Search Results (33,462)

School leadership practices may influence teachers’ motivation and professional engagement, which, in turn, may affect overall school performance. This study explores how secondary school teachers and deputy head teachers perceive head teachers’ leadership practices and how these practices are understood to influence teacher motivation and professional engagement. Drawing on a qualitative design, data were collected through semi-structured interviews with 12 teachers and six deputy head teachers from six government secondary schools in Kabwe District, Zambia. A qualitative approach enabled an in-depth exploration of leadership perceptions across participants from multiple school contexts. Data were analysed using thematic analysis to identify patterns in leadership practices described by participants. The findings indicate that participants frequently described leadership practices aligned with delegation, mentorship, and open communication, shaped by contextual and organisational factors. However, these practices were not consistently experienced across all school contexts. Participants also described the presence of democratic and autocratic leadership practices. Participants perceived participatory and supportive leadership practices as contributing to their motivation and professional engagement. However, participants from several schools reported that autocratic leadership practices continued to shape decision-making, largely due to contextual, institutional, and workload-related constraints. The study highlights the importance of understanding leadership as contextually negotiated and relationally enacted. It contributes to African educational leadership research by demonstrating how leadership practices are experienced and interpreted within specific school contexts and emphasising the value of examining leadership beyond a single theoretical model. The implications of these findings for school leadership practice, policy development, and international educational leadership research are discussed. Full article

Opisthorchis viverrini infection remains a significant public health concern in Southeast Asia, particularly in rural communities of Northeast Thailand, where persistent environmental and behavioral factors sustain transmission. A quasi-experimental study aimed to identify environmental and behavioral risk factors for infection and to evaluate the effectiveness of a community-based intervention program. The intervention program study was conducted over 10 months and comprised three phases: baseline survey‚ health education intervention program implementation‚ and follow-up evaluation. The results were analyzed for the prevalence of parasitic infections, and multivariable logistic regression was performed to identify associated factors. The majority of study participants were female (67.94%)‚ aged 55 to 64 years (48.09%)‚ and farmers (89.31%). Parasitic infections‚ especially O. viverrini‚ substantially decreased during the follow-up period‚ and independent risk factors predicting infection included lower education‚ previous infection‚ raw fish consumption‚ and pesticide use‚ according to multivariable logistic regression analysis. This intervention considerably improved knowledge; mean knowledge score increased by 6.29 points (p < 0.001). Analysis of fecal sludge after treatment with the sand-drying system identified S. stercoralis larvae (20 eggs/L) and Taenia spp. eggs (12.4 eggs/g). These findings indicated that, despite treatment, integrated behavioral and environmental interventions can be effective in interrupting parasite transmission in rural endemic settings. Full article

Our objective was to investigate the relationship between problematic TikTok use and levels of anxiety, depression, and sleep quality. We also explored differences across sex and generational groups. A cross-sectional study was conducted in Greece using a convenience sample. Participants were classified into three generational groups: Generation Z (1997–2012), Millennials (1981–1996), and Generation X (1965–1980). Problematic TikTok use was assessed with the TikTok Addiction Scale, while anxiety and depression were measured using the Patient Health Questionnaire-4. Sleep quality was evaluated with the Sleep Quality Scale. To account for potential confounding factors, we performed multivariable linear regression analyses. Our results showed a positive association between problematic TikTok use and both anxiety and depression. Multivariable analysis revealed a negative association between problematic TikTok use and sleep quality. In summary, our findings indicate that problematic TikTok use is linked to higher levels of anxiety and depression, as well as poorer sleep quality. These results highlight the need for policymakers, stakeholders, and healthcare professionals to develop and implement targeted interventions aimed at mitigating the negative effects associated with problematic TikTok use. Full article

Background: Elevated anticardiolipin IgG (aCL IgG) has been reported in end-stage renal disease (ESRD), but its association with specific etiologies of kidney failure remains unexplored. The unique pathophysiology of diabetic–hypertensive nephropathy may be associated with a microenvironment that could potentially contribute to antiphospholipid antibody production and thrombotic complications. This study aimed to investigate whether aCL IgG elevation in hemodialysis (HD) patients is associated with combined diabetes–hypertension (DM + HTN) etiology and thrombocytopenia, thereby identifying a clinically distinct potential high-risk subgroup. In this hypothesis-generating study, we focused on within-HD patient comparisons rather than healthy controls. Methods: We enrolled 242 participants: 150 healthy controls (included only to establish local reference ranges) and 92 patients with maintenance HD. The study was conducted from 01 September to 20 November 2025 in Madinah, Saudi Arabia. Serum aCL IgG was measured by chemiluminescence immunoassay (positive ≥ 12 GPL units). Comprehensive hematological and biochemical parameters were analyzed. Multivariable logistic regression identified predictors of aCL positivity. Results: In the HD cohort, 21% demonstrated aCL positivity; this represents a substantially higher rate than the 2% observed in local healthy controls (p < 0.001). This elevation was not uniform across etiologies. Strikingly, 94.7% (18/19) of aCL-positive HD patients had DM + HTN aetiology, compared with only 17.8% of aCL-negative patients (p < 0.001). Thrombocytopenia was significantly more severe in aCL-positive patients (median platelets: 100 vs. 191 × 10⁹/L, p < 0.001). In multivariable analysis, DM + HTN etiology (HTN-alone vs. DM + HTN odds ratio [OR]: 0.0013, 95% confidence interval [CI]: 0.00002–0.0999, p = 0.003; confirmed by Firth’s penalized logistic regression sensitivity analysis, and lower platelet count (OR: 0.92 per 1 × 10⁹/L increase, 95% CI: 0.87–0.98, p = 0.006) independently predicted aCL positivity. Conclusions: These hypothesis-generating findings suggest a potential association between metabolic–vascular disease and antiphospholipid immunity in ESRD. Causality cannot be inferred from this cross-sectional design. At present, routine aCL screening is not recommended outside of research protocols; prospective studies are needed to confirm these associations. Full article

This study examines how the allocation of export expansion across sectors affects economy-wide outcomes in Bangladesh. Using a Social Accounting Matrix (SAM) framework, we combine linkage analysis with simulation to evaluate how sectoral export growth propagates through the production network. The results show that the impact of export diversification depends critically on sectoral allocation rather than export intensity alone. While aggregate differences between scenarios are modest, reallocating export growth toward sectors with stronger intersectoral linkages generates larger economy-wide gains in GDP and labor income. In particular, sectors with low initial export shares but high network connectivity—such as agriculture, hunting, forestry, and fishing; retail trade; other community, social and personal services; and inland transport—produce stronger multiplier effects than most export-intensive sectors. These findings highlight a key distinction between export intensity and network centrality, demonstrating that sectors with limited direct export participation can play a central role in transmitting economic gains. The results provide a network-based perspective on export diversification and offer policy-relevant insights for designing strategies that promote more inclusive and efficient economic growth. Full article

Internet Gaming Disorder (IGD) has emerged as an increasingly prevalent behavioral health concern among late adolescent university students, a vulnerable population with emotional distress due to the developmental changes and academic pressures. This research explored the direct correlations between IGD and Mental Health Disorder (MHD), such as depression, anxiety, and stress in Saudi Arabia (SA) with study discipline as a moderator. A total of 480 students participated in the developed self-structured questionnaire, and Partial Least Squares Structural Equation Modeling (PLS-SEM) was employed to analyze the obtained data. The results showed that IGD can exert a positive and significant association with all three aspects of MHD. Moreover, the PLS-SEM slope analysis indicated that study discipline can significantly moderate the link from IGD to both anxiety and depression, with university students in health, science, and engineering fields displaying higher symptoms of depression and anxiety as compared to their peers in humanities and social sciences. However, study discipline failed to moderate the link from IGD to stress. These findings can be interpreted through maladaptive coping mechanisms and behavioral addiction, whereby extreme IG can contribute to social withdrawal, reduce sleep quality, and worsen stress regulation, specifically during the late adolescence period. The results extend current research on IGD by emphasizing the disciplinary differences in mental health vulnerability and offering more empirical evidence from a Middle Eastern context. The study highlighted the urgent need for discipline-oriented mental health screening and targeted proactive interventions to deal with unsettled IG attitude within a higher education context. Full article

With the implementation of market-oriented electricity trading in an increasing number of countries, accurate electricity price forecasting can not only help participants in the electricity market to make more reasonable decisions but also enable regulators to have a more reliable regulatory basis. Therefore, it is necessary to propose an appropriate electricity price forecasting method. In view of the insufficiency of the traditional models in dealing with nonlinear and non-stationary data, to improve the detection ability of the model for hidden information in data and considering the high randomness of electricity price data, this paper proposes an electricity price forecasting method based on singular spectrum analysis (SSA) to decompose the original sequence and combines it with an extreme learning machine (ELM) optimized by the grey wolf optimizer (GWO). First, SSA is used to decompose the original sequence, and then the ELM is used to predict each subsequence and add them, in which the number of neurons in the hidden layer of each ELM is jointly optimized by the GWO. To verify the effectiveness of the SSA–GWO–ELM model, a total of 2106 days of electricity price data in Victoria, Australia, were selected for modeling. The results show that the prediction accuracy of the model proposed in this paper is significantly higher than that of the other comparison models, and the R² score is as high as 0.989, which is 0.017 higher than that of the suboptimal SSA–ELM. It can also maintain strong robustness and high prediction accuracy for heterogeneous data on power demand. SSA has the potential for real-time prediction, which can provide reliable data support for electricity market participants and supervisors. Full article

Many tertiary mathematics departments are seeking to improve equity in their programs; however, they may struggle to translate these goals for equity into action. This longitudinal, qualitative study focuses on a Networked Improvement Community (NIC) within the mathematics department at a public, doctoral degree-granting university located in the Southeast United States. This NIC worked together for two years (Spring 2023 to Spring 2025) to become more reflective practitioners and critically transform the mathematics program at their institution. We used Cultural Historical Activity Theory (CHAT) to examine relationships between objects, tools, and outcomes for the NIC. Data included multiple interviews and journals from eleven (n = 11) participants, and was triangulated with observer field notes of monthly NIC meetings. Thematic analysis revealed three pathways that connected NIC members’ individual and collective goals (objects), NIC activities and resources (tools), and NIC members’ perspectives on teaching and students (outcomes). We found that sometimes objects, mediated by tools, led to aligned outcomes, but not always. Specific tools could lead the NIC to adopt a new and collective object (and outcome). In other cases, the lack of the right tool led to unrealized outcomes or even secondary outcomes within the NIC. Ultimately, the critical transformations that NIC members envisioned were not realized; however, the experience of examining student data and discussing with colleagues shaped their thinking about teaching and students in impactful ways that inform faculty development for institutional change efforts on a broader scale. Our findings highlight the importance of identifying the right tools to support critical transformation, including the value of examining data as a collaborative group. We also extend NIC scholarship by using second-generation CHAT to distinguish objects over time and specify pathway models linking tools to outcomes. Full article

Background/Objectives: Nutritional vulnerability (NV) describes the interaction of diet quality, access to food, health status and socioeconomic factors and may differ between neighborhoods. Nevertheless, there is still a limited amount of evidence regarding local NV variations in contrasting resource landscapes. The purpose of this study was to operationalize NV in Windham, Connecticut and conduct an analysis of its spatial distribution and the differences between neighborhoods for NV and specifically diet quality. Methods: NV was measured with four indicators, including two diet quality measures (liking-based DQI and short food frequency-based sHEI), food security, obesity, and SNAP participation. Areas of vulnerable concentration were determined through spatial mapping. Indicators related to each other were measured by Spearman correlation. To compare the contrasting neighborhoods (resource-dense vs. resource-limited), contextual differences were studied and differences in NV indicators, sociodemographic and movement factors were compared with the help of chi-square tests. Diet quality measures were jointly examined for concordance (both measures low or high) and discordance. Results: Area-level comparisons showed significant differences in mobility-related and sociodemographic characteristics, including vehicle access and education level (p < 0.05). High diet quality (measure concordance) was reported by individuals living in high-resourced regions; low diet quality (measure concordance) by individuals in low-resourced regions. Conclusions: The NV Map illustrated focal patterns of vulnerability determined by the interplay of sociodemographic disadvantage and mobility-related limitations and not by distance to food resources. These results give practical spatial data to promote specific nutrition and resource intervention. Full article

Bullying and victimization are prevalent in school and sport settings, yet they are rarely examined concurrently. This study explored the relationships between school and sport bullying among youth athletes, assessing whether demographic and sport-related factors are associated with these behaviors across contexts. Participants included 189 youth athletes (aged 8–15 years) from Central Macedonia, Northern Greece. They completed a demographic survey and the Bullying and Victimization Questionnaire twice, assessing both school and sport environments. A multivariate analysis of variance (MANOVA) evaluated the effects of gender, educational level, sport type, and contact classification, followed by regression analyses. Results showed that educational level yielded a significant multivariate effect, with secondary school students reporting higher involvement in school bullying, sport bullying, and sport victimization. Crucially, regression analyses revealed that school-context bullying and victimization were the strongest factors associated with corresponding behaviors in sports. Additionally, team sport participation was associated with sport victimization, while demographic factors were related to school bullying perpetration. These findings demonstrate the interconnected nature of bullying between school and sport environments, emphasizing the critical need for coordinated, multi-contextual prevention strategies among educators and coaches. Full article

Background/Objectives: Blood donation is a critical component of healthcare systems worldwide, yet donor recruitment remains challenging. This study evaluates the knowledge, attitudes, motivations, and practices (KAP) of blood donation among the general population in Saudi Arabia to identify key barriers and propose targeted interventions. Methods: A cross-sectional study was conducted using a structured, validated questionnaire distributed over five months (December 2022 to April 2023) via social media and in-person recruitment at the Central Blood Bank in Riyadh. A total of 1150 participants aged 18–60 years residing in Saudi Arabia were included in the final analysis. Statistical analysis was performed using SPSS version 22, with p < 0.05 considered significant. Results: Participants demonstrated moderate knowledge (mean score 5.43 ± 1.81 out of 9), with significantly higher scores among males, individuals aged 21–30 years, and those holding a bachelor’s degree. Attitudes toward donation were highly positive (mean score 15.46 ± 2.74 out of 20) and correlated with age, gender, marital status, and occupation. Despite this positive outlook, only 34.96% of participants had donated blood previously, although 95.25% expressed willingness to do so. Primary motivators included mobile donation units (89.22%) and paid leave (89.22%), whereas 51.22% of respondents considered current media campaigns ineffective. Common barriers to donation included health concerns (25.30%), time constraints (12.87%), and fear of needles (7.74%). Conclusions: This study reveals a critical disparity between positive public attitudes and actual donation practices in Saudi Arabia. To enhance donor participation, we recommend implementing convenient donation strategies such as mobile blood drives, workplace incentives, and more effective, culturally tailored educational campaigns. Addressing these factors could help Saudi Arabia improve its voluntary donation rates and ensure a sustainable, safe blood supply. Full article

Mental health interventions in rural areas often face systemic and governance barriers that limit their implementation. This study analysed how governance dimensions at the municipal, state, and federal levels influence the perceived feasibility of implementing the Primary Care and Psychiatry Model (MAP-PSI), an early intervention strategy targeting adolescent depression in rural Mexico. A descriptive–interpretative qualitative design was employed, using semi-structured interviews and hybrid (deductive–inductive) content analysis. Participants were purposively selected institutional stakeholders involved in MAP-PSI implementation, including local health managers, state and federal decision-makers, and community-based actors. The coding process was collaboratively developed and validated through consensus and critical reflection among researchers. Five interrelated governance dimensions were identified: local leadership, intersectoral coordination, resource mobilisation, community participation, and institutional adaptability. These dimensions converge in a multilevel governance framework that illustrates how governance capacities across levels can enable or constrain community-based mental health interventions. The findings provide an empirically grounded framework to inform the design, adaptation, and future evaluation of community-based mental health strategies in underserved rural contexts. Full article

Objective: The aim of this study was to explore how healthcare professionals in the Republic of Ecuador perceive violence against women, its underlying social determinants, and their role in prevention and response within the healthcare setting. Methodology: A qualitative descriptive study was conducted using purposive sampling. Ten healthcare professionals with experience in managing cases of violence against women participated. Data were collected through semi-structured interviews and analysed using Braun and Clarke’s reflective thematic analysis. The ATLAS.ti software was used throughout the analysis process. Results: The participants emphasised the normalisation of microaggressions, institutional shortcomings in prevention systems, and the need for gender-sensitive professional training. Three main themes emerged from the data analysis: (1) the characteristics and identification of violence against women, (2) the social dimensions of violence against women, and (3) combating violence against women in clinical and educational settings. Conclusions: The healthcare professionals highlighted the need to recognise normalised and less visible forms of violence reflected in everyday attitudes and behaviours. They emphasised the importance of early identification, multidisciplinary care and sex education as preventive strategies. The social context and deep-rooted power dynamics favour the perpetuation of violence against women. Healthcare professionals can play an important role in the prevention of violence against women by improving care for survivors, identifying areas for improvement within existing prevention systems, and promoting sex education. Full article

Background: Health-related behaviors often cluster during young adulthood, potentially increasing the risk of long-term adverse health outcomes. Understanding how lifestyle risk behaviors co-occur among university students is essential for developing targeted health promotion strategies. Objective: This study aimed to identify lifestyle risk profiles among university students based on the co-occurrence of smoking behavior, alcohol consumption, sedentary behavior, and body weight status. Methods: A cross-sectional study was conducted with 147 university students enrolled in a physical education and sport undergraduate program (mean age: 20.58 ± 2.94 years; 80.3% male). Physical activity and sedentary behavior were assessed using the International Physical Activity Questionnaire–Short Form (IPAQ-SF), while smoking and alcohol consumption were self-reported. Body mass index was used to classify weight status. Lifestyle risk profiles were identified using two-step cluster analysis based on regular smoking, alcohol consumption, sedentary behavior, and overweight/obesity. Differences in cluster distribution according to sex and federated athlete status were examined using chi-square tests. A two-step cluster analysis based on the Bayesian Information Criterion (BIC) and silhouette measure was used to identify lifestyle risk profiles. Results: Overall, 46.9% of participants had experimented with tobacco, 11.6% were current smokers, and 74.8% reported alcohol consumption. Participants accumulated an average of 3772.25 ± 1957.99 MET-min/week of physical activity. Three distinct lifestyle risk profiles were identified. Cluster 1 (46.9%), labeled the alcohol profile, was characterized by alcohol consumption without smoking and no prevalence of being overweight. Cluster 2 (20.4%), the multiple-risk profile, included participants who reported regular smoking, with nearly half presenting sedentary behavior and overweight/obesity. Cluster 3 (32.7%), the overweight profile, was characterized by overweight/obesity combined with alcohol consumption but no smoking. No significant differences were observed in the distribution of lifestyle profiles according to sex (p = 0.111) or federated athlete status (p = 0.087). Conclusions: Lifestyle risk behaviors cluster into distinct profiles among university students, with alcohol consumption appearing across multiple profiles and smoking concentrated in a specific high-risk group. These findings highlight the need for targeted health promotion strategies addressing multiple co-occurring behaviors within university populations. Full article

Lumbosacral and thoracolumbar kinematics are key risk factors for lifting-related low back pain, yet their measurement is typically restricted to motion capture laboratories. Inertial measurement units (IMUs) offer the potential to quantify spine kinematics in more naturalistic settings, but the validity of IMU-based processing pipelines relative to optical motion capture (OMC) remains unclear. Nine healthy participants performed stoop, squat, free, and asymmetric lifting tasks while IMU and OMC data were simultaneously collected to evaluate the concurrent validity of two IMU pipelines: the proprietary MVN Analyze pipeline and an OpenSense pipeline using a validated OpenSim biomechanical model for lifting. Joint angles from both pipelines were compared against OMC-derived joint angles calculated using the same validated OpenSim model with one-way repeated-measures statistical parametric mapping (SPM) (α = 0.05), Bland–Altman analysis with Limits of Agreement (LoA) and 95% Confidence Intervals (CIs), and Concordance Correlation Coefficients (CCCs) with 95% CIs. Xsens MVN Analyze consistently overestimated flexion-extension at both spinal levels across all lift types (lumbosacral: RMSE ≤ 9.8◦, bias ≤ −14.5◦, LoA ≤ ±10◦; thoracolumbar: RMSE ≤ 5.4◦, bias ≤ −8.3◦, LoA ≤ ±5◦), with SPM confirming significant differences during the lifting and lowering phases of all lifting cycles. In contrast, processing Xsens data with OpenSense using the same biomechanical model as the OMC data yielded excellent agreement with OMC (RMSE ≤ 2.9◦, bias ≤ 3◦, LoA ≤ ±10◦). CCC was poor to moderate, specifically in lateral bending and axial rotation planes, likely reflecting limited between-participant ROM variability. These results suggest that discrepancies are driven primarily by biomechanical model differences rather than sensor or sensor fusion limitations. Ultimately, when paired with an appropriate biomechanical model, XSens sensors show promise for practical field-based assessment of lifting biomechanics, potentially requiring only sensors at the chest and pelvis. Full article