Search Results (954)

Background: Concerns over women’s mental health have intensified globally, especially among mothers managing dual careers and family responsibilities. Positive Psychology Interventions (PPIs), such as gratitude journaling and well-being workshops, have demonstrated promise in enhancing mental health; however, their applicability in Arab contexts remains underexplored. This study aims to investigate the effectiveness of PPIs on mothers’ well-being, gratitude, depression, anxiety, and stress in Saudi Arabia. Methods: This quasi-experimental, one-group pretest–posttest study assessed the effects of a four-week PPI on 37 Saudi working mothers (aged 21–50 years) employed at a private school in Riyadh. The intervention included guided gratitude journaling thrice weekly and two workshops on positive psychology and gratitude. Pre- and post-intervention assessments used validated Arabic versions of the Depression Anxiety Stress Scale (DASS-21), WHO-5 Well-being Index, and Gratitude Questionnaire (GQ-6). Results: Significant improvements were found post-intervention: depression, anxiety, and stress scores decreased (p < 0.001), while well-being and gratitude increased (p = 0.001). However, participants with lower household income (<50,000 SAR) showed less improvement, indicating a potential moderating effect of socioeconomic status. Conclusions: The intervention demonstrated promising short-term improvements in mental health and well-being among Saudi mothers. The findings underscore the importance of culturally appropriate PPIs and highlight the need for further research using controlled, long-term designs. Limitations include the small, non-random sample, absence of a control group, and restriction to a single geographic region. Full article

Although organizational resilience is well established, refining the systematic quantitative evaluation of health systems resilience (HSR) remains an ongoing opportunity for advancement. Research either focuses on individual HSR indicators, such as social welfare policy, public expenditure, health insurance, healthcare quality, and technology, or broadly examines socio-economic factors, highlighting the need for a more comprehensive methodological approach. This study employed the Slacks-Based Measure (SBM) within Data Envelopment Analysis (DEA) to analyze efficiency by maximizing outputs. It systematically examined key HSR factors across countries, providing insights for improved policymaking and resource allocation. Taking a five-year (2016–2020) dataset that covered 55 to 56 countries and evaluating 17 indicators across governance, health systems, and economic aspects, the paper presents that all sixteen top-ranked countries with a perfect efficiency score of 1 belonged to the high-income group, with ten in Europe, highlighting regional HSR differences. This paper concludes that adequate economic resources form the foundation of HSR and ensure stability and sustained progress. A properly supported healthcare workforce is essential for significantly enhancing health systems and delivering quality care. Last, effective governance and the equitable allocation of resources are crucial for fostering sustainable development and strengthening HSR. Full article

Numerous studies have demonstrated that in residential areas of Western cities, both luxury and legacy effects significantly shape tree species diversity dynamics. However, the specific mechanisms driving these diversity patterns in China, where urbanization has progressed at an unprecedented pace, remain poorly understood. In this study we selected 20 residential settlements and 7 key socio-economic properties to investigate the change trend of tree diversity (2006–2021) and its socio-economic driving factors in Beijing. Our results demonstrate significant increases in total, native, and exotic tree species richness between 2006 and 2021 (p < 0.05), with average increases of 36%, 26%, and 55%, respectively. Total and exotic tree Shannon-Wiener indices, as well as exotic tree Simpson’s index, were also significantly higher in 2021 (p < 0.05). Housing prices was the dominant driver shaping total and exotic tree diversity, showing significant positive correlations with both metrics. In contrast, native tree diversity exhibited a strong positive association with neighborhood age. Our findings highlight two dominant mechanisms: legacy effect, where older neighborhoods preserve native diversity through historical planting practices, and luxury effect, where affluent communities drive exotic species proliferation through ornamental landscaping initiatives. These findings elucidate the dual dynamics of legacy conservation and luxury-driven cultivation in urban forest development, revealing how historical contingencies and contemporary socioeconomic forces jointly shape tree diversity patterns in urban ecosystems. Full article

Urban health planning requires a multi-scalar understanding of the territory, capable of capturing socio-economic inequalities and health needs at the local level. In the case of Rome, current administrative subdivisions—Urban Zones (Zone Urbanistiche)—are too large and internally heterogeneous to serve as effective units for equitable health planning. This study presents a methodology for the territorial redefinition of Rome’s Municipality III, aimed at supporting healthcare planning through an integrated analysis of census sections. These were grouped using a combination of census-based socio-demographic indicators (educational attainment, employment status, single-person households) and real estate values (OMI data), alongside administrative and road network data. The resulting territorial units—21 newly defined Mesoareas—are smaller than Urban Zones but larger than individual census sections and correspond to socio-territorially homogeneous neighborhoods; this structure enables a more nuanced spatial understanding of health-related inequalities. The proposed model is replicable, adaptable to other urban contexts, and offers a solid analytical basis for more equitable and targeted health planning, as well as for broader urban policy interventions aimed at promoting spatial justice. Full article

Atmospheric warming results in increase in temperatures for the mean, the coldest, and the hottest day of the year, season, or month. Global warming leads to a large increase in the atmospheric water vapor content and to changes in the hydrological cycle, which include an intensification of precipitation extremes. Using the GISS-E2.1 climate model, we present the future changes in the coldest and hottest daily temperatures as well as in extreme precipitation indices (under four main Shared Socioeconomic Pathways (SSPs)). The increase in the wet-day precipitation ranges between 6% and 15% per 1 °C global surface temperature warming. Scaling of the 95th percentile versus the total precipitation showed that the sensitivity for the extreme precipitation to the warming is about 10 times stronger than that for the mean total precipitation. For six precipitation extreme indices (Total Precipitation, R95p, RX5day, R10mm, SDII, and CDD), the histograms of probability density functions become flatter, with reduced peaks and increased spread for the global mean compared to the historical period of 1850–2014. The mean values shift to the right end (toward larger precipitation and intensity). The higher the GHG emission of the SSP scenario, the more significant the increase in the index change. We found an intensification of precipitation over the globe but large uncertainties remained regionally and at different scales, especially for extremes. Over land, there is a strong increase in precipitation for the wettest day in all seasons over the mid and high latitudes of the Northern Hemisphere. There is an enlargement of the drying patterns in the subtropics including over large regions around Mediterranean, southern Africa, and western Eurasia. For the continental averages, the reduction in total precipitation was found for South America, Europe, Africa, and Australia, and there is an increase in total precipitation over North America, Asia, and the continental Russian Arctic. Over the continental Russian Arctic, there is an increase in all precipitation extremes and a consistent decrease in CDD for all SSP scenarios, with the maximum increase of more than 90% for R95p and R10 mm observed under SSP5–8.5. Full article

Liver transplantation (LT) for hepatic malignancies is becoming increasingly common, largely because it offers superior survival relative to other treatment approaches. LT is well-accepted for primary liver cancers such as hepatocellular carcinoma and perihilar cholangiocarcinoma and is being increasingly accepted for intrahepatic cholangiocarcinoma and metastases of colorectal cancer or neuroendocrine tumors to the liver. Over time, indications for transplant oncology have broadened, as has the acceptable disease burden for transplantation, particularly with the advent of new neoadjuvant therapies. Other current frontiers in the field include expanding the donor pool through living donors, extended criteria donors, machine perfusion and increasing access to LT for people from disadvantaged socioeconomic backgrounds. Expanding access to LT can offer renewed hope for long-term survival to patients with primary and secondary liver cancer. Full article

This study explores the role of community-centered farm-based hospitality in promoting sustainable rural development, with a focus on South Tyrol, Italy. A survey of 461 local residents assessed perceptions of agritourism’s impact on agricultural heritage, environmental sustainability, and community well-being. Factor analysis identified two main constructs—Agroheritage Sustainability and Empowered Eco-Tourism—which together capture the multifaceted benefits of agritourism. Agroheritage Sustainability reflects the preservation of traditional farming practices, cultural landscapes, and intergenerational knowledge, emphasizing the role of tourism in maintaining cultural identity and preventing land abandonment. Empowered Eco-Tourism highlights the socio-economic benefits of sustainable tourism, including community empowerment, environmental stewardship, and the creation of new economic opportunities. The study’s findings indicate that local residents view agritourism as a holistic approach that supports rural livelihoods while preserving cultural heritage and promoting ecological resilience. The analysis further supports the potential of farm-based hospitality as a model for sustainable rural development, aligning closely with EU policies and global best practices. The Roter Hahn initiative in South Tyrol serves as a practical example of this approach, demonstrating the value of certification programs in enhancing transparency, quality, and sustainability. These insights provide valuable guidance for policymakers and tourism developers seeking to promote sustainable rural tourism globally. The contribution of this research lies in its empirical validation of a dual-construct model that links community engagement with agroecological and cultural sustainability, offering a transferable framework for evaluating agritourism as a lever for sustainable rural development in diverse regional contexts. Full article

Background: Adolescents’ subjective well-being (SWB) is a key indicator of quality of life. While its development during schooling has been widely studied, few studies have examined changes in SWB after leaving school due to the need for longitudinal data. This study investigates changes in SWB among adolescents in Germany over the two years before and after leaving school, focusing on school type, socioeconomic position, gender, and family structure. Methods: We use data from the ninth-grade cohort of the German National Educational Panel Study, first surveyed in 2010 and followed annually. Growth modeling (specifically, a multilevel discontinuity model) is applied to analyze SWB trajectories and potential moderation by background characteristics. The final sample includes 19,767 observations from 6599 individuals. Results: SWB increases notably after leaving school and remains stable before and after the transition. The increase is smaller for adolescents completing higher secondary education, living in nuclear families, or identifying as male. These groups report higher SWB prior to the transition, so post-school changes reduce group differences. Conclusion: The findings suggest that schools may lack adequate resources to support adolescents in mastering key developmental challenges. While school is a critical environment, it may also impose pressures that are associated with lower well-being. Full article

This study investigates economic decision-making behaviors among welfare recipients in Miami, Florida, by leveraging well-established experimental protocols: the Guessing Game, the Prudence Measurement Task, the Risk Aversion Task, and the Stag Hunt Game. For this purpose, our study defines financial decisions as the underlying individual preferences that serve as validated proxies for savings behavior, debt management, job-search intensity, and participation in cooperative finance. A central objective is to compare the behavior of welfare recipients to that of undergraduate students, a cohort typically used in experimental economics research. The analysis reveals significant differences between the two groups in strategic thinking and coordination, particularly across ethnic and gender lines. Non-Hispanic/Latino participants in Miami displayed significantly higher average guesses in the Guessing Game compared to their counterparts in Tucson, indicating potential discrepancies in the depth of strategic reasoning. Additionally, female participants in Tucson exhibited higher levels of coordination in the Stag Hunt Game compared to females in Miami, suggesting variance in cooperative behavior between these groups. Despite these findings, regression models demonstrate that location, gender, and ethnicity collectively account for only a small fraction of the observed variance, as evidenced by low R² values and substantial mean squared errors across all games. These results suggest that individual heterogeneity, rather than broad demographic variables, may be more influential in shaping economic decisions. This study underscores the complexity of generalizing findings from traditional student samples to more diverse populations, highlighting the need for further investigation into the socioeconomic factors that drive financial decision-making. Full article

Air pollution monitoring in ungauged zones presents unique challenges yet remains critical for understanding environmental health impacts and socioeconomic dynamics in the Eastern Mediterranean region. This study investigates air pollution patterns in northwestern Syria during 2019–2024, analyzing NO₂ and CO concentrations using Sentinel-5P TROPOMI satellite data processed through Google Earth Engine. Monthly concentration averages were examined across eight key locations using linear regression analysis to determine temporal trends, with Spearman’s rank correlation coefficients calculated between pollutant levels and five meteorological parameters (temperature, humidity, wind speed, atmospheric pressure, and precipitation) to determine the influence of political governance, economic conditions, and environmental sustainability factors on pollution dynamics. Quality assurance filtering retained only measurements with values ≥ 0.75, and statistical significance was assessed at a p < 0.05 level. The findings reveal distinctive spatiotemporal patterns that reflect the region’s complex political-economic landscape. NO₂ concentrations exhibited clear political signatures, with opposition-controlled territories showing upward trends (Al-Rai: 6.18 × 10⁻⁸ mol/m²) and weak correlations with climatic variables (<0.20), indicating consistent industrial operations. In contrast, government-controlled areas demonstrated significant downward trends (Hessia: −2.6 × 10⁻⁷ mol/m²) with stronger climate–pollutant correlations (0.30–0.45), reflecting the impact of economic sanctions on industrial activities. CO concentrations showed uniform downward trends across all locations regardless of political control. This study contributes significantly to multiple Sustainable Development Goals (SDGs), providing critical baseline data for SDG 3 (Health and Well-being), mapping urban pollution hotspots for SDG 11 (Sustainable Cities), demonstrating climate–pollution correlations for SDG 13 (Climate Action), revealing governance impacts on environmental patterns for SDG 16 (Peace and Justice), and developing transferable methodologies for SDG 17 (Partnerships). These findings underscore the importance of incorporating environmental safeguards into post-conflict reconstruction planning to ensure sustainable development. Full article

Background: Depression is a mental disorder characterized by a combination of somatic and cognitive disturbances, in which a predominantly sad or irritable mood significantly interferes with the patient’s functioning. This condition can affect individuals of all ages and socioeconomic backgrounds. Currently, various studies are exploring a possible association between oral dysbiosis and depression—an increasingly relevant topic, as confirmation of such a relationship could position the oral microbiota as a potential etiological or diagnostic factor for depression, given its accessibility and ease of analysis. Aim: To present a qualitative synthesis of studies addressing how oral dysbiosis influences the onset of depression, as well as the importance of controlling this alteration of the oral microbiota to aid in the prevention of the disease. Materials and Methods: The PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) outline the procedures to be followed for conducting this systematic review. The article search was carried out on 22 May 2025, across the PubMed, Scopus, Scielo, and The Cochrane Library databases, using terms related to “depression” and “oral dysbiosis”. Studies published within the last 10 years that addressed the potential association between oral dysbiosis, and depression were included. Furthermore, the quality of the studies was assessed using various tools depending on their design: the Newcastle–Ottawa Scale (NOS) was applied to case-control and cohort studies; the Joanna Briggs Institute (JBI) critical appraisal checklist was used for cross-sectional studies; and experimental studies were evaluated using SYRCLE’s Risk of Bias Tool. Results: A total of eleven studies were included in this systematic review. The findings suggest the presence of alterations in the oral microbiota of patients with depression, particularly in terms of composition, structure, and diversity. A reduction in alpha diversity—an indicator of local microbial balance—was observed, along with an increase in beta diversity, indicating greater inter-individual variability, which may be associated with inflammatory processes or immunological dysfunctions. Some studies reported differing results, which may be attributable to methodological variability regarding study design, or the populations sampled. Conclusions: This systematic review suggests that the oral microbiome could be considered a diagnostic biomarker and therapeutic target for depression, as the analyzed studies demonstrate a significant association between oral microbiome dysbiosis and this mental disorder. However, the methodological heterogeneity among the studies highlights the need for further research to confirm this potential relationship. Full article

Background: The Kidney Disease and Quality of Life Short Form (KDQOL-SF™ 1.3) is widely used to assess health-related quality of life (HRQoL) in patients with end-stage renal disease. However, no prior validation had been conducted in Kazakhstan, where both Kazakh and Russian are commonly spoken. This study aimed to validate the Kazakh and Russian versions of the KDQOL-SF™ 1.3 and to identify predictors of HRQoL among hemodialysis patients in Kazakhstan. Methods: A cross-sectional survey was conducted among 217 adult hemodialysis patients from February to April 2025 using a mixed-methods approach (in-person interviews and online data collection). Psychometric testing included Cronbach’s alpha, floor and ceiling effect analysis, and Pearson correlations with self-rated overall health. Multiple linear regression was used to identify predictors of the Kidney Disease Component Summary (KDCS), Physical Component Summary (PCS), and Mental Component Summary (MCS) scores. Results: Both language versions demonstrated acceptable to excellent internal consistency (Cronbach’s α = 0.692–0.939). Most subscales were significantly correlated with self-rated health, supporting construct validity. Regression analyses revealed that greater satisfaction with care, better economic well-being, and more positive dialysis experiences were significant predictors of higher KDCS and MCS scores. Lower PCS scores were associated with female gender, comorbidities, and financial burden. Importantly, financial hardship and access challenges emerged as strong negative influences on HRQoL, underscoring the role of socioeconomic and care-related factors in patient well-being. Conclusions: The KDQOL-SF™ 1.3 is a valid and reliable tool for assessing quality of life among Kazakh- and Russian-speaking hemodialysis patients in Kazakhstan. Integrating this instrument into routine clinical practice may facilitate more personalized, patient-centered care and help monitor outcomes beyond traditional clinical indicators. Addressing economic and access-related barriers has the potential to significantly improve both physical and mental health outcomes in this vulnerable population. Full article

Over the past few decades, occurrences of extreme climatic events have escalated significantly, with severe repercussions for global ecosystems and socio-economics. northern China (NC), characterized by its complex topography and diverse climatic conditions, represents a typical ecologically vulnerable region where vegetation is highly sensitive to climate change. Therefore, monitoring vegetation dynamics and analyzing the influence of extreme climatic events on vegetation are crucial for ecological conservation efforts in NC. Based on extreme climate indicators and the Normalized Difference Vegetation Index (NDVI), this study employed trend analysis, Ensemble Empirical Mode Decomposition, all subsets regression analysis, and random forest to quantitatively investigate the spatiotemporal variations in historical and projected future NDVI trends in NC, as well as their responses to extreme climatic conditions. The results indicate that from 1982 to 2018, the NDVI in NC generally exhibited a recovery trend, with an average growth rate of 0.003/a and a short-term variation cycle of approximately 3 years. Vegetation restoration across most areas was primarily driven by short-term high temperatures and long-term precipitation patterns. Future projections under different emission scenarios (SSP245 and SSP585) suggest that extreme climate change will continue to follow historical trends. However, increased radiative forcing is expected to constrain both the rate of vegetation growth and its spatial expansion. These findings provide a scientific basis for mitigating the impacts of climate anomalies and improving ecological quality in NC. Full article

A partially ordered set (or a poset, for short) is a set endowed with a partial order relation, i.e., with a reflexive, anti-symmetric, and transitive binary relation. As mathematical objects, posets have been intensively studied in the last century, coming to play essential roles in pure mathematics, logic, and theoretical computer science. More recently, they have been increasingly employed in data analysis, multi-criteria decision-making, and social sciences, particularly for building synthetic indicators and extracting rankings from multidimensional systems of ordinal data. Posets naturally represent systems and phenomena where some elements can be compared and ordered, while others cannot be and are then incomparable. This makes them a powerful data structure to describe collections of units assessed against multidimensional variable systems, preserving the nuanced and multi-faceted nature of the underlying domains. Moreover, poset theory collects the proper mathematical tools to treat ordinal data, fully respecting their non-numerical nature, and to extract information out of order relations, providing the proper setting for the statistical analysis of multidimensional ordinal data. Currently, their use is expanding both to solve open methodological issues in ordinal data analysis and to address evaluation problems in socio-economic sciences, from multidimensional poverty, well-being, or quality-of-life assessment to the measurement of financial literacy, from the construction of knowledge spaces in mathematical psychology and education theory to the measurement of multidimensional ordinal inequality/polarization. Full article

Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and tailored policy recommendations. As part of the MEDIET4ALL PRIMA project, this cross-sectional study aimed to comprehensively examine geo-demographic, socio-economic, psychological, behavioral, and barrier-related factors associated with and potentially contributing to MedLife adherence. Methods: Data were collected from 4010 participants aged 18 years and above across ten Mediterranean and neighboring countries using the multinational MEDIET4ALL e-survey, which included the validated MedLife index, along with various other questionnaires. Results: Results indicate that only 22% of respondents demonstrated high adherence to the Mediterranean lifestyle (MedLife), with significant variability observed across countries, age groups, education levels, and health statuses. Spain had the highest proportion of participants with high adherence (38%). Factors associated with significantly higher adherence rates include older age, living in the Mediterranean region, higher education levels, a greater awareness of MedLife principles, lower perceived barriers, normal BMI, better health status, and stable economic and marital conditions (p-values ranging from 0.04 to <0.001). Additionally, individuals with high MedLife adherence exhibited more socially and physically active lifestyles and experienced less psychological strain (p < 0.001). Regression analyses identified MedLife awareness as the strongest positive predictor of adherence (β = 0.206), followed by social participation (β = 0.194) and physical activity (β = 0.096). Additional positive contributors include life satisfaction, sleep quality, living in the Mediterranean region, age, and education (β ranging from 0.049 to 0.093). Conversely, factors that are negatively associated with adherence include sedentary behavior, living environment, and barriers such as low motivation, taste dislike, price unaffordability, limited availability, and the time-consuming nature of preparing Mediterranean food (MedFood; β ranging from −0.036 to −0.067). Conclusions: These findings indicate that fewer than one in four adults across Mediterranean and neighboring countries demonstrate high adherence to MedLife, supporting prior evidence of suboptimal adherence even within Mediterranean regions. This study identified a range of behavioral, socio-demographic, and environmental factors—both positive and negative predictors—that can help guide the design of targeted, culturally adapted interventions to promote MedLife behavior. Future research should incorporate objective measurements and longitudinal monitoring to better understand underlying mechanisms, establish causality, and develop sustainable strategies for enhancing MedLife adherence in diverse populations. Full article