High heel use in professional environments is a common occupational norm for women, particularly in the hospitality, retail, and fashion industries. However, extended and repetitive use may increase the risk of ankle injuries. The objective of this exploratory cross-sectional study was to examine the factors associated with a history of ankle sprain among women wearing high heels at work. A total of 203 participants were recruited from selected workplaces in Lahore, Pakistan, via a nonprobability convenience sampling technique. Data were collected through a structured questionnaire assessing sociodemographic information, footwear usage patterns, pain symptoms, occupational standing duration, and ankle sprain history. Chi-square analysis revealed significant associations between ankle sprains and heel height, duration of heel wear, type of heel, workplace footwear requirements, and the presence of pain during high heel use (p < 0.05). Women wearing heels ≥ 10 cm and those wearing stilettos were more likely to report a history of ankle sprain. Logistic regression analysis revealed that standing more than 4 hours per day (OR = 3.803), footwear requirements at work (OR = 3.534), and pain during heel use (OR = 9.893) significantly increased the odds of experiencing an ankle sprain, whereas increasing age (OR = 0.789) and being married (OR = 0.304) were associated with lower risk (p < 0.05). Ankle sprains led to productivity loss in more than 75% of the participants, with the majority missing 1–5 workdays. These findings highlight the occupational health risks of high heel use, with prolonged standing, footwear mandates, and early pain symptoms identified as key predictors of injury. Implementing preventive workplace measures—such as ergonomic footwear policies, scheduled standing breaks, and employee education—may help reduce ankle injury risk among women in professions requiring high heels.

Pressure ulcers (PUs) remain a critical and preventable challenge in hospital care, especially in resource-constrained settings. Despite formal training, early-career nurses often experience gaps in applying evidence-based PU prevention practices. This study identified the behavioral and contextual predictors of evidence-based PU prevention behaviors among recently graduated nurses in tertiary care hospitals in Lahore, Pakistan, by assessing their level of knowledge, attitudes, and self-efficacy, as well as the impact of clinical exposure, internship training, and perceived barriers to their preventive practices. A cross-sectional design involving 135 BSN graduates who had completed their clinical internships within the past six months were recruited for the study using a purposive sampling method. Data were collected via a structured, self-administered questionnaire composed of validated tools, including the Pressure Ulcer Knowledge Assessment Tool 2.0, the Attitude towards Pressure Ulcer Prevention (APuP) scale, and as well as constructs derived from the Theory of Planned Behavior framework. Descriptive statistics, Pearson correlations, one-way ANOVA, and multiple linear regression were used for analysis. While participants showed moderately positive attitudes and self-efficacy, only knowledge of PU prevention emerged as a statistically significant predictor of evidence-based behavior (p = 0.003). Other factors, such as attitudes, perceived barriers, and clinical decision-making ability, did not significantly influence behavior. Despite high exposure to PU cases, most participants reported limited workshop participation and demonstrated low decision-making accuracy. This study highlights that factual knowledge, rather than attitudinal or perceptual factors, plays a pivotal role in shaping evidence-based PU prevention behavior among newly graduated nurses. This finding emphasizes the need for knowledge-intensive interventions and scenario-based training in early clinical practice. Further longitudinal studies are recommended to evaluate the impact of mentorship and institutional support on sustained preventive behaviors.

Agricultural productivity plays a vital role in ensuring food security, rural livelihoods, and environmental sustainability, particularly in regions facing ecological stress and institutional variation. This study offers a comparative analysis of South Asian and Southern European countries from 2000–2022, investigating how environmental quality, economic investment, and governance influence agricultural output. Using secondary panel data and the Driscoll–Kraay (DSK) estimator, the analysis addresses the challenges of cross-sectional dependence (CSD), heteroskedasticity, and autocorrelation. The findings show that in South Asia, gross fixed capital formation (GFCF) (β = 0.577, p < 0.01) and fertilizer use (β = 0.113, p < 0.01) are significant drivers of productivity. Crop residue burning (CRB), despite its environmental drawbacks, also has a positive association with productivity (β = 0.227, p < 0.01). However, stricter air quality regulations appear to constrain productivity (β = –0.228, p < 0.01), likely due to disruptions in conventional farming practices. Governance and surface air temperature (SAT) were not statistically significant in this region. In Southern Europe, productivity is positively linked with GFCF (β = 0.362, p < 0.01), fertilizer use (β = 0.203, p < 0.10), and SAT (β = 0.238, p < 0.05), suggesting a potential benefit from moderate warming. No significant effects were observed for governance, air quality performance (AQP), or crop burning, likely reflecting stronger institutions and regulatory stability. The model explains a greater proportion of the productivity variation in South Asia (R² = 0.8744) than in Southern Europe (R² = 0.1456). These results highlight the importance of region-specific strategies. South Asia requires policies that reconcile environmental regulation with agricultural output, whereas Southern Europe should prioritize climate adaptation and ecological safeguards. Aligning agricultural policy with public health, governance, and sustainability goals is essential for resilient food systems.

Effective pain management is a cornerstone of quality nursing care, yet knowledge gaps and systemic barriers often hinder optimal practice, particularly in low-resource settings. This study aimed to assess nurses’ knowledge and attitudes regarding pain management, evaluate their self-reported pain practices, and explore the role of perceived organizational support in shaping pain management competence among nurses in a tertiary care hospital in Lahore, Pakistan. A cross-sectional survey was conducted with 120 registered nurses using the Knowledge and Attitudes Survey Regarding Pain (KASRP), a perceived organizational support scale, and a self-reported practice checklist. Descriptive statistics revealed that only 22.5% of nurses demonstrated good knowledge, while 45% had moderate and 32.5% poor knowledge levels. Perceived organizational support was moderate on average, and although self-reported practice scores were relatively high, they did not significantly correlate with knowledge levels. Independent samples t-tests showed no significant differences in knowledge or practice scores by gender. Pearson correlation indicated a significant positive association between organizational support and knowledge scores. Multiple linear regression identified organizational support as the only significant predictor of knowledge scores (p = 0.003). These findings highlight the critical role of organizational factors in fostering clinical competence and suggest the need for system-level interventions—such as regular training, managerial support, and access to protocols—to improve pain management outcomes in nursing practice.