Discourse possesses the capacity to shape reality, and the concept of “discourse power” continues to evolve alongside transformations in global communication. Digital platforms, by virtue of their vast user bases and extensive data resources, have restructured multiple dimensions of social life and emerged as a key arena for contesting international discourse power. This study develops an embedded model of digital platforms and international discourse power by examining their theoretical implications, strategic orientations, and structural interconnections. Using TikTok and Twitter as illustrative cases, it analyzes how major powers engage in discourse competition within the digital platform environment. The findings suggest that international discourse power in the platform era follows a logic of contestation for dominance, characterized by competition over capital, content, and technology—injecting new variables and uncertainties into the global communication order. Looking ahead, artificial intelligence will play an increasingly central role, discourse dissemination mechanisms will continue to innovate, and the development of autonomous, internationally recognized digital platforms will be imperative.

Endometriosis impairs multiple dimensions of women's lives. Ovarian endometrioma and deep endometriosis present distinct clinical profiles. The dietary pattern has shown controversial data both for pain control and in the effect on women's vitality and physical health. This study aimed to evaluate the relationship between dietary patterns and quality-of-life outcomes and pain perception in women with endometrioma and deep endometriosis. This cross-sectional observational study included 40 Spanish-women grouped as controls, with endometrioma, or deep endometriosis. Dietary intake was assessed using a food frequency questionnaire, and was estimated macronutrient and food group intake, as well as adherence to DASH-diet, Mediterranean adherence, and healthy eating index. They were measured bodily pain, vitality, general health, and quality of life dimensions specific to endometriosis. Dietary supplement use was higher in women with deep endometriosis (70%) compared to controls (13.3%, P = 0.015). Women with endometrioma consumed more dietary fat, monounsaturated fatty acids, and cholesterol than controls and, their adherence to the Mediterranean diet (control = 29.1 ± 5.0; endometrioma = 24.1 ± 7.2) and healthy eating index (control = 57.3 ± 3.9; endometrioma = 49.6 ± 8.0) were significantly lower. Dairy intake was lower in endometriosis groups compared to controls, while meat, snack, and fat consumption was higher in the endometrioma group. Furthermore, fat intake negatively impacted physical and reproductive health in endometriosis, while adherence to healthy dietary patterns was associated with improved life-outcomes. Dietary patterns impact the health of women with ovarian and deep endometriosis, especially regarding pain and quality of life. Women with endometrioma have poor dietary habits, which affect sexual function and vitality. Targeted dietary interventions, particularly focusing on healthy fats, may improve pain symptoms and overall well-being.

Volunteering has become an increasingly visible dimension of educational and community life in Romania, especially in regions where schools have established partnerships with local organizations. This paper explores volunteering as a form of social capital that supports the career orientation of high school students in Arad County. Through the theoretical lenses of Bourdieu, Coleman, and Putnam, the study highlights how voluntary engagement contributes to the development of professional identity, civic competence, and relational networks that facilitate career decision-making. Volunteering is understood as both an educational and sociological process—one that links the school environment to the broader community and the labor market.

ABSTRACT Migration, influenced by various socio-political factors, significantly impacts the psychosocial well-being of individuals globally. This study investigates the intricate interplay between quality of life, forgiveness, and hope among Kashmiri migrants residing in diverse regions of India. Employing a robust methodology involving standardized assessments, data were collected from 207 participants spanning two distinct age cohorts (30–50 years and 50–70 years). The findings underscore positive correlations among quality of life, forgiveness, and hope across the entire cohort and within distinct age brackets. Moreover, regression analysis unveils the profound predictive capacity of quality of life on both forgiveness and hope, particularly accentuated among older migrants. Through nuanced discussions, the study unveils the pivotal role of emotional well-being, coping mechanisms, and social support in shaping quality of life, thereby nurturing forgiveness and hope. Intriguingly, age emerges as a moderating factor, intensifying the link between QOL and forgiveness among elder migrants, while leaving the nexus with hope unaltered. Ultimately, this research underscores the imperative of addressing quality of life dimensions to foster forgiveness and engender hope within migrant populations, thereby offering profound implications for intervention strategies and policy initiatives.

BackgroundFamily is the primary context for attachment, nurturing, and socialization, shaping essential communication, social, and survival skills, but it can also be a place for expression of aggression. For social workers and mental health professionals, a brief and valid tool for assessing family functioning can guide safety-focused interventions. The Family Functioning and Cohesion Scale (FFCS), a 14-item self-report questionnaire developed by Greek researchers, has attracted international interest. It captures core dimensions of family life—communication, expression of aggression, and shared values. A current study is assessing FFCS on families of two culturally and geographically distinct European countries—Greece and Iceland.MethodsIn its validation study (N = 481), the FFCS demonstrated high internal consistency and strong test-retest reliability. Each item is rated 0-3, with higher values representing better outcomes (i.e., higher communication and shared values/beliefs within the family, less expression of aggression). The current comparative study between Greece and Iceland includes 60 families per country: 20 with mental health issues, 20 multiproblem, and 20 healthy families.ResultsSubscale item means in the original validation study were 2.18 (Communication), 2.01 (Anger/Resentment/Aggression), and 1.50 (Sharing of Values/Beliefs). While positive correlations were found between Communication and both Anger/Resentment/Aggression (r = .451) and Values/Beliefs (r = .522), the correlation between the two latter subscales was very low (r = .165).ConclusionsThe FFCS contributes to early identification of risk factors related to conflict, neglect, and reduced cohesion—critical elements in ensuring family safety. Our results suggest that overt aggression within the family relates more to problems of communication rather than to non-shared values. The FFCS ongoing cross-national study will further explore its validity in diverse cultural settings.Key messages• The FFCS is brief and easy to use across diverse populations. The Greece – Iceland collaboration will further explore its international application.• The FFCS can provide insight into the expression of aggression in the family and assist the implementation safety-focused interventions.TopicFamily Cohesion, Risk Assessment in Families, Family Functioning.

ABSTRACT This study analyses the impact of international labour migration on civic engagement in two ethnically and culturally diverse local communities in Poland. Within the broader debate on the social consequences of migration for sending communities, the research employs in-depth interviews with migrants and experts to explore both formal (participation in local elections, membership in non-governmental organizations and local institutions) and informal (community initiatives, spontaneous social actions) dimensions of civic life. The findings indicate that labour migration contributes to the withdrawal of active community members, thereby disrupting the continuity of civic organizations and diminishing the overall level of civic participation. The study identifies two interrelated mechanisms through which international labour migration weakens civic engagement in migrants’ communities of origin. The first, social-organisational discontinuity, results from the departure of active members and the social distancing of returnees. The second, intergroup boundary closure, reinforces existing ethnic and cultural divisions, particularly in heterogeneous environments. Taken together, these mechanisms demonstrate how migration reshapes local social structures, revealing the moderating role of historical, socio-economic, and cultural contexts.

Abstract BACKGROUND Brain metastases affect over 50% of patients with advanced lung cancer, though their impact on patients’ functioning and symptoms has not been well-described. We aimed to characterize and explore associations between neurocognitive deficits, functional difficulties, and mood. METHODS This is a cross-sectional study of patient-reported outcomes among patients with lung cancer with brain metastases at the time of stereotactic radiosurgery (SRS) evaluation, using a prospectively collected single-site registry. We summarized patients’ demographic and clinical data, neurocognitive deficits per clinician exam, and patient-reported functioning (self-care, usual activities, mobility) and mood (anxiety/depression) using the European Quality of Life 5-Dimensions 3-Level Version. We used logistical regressions to assess associations between (1) the presence of neurocognitive deficits and functional difficulties and (2) the presence of functional difficulties and mood symptoms, adjusting for age, tobacco use, performance status, and extracranial disease status. RESULTS Among 463 patients, the mean age was 65.4 years at cancer diagnosis and 20.5% had controlled extracranial disease at SRS evaluation. One third (33.9%) of patients demonstrated any neurocognitive deficit, such as gait dysfunction/incoordination (14.7%), motor deficit (13.2%), sensory deficit (5.2%), memory decline (5.0%), visual deficit/double vision (3.7%), cranial nerve deficit (3.5%), or concentration decline (0.9%). Many (38.7%) self-reported any functional difficulty, including with usual activities (32.1%), mobility (28.9%), or self-care (15.8%), as well as anxiety/depression (15.3%). Motor deficits and gait dysfunction/incoordination were associated with difficulties with mobility, self-care, and usual activities (ORs=4.05-9.16, p’s<0.01). Difficulties with usual activities were associated with anxiety/depression (OR=4.81, p<0.01). CONCLUSIONS Patients with lung cancer with brain metastases experience functional difficulties, particularly if they have motor deficits or gait dysfunction/incoordination. Patients also experience mood symptoms, especially if they have difficulties with usual activities. These findings highlight the need for tailored supportive care for patients with lung cancer with brain metastases.

This paper argues that there are three prevailing paradigms in the construction of teachers ethics in Chinese universities: the moral paradigm of ultimate goodness and beauty, the rationalist moral paradigm, and the moral paradigm of social transformation. However, these paradigms are in urgent need of a discursive transformation. To address this, the paper introduces the analytical perspective of lifestyle and proposes that the principle of trusting and loving, loving and respecting should serve as the fundamental guideline for the cultivation of teachers ethics. This lifestyle perspective calls for a sense of calling among educators, the awakening of self-awareness, and the elevation of moral cultivation to a universal and lived dimension.

This article examines Hong Kongese writers Hon Lai-chu and Dorothy Tse's cowritten A Dictionary of Twin Cities (雙城辭典) (2012) in relation to the question of urbanity in the Anthropocene era. While much attention is paid to anglophone literature about ecological crises, discussions of how East Asian writings of the city articulate the Anthropocene in local Asian contexts remain inadequate. Focusing on urban space, sociality, and affect, this article shows that Dictionary offers surreal cityscapes that speak to specific dimensions of urban life in Hong Kong and weird nature-cultural entanglements symptomatic of the Anthropocene. The article proposes an ecocritical reading of Dictionary, arguing that it reimagines Hong Kong as a city of the Anthropocene surreal. This demonstrates a crucial connection between Anthropocene aesthetics and surrealism, reorients our attention to the experiential and imaginary dimensions of urbanity, and helps us rethink the efficacies of literature in our time.

Background and aims Sodium-glucose transporter 2 inhibitors have recently shown promise as a therapy to reduce mortality and hospitalisation for heart failure (HF) in patients with and without type 2 diabetes mellitus. The aim of this prospective study was to determine the results of a multiparametric evaluation after the addition of dapagliflozin to standard therapy in patients with heart failure with reduced ejection fraction (HFrEF). Methods From February to November 2022, 45 patients with chronic HF who regularly visited our HF outpatient clinic were selected for this study. Exclusion criteria were severe chronic renal insufficiency (GFR < 25 ml/min), type 1 diabetes, hypertrophic or restrictive cardiomyopathy, active myocarditis, constrictive pericarditis. The included patients took dapagliflozin once daily in addition to sacubitril/valsartan and other HF drugs. The following parameters were recorded before the start of therapy and at the 3-month follow-up: NYHA functional class, characteristics of the cardiopulmonary exercise test (CPET), parameters of the six-minute walk test (6MWT), quality of life (QoL) using the Kansas City Cardiomyopathy Questionnaire (KCCQ), echocardiographic evaluation. Results At 3-month follow-up, a significant increase in peak Vo2 (from 17.5 to 18.2, p < 0.001) and a significant decrease in VE/VCO2 (35.2 to 33.1, p = 0.011) were observed. In addition, Vo2/work gradient and pulse O2 increased significantly. Furthermore, a significant improvement in 6MWT, quality of life and left ventricular dimensions and systolic function was observed. Conclusion This prospective, multiparametric study showed that the additional administration of dapaglifozin to sacubitril/valsartan and other HF drugs is effective after three months.

Integrating contemporary art into restored historical and industrial buildings has become a significant interdisciplinary practice that bridges heritage conservation, spatial design, and artistic production. This study investigates the conversion of Şerefiye Cistern, Çubuklu Silos, Museum Gashouse, Artİstanbul Feshane, Casa Botter, Cendere Art Museum, Metrohan, and Yedikule Gashouse, restored under the Istanbul Metropolitan Municipality (IMM) Heritage projects, into spaces that serve artistic functions. Post-restoration evaluations focus on spatial organization and interior components such as form, material, light, and color. The research is theoretically grounded in Henri Lefebvre’s Production of Space and Christian Norberg-Schulz’s Genius Loci. Within this framework, the study explores how space is shaped through perceived, conceived, and lived dimensions, and it offers a comprehensive analysis of spatial meaning and identity. The findings reveal that digital art interventions enhance space’s aesthetic and functional qualities, while interior architectural decisions play a direct role in shaping artistic perception. Ultimately, integrating digital art into restoration processes, when approached holistically, supports both the cultural continuity and artistic transformation of historic spaces.

This study traced the sources and changes of Jamdani weaving, a UNESCO recognized intangible cultural heritage from Bangladesh. It also examined how this centuries-old craft turned into an important element of fashions in contemporary society and its wider implications for cultural policy, local governance, and sustainable industrial development. Following in-depth interviews with weavers, officials and people from the fashion world, and by analyzing cultural policy documents, our research presents the dimensions of Jamdani's social, cultural and economic life. The results showed that Jamdani weaving still serves as more than just a symbol of a cultural force. As the findings make clear, a community's culture and s be its source of sustenance also. Its transplantation into fashion house design exemplifies both resilience and creativity. Yet there are challenges ahead, such as insufficient policy support, lack of local governance frameworks, and market instability. The symposium concluded that integrated cultural policies, better local governance and collaboration among the various stakeholders concerned can help preserve Jamdani as well as increase its market price. In the end, this research probes the relationship between tradition, government structure, and fashion retail management. It offers new insights for both political circles and industry leaders.

Introduction The study aims to verify the reliability and validity of the Turkish versions of the Hopkins Rehabilitation Engagement Rating Scale (HRERS-T) for knee arthroplasty. Methods Cronbach’s alpha coefficient was used to assess internal consistency. The scores of 51 patients were evaluated, and test-retest reliability was determined using the intraclass correlation coefficient (ICC). Pearson’s correlation coefficient was used to assess the construct validity. Results Cronbach’s alpha coefficient was determined for the HRERS-T items and overall ratings. Internal consistency of all items and the total score of the HRERS-T was excellent (>0.90; ranged 0.93–0.97). HRERS-T showed excellent test-retest reliability (ICC2, k =0.94; ranged 0.93–0.97) and inter-rater reliability (ICC2, k =0.93; ranged 0.93–0.97). The correlation between HRERS-T and the Functional Independence Measurement was strong (r = 0.53, p < 0.05), and the Barthel Index was moderate (r = 0.36, p < 0.05). In addition, there was a moderate relationship between the HRERS-T and the European Quality of Life-5 Dimensions Questionnaire (r = 0.43, p < 0.05) and the European Quality of Life-5 Dimensions Questionnaire-Visual Analog Scale (r = 0.30, p < 0.05). Discussion Determining rehabilitation engagement is important in assessing the effectiveness of the patient’s rehabilitation program and identifying strategies to increase participation. HRERS-T is applicable for use with patients undergoing a rehabilitation program and has relatively high validity and reliability.

Introduction Hospital staff’s perception of oral health directly impacts their overall oral health-related well-being (OHRQoL) and their job performance. This study seeks to analyze the relationship between these two dimensions, providing information for designing strategies that promote a healthier work environment. Aim To determine the relationship between oral health-related quality of life (OHRQoL) and oral health perceptions in the staff of a level II-1 hospital located in northern Peru. Methods The study had a quantitative approach, with a cross-sectional, applied, and correlational design. Seventy-two participants participated. The validated OHIP-14 and HU-DBI questionnaires were used, with reliability coefficients of 0.847 and 0.804, respectively. Spearman’s correlation coefficient, appropriate for ordinal variables, was used for data analysis. Results A statistically significant association was found between health-related quality of life and subjective perception of oral status (Rho = 0.391, p &lt; 0.05), with an explained variance of 19.8% according to Nagelkerke’s pseudo R-squared. The most frequently associated quality of life dimensions were physical disability (Rho = 0.319; p &lt; 0.05) and social disability (Rho = 0.242; p &lt; 0.05). Excellent quality of life was the most prevalent (38.9%), while poor oral health was the most common (52.8%). Conclusion The findings show a significant relationship between self-perceived oral health and oral health-related quality of life in this group of professionals. Promoting oral health strategies tailored to the hospital setting is recommended to improve workplace well-being.

This study examines how international students in U.S. higher education intersecting forms of temporal and spatial precarity shaped by immigration enforcement and institutional policies. Drawing on critical discourse analysis of interviews with 20 international graduate students and public narratives surrounding recent visa revocations, the research explores how algorithmic enforcement systems and overlapping temporal constraints produce distinctive vulnerabilities, and what strategies students develop to maintain academic progress within these constraints. The analysis reveals that international students experience temporally compressed academic timelines governed by visa durations and degree completion deadlines, while simultaneously being subjected to heightened surveillance through systems like SEVIS monitoring. Despite these structural vulnerabilities, students demonstrate agency through digital community building, strategic confrontation, and transnational mentorship networks. The findings challenge dominant framing of international students as apolitical learners, instead positioning them as politically situated subjects navigating complex power structures. This study contributes to precarity scholarship by extending its analysis beyond labor markets to educational mobility, documenting a critical historical moment when immigration enforcement is being restructured through automation and AI.

The Leadership and Role of Sabah Muslim Women in Various Dimensions of Life

Effect of family-centered empowerment program on quality of life and caregiving burden in family caregivers of patients with hematologic malignancies: A quasi-experimental study.

Spinal cord stimulation (SCS) is a well-established treatment for chronic neuropathic and ischaemic pain. Although patient-reported outcomes have increasingly gained recognition, the impact of SCS on informal caregivers-an equally important consideration-remains underexplored. This study aims to address this gap by evaluating multidimensional outcomes following SCS, with a particular focus on the burden experienced by informal caregivers over a one-year period. A prospective cohort study was conducted involving 35 patient-caregiver dyads treated with SCS between January and December 2021 at AZ Delta and Jan Yperman Hospital. Inclusion required the availability of a spousal or offspring caregiver. Patients and caregivers were evaluated preoperatively and at 3, 6 and 12 months postoperatively using validated instruments including the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQuality of Life-5 Dimensions (EQ5D), Zarit Burden Index (ZBI), Modified Caregiver Strain Index (MCSI) and Relation Quality Indexes (RQI). Patients reported significant reductions in leg and back pain (p < 0.001), leading to decreased disability (p < 0.001) and improved quality of life (p < 0.05) during follow-up. However, no significant changes were observed in caregiver burden or in the quality of the patient-caregiver relationship. While patients reported significantly lower pain and better quality of life following SCS, these benefits do not extend to reducing caregiver burden or strengthening the patient-caregiver relationship. A holistic treatment approach that actively involves caregivers may be necessary to optimise outcomes for both patients and caregivers. Further research with a larger cohort is required. This prospective cohort study is the first to analyze the patient-caregiver dyad in chronic pain patients treated with SCS. Although SCS effectively reduces pain and improves the quality of life of patients, these benefits do not extend to reducing caregiver burden or enhancing the patient-caregiver relationship. We argue that a more holistic approach, including caregiver involvement in the treatment process, may be necessary to improve outcomes for both patients and caregivers.

This article examines ecological anxiety and freedom in Willa Cather’s My Ántonia and O Pioneers!, exploring how the American prairie is depicted not as a passive backdrop but as a volatile, shaping force in human experience. The frontier emerges as a space of contradiction, offering both promise and disorientation, where vastness and unpredictability evoke not only freedom, but vulnerability and unease. This ecological anxiety is intertwined with the emotional and psychological tensions of frontier life, challenging the myth of individual mastery over the land. Freedom, in Cather’s work, is not marked by escape or conquest, but by endurance, rootedness, and negotiation with both environmental forces and social expectations. Through close textual analysis, the article highlights how both novels portray the prairie as a site where traditional ideals of self-determination and progress are complicated by natural resistance and existential doubt. Women’s experiences are central to this vision, presenting alternative models of autonomy grounded in resilience and connection rather than domination. By reading Cather’s prairie fiction through ecocritical and structural frameworks of anxiety, the article reveals how literary representations of the frontier resist romanticisation and instead foreground the uneasy interplay between land, identity, and belonging. In doing so, it contributes to a broader understanding of how early twentieth-century American literature reflects the psychological and environmental dimensions of settler life.

BackgroundMultimorbidity is common among older people and is associated with a reduction in quality of life, including physical and psychological dimensions of health. This study aims to examine the association between multimorbidity and health-related quality of life (HRQoL) by gender and key socioeconomic factors among older adults in India.MethodThe Longitudinal Ageing Study in India (LASI) Wave-I data were used, and older persons aged 60 and above were selected for the study, which included 30,716 final samples. The HRQoL was measured based on a EuroQol Five-Dimension (EQ-5D) measure. The preliminary study used descriptive statistics to examine the baseline characteristics of the sample, the prevalence of chronic conditions, and the mean EQ-5D score. Aside from that, the findings on the association of EQ-5D score with exposure and the independent variables were carved out using a multiple linear regression model. Furthermore, the results were stratified by gender and tested for interactions.ResultsThis study revealed that 23.8% of older adults had multimorbidity, with a higher prevalence among females and older age groups. Hypertension (32.7%), bone/joint diseases (19.6%), diabetes (14.3%), and stroke (2.5%) were common conditions. Individuals with multimorbidity exhibited significantly lower HRQoL scores (mean: 10.53) compared to those with single (8.98) or no morbidity (7.54). Adjusted regression models confirmed that multimorbidity (β = 2.19, 95%CI: 2.04,2.35) and female gender (β = 0.86, 95%CI: 0.71,1.00) strongly predicted poorer HRQoL. The association between multimorbidity and HRQoL was stronger in females compared to males. Lower socioeconomic status, rural residence, and poor self-rated health further exacerbated these disparities. These findings highlight the negative impact of multimorbidity on the physical and psychological well-being of older adults in India.ConclusionsThis study found that multimorbidity significantly reduces HRQoL among older adults in India, with women, individuals of lower socioeconomic status, and those reporting poor self-rated health experiencing the most significant burden. These findings highlight the need for gender-sensitive, equity-focused public health strategies aimed at managing chronic conditions and improving quality of life among the ageing population in India.