Search Results (1,736)

Background: Eating disorders (EDs) and self-harm (SH) are both associated with distress, poor psychosocial functioning, and increased risk of mortality. Much of the literature discusses the complex interplay between SH and ED behaviours where co-occurrence is common. The onset of both is typically seen during teenage years into early adulthood. A better understanding of the functions of these behaviours is needed to guide effective prevention and treatment, particularly during the crucial developmental years. An earlier review has explored the functions of self-harm, but an equivalent review for eating disorder behaviours does not appear to have been completed. Objectives: This evidence synthesis had two objectives. First, to identify and synthesise published first-hand accounts of the reasons why people engage in eating disorder behaviours with the view to develop a broad theoretical framework of functions. Second, to draw comparisons between the functions of eating disorder behaviours and self-harm. Methods: A qualitative evidence synthesis reporting first-hand accounts of the reasons for engaging in eating disorder behaviours. A ‘best fit’ framework synthesis, using the a priori framework from the review of self-harm functions, was undertaken with thematic analysis to categorise responses. Results: Following a systematic search and rigorous screening process, 144 studies were included in the final review. The most commonly reported functions of eating disorder behaviours were distress management (affect regulation) and interpersonal influence. This review identified significant overlap in functions between self-harm and eating disorder behaviours. Gender identity, responding to food insecurity, to delay growing up and responding to weight, shape, and body ideals were identified as functions more salient to eating disorder behaviours. Similarly, some self-harm functions were not identified in the eating disorder literature. These were experimenting, averting suicide, personal language, and exploring/maintaining boundaries. Conclusions: This evidence synthesis identified a prominent overlap between psychological functions of eating disorder behaviours and self-harm, specifically in relation to distress management (affect regulation). Despite clear overlap in certain areas, some functions were found to be distinct to each behaviour. The implications for delivering and adapting targeted interventions are discussed. Full article

Background: Social and financial services are essential for the inclusion and well-being of people with disabilities (PWDs), who often rely on family caregivers to access these systems. In Saudi Arabia, where disability inclusion is a strategic goal under Vision 2030, understanding caregiver experiences is crucial to identifying service gaps and improving accessibility. Objectives: This study aimed to explore caregivers’ perspectives on awareness, perceived barriers, and accessibility of social and financial services for PWDs in Saudi Arabia. The analysis is grounded in Andersen’s Behavioural Model of Health Service Use and the WHO’s International Classification of Functioning, Disability and Health (ICF) framework. Methods: A cross-sectional survey was conducted with 3353 caregivers of PWDs attending specialised day schools. The survey collected data on demographic characteristics, service awareness, utilisation, and perceived obstacles. Exploratory Factor Analysis (EFA) identified latent constructs, and Structural Equation Modelling (SEM) was used to test relationships between awareness, barriers, and accessibility. Results: Findings reveal that over 70% of caregivers lacked awareness of available services, and only about 3% had accessed them. Key challenges included technological barriers, complex procedures, and non-functional or unclear service provider platforms. Both User Barriers and Service Barriers were negatively associated with Awareness and Accessibility. Awareness, in turn, significantly predicted perceived Accessibility. Caregiver demographics, such as age, education, gender, and geographic location, also influenced awareness and service use. Conclusions: There is a pressing need for targeted awareness campaigns, accessible digital service platforms, and simplified service processes tailored to diverse caregiver profiles. Inclusive communication, decentralised outreach, and policy reforms are necessary to enhance service access and promote the societal inclusion of PWDs in alignment with Saudi Arabia’s Vision 2030. Full article

Most academic papers on Jordanian colloquial Arabic allophonic consonant variants have primarily examined their influence on the social status of speakers and their role in shaping linguistic prestige. However, there is a significant lack of research exploring the potential for manipulation and establishment of power through the deliberate use of consonantal variants by Jordanian speakers in Arabic. Using a variety of allophonic consonantal variants, this study investigates how speakers of Jordanian colloquial Arabic attempt to construct their discourse of power. The targeted phonemes in the current study were /q/, /θ/, /ð/, and /k/. Focus groups were used to gather data, which were then examined within the framework of Fairclough’s technologized discourse and thematic approaches. Twenty persons, 10 women and 10 men, ranging in age from 18 to 45 years, comprised each of the two groups. The duration of each focus group session was 50 min. Analysis of the data indicates that the presence of [q], [θ], [ð], and [k] allophones in Standard Arabic is restricted to particular social circumstances, such as official and scientific environments. This usage is a common trait among those who have received formal education and privileged social standing. The findings also reveal that participants strategically utilize the allophonic variants [g], [ʔ], [k], [t̪], [d̪], and [tʃ] to exert influence over interlocutors by demonstrating authority related to social identity, gender, and emotional state. This study intends to advance discussions on allophonic consonant variants in Jordanian colloquial Arabic by providing insights into their manipulative functions. Full article

Objectives: The present study investigated proclivity for non-consensual intimate-image distribution and its related dimensions—enjoyment and acceptance—in relation to key demographic and relational variables, including gender, age, sexual orientation, frequency of dating app use, and current romantic relationship status. Methods: A total of 1735 Greek university students (mean age = 22 years, standard deviation = 6.18; 35.2 percent male) participated in an anonymous online survey. Pearson correlation analyses and multiple linear regression models were conducted to examine the associations and predictive value of the demographic variables on proclivity, enjoyment, and acceptance of non-consensual intimate-image distribution. Results: Men, younger participants, and those who reported more frequent use of dating applications or websites demonstrated higher proclivity for non-consensual intimate-image distribution. Gender and frequency of dating app use were also significant predictors of enjoyment, with men and frequent users reporting greater enjoyment. Regarding acceptance, sexual orientation was the only significant predictor, with non-heterosexual individuals indicating higher levels of acceptance. Romantic relationship status did not significantly predict any of the three outcome variables. Conclusions: These findings highlight the significance of gender, age, sexual orientation, and dating app engagement in understanding the psychological and behavioral dimensions of non-consensual intimate-image distribution. The results support the need for targeted prevention efforts and further research into the contextual and psychosocial factors associated with this form of image-based abuse. Full article

Background/Objectives: Despite legal frameworks acknowledging the need to protect the rights of female prisoners, penitentiary systems often neglect gender-specific needs, particularly for foreign women. Among them, Muslim women face distinct challenges linked to cultural and religious practices, which are frequently unmet in prison contexts. This review aims to explore the academic literature on the experiences of Muslim women in detention. Methods: A systematic review was conducted using three major bibliographic databases—Scopus, PubMed, and Web of Science—covering the period from 2010 to 2024. Inclusion criteria focused on peer-reviewed studies examining the condition of Muslim women in prison. Of the initial pool, only four articles met the criteria and were included in the final analysis. Results: The review reveals a marked scarcity of research on Muslim women in prison at both national and international levels. This gap may be due to their limited representation or cultural factors that hinder open discourse. The selected studies highlight key issues, including restricted access to services, limited ability to practice religion, and language and cultural barriers. These challenges contribute to increased psychological vulnerability, which is often underestimated in prison settings. Conclusions: There is an urgent need for targeted research and culturally competent training for prison staff to adequately support Muslim women in detention. Greater academic and institutional attention is essential to develop inclusive policies that consider the intersection of gender, religion, and migration, particularly in the post-release reintegration process. Full article

Introduction: Cystic fibrosis (CF) is a genetic condition affecting several organs and systems, including the pancreas, colon, respiratory system, and reproductive system. The detection of a growing number of CFTR variants and genotypes has contributed to an increase in the CF population which, in turn, has had an impact on the overall statistics regarding the prognosis and outcome of the condition. Given the increase in life expectancy, it is critical to better predict outcomes and prognosticate in CF. Thus, each person’s choice to aggressively treat specific disease components can be more appropriate and tailored, further increasing survival. The objective of our narrative review is to summarize the most recent information concerning the value and significance of clinical parameters in predicting outcomes, such as gender, diabetes, liver and pancreatic status, lung function, radiography, bacteriology, and blood and sputum biomarkers of inflammation and disease, and how variations in these parameters affect prognosis from the prenatal stage to maturity. Materials and methods: A methodological search of the available data was performed with regard to prognostic factors in the evolution of CF in children and young adults. We evaluated articles from the PubMed academic search engine using the following search terms: prognostic factors AND children AND cystic fibrosis OR mucoviscidosis. Results: We found that it is crucial to customize CF patients’ care based on their unique clinical and biological parameters, genetics, and related comorbidities. Conclusions: The predictive significance of more dynamic clinical condition markers provides more realistic future objectives to center treatment and targets for each patient. Over the past ten years, improvements in care, diagnostics, and treatment have impacted the prognosis for CF. Although genotyping offers a way to categorize CF to direct research and treatment, it is crucial to understand that a variety of other factors, such as epigenetics, genetic modifiers, environmental factors, and socioeconomic status, can affect CF outcomes. The long-term management of this complicated multisystem condition has been made easier for patients, their families, and physicians by earlier and more accurate identification techniques, evidence-based research, and centralized expert multidisciplinary care. Full article

Background/Objectives: Physical activity is a cornerstone of diabetes mellitus (DM) management and is strongly recommended in the American Diabetes Association (ADA)’s guidelines. This study aims to investigate the self-reported physical activity levels of individuals with DM in Germany, as well as the barriers and facilitators they encounter. Methods: Individuals with type 1 DM (T1DM) and type 2 DM (T2DM) were asked to fill out an online questionnaire that was partly based on the International Physical Activity Questionnaire (IPAQ). Results: The questionnaire was completed by 338 persons with either T1DM (57.1%) or T2DM (42.9%) (females: 56.2%, males: 42.0%, gender diverse persons: 1.8%) of all age groups (at least 18 years). In total, 80.5% of respondents were aware of the current physical activity recommendations. Among the respondents, 58% reported meeting the recommendations for endurance-type physical activity, while only 30.5% reported meeting those for strength training. The three most frequently cited barriers to physical activity were lack of time, lack of motivation and current state of health. Supporting factors included coverage of costs, availability of exercise programs in close proximity to the patient’s home and target group specific exercise programs. Conclusions: The results imply that many individuals with DM in Germany do not meet ADA’s physical activity recommendations, especially considering that self-reports often overestimate actual behavior. In particular, the actual number of individuals who regularly engage in strength training may be too low. There is a clear need to better communicate the benefits of different forms of physical training and to provide physical activity programs aligned with patients’ individual needs. Full article

Road traffic accidents are a leading cause of injury and death among adolescents, making road safety education crucial. This study assesses the performance of and users’ opinions on the Route 2 School (R2S) traffic safety education program, designed for secondary school students (13–17 years) in Belgium. The program incorporates gamified e-learning modules containing, among others, podcasts, interactive 360° visuals, and virtual reality (VR), to enhance traffic knowledge, situation awareness, risk detection, and risk management. This study was conducted across several cities and municipalities within Belgium. More than 600 students from school years 3 to 6 completed the platform and of these more than 200 students filled in a comprehensive questionnaire providing detailed feedback on platform usability, preferences, and behavioral risk assessments. The results revealed shortcomings in traffic knowledge and skills, particularly among older students. Gender-based analysis indicated no significant performance differences overall, though females performed better in risk management and males in risk detection. Furthermore, students from cities outperformed those from municipalities. Feedback on the R2S platform indicated high usability and engagement, with VR-based simulations receiving the most positive reception. In addition, it was highlighted that secondary school students are high-risk groups for distraction and red-light violations as cyclists and pedestrians. This study demonstrates the importance of gamified, technology-enhanced road safety education while underscoring the need for module-specific improvements and regional customization. The findings support the broader application of e-learning methodologies for sustainable, behavior-oriented traffic safety education targeting adolescents. 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

COVID-19 vaccine hesitancy (VH), like attitudes towards other vaccines, is a critical global public health concern. Despite numerous studies covering psychological, sociodemographic, and other determinants of vaccine acceptance, resistance, and hesitance, few studies have reported these factors among students, particularly in politically unstable settings like Ukraine. This cross-sectional, descriptive, and quantitative study assesses hesitancy towards COVID-19 vaccines, utilizing the 5Cs Model. Among 936 respondents surveyed in 2023, 64% received at least one shot of the COVID-19 vaccine (acceptant), 11% were still considering getting vaccinated (hesitant), and 25% refused vaccination (resistant). Vaccination behavior is significantly associated with the 5Cs. Higher collective responsibility significantly increased acceptance and reduced resistance, while higher constraints lowered the chances of being either acceptant or resistant. Confidence protected against resistance. Complacency, counterintuitively, reduced odds of resistance, pointing to differences between passive hesitancy and active refusal. Male gender and sources of information and misinformation influenced confidence. Collective responsibility was positively associated with official sources and negatively with conspiracy beliefs. Complacency increased with official sources, while constraints and calculation were least explained by predictors. Practical barriers should be tackled through improved accessibility and fostering collective responsibility via targeted communication strategies. These findings provide actionable insights for policymakers, healthcare providers, and academic institutions to enhance vaccine uptake among university students, particularly in crisis settings. Full article

Background/Objectives: Inborn errors of immunity (IEIs) represent a wide spectrum of diseases characterized by a predisposition to recurrent infections, as well as increased susceptibility to autoimmune, atopic, and autoinflammatory diseases and malignancies. The aim of this study was to report the registry-based frequency and describe the clinical characteristics of IEIs among patients in the Republic of Kazakhstan. Methods: We analyzed data from 269 patients belonging to 204 families who were either self-referred or referred by healthcare providers to the University Medical Center of Nazarbayev University with suspected IEIs. All patients resided in various regions across Kazakhstan. Results: A total of 269 diagnosed cases were identified in the national registry. The estimated prevalence was 1.3 per 100,000 population. The gender ratio was nearly equal, with 139 males and 130 females. The median age at diagnosis was 5 years (range: 1 month to 70 years), while the mean age was 11.3 years. The most common diagnosis was humoral immunodeficiency, observed in 120 individuals (44.6%), followed by complement deficiencies in 83 individuals (30.8%). Combined immunodeficiencies with syndromic features were found in 35 patients (13%), and phagocytic cell defects were identified in 12 patients (4.5%). The predominant clinical manifestations included severe recurrent infections and autoimmune cytopenias, while atopic and autoinflammatory symptoms were reported less frequently. Conclusions: These findings contribute to a better understanding of the registry-based distribution and clinical spectrum of IEIs in Kazakhstan and underscore the importance of early diagnosis and targeted care for affected individuals. Full article

HIV disproportionately affects key populations (MSM, transgender people, sex workers and psychoactive substance users), who face greater social vulnerability and limited healthcare access. This study aimed at analyzing sexual orientation and gender identity and their association with sexual practices, sexually transmitted infections and psychoactive substance use among PrEP users. Method: A cross-sectional study was conducted between January 2018 and June 2021 with 736 Brazilian PrEP users from a health service in São Paulo. Sociodemographic data, sexual behaviors, STI history (past 3 months) and psychoactive substances use (past 3 months) were extracted from clinical records. The associations were analyzed using binomial logistic regression (p < 0.05). Results: Most of the participants were cisgender men (93.4%) and homosexual (84.8%), with a mean age of 34.9 years old. Condomless sex was reported by 98.5%, and 18.4% had some recent sexually transmitted infection, mainly syphilis. Psychoactive substance use was reported by 55.4%, especially marijuana, club drugs, erectile stimulants and poppers. Transgender and cisgender women were more likely to report sex work and crack use. Homosexual and bisexual participants had higher odds of using erectile stimulants. Conclusions: The study reveals key links between gender, sexual orientation and risk behaviors, highlighting the need for inclusive, targeted prevention. Full article

This study developed and validated an integrated theoretical framework combining the Theory of Planned Behavior (TPB) and the Technology Acceptance Model (TAM) to investigate how driving assistance technologies (DATs) influence risky driving behaviors among young urban Chinese drivers. Based on this framework, we proposed and tested several hypotheses regarding the effects of psychological and technological factors on risky driving intentions and behaviors. A survey was conducted with 495 young drivers in Shaoguan, Guangdong Province, examining psychological factors, technology acceptance, and their influence on risky driving behaviors. Structural equation modeling revealed that the integrated TPB-TAM explained 58.3% of the variance in behavioral intentions and 42.6% of the variance in actual risky driving behaviors, significantly outperforming single-theory models. Attitudes toward risky driving (β = 0.287) emerged as the strongest TPB predictor of behavioral intentions, while perceived usefulness (β = −0.172) and perceived ease of use (β = −0.113) of driving assistance technologies negatively influenced risky driving intentions. Multi-group analysis identified significant gender and driving experience differences. Logistic regression analyses demonstrated that model constructs significantly predicted actual traffic violations and accidents. These findings provide theoretical insights into risky driving determinants and practical guidance for developing targeted interventions and effective traffic safety policies for young drivers in urban China. Full article

Introduction: Nutrition literacy has garnered growing research attention worldwide, yet only a few instruments have been developed to specifically measure this construct among adolescents. Accordingly, the present research sought to examine the validity and reliability of the Adolescent Nutrition Literacy Scale (ANLS) within a group of Lebanese adolescents. Methods: A cross-sectional study was carried out from December 2022 to March 2023, targeting a nationally representative sample. Results: Fit indices of the three-factor structure were good. Internal reliability was adequate for the following three subscales: Functional Nutrition Literacy (FNL) (ω = 0.88/α = 0.88), Interactive Nutrition Literacy (INL) (ω = 0.87/α = 0.86) and Critical Nutrition Literacy (CNL) (ω = 0.89/α = 0.89). Invariance was established across genders at configural, metric, and scalar levels. A significantly higher mean FNL and INL scores were found in males compared to females, with no significant difference between the two genders in terms of CNL. Higher FNL, but not CNL and INL scores were significantly associated with lower child food security. Conclusions: The Arabic ANLS has exhibited robust psychometric reliability, validity, and cost-effectiveness as a tool for assessing nutrition literacy. By utilizing the Arabic version of the ANLS, we can more efficiently and accurately assess the nutritional literacy of adolescents. Full article

This research examines how influencer information spreads and is accepted by consumers, focusing on a Tunisian sample of social media users, and how these effects percolate into consumers’ perception of the quality of cosmetic products. Drawing on the Information Adoption Model (IAM), this study develops a conceptual framework adapted to the social media landscape, particularly the TikTok platform. To test this framework, we conducted a survey targeting 285 consumers using a non-random sampling frame, primarily through Facebook and Instagram. The findings suggest that consumers perceive influencer information as useful when they believe it is credible and of high quality. Interestingly, while high-quality information tends to lead to influencer information adoption, credibility alone does not guarantee adoption. Additionally, our study emphasizes the role of influencer information usefulness in driving its adoption. One notable discovery is the link between influencer information adoption and consumers’ perceptions of the quality of cosmetic products. However, this correlation does not hold equally for both genders, thus suggesting a moderation effect between gender and influencer information processing in this context. Full article