Search Results (4,447)

The proliferation of social media has paradoxically facilitated the widespread dissemination of fake news, impacting individuals, politics, economics, and society as a whole. Despite the increasing scholarly research on this phenomenon, a significant gap exists regarding its dynamics in developing countries, particularly how predictors of fake news sharing interact, rather than merely their net effects. To acquire a more nuanced understanding of fake news sharing behavior, we propose identifying the direct and complex interplay among key variables by utilizing a dual analytical framework, leveraging Structural Equation Modeling (SEM) for linear relationships and Fuzzy-Set Qualitative Comparative Analysis (fsQCA) to uncover asymmetric patterns. Specifically, we investigate the influence of news-find-me orientation, social media trust, information-sharing tendencies, and status-seeking motivation on the propensity of fake news sharing behavior. Additionally, we delve into the moderating influence of social media literacy on these observed effects. Based on a cross-sectional survey of 1028 Haitian social media users, the SEM analysis revealed that news-find-me perception had a negative but statistically insignificant influence on fake news sharing behavior. In contrast, information sharing exhibited a significant negative association. Trust in social media was positively and significantly linked to fake news sharing behavior. Meanwhile, status-seeking motivation was positively associated with fake news sharing behavior, although the association did not reach statistical significance. Crucially, social media literacy moderated the effects of trust and information sharing. Interestingly, fsQCA identified three core configurations for fake news sharing: (1) low status seeking, (2) low information-sharing tendencies, and (3) a unique interaction of low “news-find-me” orientation and high social media trust. Furthermore, low social media literacy emerged as a direct core configuration. These findings support the urgent need to prioritize social media literacy as a key intervention in combating the dissemination of fake news. Full article

This study intends to provide insights and challenges for the shape of the B movement, an emerging paradigm that fosters cross-sectoral partnerships and encourages ethical business practices through so-called purpose-driven businesses. Focusing on Italy, the first European country to adopt this managerial model, the research investigates Italian Benefit Corporations, known as Società Benefit (SB), and their most appealing sustainability claims from a consumer perspective. The analysis intends to inform theory development by assuming the cultural and creative industry (CCI) as a field of interest, utilizing a within-subjects experimental design to analyze data from a diverse consumer sample across various contexts. The results indicate that messaging centered on economic sustainability emerged as the most effective in generating positive consumer responses, highlighting a prevailing inclination toward pragmatic factors such as affordability, economic accessibility, and tangible benefits rather than social issues. While sustainable behaviors are not yet widespread, latent ethical sensitivity for authentic, value-driven businesses suggests that economic and ethical dimensions can be strategically synthesized to enhance consumer engagement. This insight highlights the role of BCs in catalyzing a shift in consumption patterns within ethical-based and creative-driven sectors. Full article

Where we find and form identity and belonging, meaning and purpose, is often entangled in the dynamics that play out between people and place, and for Aboriginal and Torres Strait Islander Peoples, the legacy and ongoing experience of invasion and colonisation. Place-based understandings of identity and its importance in shaping young people’s experience of what is possible and probable in their futures might be critical to framing cross-cultural work with young people impacted by violence and trauma. This paper draws on practitioner reflections of work with young Aboriginal women both on, and off Country, highlighting common and distinct themes related to identity formation and migration in navigating new futures. These include connection to Country and spiritual connection, family and kinship relationships, Women’s Business and felt cultural safety. The findings illustrate a meaningful parallel instructive to practice; for both young women and practitioners, access to cultural knowledge and connection is strengthened by endorsement and in turn strengthens understanding and experienced safety. This work emphasises the importance of creating culturally connected opportunities, sensitive to dynamics of place, to support positive identity expression and wellbeing. Full article

Although organizational resilience is well established, refining the systematic quantitative evaluation of health systems resilience (HSR) remains an ongoing opportunity for advancement. Research either focuses on individual HSR indicators, such as social welfare policy, public expenditure, health insurance, healthcare quality, and technology, or broadly examines socio-economic factors, highlighting the need for a more comprehensive methodological approach. This study employed the Slacks-Based Measure (SBM) within Data Envelopment Analysis (DEA) to analyze efficiency by maximizing outputs. It systematically examined key HSR factors across countries, providing insights for improved policymaking and resource allocation. Taking a five-year (2016–2020) dataset that covered 55 to 56 countries and evaluating 17 indicators across governance, health systems, and economic aspects, the paper presents that all sixteen top-ranked countries with a perfect efficiency score of 1 belonged to the high-income group, with ten in Europe, highlighting regional HSR differences. This paper concludes that adequate economic resources form the foundation of HSR and ensure stability and sustained progress. A properly supported healthcare workforce is essential for significantly enhancing health systems and delivering quality care. Last, effective governance and the equitable allocation of resources are crucial for fostering sustainable development and strengthening HSR. Full article

Background and Objectives: The uric acid to HDL-cholesterol ratio (UHR) has recently emerged as a promising biomarker reflecting systemic inflammation and metabolic disturbances. Elevated liver transaminases are clinical indicators of hepatic injury and underlying metabolic dysfunction. Many Middle Eastern countries face constrained clinical and laboratory resources, where access to comprehensive diagnostic tools may be limited. In such settings, identifying simple and easily accessible markers could offer significant practical value in detecting and monitoring health disorders. This study investigates the potential association between UHR and elevated liver transaminases levels in the Saudi general population. Materials and Methods: This retrospective cross-sectional study included 9618 subjects, and the association between the UHR and elevated liver transaminases, alanine transaminase (ALT), and aspartate transaminase (AST), was comprehensively analysed. In addition, the study assessed risk indicators including the prevalence ratio (PR) and odds ratio (OR) as well as the diagnostic accuracy of UHR and C-reactive protein (CRP) in detecting liver transaminases abnormalities, with analyses stratified by age and gender. Results: UHR was significantly elevated in subjects with increased ALT and AST activities, and this pattern was consistent across all age and gender categories. High UHR was significantly associated with elevated ALT (OR = 2.32, 95% CI: 2.12–2.53, p < 0.001) and AST (OR = 1.38, 95% CI: 1.25–1.52, p < 0.001), with stronger associations observed in males and for ALT activity. In addition, elevated UHR was more prevalent among individuals with increased liver transaminase activities. Receiver operating characteristic (ROC) analysis showed that UHR outperformed CRP in identifying elevated liver transaminases, with better discriminative ability for ALT than AST activity. Conclusions: These findings highlight a significant association between UHR and liver transaminase abnormalities in the general population, underscoring the potential utility of UHR as a simple and accessible indicator for liver function assessment in clinical settings. Full article

Background: Breast cancer is the most prevalent malignancy among women globally. In Romania, it is the most frequent form of cancer affecting women, with approximately 12,000 new cases diagnosed annually, and the second most common cause of cancer-related mortality, second only to lung cancer. Methods: This study looked at 79 breast cancer patients from Oltenia, concentrating on epidemiology, histology, diagnostic features, and treatments. Patients were chosen based on inclusion criteria such as histopathologically verified diagnosis, availability of clinical and treatment data, and follow-up information. The analyzed biological material consisted of tissue samples taken from the breast parenchyma and axillary lymph nodes. Even though not the primary subject of this paper, all patients underwent immunohistochemical (IHC) evaluation both preoperatively and postoperatively. Results: We found invasive ductal carcinoma to be the predominant type, while ductal carcinoma in situ (DCIS) and mixed types were rare. We performed cross-tabulations of metastasis versus nodal status and age versus therapy type; none reached significance (all p > 0.05), suggesting observed differences were likely due to chance. A chi-square test comparing surgical interventions (breast-conserving vs. mastectomy) in patients who did or did not receive chemotherapy showed, χ² = 3.17, p = 0.367, indicating that chemotherapy did not significantly influence surgical choice. Importantly, adjuvant chemotherapy and radiotherapy were used at similar rates across age groups, whereas neoadjuvant hormonal (endocrine) therapy was more common in older patients (but without statistical significance). Conclusions: Finally, we discussed the consequences of individualized care and early detection. Romania’s shockingly low screening rate, which contributes to delayed diagnosis, emphasizes the importance of improved population medical examination and tailored treatment options. Also, the country has one of the lowest rates of mammography uptake in Europe and no systematic population screening program. Full article

Background: Point-of-care ultrasound (POCUS) is gaining recognition as a valuable diagnostic tool in various fields of medicine, including pediatrics. Its application at the point of care enables real-time clinical decision-making, which is particularly advantageous in pediatric settings. Although global interest in POCUS is growing, many European countries—including Poland—still lack formal training programs for POCUS at both the undergraduate and postgraduate levels. Nevertheless, the number of pediatricians incorporating POCUS into their daily clinical practice in Poland is increasing. However, the extent of its use and perceived value among pediatricians remains largely unknown. This study aimed to evaluate the current level of POCUS utilization in pediatric care in Poland, focusing on pediatricians’ self-assessed competencies, perceptions of its clinical utility, and key barriers to its implementation in daily practice. Methods: This cross-sectional study was conducted between July and August 2024 using an anonymous online survey distributed to pediatricians throughout Poland via national professional networks, with a response rate of 7.3%. Categorical variables were analyzed using the chi-square test of independence to assess the associations between key variables. Quantitative data were analyzed using descriptive statistics, and qualitative data from open-ended responses were subjected to a thematic analysis. Results: A total of 210 pediatricians responded. Among them, 149 (71%) reported access to ultrasound equipment at their workplace, and 89 (42.4%) reported having participated in some form of POCUS training. Only 46 respondents (21.9%) reported frequently using POCUS in their clinical routine. The self-assessed POCUS competence was rated as low or very low by 136 respondents (64.8%). While POCUS was generally perceived as a helpful tool in facilitating and accelerating clinical decisions, the main barriers to implementation were a lack of formal training and limited institutional support. Conclusions: Although POCUS is perceived as clinically valuable by the surveyed pediatricians in Poland, its routine use remains limited due to training and systemic barriers. Future efforts should prioritize the development of a validated, competency-based training framework and the implementation of a larger, representative national study to guide the structured integration of POCUS into pediatric care. Full article

Background/Objectives: The social importance of health literacy (HL) is widely understood, and its measurement is the subject of various studies. Due to the recent pandemic, several instruments for measuring HL about COVID-19 have been proposed in different countries, including the HLS-COVID-Q22 questionnaire. The diversity of cultures and languages necessitates the cross-cultural adaptation of this instrument. Thus, the present study translates, adapts, and validates the psychometric properties of the HLS-COVID-Q22 questionnaire to provide its cross-cultural adaptation from English to Spanish (Peru). Methods: As part of ensuring that the final questionnaire accommodates the cultural nuances and idiosyncrasies of the target language, the following activities were carried out: (a) a survey of 40 respondents; and (b) a focus group with 10 participants, followed by expert approval. In addition, the validity and reliability of the health instrument have been ascertained through a further pilot test administered to 490 people in the city of Tacna in southern Peru. Results: The resulting questionnaire helps measure HL in Peru, aiding better-informed decision-making for individual health choices. Conclusions: The presence of such a tool is advantageous in case of similar global health emergencies, when the questionnaire can be made readily available to support a promotion of strategies towards better self-care. Moreover, it encourages other Latin American stakeholders to adjust the instrument to their own cultural, language, and socio-economic contexts, thus invigorating the regional and global expansion of the HL study network. Full article

The study investigates the contribution of technology (TECH), quantified by Internet penetration, in influencing tourism performance (TP) among the top ten touristic nations in Europe: France, Spain, Italy, Turkey, the United Kingdom, Germany, Greece, Austria, Portugal, and the Netherlands. Using panel data from 2000–2022, the study includes additional structural controls like environment quality, gross domestic production (GDP) per capita, exchange rate (ER), and safety index (SI). The Method of Moments Quantile Regression (MMQR) is employed to capture heterogeneous effects at different levels of TP, and Driscoll–Kraay standard error (DKSE) correction is employed to make the analysis robust against autocorrelation as well as cross-sectional dependence. Spectral–Granger causality tests are also conducted to check short- and long-run dynamics in the relationships. Empirical results are that TECH and SI are important in TP at all quantiles, but with stronger effects for lower-performing countries. Environmental quality (EQ) and GDP per capita (GDPPC) exert increasing impacts at upper quantiles, suggesting their importance in sustaining high-level tourism economies. ER effects are limited and primarily short-term. The findings highlight the need for integrated digital, environmental, and economic policies to achieve sustainable tourism development. The paper contributes to tourism research by providing a comprehensive, frequency-sensitive, and distributional analysis of macroeconomic determinants of tourism in highly developed European tourist destinations. Full article

Educational admission systems, particularly in developing countries, often suffer from opaque decision processes, unstructured data, and limited analytic insight. This study proposes a novel methodology that integrates structural causal models (SCMs), ontological modeling, and machine learning to uncover and apply interpretable knowledge from an admission database. Using a dataset of 12,043 records from Benue State Polytechnic, Nigeria, we demonstrate this approach as a proof of concept by constructing a domain-specific SCM ontology, validate it using conditional independence testing (CIT), and extract features for predictive modeling. Five classifiers, Logistic Regression, Decision Tree, Random Forest, K-Nearest Neighbors (KNN), and Support Vector Machine (SVM) were evaluated using stratified 10-fold cross-validation. SVM and KNN achieved the highest classification accuracy (92%), with precision and recall scores exceeding 95% and 100%, respectively. Feature importance analysis revealed ‘mode of entry’ and ‘current qualification’ as key causal factors influencing admission decisions. This framework provides a reproducible pipeline that combines semantic representation and empirical validation, offering actionable insights for institutional decision-makers. Comparative benchmarking, ethical considerations, and model calibration are integrated to enhance methodological transparency. Limitations, including reliance on single-institution data, are acknowledged, and directions for generalizability and explainable AI are proposed. Full article

Air pollution is linked to childhood mortality and morbidity in low- and middle-income countries globally. There is growing evidence linking air pollution to asthma and other respiratory diseases in children. Studies have shown that children are likely to experience asthma due to their narrow airways and their heightened sensitivity to environmental irritants. This study aims to investigate the relationship between ambient air pollution and respiratory diseases in children under the age of 5. The study will be conducted in the informal township of Alexandra, north of Johannesburg, South Africa. A quantitative approach will be used in this cross-sectional analytical study. Data will be collected using different tools that include a questionnaire to determine the prevalence of asthma and respiratory disease and potential risk factors. While environmental air pollution will be measured using Radiello passive samplers and Gillian pumps. Data will be analyzed using the latest version of the STATANow/MP 19.5 software. Furthermore, health risk assessment will be conducted for lifetime non-carcinogenic and carcinogenic risk estimation following the USEPA framework. The study will identify environmental triggers that exacerbate asthma and other respiratory conditions in other similar community settings and will contribute to the body of knowledge in public health. Ethical approval was obtained from the Research Ethics Committee, Faculty of Health Sciences at the University of Johannesburg. Full article

Global policy narratives on livestock development increasingly emphasize environmental concerns, often overlooking the social dimensions of the sector. In the case of dairy, the world’s most valuable agricultural commodity, its role in social and economic development remains poorly quantified. Our study contributes to a more balanced vision of the UN SDGs thanks to the inclusion of a socio-economic dimension. Here we present a novel empirical approach to assess the socio-economic impacts of dairy development using a new global dataset and non-parametric modelling techniques (local polynomial regressions), with yield as a proxy for sectoral performance. We find that as dairy systems intensify, the number of farm households engaged in production declines, yet household incomes rise. On-farm labour productivity also increases, accompanied by a reduction in employment but higher wages. In dairy processing, employment initially grows, peaks, and then contracts, again with rising wages. The most substantial impact is observed among consumers: an increased milk supply leads to lower prices and improved affordability, expanding the access to dairy products. Additionally, dairy development is associated with greater agricultural value added, an expanding tax base, and the increased formalization of the economy. These findings suggest that dairy development, beyond its environmental footprint, plays a significant and largely positive role in social transformation, yet is having to adapt sustainably while tackling labour force relocation, and that dairy development’s social impacts mimic the general agricultural sector. These results might be of interest for the assessment of policies regarding dairy development. Full article

This study synthesizes the rapidly expanding evidence on how digital technologies reshape international trade, with a particular focus on small and medium-sized enterprises (SMEs). Guided by two research questions—(RQ1) How do digital tools influence the volume and composition of cross-border trade? and (RQ2) How do these effects vary by countries’ development level and firm size?—we conducted a PRISMA-compliant systematic literature review covering 2010–2024. Searches across eight major databases yielded 1857 records; after duplicate removal, title/abstract screening, full-text assessment, and Mixed Methods Appraisal Tool (MMAT 2018) quality checks, 86 peer-reviewed English-language studies were retained. Findings reveal three dominant technology clusters: (1) e-commerce platforms and cloud services, (2) IoT-enabled supply chain solutions, and (3) emerging AI analytics. E-commerce and cloud adoption consistently raise export intensity—doubling it for digitally mature SMEs—while AI applications are the fastest-growing research strand, particularly in East Asia and Northern Europe. However, benefits are uneven: firms in low-infrastructure settings face higher fixed digital costs, and cybersecurity and regulatory fragmentation remain pervasive obstacles. By integrating trade economics with development and SME internationalization studies, this review offers the first holistic framework that links national digital infrastructure and policy support to firm-level export performance. It shows that the trade-enhancing effects of digitalization are contingent on robust broadband penetration, affordable cloud access, and harmonized data-governance regimes. Policymakers should, therefore, prioritize inclusive digital-readiness programs, while business leaders should invest in complementary capabilities—data analytics, cyber-risk management, and cross-border e-logistics—to fully capture digital trade gains. This balanced perspective advances theory and practice on building resilient, equitable digital trade ecosystems. Full article

Sustainable education requires addressing the challenges posed by digital transformation, including technostress among university students. This study evaluates technostress levels in higher education through the validation of the TS4US scale and its implications for sustainable learning environments. A cross-sectional study was conducted with 328 university students from four districts in Lima, Peru, using an online survey to measure technostress. Confirmatory factor analysis (CFA) was performed to assess the psychometric properties of the TS4US scale, resulting in a refined model with two latent factors and thirteen validated items. Findings indicate that 28% of students experience high technostress levels, while 5% report very high levels, though no significant associations were found between technostress and sociodemographic variables such as campus location, employment status, gender, and academic level. The TS4US instrument had been previously validated in Chile; this study confirms its structure in a new sociocultural context, reinforcing its cross-cultural applicability. These results highlight the need for sustainable strategies to mitigate technostress in higher education, including institutional support, digital literacy programs, and policies fostering a balanced technological environment. Addressing technostress is essential for promoting sustainable education (SDG4) and enhancing student well-being (SDG3). This study directly contributes to the achievement of Sustainable Development Goals 3 (Good Health and Well-being) and 4 (Quality Education) by providing validated tools and evidence-based recommendations to promote mental health and equitable access to digital education in Latin America. Future research should explore cross-country comparisons and targeted interventions, including digital well-being initiatives and adaptive learning strategies, to ensure a resilient and sustainable academic ecosystem. Full article

Introduction: Low medication adherence and low hypertension control are a public health challenge, particularly in low- and middle-income countries (LMICs). Healthcare system- and patient-related barriers hinder the successful management of hypertension. This study aimed to identify the perceptions of barriers and facilitators to hypertension management among health system stakeholders in Santander, Colombia. Materials and Methods: We conducted a qualitative, phenomenological, and interpretative study, comprising five focus groups, to explore the barriers and facilitators to managing people with hypertension. Each focus group was formed by stakeholders from territorial entities, healthcare insurers, or healthcare providers. Meetings were held between December 2022 and February 2023. The sessions were recorded and transcribed using NVivo Transcription and analyzed using NVivo version 1.6.1. Results: Seven categories of barriers and facilitators were identified: strategies, resources, access, risk assessment, cross-sector collaboration, articulation, and stewardship. Of these categories, articulation and stewardship emerged as the main barriers, as revealed through axial coding and cluster analysis, which highlighted deficiencies in stewardship practices, a lack of clear objectives, and misalignment with public policy frameworks. Conclusions: Multisectoral actions extending beyond healthcare providers and aimed at improving coordination and intersectoral collaboration are essential for enhancing hypertension control in LMICs, such as Colombia. Addressing social determinants and strengthening primary healthcare through community-based strategies are critical, making stewardship and improved access key priorities. Full article