Search Results (48)

This study examines how Windhoek’s urban form, shaped by apartheid-era planning, continues to influence neighbourhood travel behaviour, socio-economic disparity, and residential perceptions. It addresses three key questions: (1) How do socio-economic characteristics, neighbourhood perceptions, and travel patterns differ between compact and sprawled areas? (2) Which socio-economic, perceptual, and spatial factors are associated with the likelihood of neighbourhood-based shopping in compact versus sprawled urban forms? (3) What are the determinants of entertainment and recreational travel behaviour within neighbourhoods across the two urban forms? Using survey data from 1000 residents, the analysis employs chi-square tests, Mann–Whitney U tests, binary logistic regression, and multivariate regression models. Findings reveal that compact areas, characterised by higher incomes, stronger place attachment, and greater infrastructural diversity, support more frequent neighbourhood travel. By contrast, sprawled peripheries, despite higher population densities, remain marked by socio-economic marginalisation, limited amenity access, and negative perceptions that constrain neighbourhood mobility. Across both forms, long-term residence and belonging strongly predict neighbourhood travel, while concerns over traffic safety and crime consistently suppress participation. The results show that spatial proximity alone does not ensure accessibility; emotional, perceptual, and structural barriers mediate neighbourhood mobility. The study highlights the need for integrated planning that addresses both physical infrastructure and lived experience to advance equitable and sustainable mobility in post-colonial contexts. Full article

This study investigates the determinants of Romanian workers’ migration intentions towards Italy, integrating economic, social, and psychological perspectives. Based on a sample of 358 respondents, four hypotheses were tested concerning perceived living standards, working conditions, quality of public services, and anticipated integration difficulties. Data were analysed using descriptive statistics, Spearman’s rho correlation, Mann–Whitney U, Chi-square, ANOVA, and ordinal logistic regression. The results confirm that higher perceived living standards and better working conditions in Italy significantly increase the likelihood of expressing migration intentions, while favourable evaluations of healthcare and education act as additional pull factors. Conversely, anticipated integration difficulties, particularly language barriers and cultural adaptation, reduce migration intentions, indicating that socio-psychological obstacles can counterbalance economic incentives. By combining non-parametric and multivariate analyses, the study demonstrates that migration is a multidimensional process shaped not only by structural opportunities but also by behavioural and psychological appraisals. These findings are consistent with recent research on European labour mobility and contribute to the literature by highlighting the role of subjective perceptions in shaping migration decisions. Implications for policy include the need to address both economic disparities and integration barriers to support more balanced mobility within the European space. Full article

Generational approaches to climate engagement among older adults remain limited. This study examines the evolution of eco-anxiety, environmental activism, and pro-environmental behavior from a life course perspective, focusing on older adults in Spain. A nationwide CATI survey of 3000 residents aged 18 and older was conducted, employing validated multidimensional scales for eco-anxiety, environmental activism, and pro-environmental behavior, each rescaled to a 0–10 range. Data were analyzed using descriptive statistics, analyses of variance, and hierarchical regression models to estimate linear and quadratic age effects beyond sex, education, and subjective social class. Results show that (1) eco-anxiety follows an inverted-U pattern, peaking at ages 45–49 and declining significantly after 60; (2) environmental activism remains high until the late sixties, while everyday pro-environmental behaviors sharply decline after retirement; and (3) eco-anxiety and environmental action in older adults are partially decoupled, reflecting the role of supportive personal and contextual factors beyond emotional concern. The findings challenge prevailing stereotypes of passive older adults by demonstrating that older age can constitute a significant period of climate engagement. Despite a slight decline in climate concern following retirement, the willingness to take action remains notably resilient. Older adults maintain consistent involvement in environmental volunteering and activism, often motivated by a desire to leave a lasting legacy and shaped by personal experiences of past crises and collective struggles. However, pro-environmental behaviors show a marked decrease in older adults, not due to diminished interest but likely as a result of structural constraints such as declining health, limited income, and inadequate housing conditions. This study suggests that, in the context of liquid modernity marked by rapid change and uncertainty, older adults may serve as societal anchors—preserving narratives, emotional bonds, and civic networks. Through policies that address structural barriers, this anchor role can be supported, empowering older adults to improve their well-being and strengthening community resilience in the face of climate change. Full article

Background: Despite growing interest in supply chain resilience (SCRes), theoretical overlap between dynamic capabilities (DC) and supply chain agility (SCA) has complicated empirical analysis of their distinct roles. Additionally, the contextual role of information asymmetry in shaping resilience remains underexplored. This study addresses both issues by modeling DC hierarchically and examining IA as a moderator. Methods: Data were collected through a cross-sectional survey of 157 U.S.-based supply chain professionals. Partial least squares structural equation modeling (PLS-SEM) was used to examine the relationships among DC, SCA, IA, and SCRes. Results: SCA was a strong, direct predictor of SCRes. In contrast, DC showed no direct effect in the full model; however, in a hierarchical component model (HCM), DC, a higher-order construct, emerged as significant predictor of SCRes. IA exerted a dual negative influence: it directly weakened SCRes and negatively moderated the relationship between DC and SCRes. Conclusions: This study makes two novel contributions. First, it resolves ambiguity between DC and SCA by empirically modeling DC as a higher-order construct that encompasses but remains distinct from SCA. Second, it introduces IA as a multidimensional barrier to resilience, demonstrating its direct and interactive effects. These findings provide new insight into capability design and contextual adaptation for SCRes in uncertain, information-constrained environments. Full article

Background: Although evidence-based practice is widely promoted in nursing, direct care nurses remain underrepresented in research activities. This study aimed to assess nurses’ attitudes toward research, their perceptions of the organizational research environment, and their levels of involvement, as well as identify key barriers and facilitators to engagement within a comprehensive healthcare system. This study also explored how racial and ethnic diversity within the nursing workforce may shape research engagement and contribute new perspectives to the field. Methods: A cross-sectional electronic survey was administered to registered nurses across 10 hospitals in a Northeast U.S. health system. The survey instrument assessed research attitudes, environment, involvement (past, present, future), and demographics. Descriptive and inferential statistics, including matched-pairs t-tests, were used to analyze responses. Results: Of 7655 invited nurses, 1094 responses were analyzed. Respondents were predominantly female (88.5%), White (56.8%), and employed full-time (87.1%) as clinical staff nurses (77.3%). While 54.8% had completed a formal research course (mainly within the past 1–3 years), informal research and statistics training were uncommon (17.4% and 5.4%, respectively). Nurses reported highly positive attitudes toward research (composite M = 2.15, SD = 0.51), especially its role in guiding practice, professional growth, and education. However, actual involvement was low. The most common current activities included practice change based on research (20.7%) and participation in committees (18.8%). Anticipated future engagement increased substantially, particularly in collaboration (+21.3%), committee participation (+20.6%), and IRB submission (+18.2%). The research environment was perceived as under-resourced, particularly in terms of protected time, funding, and mentorship. Statistically significant gaps were observed between perceived present and desired future supports (p < 0.01 for all 15 items). The Research Awareness Index revealed high rates of uncertainty about available resources (e.g., 66.1% did not know if internal funding existed). Conclusions: Nurses demonstrate strong positive attitudes and a desire to engage in research, including more advanced roles. Yet structural and informational barriers, particularly a lack of protected time, mentorship, and awareness of existing supports, limit participation. Investments in infrastructure, communication, and accessible development pathways are needed to translate nurses’ readiness into active research engagement. Implications: Institutions should prioritize making research support more visible and navigable while investing in mentorship, protected time, and user-friendly infrastructure. Addressing both facets will empower a highly motivated nursing workforce to engage in and lead practice-relevant research. Full article

Advancements in material technologies and increasingly stringent thermal insulation requirements are driving the search for innovative solutions to serve as an alternative to traditional insulating materials. Using 3D printing techniques to produce thermal insulation opens up new possibilities for creating structures, geometries, and shapes from a variety of raw materials, ranging from synthetic polymers to biodegradable composites. This study aimed to develop a modern thermal insulation barrier with a comparable thermal conductivity to conventional materials to enhance the energy efficiency of buildings. Cellular materials based on the Kelvin cell were fabricated using additive manufacturing via 3D SLS printing from a composite consisting of a biodegradable material (TPS) and a recyclable polymer (PA12). The printed cellular structural partitions were tested for their thermal insulation properties, including thermal conductivity coefficient, thermal transmittance (U-value), and thermal resistance. The best thermal insulation performance was demonstrated by a double-layer partition made from TPS + PA12 at a mass ratio of 5:5 and with a thickness of 60 mm. This sample achieved a thermal conductivity of λ = 0.026 W/(m·K), a thermal resistance of R = 2.4 (m²·K)/W, and a thermal transmittance of U = 0.42 W/(m²·K). Cellular partition variants with the most favorable properties were incorporated into building thermal balance software and an energy simulation was conducted for a single-family house using prototype insulating materials. This enabled an assessment of their energy efficiency and cost-effectiveness. Full article

Background: Life insurance markets are experiencing unprecedented transformation in the wake of economic disruption, evolving consumer expectations, and behavioral shifts following the COVID-19 pandemic. Traditional economic models often fail to capture the complex interplay of attitudinal, and cognitive factors that now shape insurance demand and premium selection. Methods: This study analyzes nationally representative survey data from over 3600 U.S. adults (2024 NAIC Financial Inclusion Survey). It uses a weighted full maximum likelihood Heckman selection model to identify determinants of life insurance uptake and premiums. The main innovation is modeling psychological price, a composite of perceived affordability, with higher-order polynomials. The design integrates psychometrically validated measures of financial knowledge and risk tolerance. Political ideology, race and ethnicity, and sources of financial advice serve as exclusion restrictions in the selection equation. Results: Psychological price shows an inverse-U relation with term outcomes: uptake rises at low to moderate affordability and declines at high affordability; among purchasers, term premiums rise at low to mid affordability and decline at high levels. For cash value policies, premiums decrease as psychological price increases. Financial knowledge and risk tolerance increase term uptake; financial knowledge reduces cash premiums. Education and income increase term uptake and term premiums. Compared with respondents reporting no ideology, conservative and centrist respondents have lower term uptake and higher cash uptake; using a professional advisor is associated with higher cash uptake. The selection correlation is positive for term ($\rho \approx 0.98$) and negative for cash ($\rho \approx -0.38$), indicating non-random selection in both markets. Implications: In order to reduce disparities, insurers should target the mid-affordability threshold with term offerings, streamline options for high-affordability consumers, offer pricing support and guidance for low-affordability households, increase uptake through advice channels and financial education, and address affordability barriers. Conclusions: Nonlinear affordability effects shape both market entry and pricing choices. Modeling psychological price with higher-order polynomials identifies thresholds and turning points that linear specifications miss. The results support targeted product design and outreach when perceived affordability drives insurance participation and premium choices. Full article

In the era of digital business model innovation, multinational corporations face a dual challenge: leveraging digital technologies to overcome institutional barriers while reconfiguring value creation in cross-border operations. Grounded in institutional theory and the digital transformation literature, this study investigates how knowledge distance and political distance shape subsidiary exits through a U-shaped relationship, and how digital transformation breadth and depth differentially reconfigure these effects. We conduct empirical research on 1203 Chinese multinational enterprises from 2015 to 2019. The results indicate that both knowledge distance and political distance exhibit a U-shaped relationship with the subsidiary exit. The breadth of digital transformation strengthens the U-shaped relationship between knowledge distance and subsidiary exit but weakens the relationship between political distance and subsidiary exit. The depth of digital transformation mitigates the effects of both knowledge distance and political distance on subsidiary exit. These findings provide a novel explanatory perspective on the ‘Distance Paradox’ in internationalization theory, address a critical gap in the multinational enterprise (MNE) exit literature, and propose a modular governance blueprint for MNEs. Full article

This study investigates the factors influencing electric ride-hailing vehicle (ERV) adoption and market exit among ride-hailing drivers in underdeveloped cities, aiming to enhance industry operational efficiency and workforce stability. Using survey data from 630 drivers in Zhangzhou, Fujian Province, China, we employ statistical modeling to analyze heterogeneous mechanisms behind ERV acceptance and market-exit behavior. The results indicate that: (1) Drivers’ environmental awareness and positive attitudes toward new energy vehicle development significantly increase ERV adoption willingness, though weak policy implementation and misconceptions about electric vehicle technology are associated with these incentives. Unlike in developed regions, range anxiety is not a significant barrier in underdeveloped cities with limited operational ranges. (2) Concerning market-exit behavior, job intensity exhibits a U-shaped relationship with exit risk, while platform income redistribution adjustments emerge as a key external factor. Notably, local full-time drivers show a marked lag in technology adoption. The findings offer valuable insights for optimizing policies and promoting sustainable development in the ride-hailing industry in underdeveloped cities, providing practical guidance for policymakers and companies in shaping tailored industry regulations and operational strategies. Full article

Background: The U.S. Medicare Annual Wellness Visit (AWV) offers a structured opportunity for cognitive screening and personalized prevention planning among older adults. Yet, implementation of AWVs, particularly for individuals with cognitive impairment, remains inconsistent across primary care or other diverse care settings. Methods: We conducted a scoping review using the Consolidated Framework for Implementation Research (CFIR) to explore multilevel factors influencing the implementation of the Medicare AWV’s cognitive screening component, with a focus on how these processes support the detection and management of cognitive impairment among older adults. We searched four databases and screened peer-reviewed studies published between 2011 and March 2025. Searches were conducted in Ovid MEDLINE, PubMed, EBSCOhost, and CINAHL databases. The initial search was completed on 3 January 2024 and updated monthly through 30 March 2025. All retrieved citations were imported into EndNote 21, where duplicates were removed. We screened titles and abstracts for relevance using the predefined inclusion criteria. Full-text articles were then reviewed and scored as either relevant (1) or not relevant (0). Discrepancies were resolved through consensus discussions. To assess the methodological quality of the included studies, we used the Joanna Briggs Institute critical appraisal tools appropriate to each study design. These tools evaluate rigor, trustworthiness, relevance, and risk of bias. We extracted the following data from each included study: Author(s), year, title, and journal; Study type and design; Data collection methods and setting; Sample size and population characteristics; Outcome measures; Intervention details (AWV delivery context); and Reported facilitators, barriers, and outcomes related to AWV implementation. The first two authors independently coded and synthesized all relevant data using a table created in Microsoft Excel. The CFIR guided our data analysis, thematizing our findings into facilitators and barriers across its five domains, viz: (1) Intervention Characteristics, (2) Outer Setting, (3) Inner Setting, (4) Characteristics of Individuals, and (5) Implementation Process. Results: Among 19 included studies, most used quantitative designs and secondary data. Our CFIR-based synthesis revealed that AWV implementation is shaped by interdependent factors across five domains. Key facilitators included AWV adaptability, Electronic Health Record (EHR) integration, team-based workflows, policy alignment (e.g., Accountable Care Organization participation), and provider confidence. Barriers included vague Centers for Medicare and Medicaid Services (CMS) guidance, limited reimbursement, staffing shortages, workflow misalignment, and provider discomfort with cognitive screening. Implementation strategies were often poorly defined or inconsistently applied. Conclusions: Effective AWV delivery for older adults with cognitive impairment requires more than sound policy and intervention design; it demands organizational readiness, structured implementation, and engaged providers. Tailored training, leadership support, and integrated infrastructure are essential. These insights are relevant not only for U.S. Medicare but also for global efforts to integrate dementia-sensitive care into primary health systems. Our study has a few limitations that should be acknowledged. First, our scoping review synthesized findings predominantly from quantitative studies, with only two mixed-method studies and no studies using strictly qualitative methodologies. Second, few studies disaggregated findings by race, ethnicity, or geography, reducing our ability to assess equity-related outcomes. Moreover, few studies provided sufficient detail on the specific cognitive screening instruments used or on the scope and delivery of educational materials for patients and caregivers, limiting generalizability and implementation insights. Third, grey literature and non-peer-reviewed sources were not included. Fourth, although CFIR provided a comprehensive analytic structure, some studies did not explicitly fit in with our implementation frameworks, which required subjective mapping of findings to CFIR domains and may have introduced classification bias. Additionally, although our review did not quantitatively stratify findings by year, we observed that studies from more recent years were more likely to emphasize implementation facilitators (e.g., use of templates, workflow integration), whereas earlier studies often highlighted systemic barriers such as time constraints and provider unfamiliarity with AWV components. Finally, while our review focused specifically on AWV implementation in the United States, we recognize the value of comparative analysis with international contexts. This work was supported by a grant from the National Institute on Aging, National Institutes of Health (Grant No. 1R01AG083102-01; PIs: Tzeng, Kuo, & Raji). Full article

The structural analysis of shelterbelts forms the foundation of their planning and management, yet the scientific and effective quantification of shelterbelt structures requires further investigation. This study developed an innovative heterogeneous analytical framework, integrating three key methodologies: the LeWoS algorithm for wood–leaf separation, TreeQSM for structural reconstruction, and 3D alpha-shape spatial quantification, using terrestrial laser scanning (TLS) technology. This framework was applied to three typical farmland shelterbelts in the Ulan Buh Desert oasis, enabling the first precise quantitative characterization of structural components during the leaf-on stage. The results showed the following to be true: (1) The combined three-algorithm method achieved ≥90.774% relative accuracy in extracting structural parameters for all measured traits except leaf surface area. (2) Branch length, diameter, surface area, and volume decreased progressively from first- to fourth-order branches, while branch angles increased with ascending branch order. (3) The trunk, branch, and leaf components exhibited distinct vertical stratification. Trunk volume and surface area decreased linearly with height, while branch and leaf volumes and surface areas followed an inverted U-shaped distribution. (4) Horizontally, both surface area density (Scd) and volume density (Vcd) in each cube unit exhibited pronounced edge effects. Specifically, the Scd and Vcd were greatest between 0.33 and 0.60 times the shelterbelt’s height (H, i.e., mid-canopy). In contrast, the optical porosity (Op) was at a minimum of 0.43 H to 0.67 H, while the volumetric porosity (Vp) was at a minimum at 0.25 H to 0.50 H. (5) The proposed volumetric stratified porosity (Vsp) metric provides a scientific basis for regional farmland shelterbelt management strategies. This three-dimensional structural analytical framework enables precision silviculture, with particular relevance to strengthening ecological barrier efficacy in arid regions. Full article

New infrastructure construction (NIC) is pivotal for advancing China’s sustainable development, yet the spatial interdependencies between NIC and inclusive green growth (IGG) remain critically underexplored. This study quantifies provincial-level NIC–IGG coordination dynamics across China (2011–2023) using a novel coupling coordination model. We further dissect regional disparities through Dagum Gini decomposition and identify causal drivers via QAP regression analysis. Key findings reveal: (1) Despite a gradual upward trend, overall NIC–IGG coordination remains suboptimal, hindering sustainable transition; (2) Regional disparities follow a “U-shaped” trajectory, primarily driven by inter-regional imbalances; (3) Uneven marketization is the dominant factor fragmenting spatial coordination. Our results expose systemic barriers to regionally integrated sustainable development and provide actionable pathways for place-based policies that synchronize NIC investment with IGG objectives. Full article

Background/Objectives: Oral health (OH) in early childhood is a key determinant of long-term well-being, shaped by parenting-related dietary and hygiene habits. While these influences are well-documented, they remain underexplored among Brazilian immigrant families in the United States (U.S.). Therefore, this study was designed to examine how Brazilian immigrant parents’ perceptions and practices regarding diet and oral hygiene affect their preschool-aged children’s OH. Methods: This qualitative study consisted of in-depth interviews with Brazilian immigrant parents of preschool-aged children (ages 2–5) living in the U.S. Individual, in-depth interviews were conducted via Zoom, recorded, and transcribed in Brazilian Portuguese. Two native Brazilian researchers experienced in qualitative methods conducted a thematic analysis of the transcripts in Brazilian Portuguese using MAXQDA, a qualitative data analysis software. The analysis focused on identifying key perceptions, parenting practices, and barriers related to children’s diet and OH. Results: Parents strongly associated sugary foods with poor OH, identifying sugar as a major contributor to dental issues. Both mothers and fathers reported limiting sugar intake and encouraging good oral hygiene practices. While parents prioritized educating their children on healthy habits, barriers such as time constraints, reliance on external childcare, and economic limitations affected the consistent implementation of strategies. Conclusions: Brazilian immigrant parents understand the importance of diet and oral hygiene in in supporting their children’s early OH but face barriers in broader social contexts, such as daycare, preschools, and communities. Interventions should aim to support parents in their caregiving roles while simultaneously addressing systemic and environmental obstacles. Public health efforts should account for cultural, economic, and contextual factors to more effectively support Brazilian immigrant families in promoting their children’s OH. Full article

Background: Food and nutrition security are key social determinants of cardiometabolic health. While food security reflects access to sufficient food, nutrition security incorporates the quality, consistency, and usability of food that supports long-term health. However, few studies have examined how household-level barriers to food utilization shape these relationships. Objective: This study assessed whether tangible (e.g., equipment, storage) and intangible (e.g., time, knowledge) food utilization barriers modify the associations between food and nutrition security and cardiometabolic outcomes in low-income adults. Methods: A cross-sectional survey was conducted among 486 low-income adults across five U.S. states. Participants reported household food security (USDA 18-item module), nutrition security (four-item scale), and utilization barriers (eight-item scale, categorized into tangible and intangible subscales). Self-reported diagnoses of hypertension, hyperlipidemia, and diabetes were combined into a cardiometabolic outcome. Mixed-effects logistic regression models, adjusted for sociodemographic and program participation factors, were used to assess associations and effect modification. Results: Higher nutrition security was associated with lower odds of cardiometabolic conditions (AOR = 0.59; 95% CI: 0.41–0.83). Tangible barriers significantly modified the relationship between nutrition security and hypertension (p-interaction = 0.04), with stronger protective effects observed in households without such barriers. No significant moderation effects were found for intangible barriers or for food security. Conclusions: Tangible household barriers influence the protective association between nutrition security and cardiometabolic outcomes. Public health strategies should address not only food access but also the practical resources required to store, prepare, and consume healthy foods effectively. Full article

Physical activity (PA) is a crucial tool for managing comorbidities and preventing secondary complications in individuals with spinal cord injuries (SCIs). Despite its well-documented benefits, participation in PA among individuals with SCI remains low, with significant barriers affecting engagement. The aim of this study was to assess the attitudes of Italian individuals with SCI towards PA and to identify the factors that influence these attitudes. A cross-sectional observational study was conducted using an ad hoc questionnaire to assess five domains of attitudes towards PA: physical benefits, psychological benefits, motivation, social aspects, and perceived barriers. Demographic characteristics were analyzed using descriptive statistics. Spearman’s correlation was used to examine associations between domains. Group differences based on activity levels were assessed using the Mann–Whitney U test. A total of 54 participants (mean age 51.0 ± 13.89 years) completed the questionnaire. Among them, 49 acknowledged the physical benefits of physical activity for health, while 44 recognized its psychological benefits. However, 17 participants (31.5%) reported barriers related to accessibility, cost, and lack of adapted programs. Individuals with SCI demonstrate a predominantly positive attitude towards PA, but significant barriers limit their participation. Previous sports participation showed a promising contribution in shaping attitudes towards PA, particularly in the psychological, motivational, and social domains. Full article