs. 24.0%, p < 0.001). In both sexes, vegetable consumers slept more, ate healthier, spent less time on screens, and had better anthropometric and aerobic fitness measurements than non-consumers. Healthy eating practices, such as regularly consuming fruits, legumes, nuts, and dairy products, were strongly correlated with vegetable intake. For every one-year increase in age, the odds of being a vegetable consumer decreased by 8% and 10% in boys and girls, respectively. Overweight/obese participants had lower odds of being a vegetable consumer by 20%. Increased screen time, inadequate physical activity, and insufficient sleeping hours decreased the odds of being a vegetable consumer by 22%, 30%, and 25%, respectively (all p-values < 0.001). Overall, a healthier lifestyle profile was associated with higher vegetable intake for both sexes among children and adolescents. Full article

With deepening global higher education reforms, outcome-based education has emerged as the core paradigm for teaching model innovation. This study investigates the structural dependencies and teaching effectiveness of the Environmental Design curriculum at Hubei Engineering University in medium-sized cities, China, addressing challenges of enrollment decline and market contraction critical for urban sustainability. Using network analysis, we construct curriculum support and contribution networks and course temporal networks to assess structural dependencies and teaching effectiveness, revealing structural patterns and optimizing the OBE-based Environmental Design curriculum to enhance educational quality and student competencies. Analysis reveals computer basic courses as knowledge transmission hubs, creating a course network with a distinct core–periphery structure. Technical course reforms significantly outperform theoretical course reforms in improving student performance metrics, such as higher average scores, better grade distributions, and reduced performance gaps, while innovative practice courses show peripheral isolation patterns, indicating limited connectivity with core curriculum modules, which reduces their educational impact. These findings provide empirical insights for curriculum optimization, supporting urban sustainable development through enhanced professional talent cultivation equipped to address environmental challenges like sustainable design practices and resource-efficient urban planning. Network analysis applications introduce innovative frameworks for curriculum reform strategies. Future research expansion through larger sample validation will support urban sustainable development goals and enhance professional talent cultivation outcomes. Full article

Background: Dentinal hypersensitivity (DH) significantly impacts oral health-related quality of life. While global prevalence estimates range from 10–15%, region-specific data from Saudi Arabia remain limited. This study also aligns with Saudi Vision 2030’s mental health initiatives, as DH-associated anxiety impacts overall well-being. This study assessed DH prevalence and quality of life impact among Saudi adults. Methods: A cross-sectional online survey was conducted among 748 Saudi adults aged ≥ 18 years between April and May. Data were collected using a validated Arabic Dentinal Hypersensitivity Experience Questionnaire (DHEQ) alongside socio-demographic variables. Participants reporting DH symptoms within 12 months were included in impact analyses. Descriptive statistics and one-way ANOVA examined associations between DHEQ scores and participant characteristics. Results: Self-reported DH prevalence was 54.3% (n = 406), substantially exceeding global estimates. Among affected individuals, mean DHEQ score was 0.56 ± 0.19, indicating moderate-to-substantial quality-of-life impact. Functional limitations were most affected, particularly enjoyment of eating and drinking (0.72 ± 0.21). Significant associations were identified between higher DHEQ scores and age extremes (<18 and >35 years; p < 0.001), higher income levels (p = 0.032), fewer teeth (p = 0.040), and dental pain presence (p = 0.009). Sex, residence, education, and employment showed no significant associations. Conclusions: More than half of Saudi adults reported DH symptoms, representing a significant public health concern with substantial quality of life implications. Prevalence substantially exceeds global estimates, highlighting the need for targeted interventions. Age, income, tooth count, and pain presence emerged as key factors. These findings support developing population-specific prevention strategies, particularly targeting younger and older adults with tooth loss. Full article

Burnout syndrome is a growing concern in higher education, affecting the psychological well-being and performance of university professors. This systematic review presents a narrative synthesis of findings from quantitative studies on sociodemographic and psychosocial determinants of academic burnout. Following PRISMA 2020 guidelines, sixty peer-reviewed articles published between Jan 2019 and May 2024 were selected from Scopus and Web of Science. Inclusion criteria required validated psychometric instruments and exclusive focus on university faculty. Methodological quality was assessed using the Newcastle-Ottawa Scale and CASP checklist. Data from approximately 43,639 academic staff were analyzed. Key risk factors identified include excessive workload, lack of institutional support, and workplace conflict. In contrast, collegial support, participative leadership, and job satisfaction functioned as protective elements. Variables such as age, gender, academic rank, and employment stability significantly influenced burnout vulnerability. While general patterns were observed across studies, differences in design and sampling require caution in generalization. The evidence supports the implementation of integrated strategies encompassing mental health programs, workload regulation, participatory governance, and culturally responsive approaches. These findings inform the development of institutional policies aimed at preventing burnout and fostering academic well-being. Future research should adopt longitudinal and cross-cultural designs to further explore burnout trajectories and support educational reform. Full article

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by inattention, hyperactivity, and impulsivity, frequently observed in juvenile offenders. This systematic review explores the interplay between ADHD and juvenile delinquency, focusing on behavioural, psychological, and social dimensions. Following the PRISMA guidelines, a systematic literature review was conducted using EBSCO Discovery Service, Science Direct, PubMed, and snowballing techniques. Studies meeting specific inclusion criteria, including juvenile offenders diagnosed with ADHD and comparisons to non-offender or non-ADHD control groups, were analysed. The methodological quality of studies was assessed using the Joanna Briggs Institute appraisal tools. A total of 21 studies were included, highlighting significant associations between ADHD and juvenile delinquency. ADHD symptoms, especially impulsivity and emotional dysregulation, were linked to an earlier onset of offending and higher rates of property crimes. Comorbidities such as conduct disorder, substance use disorder, and depression exacerbated these behaviours. Sociodemographic factors like low education levels and adverse family environments were also critical modifiers. Early intervention and tailored treatment approaches were emphasised to address these challenges. The findings underscore the need for early diagnosis, individualised treatment, and integrative rehabilitation programmes within the juvenile justice system to mitigate long-term risks and promote social inclusion. Full article

The present study focuses on the attractiveness and perceived value of differentiated quality labels, such as the Protected Designation of Origin (PDO) and Protected Geographical Indication (PGI), for agri-food products from Extremadura (Spain). In doing so, it addresses a gap in the scientific literature concerning consumer behavior toward products bearing these certifications. The results show that awareness of these quality schemes is significantly higher among middle-aged and older individuals, underscoring the need for more modern and targeted communication strategies. The findings highlight the strategic role of agri-food marketing in promoting certified products and emphasize the importance of bridging the generational gap in consumer education. Overall, differentiated quality schemes are perceived as strategic tools to enhance the competitiveness of local products, strengthen cultural identity, and foster sustainable rural economies. Furthermore, this study identifies a negative relationship between the consumption of certified products and the awareness of certification and a positive relationship with the willingness to pay a premium. Consumers with greater awareness tend consume these products less, although they are more willing to pay higher prices for items bearing quality labels. Full article

Sustainable education requires addressing the challenges posed by digital transformation, including technostress among university students. This study evaluates technostress levels in higher education through the validation of the TS4US scale and its implications for sustainable learning environments. A cross-sectional study was conducted with 328 university students from four districts in Lima, Peru, using an online survey to measure technostress. Confirmatory factor analysis (CFA) was performed to assess the psychometric properties of the TS4US scale, resulting in a refined model with two latent factors and thirteen validated items. Findings indicate that 28% of students experience high technostress levels, while 5% report very high levels, though no significant associations were found between technostress and sociodemographic variables such as campus location, employment status, gender, and academic level. The TS4US instrument had been previously validated in Chile; this study confirms its structure in a new sociocultural context, reinforcing its cross-cultural applicability. These results highlight the need for sustainable strategies to mitigate technostress in higher education, including institutional support, digital literacy programs, and policies fostering a balanced technological environment. Addressing technostress is essential for promoting sustainable education (SDG4) and enhancing student well-being (SDG3). This study directly contributes to the achievement of Sustainable Development Goals 3 (Good Health and Well-being) and 4 (Quality Education) by providing validated tools and evidence-based recommendations to promote mental health and equitable access to digital education in Latin America. Future research should explore cross-country comparisons and targeted interventions, including digital well-being initiatives and adaptive learning strategies, to ensure a resilient and sustainable academic ecosystem. Full article

In today’s fast-changing world, the higher education system must evolve to enhance the quality of learning and teaching. Fulfilling the role of a university is a major challenge. Universities must implement strategies that place the student at the center of their concerns; so, these strategies must be designed for and by the student. However, the high university dropout rate is one of the current problems faced by many universities. This suggests that there are some issues that hinder the learning process. Several studies have highlighted the advantage of artificial intelligence (AI) technologies in providing explorative and predictive analyses that explain why students are dropping out, with the aim of improving the quality of teaching and providing an integrated learning environment. This paper proposes a framework that predicts student dropout rates using machine learning techniques, based on data collected from various sources. Data collection was carried out between 2022 and 2024. We used a quantitative analysis method employed through a questionnaire distributed to 120 students (aged 18–26) from open access faculties of a Moroccan public university to identify the factors leading to an increase in university dropout rates. We discuss the impact of selected variables, and the findings show that several factors are related to university dropout rates, such as social background, psychological and health problems, insufficient motivation of professors, limited perspective on educational programs, changes in language and teaching methodologies, absenteeism, student attitude, and a lack of interaction between professors and students. Full article

Introduction: Congestive heart failure (CHF), a complex clinical syndrome characterized by the heart’s inability to pump blood effectively due to structural or functional impairments, is a growing public health concern, with profound implications for patients’ physical and emotional well-being. In India, the burden of CHF is rising due to aging demographics and increasing prevalence of lifestyle-related risk factors. Among the subtypes of CHF, heart failure with preserved ejection fraction (HFpEF), i.e., heart failure with left ventricular ejection fraction of ≥50% with evidence of spontaneous or provokable increased left ventricular filling pressure, and heart failure with reduced ejection fraction (HFrEF), i.e., heart failure with left ventricular ejection fraction of 40% or less and is accompanied by progressive left ventricular dilatation and adverse cardiac remodeling, may present differing impacts on health-related quality of life (HRQoL), i.e., an individual’s or a group’s perceived physical and mental health over time, yet comparative data remains limited. This study assesses HRQoL among CHF patients using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), one of the most widely used health-related quality of life questionnaires for patients with heart failure based on physical and emotional dimensions and identifies sociodemographic and clinical variables influencing these outcomes. Methods: A cross-sectional analytical study was conducted among 233 CHF patients receiving inpatient and outpatient care at the Department of Cardiology at a quaternary care teaching hospital in coastal Karnataka in India. Participants were enrolled using convenience sampling. HRQoL was evaluated through the MLHFQ, while sociodemographic and clinical characteristics were recorded via a structured proforma. Statistical analyses included descriptive measures, independent t-test, Spearman’s correlation and stepwise multivariable linear regression to identify associations and predictors. Results: The mean HRQoL score was 56.5 ± 6.05, reflecting a moderate to high symptom burden. Patients with HFpEF reported significantly worse HRQoL (mean score: 61.4 ± 3.94) than those with HFrEF (52.9 ± 4.64; p < 0.001, Cohen’s d = 1.95). A significant positive correlation was observed between HRQoL scores and age (r = 0.428; p < 0.001), indicating that older individuals experienced a higher burden of symptoms. HRQoL also varied significantly across NYHA functional classes (χ² = 69.9, p < 0.001, ε² = 0.301) and employment groups (χ² = 17.0, p < 0.001), with further differences noted by education level, gender and marital status (p < 0.05). Multivariable linear regression identified age (B = 0.311, p < 0.001) and gender (B = –4.591, p < 0.001) as significant predictors of poorer HRQoL. Discussion: The findings indicate that patients with HFpEF experience significantly poorer HRQoL than those with HFrEF. Older adults and female patients reported greater symptom burden, underscoring the importance of demographic-sensitive care approaches. These results highlight the need for routine integration of HRQoL assessment into clinical practice and the development of comprehensive, personalized interventions addressing both physical and emotional health dimensions, especially for vulnerable subgroups. Conclusions: CHF patients, especially those with HFpEF, face reduced HRQoL. Key factors include age, gender, education, employment, marital status, and NYHA class, underscoring the need for patient-centered care. Full article

This scoping review examines the integration of the Sustainable Development Goals (SDGs)—specifically SDG 4, which concerns quality education—into national curricula at various levels of education between 2020 and 2025. This qualitative study uses the scoping review method to synthesise international research, identifying thematic trends, methodological approaches, and implications for curriculum development. The analysis reveals a strong focus on higher education, with articles from Asia and Europe dominating the discourse, while perspectives from early childhood education and the Global South are under-represented. Most articles favour qualitative designs, engaging with the SDGs as curricular content, institutional transformation frameworks, or community-based education tools. Despite these promising approaches, significant gaps remain in addressing behavioural change and equity across educational systems. Therefore, the study calls for more inclusive, context-sensitive, and interdisciplinary strategies to support the transformative ambitions of the 2030 Agenda. Full article

High-quality, openly accessible clinical datasets remain a significant bottleneck in advancing both research and clinical applications within medical artificial intelligence. Case reports, often rich in multimodal clinical data, represent an underutilized resource for developing medical AI applications. We present an enhanced version of MultiCaRe, a dataset derived from open-access case reports on PubMed Central. This new version addresses the limitations identified in the previous release and incorporates newly added clinical cases and images (totaling 93,816 and 130,791, respectively), along with a refined hierarchical taxonomy featuring over 140 categories. Image labels have been meticulously curated using a combination of manual and machine learning-based label generation and validation, ensuring a higher quality for image classification tasks and the fine-tuning of multimodal models. To facilitate its use, we also provide a Python package for dataset manipulation, pretrained models for medical image classification, and two dedicated websites. The updated MultiCaRe dataset expands the resources available for multimodal AI research in medicine. Its scale, quality, and accessibility make it a valuable tool for developing medical AI systems, as well as for educational purposes in clinical and computational fields. Full article

Blended and virtual learning have become an integral part in international higher education, especially in the wake of the COVID-19 pandemic and the European Union’s Digital Education Action Plan. These modalities have enabled more inclusive, flexible, and sustainable forms of international collaboration, such as Collaborative Online International Learning (COIL) and Blended Intensive Programs (BIPs), reshaping the landscape of global academic mobility. This paper introduces the INVITE Learning Design Framework (LDF), developed to support higher education instructors in designing high-quality, internationalized blended and virtual learning experiences. The framework addresses the growing need for structured, theory-informed approaches to course design that foster student engagement, intercultural competence, and motivation in non-face-to-face settings. The INVITE LDF was developed through a rigorous scoping review of existing models and frameworks, complemented by needs-identification analysis and desk research. It integrates Self-Determination Theory, Active Learning principles, and the ADDIE instructional design model to provide a comprehensive, adaptable structure for course development. The framework was successfully implemented in a large-scale online training module for over 1000 educators across Europe. Results indicate that the INVITE LDF enhances educators’ ability to create engaging, inclusive, and pedagogically sound international learning environments. Its application supports institutional goals of internationalization by making global learning experiences more accessible and scalable. The findings suggest that the INVITE LDF can serve as a valuable tool for higher education institutions worldwide, offering a replicable model for fostering intercultural collaboration and innovation in digital education. This contributes to the broader transformation of international higher education, promoting equity, sustainability, and global citizenship through digital pedagogies. Full article

In the increasingly competitive landscape of higher education, student satisfaction and loyalty are recognized as essential components for institutional sustainability and long-term success. This study aims to examine the interrelationships between service quality, technological innovation, student satisfaction, and student loyalty within higher education institutions in the Turkish Republic of Northern Cyprus (TRNC). Grounded in relationship marketing theory and the expectancy–disconfirmation paradigm, the research develops and tests a structural model that investigates the impact of perceived service quality on technological innovation, student satisfaction, and loyalty. The data were collected from 448 undergraduate students studying in the faculties of education at five leading private universities in TRNC, selected based on their international academic rankings. The analysis, conducted using structural equation modelling (SEM), reveals that service quality significantly and directly influences technological innovation, student satisfaction, and student loyalty. Additionally, technological innovation has a positive but comparatively weaker effect on student loyalty. Among the variables, student satisfaction emerges as the strongest determinant of loyalty, serving as a key mediator in the relationship between service quality and loyalty. This research contributes to the higher education literature by extending the traditional service quality–loyalty framework with the inclusion of technological innovation. The findings offer practical insights for university administrators, emphasizing the importance of delivering high-quality educational services combined with continuous digital innovation to enhance the student experience and foster long-term student commitment. Full article

The demand for sustainable animal production is increasing. Microalgae such as Chlorella and Spirulina show promise as sustainable and functional ingredients in animal (poultry) feed. However, little is known about consumer perceptions regarding the use of algae in broiler diets and potential effects of algae on chicken meat. Residents of Flanders (Belgium) were surveyed to evaluate consumer knowledge, attitudes and willingness to buy chicken meat produced with algae-supplemented feed. Demographic data were collected, and both descriptive and inferential statistics were applied to assess influencing factors (n = 275 respondents who purchase chicken meat). While most respondents (69.6%) had tasted macroalgae (seaweed), only 11.4% and 24.6% indicated having tasted Chlorella and Spirulina before, respectively. Health, taste and safety were the most important drivers for consuming algae. Meat quality was the most important factor when purchasing chicken meat, while organic production was least valued. Regarding algae-fed chicken, 72.5% expressed willingness to purchase meat labeled as such, and 83.7% would buy algae-fed chicken regardless of its color. Sustainability beliefs significantly influenced willingness to accept a yellower meat color (β = 0.42 to 0.66, p < 0.001). Educational level and age also played a role, with higher-educated consumers showing greater acceptance. The influence of age was also related to the price of the meat, with consumers over 30 expressing a greater willingness to pay more than young people (under 30). Despite limited general knowledge about microalgae, the consumers surveyed are open to the idea of algae-fed chicken meat, particularly when it is framed as more sustainable. Clear ingredient labeling and consumer education may further support market acceptance. Full article

Background and Objectives: Gender disparities in pain management persist, with women frequently receiving inadequate analgesia despite reporting similar or higher pain levels compared with men. This issue is particularly evident across various medical and gynecological procedures. Materials and Methods: This integrative literature review synthesizes recent empirical studies examining gender biases in pain perception and management, focusing specifically on procedural pain in women. It includes an analysis of clinical research, patient-reported outcomes, and healthcare provider behaviors. Results: The findings indicate that unconscious biases, a lack of gender-specific clinical protocols, and prevailing cultural stereotypes contribute to the undertreatment of pain in women during procedures such as intrauterine device insertion and diagnostic hysteroscopy. Additionally, communication gaps between patients and healthcare providers exacerbate these disparities. Conclusions: Addressing gender disparities in pain management necessitates systemic reforms, including the implementation of gender-sensitive clinical guidelines, enhanced provider education, and targeted policy changes. Personalized, gender-informed approaches are essential to improving equity and quality of care in pain treatment. Full article