Search Results (2,112)

Background: Patellofemoral pain (PFP) is a prevalent overuse injury among recreational cyclists worldwide. Despite its ubiquity, little is known about the lived experiences of people with PFP, especially in Saudi Arabia, where healthcare and cultural factors may have a specific impact on how the condition is managed. The aim of this study was to explore the lived experiences of recreational cyclists with patellofemoral pain in Al Madinah, Saudi Arabia. Method: A qualitative, descriptive design using reflexive thematic analysis was employed. Eleven male recreational cyclists aged 28–44 years diagnosed with PFP were purposely recruited from Al Madinah Physical Therapy Centre. Female participants were excluded due to cultural constraints regarding sports participation. The participants consented to participate in the study and to be audio recorded. Data were collected through semi-structured interviews using an interview guide. The interview data were transcribed verbatim and thematically analysed using Atlas.ti, version 24. Results: The thematic analysis revealed six themes highlighting the multidimensional impact of PFP. The participants described localised mechanical impairment with rapid onset during activity and persistent symptoms lasting up to two weeks. Pain was exacerbated by eccentric loading and cycling-specific stressors, such as uphill riding, leading to significant anxiety and avoidance behaviours. To maintain activity, these cyclists employed adaptive strategies, including bike modifications and self-management. Notably, PFP imposed substantial cultural and social burdens, hindering spiritual practices, specifically Salah (prayer) postures, professional duties, and family caregiving. While the participants demonstrated resourcefulness through a hybrid of physiotherapy and independent research, pharmacological relief was viewed as a transient solution. Conclusions: Patellofemoral pain imposes significant multidimensional burdens on recreational cyclists in Al Madinah, which are exacerbated by cultural practices. Physiotherapy offers targeted interventions for pain relief, functional restoration, and participation enhancement, necessitating the need for culturally sensitive management programmes. Full article

Reflection, as a key component of the educational process, strengthens the child’s sense of identity, self-awareness, and ability to learn consciously. Although the theoretical foundations of reflection are widely studied in educational science, its practical application in the context of preschool education remains fragmented and under-researched. The aim of this study is to reveal how preschool teachers understand, apply, and model the reflection process in educating 4–5-year-old children, to reveal the role of reflection between pedagogical action and conscious perception of education. The study is based on a qualitative methodology, applying the semi-structured interview method and the principles of qualitative content analysis. The study involved preschool teachers and educational support specialists working with 4–5-year-old children. Data analysis made it possible to identify the fundamental directions of the concept and application of reflection in pedagogical practice. The results of the study showed that reflection in preschool education acts as a link between action and awareness, that is, a process that allows both the teacher and the child to reflect on and transform the educational experience. It manifests itself through emotional awareness, self-assessment, professional growth, and adaptation of activities to the needs of children. Reflective practices integrated into daily education promote children’s metacognitive and emotional abilities, strengthen their self-awareness and motivation for learning, and provide teachers with the opportunity to purposefully improve their professional practice and improve the quality of education. Full article

Background: Dental disorders, such as cavities, periodontal disease, and periapical infections, remain major global health issues, often resulting in pain, tooth loss, and systemic complications if not identified early. Traditional diagnostic methods rely heavily on visual inspection and manual interpretation of panoramic X-ray images by dental professionals, making them time-consuming, subjective, and less accessible in resource-limited settings. Objectives: Accurate and timely diagnosis is vital for effective treatment and prevention of disease progression, reducing healthcare costs and patient discomfort. Recent advances in deep learning (DL) have demonstrated remarkable potential to automate and improve the precision of dental diagnostics by objectively analyzing panoramic, periapical, and bitewing X-rays. Methods: In this research, a hybrid feature-fusion framework is proposed. It integrates handcrafted Histogram of Oriented Gradients (HOG) features with deep representations from DenseNet-201 and the Shifted Window (Swin) Transformer models. Sequential dependencies among the fused features were learned utilizing the Long Short-Term Memory (LSTM) classifier. The framework was evaluated on the Dental Radiography Analysis and Diagnosis (DRAD) dataset following preprocessing steps, including resizing, normalization, Contrast Limited Adaptive Histogram Equalization (CLAHE) enhancement, and image cropping. Results: The proposed LSTM-based hybrid model achieved 96.47% accuracy, 91.76% specificity, 94.92% precision, 91.76% recall, and 93.14% F1-score. Conclusions: The proposed framework offers flexibility, interpretability, and strong empirical performance, making it suitable for various image-based recognition applications and serving as a reproducible framework for future research on hybrid feature fusion and sequence-based classification. Full article

Resilience to stress integrates cognitive, physiological, and behavioral adaptations to sustain performance under adversity. Genetic variation in catechol-O-methyltransferase (COMT, rs4680) and angiotensin-converting enzyme (ACE, rs1799752) modulates dopaminergic and renin–angiotensin signaling, influencing tissue oxygenation and fatigue resistance. We examined COMT- and ACE-promoter methylation and genotypes in relation to resilience traits in Swiss tactical athletes (24.6 years) with a maximal power output of 534 W and 21,656 W, respectively, during cardiopulmonary exercise and elbow strike testing. At a 5% false-discovery rate, COMT genotype/methylation explained ~12% of the variance in cognitive performance and metabolic resilience, while ACE explained ~6–7% in strength-endurance and muscle resistance. Antidromic linear associations between COMT genotype and methylation with visual reaction time under reactive stress indicate opposing regulatory influences, best captured by regression models incorporating (epi)genetic covariates. The strongest methylation effects involved COMT promoter associations with muscle hemoglobin content across cardiopulmonary exercise zones (r = 0.43–0.58) and sport-specific strain (r = −0.46). COMT- and ACE-promoter methylation, correlated with time spent in the first aerobic training zone (r = 0.55 and 0.32), indicating environmentally responsive epigenetic modulation. These findings highlight neurovascular–metabolic coupling via dopaminergic and renin–angiotensin pathways as a key mechanism in stress adaptation. System-level adaptations in these pathways align with COMT and ACE (epi)genetic blood profiles, positioning them as candidate resilience biomarkers. Larger, preregistered studies with site-specific CpG analyses and mechanistic assays are needed to establish causal relevance and translational utility for resilience-informed performance optimization in high-stakes professionals. Full article

The experiences and repercussions of the cross-border migration process on family life have not yet been synthesized. This study aimed to synthesize the best available qualitative findings on this theme. A systematic review of qualitative evidence with meta-synthesis was conducted. Articles were identified according to predefined extraction criteria in the first half of 2025, across seven databases: Web of Science, MEDLINE/PubMed, PsycINFO, LILACS, CINAHL, SCOPUS, and Social Science Citation Index. Two researchers independently screened and appraised the reports, assessing methodological quality and systematically recording and analyzing relevant information. A protocol was registered in PROSPERO (ID: CRD42024505655). Fifty studies were included, and three main themes emerged: (a) living in multiple possible contexts, where space and relationships influence family functionality, including reduced family time due to long working hours, substance use, fear of losing cultural roots, new financial responsibilities, and the desire to return to the country of origin; (b) challenges and repercussions on family life after migration, such as increased family conflicts, mental health problems, separation, and loss of ties; (c) strategies for maintaining family functioning, including role adjustment, strengthening of family ties, and support through cultural and religious practices. Families undergoing migration face multiple challenges in their new environments, revealing the complexity of adapting to diverse cultural and social contexts. These findings highlight the need to address the emotional and social demands of migrant families to improve well-being and integration. Understanding these dynamics allows healthcare professionals to design culturally sensitive interventions that promote reception and inclusion. Full article

This article analyses the professional routines of health journalists in Spain, and their role in tackling disinformation in health reporting targeted at people over the age of 74. It is based on the premise that this age group, being highly exposed to health issues and particularly vulnerable to health-related misinformation, requires content that is tailored, reliable and easy to understand. The research adopts an exploratory-descriptive approach through a self-administered questionnaire addressed to health journalists belonging to professional associations and working in both general and specialist media outlets. As this is an ongoing study, the preliminary results indicate that these professionals report applying rigorous verification mechanisms, which suggests a trend within the surveyed group towards the consolidation of practices against disinformation. The findings also reveal a preference for informative styles that avoid sensationalism and prioritise clarity, although there remains a tendency towards high-impact topics and those linked to media figures. In contrast, attention to the informational needs of older adults is limited and addressed only occasionally. The study concludes that, although the interviewed professionals consider that health journalism in Spain maintains high standards of rigor, it still faces the challenge of systematically adapting its communicative practices to the needs of vulnerable audiences. Full article

The increasing emphasis on responsible research assessment has renewed the need for conceptual tools that help communicate the complementary roles of quantitative and qualitative evaluation. This essay proposes an interpretative metaphor that frames bibliometric indicators as the “blood tests” of research systems—heuristic devices that reveal multidimensional aspects of system vitality, balance, and dysfunction. The metaphor, grounded in standard categories of clinical diagnostics (hematological, hepatic, renal, lipidic, and cardiovascular panels), provides an accessible language for scholars and policymakers in research. Each bibliometric technique—ranging from publication and citation counts to patent analysis, altmetrics, and topic modelling—is associated with a diagnostic function such as screening, monitoring, or early risk detection. By linking established principles of responsible metrics (DORA, Leiden Manifesto, Metric Tide, CoARA) with the professionalization of evaluators, the essay situates the metaphor within current debates on bibliometric literacy and the ethical interpretation of indicators. Rather than prescribing metrics or decision rules, the contribution invites reflection on how evaluators can interpret bibliometric signals diagnostically—as contextual evidence for institutional learning, strategic decision-making, and the cultivation of healthy, adaptive research systems. Consistent with the essay format, this contribution does not propose a new evaluative methodology nor empirical validation. Instead, it advances a heuristic and communicative framework intended to emphasize the holistic, contextual, and professionally informed interpretation of quantitative indicators in the evaluation of research activity. Full article

The growing emphasis on inclusive education highlights teachers’ attitudes and self-efficacy as interrelated yet distinct correlates of inclusive teaching. Building on prior literature that underscores their conceptual proximity, this study aimed to examine how teachers’ views on inclusion relate to their self-reported intentions and perceived self-efficacy for inclusive teaching. Given the cross-sectional, self-report design, the study addresses associations among attitudes, perceived self-efficacy, and intentions, rather than enacted inclusive practice. A cross-sectional survey was conducted with 323 Greek secondary special education teachers using three validated and culturally adapted instruments: the Attitudes toward Inclusive Education Scale (AIS), the Inclusive Classroom Teaching Intentions Scale (ITICS), and the Teacher Efficacy for Inclusive Practices Scale (TEIP). Pearson correlation analyses revealed strong within-instrument associations, indicating good internal coherence, and moderate cross-instrument associations, suggesting meaningful but not redundant relationships between attitudes, intentions, and self-efficacy. To further explore the latent structure, an Exploratory Factor Analysis (EFA) of AIS, ITICS, and TEIP items yielded a four-factor solution explaining 56.14% of the variance: Attitudes toward Inclusive Education, Intentions to Teach in Inclusive Classrooms, Self-efficacy for Behavior Management, and Self-efficacy for Collaboration and Professional Support. This study advances the field by clarifying how teachers’ attitudes, self-efficacy, and intentions covary, thereby informing the development of more targeted and theoretically grounded interventions. Full article

Background/Objectives: In recent years, quiet quitting has attracted increasing attention in nursing research and is conceptualized as a phenomenon in which nurses perform their professional duties at a minimal level without physically leaving their jobs. This study aimed to adapt the Quiet Quitting Scale into Turkish, evaluate its psychometric properties, and examine the relationships between stress of conscience, compassion fatigue, and quiet quitting among nurses. Methods: This is a descriptive, correlational, and methodological study. This study was conducted between 20 February and March 2025 with the participation of 205 nurses working in a university hospital in Turkey. The data were collected using the Nurse Descriptive Information Form, Stress of Conscience Questionnaire, Compassion Fatigue-Short Scale, and Quiet Quitting Scale. Results: The results indicated positive associations between stress of conscience, compassion fatigue, and quiet quitting. Mediation analysis revealed that compassion fatigue had a significant indirect effect on the association between stress of conscience and quiet quitting, while the direct relationship remained significant, suggesting partial mediation. Conclusions: These findings highlight the importance of supportive work environments where nurses can address ethical concerns and access interventions aimed at preventing compassion fatigue. Organizational strategies that promote psychological well-being may help sustain nurses’ work engagement and reduce quiet quitting. Full article

Background: Mental illness stigma among healthcare professionals can adversely affect patient care and recovery. While attitudes are shifting globally, limited data exist on stigma among non-psychiatrist doctors (NPDs) in India. This study aimed to assess the attitudes of NPDs toward mental illness and psychiatry using the Mental Illness Clinicians’ Attitudes Scale (MICA-4), and to explore associated sociodemographic and clinical factors. Methods: A cross-sectional online survey was conducted across India over six months in 2022, following ethics approval. The survey link was distributed via professional social media platforms using convenience and snowball sampling. Non-psychiatrist doctors with at least an MBBS degree were eligible. The MICA-4 scale assessed stigma across five domains. Descriptive statistics, correlation analyses, and multiple regression analysis were conducted. Results: A total of 102 responses were analysed. The mean MICA-4 score was 48.37, indicating moderately positive attitudes. Domain-wise analysis revealed higher stigma in knowledge/misconception and self-disclosure domains, while attitudes towards ethics and patient care were more favourable. No significant differences were found by gender, specialty, or practice setting. Weekly psychiatric caseload was not associated with reduced stigma. Internal consistency of the scale was low (Cronbach’s α = 0.46), raising concerns about cultural fit. The regression model was statistically significant F (5, 96) = 661.95, p < 0.001, explaining 97.18% of the variance in overall attitudes toward mental illness. Among the five domains, Respect for Psychiatry and Knowledge and Misconceptions emerged as the strongest predictors, highlighting their critical role in shaping positive professional attitudes in the public sector. Conclusions: Stigma toward mental illness persists among NPDs, particularly around misconceptions and help-seeking attitudes. These biases are culturally embedded and may not be significantly influenced by clinical exposure alone. While stigma was generally moderate, persistent misconceptions and self-stigma point to the importance of further developing culturally adapted tools and systemic interventions to promote reflective practice and ethical parity in clinical settings. Full article

This study presents a novel methodology that integrates Transformer-based textual analysis from professional networking platforms with traditional demographic variables within a survival analysis framework to predict turnover. Using a dataset comprising 4087 work events from Maimai (a leading professional networking platform in China) spanning 2020 to 2022, our approach combines sentiment analysis and deep learning semantic representations to enhance predictive accuracy and interpretability for HR decision-making. Methodologically, we adopt a hybrid feature-extraction strategy combining theory-driven methods (sentiment analysis and TF-IDF) with a data-driven Transformer-based technique. Survival analysis is then applied to model time-dependent turnover risks, and we compare multiple models to identify the most predictive feature sets. Results demonstrate that integrating textual and demographic features improves prediction performance, specifically increasing the C-index by 3.38% and the cumulative/dynamic AUC by 3.43%. The Transformer-based method outperformed traditional approaches in capturing nuanced employee sentiments. Survival analysis further boosts model adaptability by incorporating temporal dynamics and also provides interpretable risk factors for turnover, supporting data-driven HR strategy formulation. This research advances turnover prediction methodology by combining text analysis with survival modeling, offering small and medium-sized enterprises a practical, data-informed approach to workforce planning. The findings contribute to broader labor market insights and can inform both organizational talent retention strategies and related policy-making. Full article

By addressing the challenges of management difficulties, insufficient integration of driver analysis, and single-dimensional analysis in the governance of illegal land use and illegal construction (collectively referred to as the “Two Illegalities”) under rapid urbanization, this study designs and implements a GIS-based governance system using Xiamen City as the study area. First, we propose a standardized data-processing workflow and construct a comprehensive management platform integrating multi-source data fusion, spatiotemporal visualization, intelligent analysis, and customized report generation, effectively lowering the barrier for non-professional users. Second, utilizing methods integrated into the platform, such as Moran’s I and centroid trajectory analysis, we deeply analyze the spatiotemporal evolution and driving mechanisms of “Two Illegalities” activities in Xiamen from 2018 to 2023. The results indicate that the distribution of “Two Illegalities” exhibits significant spatial clustering, with hotspots concentrated in urban–rural transition zones. The spatial morphology evolved from multi-core diffusion to the contraction of agglomeration belts. This evolution is essentially the result of the dynamic adaptation between regional economic development gradients, urbanization processes, and policy-enforcement synergy mechanisms. Through a modular, open technical architecture and a “Data-Technology-Enforcement” collaborative mechanism, the system significantly improves information management efficiency and the scientific basis of decision-making. It provides a replicable and scalable technical framework and practical paradigm for similar cities to transform “Two Illegalities” governance from passive disposal to active prevention and control. Full article

Geothermal energy is a crucial component of climate adaptation and sustainability transitions, as it provides a dependable, low-carbon source of baseload power that can accelerate sustainable energy transitions and enhance climate resilience. Yet, in East Africa—one of the world’s most promising geothermal regions, with the East African Rift—a unique climate-energy opportunity zone—the harnessing of geothermal power remains slow and uneven. This study examines the contextual conditions that facilitate the successful and sustainable development of geothermal power in the region. Drawing on semi-structured interviews with 17 experienced professionals who have worked extensively on geothermal projects across East Africa, the analysis identifies how technical, institutional, managerial, and relational circumstances interact to shape outcomes. The findings indicate an interdependent configuration of success conditions, with structural, institutional, managerial, and meta-conditions jointly influencing project trajectories rather than operating in isolation. The most frequently emphasised enablers were resource confirmation and technical design, leadership and team competence, long-term stakeholder commitment, professional project management and control, and collaboration across institutions and communities. A co-occurrence analysis reinforces these insights by showing strong patterns of overlap between core domains—particularly between structural and managerial factors and between managerial and meta-conditions, highlighting the mediating role of managerial capability in translating contextual conditions into operational performance. Together, these interrelated circumstances form a system in which structural and institutional foundations create the enabling context, managerial capabilities operationalise this context under uncertainty, and meta-conditions sustain cooperation, learning, and adaptation over time. The study contributes to sustainability research by providing a context-sensitive interpretation of how project success conditions manifest in geothermal development under climate transition pressures, and it offers practical guidance for policymakers and partners working to advance SDG 7 (Affordable and Clean Energy), SDG 9 (Industry, Innovation and Infrastructure), and SDG 13 (Climate Action) in Africa. Full article

Education systems worldwide face a growing pressure to align with Sustainable Development Goal 4.7 by embedding Education for Sustainable Development (ESD) into school life. This study examines how primary school headteachers in Cyprus interpret and enact sustainable leadership to advance ESD within a small, highly centralised system. Drawing on sustainable and distributed leadership theories and a whole-school lens, the study employed semi-structured interviews with ten headteachers from diverse regions (urban, rural, and semi-rural). Reflective thematic analysis identified four patterns: (1) leaders sought a strategic integration of ESD into planning and culture; (2) empowerment and participation were pursued through teacher working groups, student eco-councils, and community partnerships; (3) systemic constraints, a rigid curriculum, limited autonomy, and scarce professional development produced a policy–practice gap; and (4) leaders relied on adaptive, collaborative micro-practices to sustain momentum. The findings suggest that, in Cyprus, sustainable leadership operates as a values-based stewardship enacted through ‘quiet activism’. The study highlights implications for leadership development, such as reflexivity, systems thinking, and ethical reasoning, as well as policy design, such as time, autonomy, and structured support for whole-school ESD, in small-state contexts. Full article

This article introduces a framework for scientific and professional language training tailored for STEM (Science, Technology, Engineering and Mathematics) specialists, emphasising the integration of digital technologies and artificial intelligence (AI) in language education. The framework aims to develop students’ research communication skills and digital competencies, which are essential for effective participation in both national and international scientific discourse. The article discusses contemporary trends in STEM education, emphasising the importance of interdisciplinary approaches, project-based learning, and the utilisation of digital tools to boost language skills and scientific literacy. The article outlines the development and deployment of a digital platform aimed at supporting personalised and adaptive learning experiences, integrating various educational technologies and approaches. Empirical research conducted through a pedagogical experiment demonstrates the effectiveness of the framework, showing significant improvements in students’ academic and linguistic competencies across multiple modules. The findings highlight the importance of combining language training with STEM education to equip future engineers for the challenges of a globalised and digitalised professional world. This work reports on the “Enhancing Scientific and Professional Language Learning for Engineering Students in Kazakhstan through Digital Technologies” project conducted at Saginov Technical University (STU) in Kazakhstan and funded by the Science Committee of the Ministry of Science and Higher Education of the Republic of Kazakhstan (Grant No. AP19678460). The research contributes to the ongoing discussion on improving language teaching in STEM fields, offering a framework that aligns with current educational demands and technological progress. Full article