Search Results (13,928)

Currently, identity formation is undertaken in hyper-individualized virtual microsystems, such as TikTok. Here, content creators set the boundaries of adolescents’ identity exploration and construction. However, few studies have engaged with the content adolescents actively choose to follow to understand the behaviors and messages that are circulated and modeled by TikTok creators. To bridge this gap, 127 TikTok videos from accounts that a sample of 328 Romanian adolescents (M_age = 16.99, SD_age = 0.78; 60.4% male) reported following were thematically analyzed. This resulted in a novel codebook that went beyond surface-level content typologies to reveal exposure to positive content, such as awareness raising, family values, and motivational videos, as well as negative content, such as age-inappropriate behaviors, materialistic values, and gender stereotypes. Results suggest that master and alternative narratives are portrayed by TikTok creators, generating tensions between conforming to norms that might be potentially harmful and following less common identity scripts. Full article

Urban development in medium-sized provinces is increasingly influenced by the interplay of demographic change, socio-economic disparity, and labour market structure. However, these dimensions are frequently examined in isolation, which limits their utility for integrated regional planning. This study offers a planning-oriented assessment of Amasya Province, Türkiye, by integrating population projections, district-level socio-economic disparity analysis, and labour market indicators to evaluate the province’s developmental trajectory toward 2035. The study utilizes official population data for 2007–2024, district-level socio-economic status scores for 2023, and provincial labour market indicators. Linear trend projection and compound annual growth rate analysis were employed to estimate population change, while the Gini coefficient, Theil index, and coefficient of variation were used to assess intra-provincial socio-economic disparities. Labour market performance was evaluated through participation, employment, unemployment, and employment-to-participation efficiency indicators. The results indicate that Amasya is projected to experience a moderate population increase, reaching approximately 350,118 inhabitants by 2035. Growth is anticipated to remain concentrated primarily in the Central District and Merzifon, while socio-economic advantages also exhibit a central–peripheral pattern. Labour market indicators suggest relatively stable employment performance, although more detailed sectoral, gender, and age-specific analyses are necessary for more robust conclusions. The study contributes an integrated framework for linking demographic projection, socio-economic hierarchy, and labour market capacity in medium-sized provincial planning. The findings suggest that future planning should focus on managing growth in central districts while supporting balanced development in peripheral districts. Full article

Background: Shift-working healthcare workers (HCWs) are at elevated cardiovascular (CV) risk due to chronic circadian disruption; however, gender-stratified data on CV risk profiles and modifiable risk factor distribution by occupational exposure duration remain scarce in the Italian hospital setting. This cross-sectional study aimed to characterise the 10-year CV risk profile and the distribution of modifiable risk factors in a hospital-based sample of shift-working HCWs. Methods: A retrospective cross-sectional study was conducted using data from routine occupational health surveillance of shift-working HCWs at a large Italian hospital in Salento, Southern Italy (survey year: 2025). The 10-year CV risk was estimated using the CUORE Project algorithm, validated for the Italian population. Risk was stratified by gender, age group, and shift work duration. Multivariable logistic regression models, adjusted for age, marital status, and presence of children at home, evaluated associations between selected risk factors and CV risk category. The study was reported in accordance with STROBE guidelines. Results: Of 765 HCWs included (320 males, 445 females; mean age 49.3 ± 8.5 years), male workers showed a significantly higher mean 10-year CV risk score (4.98 ± 2.8 vs. 1.34 ± 0.9; p < 0.05). Among male workers, the odds of moderate/high CV risk increased progressively with shift work duration (aOR 6.4 for >30 years). Males also showed significantly higher prevalence of arterial hypertension, overweight, and obesity across all strata. Conclusions: Male shift-working HCWs represent a higher-risk subgroup, characterised by a greater burden of modifiable cardiovascular risk factors. Integration of validated risk assessment tools into occupational health surveillance may support targeted preventive strategies in hospital settings. Full article

Background/Objectives: Parenting stress and life satisfaction are important indicators of family well-being and parent mental health in families of children with disabilities. However, limited empirical attention has been given to how these outcomes differ among parents whose children receive adapted physical activity (APA) services within South Korea’s Developmental Rehabilitation Service system. This cross-sectional study examined subgroup differences in parenting stress and life satisfaction according to sociodemographic, disability-related, and service-utilization characteristics among parents of children receiving APA services. Methods: Data were collected from 295 parents of school-aged children with disabilities enrolled in APA services at child development centers. Welch-type tests, Welch’s ANOVA or one-way ANOVA, Pearson correlation analyses, Benjamini–Hochberg FDR adjustment, and supplementary analyses of covariance (ANCOVA) were used to examine group differences and the stability of selected associations after adjustment for prespecified covariates. Confirmatory factor analysis and gender-based measurement invariance testing were also conducted for the adapted parenting stress scale. Results: Parenting stress subdomains were positively correlated with one another (r = 0.19–0.53) and negatively correlated with life satisfaction (r = −0.28 to −0.40). Female parents reported higher social and psychological stress than male parents. Household income showed the largest association with economic stress, and significant differences were also observed according to parental age, education level, disability severity, and selected service-utilization characteristics. Some associations remained after ANCOVA adjustment, whereas others were attenuated or emerged only after adjustment. Conclusions: The findings indicate subgroup differences in parenting stress and life satisfaction among parents of children receiving APA services. Because the study used a cross-sectional, self-reported design with convenience sampling and an adapted instrument, the results should be interpreted as preliminary associative evidence rather than evidence of causal or service-specific effects. Future longitudinal, comparative, and service-level research is needed to clarify how APA service contexts relate to caregiver well-being over time. Full article

Background: Inflammation is believed to play a significant role in the pathophysiology of hypertension (HT). The aim of this study was to evaluate the relationship between the systemic immune-inflammation index (SII) and the pan-immune-inflammation value (PIV) and HT in adults. Methods: A total of 1060 adult individuals who presented between 1 December 2025 and 1 February 2026, were included. Participants were grouped according to the presence of HT. SII and PIV were calculated. Univariate and multivariate logistic regression analyses were performed to identify factors independently associated with HT. Due to the high correlation between SII and PIV, they were evaluated in separate models. Discriminatory performance was examined using ROC analysis, and correlations were assessed using the Spearman test. Results: HT was present in 18.1% of participants. In the HT group, SII and PIVs were significantly higher (p < 0.001 for both). In univariate analysis, older age (p < 0.001), male gender (p = 0.030), presence of comorbidities (p < 0.001), high SII (p < 0.001), and high PIV (p < 0.001) were found to be associated with HT. In multivariate analyses, age and comorbidities remained independent predictors in both models (all p < 0.001). In the multivariable models adjusted for available covariates, high SII was significantly associated with HT in the SII model (adjusted OR: 2.035; 95% CI: 1.374–3.010; p < 0.001). Similarly, high PIV was significantly associated with HT in the PIV model (adjusted OR: 5.577; 95% CI: 3.398–9.160; p < 0.001). In the ROC analysis, both indices demonstrated modest predictive ability, with PIV showing slightly higher performance compared to SII (AUC: 0.648 vs. 0.623). A positive correlation was observed between the duration of HT and both SII (r = 0.700; p < 0.001) and PIV (r = 0.847; p < 0.001). Conclusions: The finding that SII and PIV were significantly associated with HT after adjustment for available covariates supports the potential role of systemic inflammation in the pathophysiology of HT. These indices, which can be easily calculated from routine laboratory parameters and do not require additional costs, may potentially assist in risk assessment in clinical practice. Full article

This study examines how individual political predispositions and national mobilisation contexts jointly structure protest participation in contemporary Europe across the pre-pandemic, pandemic and post-pandemic periods. Using data from Rounds 9, 10 and 11 of the European Social Survey (2018–2023), the analytical sample includes 106,106 respondents from 33 countries. Descriptively, protest participation remains a minority behaviour, yet displays pronounced cross-national heterogeneity, with participation rates ranging from below 3% in several Central and Eastern European countries to nearly 20% in the most mobilised contexts and remains remarkably stable across rounds at approximately 8.5%. Building on resource mobilisation theory, political process approaches and New Social Movements perspectives, the analysis conceptualises protest participation not as an isolated behavioural act but as the outcome of interactions between individual resources, evaluative orientations toward democratic institutions and broader mobilisation environments. Logistic regression models, country fixed-effects specifications and multilevel models with random intercepts are used to assess these relationships. At the individual level, political engagement emerges as the strongest predictor of participation: higher political interest is associated with substantially higher protest propensity, while ideological self-placement indicates lower participation among respondents positioned further to the right. Younger age and higher education also increase participation. Lower satisfaction with democracy and stronger perceptions of inequality are consistently associated with protest behaviour, supporting grievance-based interpretations linked to democratic evaluations rather than material deprivation alone. Country fixed-effects and multilevel models confirm that these individual-level associations are robust within countries, while significant between-country variation persists (random-intercept SD = 0.554), indicating that national mobilisation environments shape baseline levels of protest participation. Multilevel results further reveal that protest participation was significantly lower during the pandemic period (Round 10) relative to the pre-pandemic baseline, with only partial recovery in the post-pandemic period. A cross-round comparison demonstrates that the core individual-level associations are stable across all three periods, indicating that these relationships reflect durable structural patterns rather than dynamics specific to any particular mobilisation cycle. Beyond this overall stability, the analysis identifies two theoretically informative exceptions: subjective financial difficulty is significant only in the pre-pandemic period and gender differences in protest participation attenuate over time—patterns consistent with broader shifts in protest repertoires during and after the pandemic. These findings make three contributions to the comparative literature on contentious politics. First, by extending the analysis across three ESS rounds, the study demonstrates the temporal robustness of individual-level determinants of protest—an empirical question rarely addressed in the existing literature. Second, the multilevel design with round fixed effects allows for direct estimation of pandemic-related suppression and post-pandemic recovery in protest activity at the aggregate level. Third, the cross-national scope and temporally structured comparison provide new evidence on how individual political predispositions interact with shifting mobilisation environments across a period of exceptional socio-political strain in Europe. Full article

Climate change continues to threaten global food security. Climate-smart agriculture (CSA) offers a solution to addressing this challenge in urban agriculture (UA). This paper addresses a gap in the empirical literature on decision-making about the adoption of CSA practices by examining the determinants of CSA adoption among small-scale urban crop (SSUC) farmers in eThekwini (ETH) Municipality, South Africa. Grounded in a utility theory framework, the paper draws on 412 respondents (Cochran-estimated) from a multi-stage sample design across four wards, providing reasonable coverage of SSUC farmers in ETH Municipality. While the sample size is statistically representative of SSUC farmers in ETH Municipality, it is a single metropolitan case rather than universal. The results show strong complementarities among these CSA practices, for example, between OM and CD (r ≈ 0.70, p < 0.001) and M and CD (r ≈ 0.61, p < 0.001). The multivariate probit (MVP) model predicts that the socio-economic and institutional factors age, gender, marital and employment status, education, credit access, extension contact, land tenure, and location (distance from home to farm plots) (p < 0.05) were significant determinants of adopting CSA practices by SSUC farmers. The findings contribute to the global literature on the UA–CSA nexus, demonstrating that socio-economic and institutional factors shape the adoption of bundled CSA practices. While the findings underscore the need for integrated, custom, and UA context-specific policy and extension interventions to strengthen urban food system resilience, UA farmers, practitioners, researchers, and policymakers should apply these insights elsewhere with caution. Full article

Sexual violence against women frequently originates during adolescence, when structural inequalities and gendered power dynamics heighten vulnerability, making early identification of risk factors essential to prevent trajectories leading to sexual exploitation. This study presents the psychometric validation of the EDR-ESIA, a screening instrument designed to detect vulnerability to Child Sexual Exploitation (CSE) in healthcare, education, and social care settings, with particular relevance for prevention strategies targeting adolescent girls. The sample comprised 199 adolescents aged 11–17 years (M = 15.23; SD = 1.59) residing in Spain (58.8% female, 40.2% male, 1.0% unspecified), assessed by trained professionals using case records and reports. The 88-item instrument underwent expert review and pilot testing prior to validation, and its internal structure was examined using Partial Least Squares Structural Equation Modeling (PLS-SEM). The results indicated that all subdimensions and higher-order constructs showed an adequate fit to the theoretical model, supporting the instrument’s validity. Female adolescents scored significantly higher than males on CSE target indicators, reflecting a medium-to-large gender difference in vulnerability levels. Overall, the EDR-ESIA constitutes an evidence-based instrument for the timely recognition of CSE vulnerability, supporting prevention, education, and intervention efforts aimed at reducing sexual violence against women from early developmental stages. Full article

Introduction: Chronic non-specific neck pain (CNSNP) is a prevalent condition where active myofascial trigger points (A-MTrPs) are commonly detected in cervical muscles and may be associated with altered electromyographic activity (EMGact). However, their association with EMGact during functional tasks remains unclear. Objectives: This study aimed to explore this relationship, hypothesizing that A-MTrPs in cervical muscles would be associated with altered EMGact. Methods: An analytical cross-sectional exploratory study was conducted in 52 patients with CNSNP. Surface EMGact of the sternocleidomastoid (SCM), anterior scalene (AS), and upper trapezius (UT) muscles was recorded during the craniocervical flexion test (CCFT) and an isometric shoulder abduction task (ABD-90). Linear mixed-effects models were constructed to identify factors associated with EMGact. Age, pain intensity, pain duration, analgesic dose, anti-inflammatory dose, and kinesiophobia score were included as covariates, while gender, physical activity level, and the presence or absence of A-MTrPs were included as categorical factors. Results: At the 22 mmHg CCFT level, analgesic consumption was positively associated with peak EMGact and average AS activation (B = 0.791 and B = 0.223, respectively) and with SCM peak EMG act (B = 0.510). At the same level, kinesiophobia was associated with average SCM EMGact (B = 0.231). At the 26 mmHg CCFT level, average AS activation remained positively associated with analgesic consumption (B = 0.148) and SCM without A-MTrPs was associated with lower EMGact compared to SCM with A-MTrPs. At the 30 mmHg CCFT level, kinesiophobia was negatively associated with average EMGact of AS. In the UT muscle, during ABD-90, kinesiophobia was negatively associated with both peak (B = −0.378) and average EMGact (B = −0.132). Conclusions: The presence of A-MTrPs may be related to SCM EMGact during CCFT in individuals with CNSNP, while analgesic consumption and kinesiophobia also could be associated with cervical muscles EMGact during functional tasks. Full article

Mental health issues, such as depression and anxiety, are rising globally, and while conventional therapies like medications and psychotherapy remain common, they face limitations, including side effects and accessibility. This highlights the need for effective non-pharmacological interventions. Painting-based art interventions are a promising non-pharmacological approach for improving scale-assessed mental health outcomes, but quantitative evidence across age groups and outcome types remains limited. This meta-analysis synthesizes data from 45 randomized controlled trials to assess the impact of painting-based art interventions on mental health. The study explores potential moderating factors such as intervention duration, type of art, gender, and age group. A rigorous quality assessment of included studies was performed using Cochrane’s risk of bias tool. The pooled effect size for painting-based interventions on mental health was significant, indicating a large positive impact. Subgroup analyses revealed that interventions of various durations, art forms, and gender compositions produced similar effects. Notably, older adults benefited the most from these interventions. Painting-based art interventions were associated with improved scale-assessed mental health outcomes. These findings should be interpreted as evidence for one visual art-making approach within broader art therapy practice, rather than as defining art therapy solely by painting-based methods. Full article

Objectives: The aim of the study was to assess the prevalence, severity and treatment needs of molar incisor hypomineralization (MIH) among a cohort of children in Lebanon. Methods: A cross-sectional study was performed in Akkar district in northern Lebanon on 1237 school children between 10 and 12 years old (mean age 11.11 ± 0.80 years) who were recruited from eight private schools. Clinical evaluations were performed after teeth cleaning and drying using sterile gauze. Examiners assessed all teeth present in the oral cavity using the MIH index of the EAPD. If MIH was diagnosed, a further grading was made according to the MIH-TNI index. Results: In total, 212 children (17.14% [95% CI:15.0, 19.2]) were diagnosed with MIH. Of these, 200 children with completed documentation were included in the further statistical analysis. Out of the affected cases, mild lesions were the most common at 41% (n = 82). Although males exhibited higher cumulative numbers of affected teeth (52.5%, n = 267), with notably greater proportions in moderate (17.7%) and severe (16.7%) cases, the difference between genders was not statistically significant (p = 0.069). Treatment needs increased with severity, in which mild lesions primarily required preventive care (41.0%), while moderate lesions required restorative treatments (34.0%); in contrast, severe lesions (25.0%) often necessitated extensive interventions, such as crowns, pulp therapies or even extractions. Although descriptive patterns suggested an increase in more complex treatment needs in older age groups, the association was not statistically significant (p = 0.26). Conclusions: The prevalence of MIH observed in this cohort study aligns with internationally reported values. Early detection, preventive management, and timely restorative interventions are essential to minimize the long-term impact of MIH. Full article

Clinical simulation is a cornerstone of healthcare education, yet comparative evidence on learner perceptions of technical skills (TS) versus non-technical skills (NTS) training remains limited. This study aimed to examine Kirkpatrick Level 1 satisfaction across simulation course types and explore associations with participant characteristics. We conducted a retrospective analysis of 1806 healthcare professionals who attended 133 simulation sessions between 2024 and 2025. Participants completed a 16-item ad hoc questionnaire (Cronbach α = 0.959) covering four domains scored 1–10. Domain scores were compared between TS (n = 1224) and NTS (n = 582) courses using Welch t-tests and Cohen’s d. Spearman correlations assessed associations with age, gender, and professional category. Overall learner satisfaction was excellent (mean 9.55 ± 0.70). TS courses scored significantly higher across all domains (p < 0.001), with effect sizes ranging from small (d = 0.21–0.28) to moderate-approaching (d = 0.45) in the Simulation/Methodology domain. Item-level analysis highlighted perceived improvement in technical skills (d = 0.49) and error awareness (d = 0.43) as the most discriminating factors. Age, gender, and professional category were significantly associated with course type (all p ≤ 0.020). Both TS and NTS simulations achieve high learner satisfaction. The perceptual advantage of TS courses suggests that instructional strategies enhancing the tangibility of NTS learning outcomes are warranted to optimize learner engagement and satisfaction. Full article

Background: Anemia is a pervasive public health issue that is both a risk factor and a consequence of infection. This study aims to determine the prevalence and correlates of anemia in adults receiving vancomycin (VAN). Methods: A retrospective cross-sectional analysis of clinical data was undertaken for 299 patients treated with VAN at a tertiary care hospital from January 2024 to February 2025. Subjects were stratified by anemia severity into non-anemic, mild, moderate, and severe groups. Frequency was examined using the chi-squared test, medians by Kruskal–Wallis test, monotonic relations by Spearman’s correlation, and independent predictors using regression models. Results: Anemia was extremely prevalent in 90% of patients, mostly at a moderate level, and a weak positive correlation was observed between anemia severity and VAN trough levels, ICU admission, kidney disease, abnormal liver markers, and inflammatory indices. Microbial isolates were differentially enriched across anemia categories with K. pneumoniae, E. coli, and MRSA peaking in mild anemia and sharply declining in moderate and severe cases. Anemia severity was differentially correlated with P. aeruginosa, creatinine, hypertension, liver disease, albumin, platelets, and derived indices. In adjusted analysis, albumin, age, gender, platelet–neutrophil ratio, kidney disease, ICU admission, and MATH-1SD were independent predictors of anemia. A diagnostic model for anemia based on multiple markers was developed with an accuracy of 77%. Conclusions: Anemia is alarmingly very common in VAN-treated patients with distinct microbial and inflammatory signatures across severity groups, which highlights the need for experimental and longitudinal studies elucidating its pathophysiological mechanisms and clinical implications. Full article

Background/Objectives: Anemia of inflammation (AI) is a prevalent condition linked to systemic inflammation in several chronic diseases, including chronic liver diseases. Hypovitaminosis D is frequently identified in patients with chronic diseases, and its pathogenic role in anemia is currently under investigation. The aim of this study was to prospectively investigate changes in hemoglobin concentration and inflammatory markers in vitamin D-deficient/-insufficient patients with decompensated cirrhosis after initiating vitamin D supplementation, in addition to the supplementation of other micronutrients if needed. Methods: Patients with cirrhosis discharged from decompensation were assessed at baseline and 3 months after vitamin D supplementation. Laboratory parameters of red cell series, nutrition, and micronutrients were assessed in both visits, together with markers of systemic inflammation. Results: Thirty-nine patients were included in the study, of whom 33 completed the 3-month evaluation and were analyzed [age: 62.7 ± 10.7 years; gender: n = 29 (87.9%) males; Charlson index: 5.9 ± 1.6; Model for End-Stage Liver Disease (MELD): 12.4 ± 4.5; baseline hemoglobin (Hb): 11.7 ± 1.8 g/dL (anemia n = 24 (72.7%)); mean 25-hydroxyvitamin D (25OHD) plasma level: 15.5 ± 8.6 µg/L]. A significant increase in plasma 25OHD (40.1 ± 17.8, p < 0.001) and in Hb (12.4 ± 2.0, p = 0.01) was observed at 3 months with a decrease in the prevalence of anemia (n = 17, p = 0.015) and of Interleukin 6 in plasma levels [IL-6, 10.7 (5.8–23.3) vs. 6.5 (4.1–11.8), p = 0.016]. A greater rise in hemoglobin was correlated with higher plasma IL-6 concentration at baseline. Milder anemia and indexes of hypoferremia at baseline, along with optimal renal function and plasma levels of 25OHD at 3 months, were linked to resolution of anemia. Conclusions: Treating vitamin D deficiency together with other micronutrient deficits is associated with inflammation amelioration and improvement in anemia in patients with cirrhosis following discharge from acute decompensation. This paper supports the potential role of vitamin D in the management of anemia in patients with decompensated cirrhosis by modulating systemic inflammation. Full article

This study examines the association between digital payments adoption and reliance on cash in Latin America and the Caribbean (LAC), as well as its potential implications for financial inclusion. Using microdata from the 2021 Global Findex Survey for 17,498 adults, logit models and average marginal effects are estimated to assess this relationship according to income, gender, age, education, rural-urban location, and internet access. The results show that the use of digital payments is associated with a lower probability (9.7 percentage points) of using cash, a statistically significant and robust effect among different population groups. People with less education, older age, and limited access to the internet are more dependent on cash, while income differences are less pronounced than expected. Counterfactual simulations consistently show lower reliance on cash among digital payment users, regardless of socioeconomic status. The study provides new microeconomic evidence for the LAC by quantifying the association between digital payments and cash use and analyzing its heterogeneity between socioeconomic groups. Sustainable financial inclusion is not measured by a composite indicator or as an independent variable; it is used as an interpretative framework to analyze whether the adoption of digital payments is associated with less dependence on cash and greater interaction with formal financial channels. Policy implications suggest strengthening payment interoperability, digital trust, financial education, and consumer protection to expand integration into formal financial channels. Full article