Search Results (9,420)

Background: Cervical cancer remains a significant health issue in Indonesia, where structural barriers, fragmented information, and sociocultural norms continue to hinder timely diagnosis and treatment. Families play a central role throughout the illness journey, yet their perspectives are often overlooked in the development of digital patient navigation systems. This study explored family experiences, caregiving challenges, and expectations for a family-centered digital navigation model, DIVA.ID, by integrating Digital Health frameworks and Family Systems Theory. Methods: A qualitative descriptive approach was employed through semi-structured, in-depth interviews with 18 purposively selected family caregivers of women with cervical cancer at a major referral hospital in West Java. Participants were selected because they were directly involved in daily care, treatment decisions, logistical support, or emotional assistance. Interviews were conducted between August and October 2025 and continued until thematic saturation was reached, as indicated by repetition of categories and the absence of new major codes in the final interviews. Data were analyzed using inductive–deductive content analysis guided by Elo and Kyngäs, with five researchers conducting independent coding, iterative code comparison, consensus meetings, and theoretical mapping. Results: Four main themes emerged: (1) family involvement in decision-making, including collective discussion, shifting authority roles, and patient autonomy; (2) caregiver burden, involving physical exhaustion, psychological distress, social restriction, stigma, financial pressure, and employment disruption; (3) psycho-spiritual coping mechanisms, including emotional sharing, prayer, crying, patience, and surrender to God; and (4) digital healthcare needs, covering BPJS guidance, treatment information, scheduling, communication pathways, shelter support, and mental–spiritual support. Mapping these themes to Digital Health frameworks and Family Systems Theory clarified how DIVA.ID could translate family experiences into practical navigation functions. Conclusions: This study provides empirical foundations for a culturally sensitive, family-centered digital navigation model in Indonesia. Rather than demonstrating effectiveness, the findings identify design requirements for DIVA.ID that should be tested in subsequent feasibility, usability, and intervention studies. Full article

To clarify the microbial contamination and wood degradation risk of the Nanhai No. 1 shipwreck hull and verify on-site antibacterial agent effectiveness, microbial samples were collected and analyzed via SEM, metagenomic sequencing, bacterial isolation, enzyme activity detection, and antibacterial experiments. The results showed that Actinomycetota was the dominant phylum, and Brachybacterium, Microbacterium, and Brevibacterium were the dominant genera. Seven bacterial strains were isolated and purified, among which Brevibacterium sp. (NH.SH-B6) had the strongest wood degradation ability, possessing cellulase, LiP, MnP, and Lac activities. When cultured with hull wood as the sole carbon source, LiP was the dominant degrading enzyme of NH.SH-B6, and its maximum enzyme activity was achieved under the optimal conditions of pH = 7, 10% NaCl, 1000 mg/L FeSO₄, and no PEG400 added. 50 mg/mL cinnamaldehyde and 0.5% isothiazolinone K100 had good inhibitory effects on the isolated bacteria, and bacterial proliferation was due to incomplete antibacterial agent spraying. This study clarifies the microbial degradation risk of the Nanhai No. 1 shipwreck hull and provides a scientific basis for optimizing the on-site protection strategy of the shipwreck. Full article

The aesthetic value of agricultural landscapes is gaining importance as rural tourism burgeons during urbanization. To ascertain key elements influencing the visual appeal of agricultural landscapes, this research employed a visual choice experiment in Hangzhou Plain during the spring flowering period to assess public preferences for four landscape attributes in ground and aerial perspectives. The mixed logit model was utilized to evaluate the respondents’ average preference, while the latent class logit model helped in identifying distinct preference groups. The research revealed that participants exhibited different preferences between the two perspectives. The diversity within public preferences was highlighted, with respondents favoring oilseed rape-dominated landscapes with a single agricultural land cover proportion in ground perspective while favoring diverse landscapes in aerial perspective. Gender, education level, landscape familiarity, connection to agriculture, and membership in relevant organizations significantly shape individual preferences. These results can help refine multi-objective policy targeting by incorporating aesthetic value perspective in agricultural landscapes. Full article

Foster parents working with children who are American Indian/Alaskan Native (AIAN) face challenges to provide trauma-informed, developmentally appropriate, and culturally relevant care for the children in their care. The Tribally Adapted National Training and Development Curriculum is a state-of-the-art training program designed to prepare foster parents to effectively parent AIAN children exposed to trauma and to provide these families with ongoing skill development necessary to understand and promote healthy child development. The current study describes the results of two focus groups (N = 11) that occurred in person in the social services office of the Salt River Pima-Maricopa Indian Community in May of 2022. Findings describe the experiences of participants that completed the tribal NTDC training and how the training impacted their readiness and experience to foster in comparison with parents of AIAN foster children who received the training-as-usual training protocol (Foster Parent College (FPC)) provided by the State child welfare authority. Full article

An Aspergillus flavus outbreak strain dominated the indoor environment in a Danish hospital ward for eight years and subsequently multiple isogenic infections occurred. We investigated whether strain-specific traits were present to understand its prevalence and persistence. The outbreak strain was studied alongside comparator A. flavus isolates with respect to altered virulence that could enhance its pathogenic potential and secondary metabolism that could influence environmental persistence. Twenty-four isolates were examined for growth patterns on ten media and by secondary metabolite profiling using high-performance liquid chromatography with diode-array detection. Strain-specific virulence and other phenotypic traits were studied in vivo using Galleria mellonella and in vitro by culturing on specialised media. No indication of virulence alterations was observed in larvae. However, the outbreak strain exhibited a reproducible fingerprint phenotype with distinct morphological features and secondary metabolites. These included mycotoxins known to be harmful to humans and animals. Although this study found no evidence of increased virulence, identification of a distinct phenotypic profile could indicate adaptation or an intrinsic ecological background of the outbreak strain and possibly competitive traits via potentially bioactive secondary metabolites. Moreover, the production of several mycotoxins by this A. flavus strain raises concerns for both patients and staff. Further analyses of the strain’s ecology, toxic potential, virulence, and phylogeny in a global context could be studied in future experiments. Full article

Patient embarrassment represents a significant yet often underrecognized barrier to effective gynecological care. This review integrates multidisciplinary evidence from Embase, PubMed, PsycINFO, and the Cochrane Library (2000–2025) to examine the relationship between embarrassment, shame, and modesty and their impact on care-seeking behaviors, clinical outcomes, and healthcare utilization. Available data indicate that embarrassment is consistently associated with reduced participation in preventive screening, with up to one-third of non-attenders citing modesty-related concerns. In symptomatic patients, these emotional barriers contribute to clinically meaningful diagnostic delays, particularly in conditions such as cervical cancer, vulvar cancer, and endometriosis. Embarrassment also affects in-consultation behavior, with a substantial proportion of patients reporting withheld concerns or incomplete disclosure of medically relevant information. The consequences extend beyond delayed diagnosis to include reduced treatment adherence, increased disease severity at presentation, and higher healthcare costs due to more complex and resource-intensive interventions. Contributing factors include cultural stigma, prior negative clinical experiences, fear of judgment, and aspects of the clinical environment that may heighten patient vulnerability. Full article

In sub-Saharan Africa, the sustainability of smallholder farming systems is threatened by climate change. Women farmers are often disproportionately affected. These disproportionate impacts are linked to gender-based inequities like limited decision-making power and resource constraints, which limit women’s adaptive capacity. Previous research has examined inequities in agriculture generally, as well as women farmers’ adaptation to climate change. However, relatively few studies have explicitly focused on the experiences of women who are the primary farmers. Intersectional research is also limited. This paper presents the results of a scoping review to identify how climate change affects women smallholder farmers and how they adapt. The review identified 41 studies between 2014 and 2024. The most frequently identified vulnerability factors were access to credit, social and cultural norms, and land issues (e.g., tenure issues). Few studies took an explicitly intersectional approach. The findings suggest the need for support that targets the challenges faced by women smallholders. More intersectional research is needed to examine how gendered impacts are shaped by other forms of inequality and inhibit sustainable livelihood options. The review revealed a pervasive patriarchal assumption in which dual-headed households are often described as “male-headed”. Revising such discourses can support women’s adaptive agency in the face of future climate challenges. These findings have direct implications for the sustainability of smallholder farming systems and rural livelihoods in the region, emphasizing the need for gender-responsive approaches to sustainable development in sub-Saharan Africa. Full article

The advancing fluency of large language models (LLMs) raises important questions about their ability to emulate complex human traits, including emotional expression and personality, across diverse linguistic and cultural contexts. This study investigates whether state-of-the-art LLMs can convincingly mimic emotional nuance in English and personality markers in Arabic, a critical under-resourced language with unique linguistic and cultural characteristics. We conduct two tasks across six models: Jais, Mistral, LLaMA, GPT-4o, Gemini, and DeepSeek. First, we evaluate whether machine classifiers can reliably distinguish between human-authored and AI-generated texts. Second, we assess the extent to which LLM-generated texts exhibit emotional or personality traits comparable to those of humans. Our results demonstrate that AI-generated texts are distinguishable from human-authored ones (F1 > 0.95), though classification performance deteriorates on paraphrased samples, indicating reliance on superficial stylistic cues. Emotion and personality classification experiments reveal significant generalization gaps: classifiers trained on human data perform poorly on AI-generated texts and vice versa, suggesting LLMs encode affective signals differently from humans. Importantly, augmenting training with AI-generated data enhances performance in the Arabic personality classification task, highlighting the potential of synthetic data to address challenges in under-resourced languages. Model-specific analyses show that GPT-4o and Gemini exhibit superior affective coherence, while LLaMA performs worse. Linguistic and psycholinguistic analyses reveal measurable divergences in tone, authenticity, and textual complexity between human and AI texts. These findings have significant implications for affective computing, authorship attribution, and responsible AI deployment, particularly within under-resourced language contexts where generative AI detection and alignment pose unique challenges. Full article

Background/Objectives: Nurses’ engagement in research is essential to strengthen evidence-based practice, knowledge translation, and quality of care. However, individual, organisational, and cultural barriers may limit nurses’ participation in research activities. This study aimed to cross-culturally adapt and psychometrically test the Italian version of the Barriers to Nurses’ Participation in Research Questionnaire within the Italian cultural and healthcare organisational context, and to explore perceived obstacles to research engagement among nurses in Italy. Methods: A cross-sectional methodological study was conducted. The instrument was translated, back-translated, reviewed by the original instrument developer and an expert panel, and evaluated for content validity by 12 clinical research professionals. Data were collected online between September and October 2024 from 196 nurses working across Italian healthcare settings, including hospitals, university hospitals, IRCCS, primary care, and private hospitals. Exploratory Structural Equation Modelling was used to examine the factor structure. Results: A total of 196 nurses were enrolled in the study. A two-factor structure was identified, comprising Research Resources and Personal Relevance of Research, which explained 35.37% and 25.14% of the variance, respectively. Both factors demonstrated good reliability. The most prominent barrier was the lack of incentive or reward for nurses to engage in research, whereas the least relevant barrier was the perception that research was not interesting or valuable. Greater barriers were reported by younger nurses, those with fewer years of experience, and those without specific research training. Lack of time to conduct research emerged as a pervasive obstacle across the sample. Conclusions: The Italian version of the Barriers to Nurses’ Participation in Research Questionnaire provides preliminary evidence of validity and reliability for assessing perceived barriers to research participation among Italian nurses. Owing to the structural modifications introduced during adaptation, the instrument should be interpreted as a culturally adapted and modified Italian version rather than as a direct replication of the original structure. Its use may support organisational diagnosis, research mentorship, training planning, and future research-capacity-building initiatives, although further validation in larger and more heterogeneous samples is warranted. Full article

Multimodal artificial intelligence-generated content (AIGC) is reshaping museum digital exhibitions through dynamic content generation, contextual storytelling, and interactive feedback. Despite its growing adoption, the impact of AIGC’s experiential attributes on visitors’ digital exhibition experience intention remains underexplored. Drawing on the Technology Acceptance Model (TAM), this study develops an integrative framework incorporating AIGC technology acceptance, perceived immersion, content creativity, interaction quality, cognitive evaluations, and affective responses. Data were collected from 481 visitors with prior digital exhibition experience and analyzed using PLS-SEM. The results indicate that AIGC technology acceptance significantly influences perceived ease of use, perceived usefulness, and digital exhibition experience intention; interaction quality enhances usability and exerts a direct effect on intention; and immersion and content creativity primarily shape intention through perceived enjoyment while also exhibiting direct effects. These findings extend TAM to multimodal AIGC-enabled museum contexts and provide empirical evidence to guide the design of culturally meaningful, interactive, and engaging digital exhibition experiences. Full article

Operational labor shortages have become a pressing challenge for hospitality organizations, especially in highly seasonal tourism destinations such as Greece, where service experiences are deeply tied to cultural identity and authentic hospitality. While much of the existing research has examined understaffing from operational or human resource management perspectives, limited attention has been paid to its impact on the organizational capacity to sustain authentic hospitality experiences. Using Service-Dominant Logic (SDL) as an interpretive framework, this study views authentic hospitality as an organizational process shaped by employee interaction, cultural transmission, and service delivery practices. Drawing on survey data from 201 hotel employees in Greece, it investigates the relationship between operational labor shortages, organizational pressures, and perceived threats to authentic hospitality within hotel operations. The findings reveal significant positive relationships between work stress and service quality decline, as well as between cultural knowledge and perceived challenges in maintaining authentic hospitality. Multiple regression analysis further shows that reactive hiring, serious understaffing, and payroll cost pressure are significantly linked to perceived challenges in sustaining authentic hospitality, while service quality decline exhibits a positive but statistically non-significant effect in the final model. The study contributes to hospitality authenticity literature by emphasizing employee perceptions of authenticity as an organizationally supported process rather than merely a guest-centered outcome. The results also highlight the importance of workforce planning, recruitment quality, and cultural onboarding in supporting authentic hospitality within Greek hotel operations. Full article

Background/Objectives: Medication-related harm is a leading global patient safety challenge, yet patients’ lived experiences of medication safety remain underexplored in Central and Eastern European healthcare systems, where structural constraints significantly shape everyday medication use. Methods: This study provides an in-depth qualitative analysis of Hungarian patients’ online narratives, building on a prior netnographic mixed-methods study. Using grounded theory-informed principles and a patient-centred medication safety framework, we inductively analysed 5174 publicly accessible Hungarian-language comments posted on health forums and social media platforms between August 2020 and August 2023. The COM-B model was applied as a secondary lens to map findings onto modifiable behavioural determinants. Results: Access to services and communication emerged as the dominant medication safety concerns. Patients reported long waiting times, limited rural emergency services, and brief consultations leading to delayed or inadequate treatment. Communication gaps included insufficient information on medication duration, side effects, and follow-up, as well as conflicting advice from multiple sources, all of which eroded trust and prompted treatment discontinuation or reliance on informal online communities. Community pharmacists were largely absent from patients’ mental models of care, representing a significant missed opportunity given their accessibility. Less frequently mentioned were medication shortages, healthcare professional workload, and systemic safety culture. Conclusions: Clear, respectful communication and timely access to care are central to medication safety from the patient perspective. Netnography combined with a grounded theory-informed methodology offers a valuable approach for capturing authentic patient perspectives in structurally burdened healthcare systems, with findings relevant beyond the Hungarian context. Full article

This paper examines whether genuine dwelling—understood as embodied engagement with a world that resists, endures, and exceeds human control—can occur in the metaverse. Drawing on Heidegger’s account of dwelling and Ingold’s concept of the ‘taskscape’, it argues that the metaverse is structurally unable to sustain dwelling in the full ontological sense. The argument unfolds in three steps. First, dwelling is shown to depend on friction: bodily cost, temporal irreversibility, material resistance, and exposure to mortal finitude. Second, the metaverse is interpreted as a technological and commercial project oriented toward reducing these frictions through attenuated bodily burden, reversible action, programmable environments, and artificial scarcity. Third, the paper extends the concept of the metaverse beyond immersive hardware to describe a broader condition of digitalized life in which experience becomes increasingly modifiable, personalized, and optimized. In this wider sense, the difficulty of dwelling in the metaverse is not limited to a niche technology but reveals a tendency within late-digital culture itself. The paper concludes by proposing a politics of friction: a public deliberation over which resistances are unjust and should be transformed, and which are constitutive conditions of ethical, ecological, and responsible life. Full article

Emotional well-being has become a central concern in contemporary educational research, particularly in contexts shaped by social and cultural diversity. However, dominant approaches to educational assessment continue to prioritize cognitive outcomes, often overlooking the affective dimensions of children’s everyday experiences. In this context, play emerges as a key yet underexplored process through which emotional well-being is constructed in childhood. This study aimed to analyze the role of play in the configuration of emotional well-being in sociocultural educational contexts from a sociocultural and relational perspective. A qualitative multiple-case study was conducted in two rural schools located in Mapuche territories in southern Chile, involving students, teachers, caregivers, and Mapuche knowledge holders (kimches). Data were generated through semi-structured interviews and focus groups and analyzed using inductive coding procedures supported by qualitative data analysis software. The findings indicate that play operates as a socioemotional ecology through which children participate in collective forms of life, construct relationships, and experience emotional well-being in interaction with others, territory, and culturally meaningful practices. Three interconnected dimensions emerged. First, play was experienced as a relational, territorialized, and culturally situated practice sustained through participation, collective interaction, and intergenerational transmission. Second, emotional well-being emerged through enjoyment, companionship, belonging, and opportunities for social participation. Third, well-being appeared as a situated experience dependent on access to meaningful spaces, material conditions, cultural repertoires, and opportunities for play. Participants also identified tensions associated with technological change, the reduction in free play opportunities, and transformations in community life, while highlighting the potential role of schools in revitalizing culturally significant play practices such as palín and linao. These findings suggest that emotional well-being is not simply an individual psychological state but a relational and sociocultural accomplishment emerging through participation in meaningful play practices. The study contributes to interdisciplinary debates on childhood, emotional well-being, intercultural education, and sociocultural approaches to development by proposing the concept of play as a socioemotional ecology. Full article

Although generative artificial intelligence (AI) has increasingly been used to create destination marketing images, tourists’ responses to such images remain unclear. Prior research has often attributed negative reactions to the visual characteristics of AI-generated images. However, limited attention has been paid to how tourists interpret these images within broader cultural contexts. Drawing on authenticity theory and cultural learning theory, this research examines the effect of image type (AI vs. human) on tourists’ perceived authenticity and visit intention, as well as the moderating roles of cultural learning cues in this process. Using three experiments, the results show that AI-generated images reduce perceived authenticity and visit intention compared with images taken by humans. Notably, while salient cultural learning cues enhance tourists’ perceived authenticity and visit intentions, different types of cues produce distinct outcomes: commodified cultural cues mitigate tourists’ negative responses to AI-generated images, whereas heritage cultural cues amplify authenticity concerns. These findings provide strategic insights for destination marketers on how to deploy AI-generated images effectively in tourism destination marketing. Full article