Search Results (86)

This conceptual article introduces Perceived Cognitive Assistance (PCA)—a novel psychological construct capturing how interactive support from Large Language Models (LLMs) alters investors’ perception of their cognitive capacity to execute complex trading strategies. PCA formalizes a behavioral shift: LLM-empowered retail investors may transition from intuitive heuristics to institutional-grade strategies—sometimes without adequate comprehension. This empowerment–distortion duality forms the theoretical contribution’s core. To empirically validate this model, this article outlines a five-step research agenda including psychological diagnostics, trading behavior analysis, market efficiency tests, and a Behavioral Shift Index (BSI). One agenda component—a dual-agent simulation framework—enables causal benchmarking in post-LLM environments. This simulation includes two contributions: (1) the Virtual Trader, a cognitively degraded benchmark approximating bounded human reasoning, and (2) the Digital Persona, a psychologically emulated agent grounded in behaviorally plausible logic. These components offer methods for isolating LLM assistance’s cognitive uplift and evaluating behavioral implications under controlled conditions. This article contributes by specifying a testable link from established decision frameworks (Theory of Planned Behavior, Technology Acceptance Model, and Risk-as-Feelings) to two estimators: a moderated regression for individual decisions (Equation (1)) and a composite Behavioral Shift Index derived from trading logs (Equation (2)). We state directional, falsifiable predictions for the regression coefficients and for index dynamics, and we outline an identification and robustness plan—versioned, time-locked, and auditable—to be executed in the subsequent empirical phase. The result is a clear operational pathway from theory to measurement and testing, prior to empirical implementation. No empirical results are reported here; the contribution is the operational, falsifiable architecture and its implementation plan, to be executed in a separate preregistered study. Full article

The intelligent transformation of the wastewater treatment industry, as a core component of the modern environmental governance system, is of decisive significance for achieving sustainable development goals. This study focuses on the issue of multi-stakeholder collaborative governance in the intelligent transformation of the wastewater treatment industry, with differential game theory as the core framework. A tripartite game model involving the government, wastewater treatment enterprises, and digital twin platforms is developed to depict the dynamic interrelations and mutual influences of strategy choices, thereby capturing the coordination mechanisms among government regulation, enterprise technology adoption, and platform support in the transformation process. Based on the dynamic optimization properties of differential games, the Hamilton–Jacobi–Bellman (HJB) equation is employed to derive the long-term equilibrium strategies of the three parties, presenting the evolutionary paths under Nash non-cooperative games, Stackelberg games, and tripartite cooperative games. Furthermore, the Sobol global sensitivity analysis is applied to identify key parameters influencing system performance, while the response surface method (RSM) with central composite design (CCD) is used to quantify parameter interaction effects. The findings are as follows: (1) compared with Nash non-cooperative and Stackelberg games, the tripartite cooperative strategy based on the differential game model achieves global optimization of system performance, demonstrating the efficiency-enhancing effect of dynamic collaboration; (2) the most sensitive parameters are β, α, μ₃, and η₃, with β having the highest sensitivity index (ST_i = 0.459), indicating its dominant role in system performance; (3) significant synergistic enhancement effects are observed among α–β, α–μ₃, and β–μ₃, corresponding, respectively, to the “technology stability–benefit conversion” gain effect, the “technology decay–platform compensation” dynamic balance mechanism, and the “benefit conversion–platform empowerment” performance threshold rule. Full article

Healthcare access is a fundamental human right, yet barriers often negatively impact health, particularly in developing countries like Pakistan, where maternal mortality remains a crisis. This study aimed to identify factors influencing healthcare access barriers among married women aged 15–49 years using spatial analysis. Methods: Data were drawn from the 2017-18 Pakistan Demographic and Health Survey (PDHS), which included an unweighted sample of 8127 women. Healthcare access barriers were identified as the outcome variable. Results: A spatial analysis using ArcGIS 10.7.1 and SaTScan identified clustered distributions, with concentration areas identified in Gilgit Baltistan, Khyber Pakhtunkhwa (KPK), Federally Administered Tribal Areas (FATA), Punjab, and Balochistan. SaTScan highlighted primary clusters in FATA, Southern KPK, Northern Balochistan, and Eastern Punjab. Geographically Weighted Regression identified women who had five or more living children, respondents who did not have four or more antenatal care (ANC) visits, respondents who experienced a lower income (wealth index), respondents who did not participate in decision-making, respondents with a primary education, and respondents who accepted domestic violence as the significant predictors of healthcare access barriers. Conclusions: To improve women’s healthcare access, integrated policy interventions are needed, addressing socioeconomic disparities, strengthening national health policies, empowering women, and expanding healthcare accessibility. Strengthening health insurance and economic empowerment is crucial for achieving Sustainable Development Goals. Full article

In recent years, urban risk incidents have become more common. Enhancing infrastructure resilience is not only crucial for adapting to climate change and addressing natural disasters but also serves as a key cornerstone for sustaining urban sustainable development. The research objects for this study are 17 coastal cities in the Bohai Rim region of China. Based on the Complex Adaptive System (CAS) theory, from the multi-dimensional perspective of urban sustainable development, a resilience evaluation index system covering five subsystems, namely transportation, water supply and drainage, energy, environment, and communication, is constructed. Employing panel data from 2013 to 2022, this study develops the entropy weight–TOPSIS model to quantify resilience levels, and applies the obstacle degree model, geographical detector, and Geographically and Temporally Weighted Regression (GTWR) model to analyze influencing factors. The main research results are as follows: (1) The regional infrastructure resilience shows a slow upward trend, but the insufficient synergy among subsystems restricts urban sustainable development; (2) The primary barrier is the drainage and water supply system, and the environmental and communication systems’ notable spatial heterogeneity will result in uneven regional sustainable development; (3) The influence of driving factors such as economic level gradually weakens over time. Based on the above research results, the following paths for resilience improvement and urban sustainable development are proposed: Improve the regional coordination and long-term governance mechanism; Focus on key shortcomings and implement a resilience enhancement plan for water supply and drainage systems; Implement dynamic and precise policy adjustments to stimulate multiple drivers; Enhance smart empowerment and build a digital twin-based collaborative management platform. Full article

Healthcare systems worldwide face growing challenges related to staff shortages, excessive workload, and deteriorating working conditions, which compromise both staff well-being and care quality. Despite these issues, there is a lack of validated tools that capture healthcare professionals’ subjective perceptions of resource adequacy. This study presents the development and initial validation of the Staff Resource Adequacy Questionnaire for Healthcare Professionals (SRAQ-HP), a multidimensional tool designed to assess staffing adequacy and workload, quality of care, and working conditions and support. The development process followed a mixed-methods design, incorporating theoretical foundations from Kanter’s empowerment theory, role enactment models, and professional competence frameworks. The initial item pool of 32 statements was reduced to 26 through expert reviews, focus groups, and pilot testing (n = 35). Content validity index (CVI = 0.931) and face validity index (FVI = 0.976) demonstrated high content relevance and clarity. Cronbach’s alpha for the full scale was 0.841, confirming internal consistency. Expert re-review confirmed strong content (S-CVI/Ave = 0.931) and face validity (FVI = 0.976) for the final 26-item version. Three core dimensions were retained: Staffing Adequacy and Workload, Quality of Care, and Working Conditions and Support. The SRAQ-HP provides a novel, evidence-based approach to systematically assess workforce sufficiency and support structures in clinical settings. It can guide decision-making in healthcare institutions and inform national workforce policies. Further research with larger and more diverse samples is needed to confirm its factorial validity and practical applicability. Full article

Black Canadians are one of the fastest-growing groups in Canada, with 59% of this population comprising immigrants. Ongoing systemic racism and discrimination have serious consequences for the mental health of Black Canadians. While research and policy efforts to address the mental health needs of this population are ongoing, a greater understanding of the healing practices relevant to this diverse population is needed. This scoping review synthesized and discussed key features of culturally inclusive, affirming, and contextually relevant approaches and practices for mental health care and healing with Black Canadians, as well as identified limitations and gaps in the current research. This study followed the PRISMA guidelines for scoping reviews and conducted a search in PsycINFO, MEDLINE, Embase, SocINDEX, CINAHL, Sociological Abstracts, and Global Health in October 2023. A total of 34 articles met the inclusion criteria. The review identified that most studies were conducted in one Canadian province (i.e., Ontario) and involved diverse perspectives, including service users and providers. The thematic review of articles revealed limited research regarding specific interventions, but identified many commonly reported features of culturally and contextually relevant approaches to mental health care and healing for Black Canadians that broaden the scope of mental health care beyond Euro-Western clinical models, including taking a holistic and empowerment-based approach, engaging in culturally affirming care, a social justice approach, community-centred and collaborative healing, and the necessity of practitioner education. Recommendations for practice, policy, education, and research are provided to support more inclusive and responsive mental health care systems for Black Canadians. Full article

With the continuous increase in urban population, the subway is the main way to alleviate traffic congestion. However, the construction environment of subway stations is complex, and the safety risks are extremely high. Therefore, it is of great practical significance to scientifically and systematically evaluate the safety vulnerability of subway station construction. This paper takes the Chengdu subway project as an example, and establishes a metro station construction safety vulnerability evaluation index system based on the driving forces–pressures–state–impacts–responses (DPSIR) theory with 5 first-level indexes and 23 second-level indexes, and adopts the fuzzy hierarchical analysis method (FAHP) to calculate the subjective weights, and the improved Harris Hawks optimization–projection pursuit method (HHO-PPM) to determine the objective weights, combined with game theory to calculate the comprehensive weights of the indicators, and finally uses the improved cloud model of Bayesian feedback to determine the vulnerability level of subway station construction safety. The study found that the combined empowerment–improvement cloud model assessment method is reliable, and the case study verifies that the vulnerability level of the project is “very low risk”, and the investigations of safety hazards and the pressure of surrounding traffic are the key influencing factors, allowing for the proposal of more scientific and effective management strategies for the construction of subway stations. Full article

The Yangtze River Economic Belt (YEB), serving as a pivotal transportation corridor connecting eastern and western China and a national strategic development hub, plays a central role in driving high-quality economic development (HQAED) across the country. Based on the new development paradigm with emphasis on green transformation and transportation integration, this study proposes a comprehensive evaluation framework for an HQAED index (HQAED) across five core dimensions. Employing the entropy-weighted CRITIC method to quantify provincial HQAED values, combined with Dagum–Gini coefficient analysis to examine regional inequality patterns and determinants, and complemented by kernel density estimation (KDE) for temporal dynamics analysis, this research reveals four key findings: (1) There are significant disparities in HQEDI levels across the YEB, with a clear east–west gradient: the lower reaches > middle reaches > upper reaches. (2) While the dimensions of green development and shared development have shown steady growth despite initial disadvantages, the openness dimension faces structural challenges that require particular attention. (3) The overall Gini coefficient fluctuates between 0.068 and 0.094, indicating moderate regional disparities with relatively limited inequality. (4) The rightward shift in the HQEDI kernel density curves confirms overall progress, but also highlights widening disparities in the upstream regions and growth stagnation in the midstream areas. Practically, the entropy–CRITIC fusion methodology offers a transferable framework for emerging economies measuring sustainability-transition progress, while the quantified “green transportation empowerment” effects provide actionable levers for policymakers to optimize ecological compensation mechanisms and cross-regional infrastructure investments. Full article

Background: Tetanus is a vaccine-preventable disease, and therefore vaccination of women of reproductive age or during pregnancy is recommended alongside childhood tetanus vaccination. Gender-related factors related to social empowerment have been established as determinants of health service utilization; however, these social determinants have not yet been explored directly with tetanus vaccination. In response, the aim of this study was to assess overall and country-specific gender-related barriers to maternal tetanus vaccine coverage. Methods: We used data from Demographic and Health Surveys (DHS) in 39 countries implemented between 2013 and 2022. Women’s empowerment was measured through three domains of the Survey-based Women’s emPowERment index (SWPER), as well as other gender-related variables. To assess the association between measures of women’s empowerment and gender-related factors and maternal tetanus immunization coverage, we used multilevel logistic models with pooled data from the 39 countries to analyze overall patterns, and we used multivariable logistic regression for each country-specific dataset to analyze country-level associations. Results: There were notable variations in the factors associated with tetanus vaccination across countries. Overall, we observed that higher levels of women’s empowerment, as measured through social independence and decision-making autonomy using the SWPER index, were associated with higher odds of maternal tetanus protection, with adjusted odds ratios of 1.23 (95%CI: 1.10–1.37) and 1.20 (95%CI: 1.02–1.40), respectively. However, women’s empowerment related to attitude to violence was not. Higher household wealth was also associated with higher odds of maternal tetanus protection overall. Conclusions: Women’s empowerment can improve the uptake of maternal tetanus vaccine. Addressing gender-related barriers may enhance vaccination coverage and contribute to the elimination of maternal and neonatal tetanus as a public health problem. However, these barriers vary from country to country, necessitating country-specific investigations to formulate tailored recommendations. Full article

Landslides are becoming increasingly frequent, intensified by extreme rainfall and human activities, and threaten ecosystems and livelihoods. In Nyomplong, West Java, they have displaced residents and damaged land, which is now repurposed for agroforestry. Sustainable agroforestry management is crucial for reducing landslide risks and enhancing farmer livelihoods, and a comprehensive assessment is required. This study presents Rapid Appraisal for Landslide (Rap-Landslide), a novel method for assessing agroforestry sustainability. Multidimensional Scaling evaluates economic, environmental, social, technological, and institutional dimensions, focusing on key factors in landslide mitigation, land conservation, and productivity enhancement. The approach includes data collection, sustainability evaluation, leverage factor analysis, and validity testing. This study indicates that the sustainability index of agroforestry in Nyomplong ranges from 40.66% to 62.82%, with an average of 56.16%, classifying it as moderately sustainable. Monte Carlo analysis confirms that this study maintains a stable sustainability status with high confidence. Furthermore, Rap-Landslide leverage analysis identifies 15 key attributes significantly influencing sustainability. Key strategies for improvement include more substantial government support in agroforestry policies, farmer group empowerment, the adoption of conservation technologies such as terracing and soil biotechnology, the use of organic fertilizers, appropriate crop selection, and improved market access. Rap-Landslide can be applied to other landslide-prone areas, offering a systematic approach to evaluating sustainability and guiding effective land management strategies. Full article

Under the dual transformation background of global digital economy and low-carbon development, the synergistic promotion of enterprise digital transformation and green upgrading has become an important path to realizing high-quality development. Based on the coupling coordination degree model, this paper constructs the enterprise “digital-green” dual transformation synergy measurement index system, and empirically analyzes the panel data of China’s A-share-listed companies from 2017 to 2022 using the entropy weight-coupling coordination degree model and the fixed effect model. This study finds that, firstly, the synergy degree of the eastern region is significantly higher than that of the inland, less-developed provinces, but the regional gap is narrowing and the spatial pattern is evolving from the “central collapse type” to the low-level equilibrium type. Second, there is a significant positive driving effect of digital finance on the collaborative transformation of enterprises’ digitalization and greening, and the path of its action includes the effect of alleviating financing constraints, the empowerment of information transparency, and the effect of moderating and amplifying entrepreneurship. Third, the driving efficacy of digital finance in state-owned enterprises is more prominent than that in private enterprises. Fourth, digital finance significantly affects the degree of synergy, but there is a threshold effect. This study reveals the catalytic role of digital finance in the coupling process of digital transformation and greening upgrading, which not only expands the analytical dimension of transition economy theory but also provides a quantitative basis for policymakers to optimize the allocation of financial resources and for enterprises to design transformation paths. Full article

Effective nurse leadership increases nurses’ job satisfaction, performance, motivation, and empowerment. Ensuring nurses’ organizational and professional commitment is vital for addressing quality, sustainability, and cost-effectiveness challenges in a high-demanding healthcare environment. The aim of this study was to explore the impact of transformational leadership on nurses’ organizational and professional commitment. A systematic review was conducted using the Scopus, ScienceDirect, PubMed/Medline, Scilit.net, and Wiley Online Library databases. Original research studies published between 2016 and 2024 focusing exclusively on nurses’ professional and organizational commitment and transformational leadership were included. The indexing terms “nursing leadership”, “transformational leadership”, “professional/organizational commitment”, and “nursing” were used along with the Boolean operators AND, OR, and NOT. According to the findings, transformational leadership practices increase nurses’ organizational and professional commitment through vision sharing, motivation, career development, interpersonal communication, a positive working environment, and productive resources management. The healthcare policy makers should invest in organizing, supporting, and promoting relational leadership practices to retain their nursing workforce and obtain their organizational and professional commitment to ensure high care quality. Full article

Background: Malnutrition among expectant mothers in underdeveloped areas is abundant and a serious public health concern. This study examines how maternal empowerment affects nutritional outcomes among under-five children in developing Asian nations. Objective: With an emphasis on nutritional outcomes, including stunting, wasting, and underweight, the main objective of this study is to investigate the connection between mother empowerment and child malnutrition and explore how better child health in developing Asian nations can be achieved through empowering mothers. Methods: Using Demographic and Health Survey (DHS) data of ten emerging Asian countries from three regions of Asia, this study evaluates maternal empowerment using the composite maternal empowerment index (CMEI) and examines how it relates to children’s nutritional health. For the assessment of the significance of the association between maternal empowerment and child health outcomes, statistical analysis was conducted. Results: Our results indicated that maternal empowerment and child health have a statistically significant relationship, especially regarding a reduction in the prevalence of stunting, wasting, and underweight conditions in children. At the same time, maternal education showed a significant role in reducing malnutrition in children in all three regions of Asia. Conclusion: In conclusion, developing Asian nations require empowering women. Also, it is essential to initiate nutrition programs, extension education, and synergistic working models that are especially suited to rural women. By strengthening mothers’ roles in promoting their children’s health, these initiatives can help solve the widespread problem of child malnutrition. Full article

We examined the association between perceived discrimination and body mass index (BMI) in Asian American (AA) women before and during the COVID-19 pandemic. The data used were from the Epidemiology/Epigenetics of Asian Women’s Action for Resilience and Empowerment (Epi AWARE) study, which enrolled 157 AA women aged 18 to 59 between December 2019 and September 2022. Two sets of questions measured “everyday” (e.g., “How often do people act as if you are dishonest?”) and “lifetime” (e.g., “unfair treatment due to your race at school”) discrimination. Responses were combined, creating a cumulative score, and dichotomized into “no” versus “any” discrimination. Self-reported height and weight were used to calculate BMI, dichotomized as <25 kg/m² and ≥25 kg/m². Multivariable binomial regression estimated risk ratios (RRs) and 95% confidence intervals (95% CIs). Overall, women reporting any versus no discrimination were more likely to be classified as having a BMI ≥ 25 kg/m² (RR = 2.09; 95% CI: 1.06–4.13). The RR for women who responded during the COVID-19 pandemic (20 March 2020 or later) was 2.65 (95% CI: 0.82–8.58); the RR for pre-pandemic response was 1.93 (95% CI: 0.75–5.01). Our data suggest that experiences of racism may impact BMI among AA women. Further research is needed to identify mechanisms and design appropriate interventions. Full article

This study aims to understand community empowerment by utilizing open innovation through Village-Owned Enterprises (VOE) to enhance sustainable public welfare. To achieve both economic and social missions, VOE must develop the ability to engage in open innovation by leveraging external knowledge sources, both inbound and outbound. This research employs a literature review method, analyzing previous studies indexed in the Scopus Database and processed using the VOSviewer software. The findings indicate that open innovation, which utilizes inbound external knowledge sources such as markets, knowledge, open resources, and cooperative networks, has already been adopted. However, the utilization of knowledge has not yet been fully optimized as a foundation for producing goods and services due to limitations in human resources. Similarly, outbound open innovation derived from technology has been implemented, although the utilization of patents remains suboptimal. This study recommends that village-owned business entities evaluate their operations, particularly in the utilization of knowledge and commercialization to ensure sustainability. Furthermore, this research contributes to the discussion on open innovation by emphasizing that leveraging market-driven knowledge, openness, cooperation, and technology should be a major focus for VOE in the context of business activities, where increased public participation plays a crucial role in sustainable economic development. Full article