Search Results (22)

Background/Objectives: Telemedicine offers significant potential to improve the quality and accessibility of geriatric care, particularly in resource-constrained settings. However, its effective implementation depends largely on healthcare professionals’ acceptance and willingness to use such systems. Drawing on an extended Technology Acceptance Model (TAM), this study examines the determinants of doctors’ and nurses’ intentions to adopt telemedicine for elderly care in Algeria, with particular emphasis on self-efficacy and institutional support. Methods: This cross-sectional study employed a structured questionnaire administered to 130 healthcare professionals, including physicians and nurses, in Algeria. Hierarchical multiple regression analysis was conducted to test the proposed hypotheses and assess the incremental explanatory power of the extended model. Results: The extended TAM accounted for 48.7% of the variance in intention to use telemedicine. Institutional support (β = 0.432, p < 0.001) and self-efficacy (β = 0.264, p = 0.001) emerged as the strongest predictors. Perceived ease of use (β = 0.178, p = 0.038) and perceived usefulness (β = 0.139, p = 0.021) also had significant positive effects. The inclusion of self-efficacy and institutional support increased the model’s explanatory power by 23.5%. Conclusions: The findings highlight the critical role of organizational support mechanisms, digital competencies, and system usability in fostering telemedicine adoption among healthcare professionals. The study provides practical implications for policymakers and healthcare institutions, emphasizing the need for targeted training programs, supportive infrastructure, and institutional policies that enhance confidence and facilitate the integration of telemedicine into clinical workflows. Full article

Background/Objectives: Digital anamnesis tools, including chatbots, are increasingly being developed and evaluated, yet their implementation in German medical practices remains limited. This study examines the acceptance of medical history-taking assisted by artificial intelligence (AI) among the German population. The objective is to derive implications for integrating such systems into digitalization strategies of medical practices. Methods: This study is based on an online survey of the German population, aged between 18 and 74 years, conducted in two independent cross-sectional waves (trend design) in 2024 and 2025 with n = 1000 respondents in each year. Based on the Unified Theory of Acceptance and Use of Technology (UTAUT), three hypotheses regarding the use of AI in medical history-taking were developed and tested using linear regression models. Results: Both waves reveal a high acceptance level of AI-supported anamnesis systems for people aged between 18 and 74, regardless of whether a chatbot is used in medical practice (Scenario 1) or at home (Scenario 2). The latter received slightly less approval for the intention to use (mean intention scores: 3.50 and 3.45, range from 1.0 to 5.0) than Scenario 1 (3.59, 3.56). The indices of Performance Expectancy (PE), Effort Expectancy (EE), and perceived Social Influence (SI) determine the intention to use a chatbot with the strongest correlation of the PE index (Scenario 1: ß =0.466, Scenario 2: ß = 0.475). Most respondents (73% and 75%) expressed a favorable opinion for digitally storing medical history data within their electronic health record (EHR). Conclusions: The findings suggest that gender- and age-specific differentiation—aside from considering the needs of older adults—may be less relevant for designing digitalization strategies than previously assumed. Instead, the focus of medical practices should lie on the practicability of the tool used. Despite currently low EHR utilization rates in Germany, medical practices may expect broad patient approval regarding the digital storage of medical history data. Full article

Background: Feigned restriction of shoulder joint movement for secondary gain is clinically relevant and may misdirect care, distort disability determinations, and inflate system costs. Distinguishing feigning from structural pathology and from functional or psychosocial presentations is difficult because pain is subjective, performance varies, and no single sign or test is definitive. This comprehensive review hypothesizes that the systematic integration of clinical examination, objective biomechanical and neurophysiological testing, and emerging technologies can substantially improve detection accuracy and provide defensible medicolegal documentation. Methods: PubMed and reference lists were searched within a prespecified time frame (primarily 2015–2025, with foundational earlier works included when conceptually essential) using terms related to shoulder movement restriction, malingering/feigning, symptom validity, effort testing, functional assessment, and secondary gain. Evidence was synthesized narratively, emphasizing objective or semi-objective quantification of motion and effort (goniometry, dynamometry, electrodiagnostics, kinematic sensing, and imaging). Results: Detection is best approached as a stepwise, multidimensional evaluation. First-line clinical assessment focuses on reproducible incongruence: non-anatomic patterns, internal inconsistencies, distraction-related improvement, and mismatch between claimed disability and observed function. Repeated examinations and documentation strengthen inference. Instrumented strength testing improves quantification beyond manual testing but remains effort-dependent; repeat-trial variability and atypical agonist–antagonist co-activation can indicate submaximal performance without proving intent. Imaging primarily tests plausibility by confirming lesions or highlighting discordance between claimed limitation and minimal pathology, while recognizing that normal imaging does not exclude pain. Diagnostic anesthetic injections and electrodiagnostics can clarify pain-mediated restriction or exclude neuropathic weakness but require cautious interpretation. Motion capture and inertial sensors can document compensatory strategies and context-dependent normalization, yet validated standalone thresholds are limited. Conclusions: Feigned shoulder impairment cannot be confirmed by any single test. The desirable strategy combines structured assessment of inconsistencies with objective biomechanical and neurophysiologic measurements, interpreted within the whole clinical context and rigorously documented; however, prospective validation is still needed before routine implementation. Full article

As the fashion industry accelerates its digital and sustainable transformation, the European Union’s policy development on Digital Product Passports (DPPs) has attracted growing attention. However, there is still a lack of systematic research into whether consumers, particularly those outside Europe, are willing to adopt this emerging technology for greater transparency. To address this, this study develops an extended Technology Acceptance Model (TAM) by integrating three individual-level consumer variables, Ethical–Sustainability Orientation (ESO), Circular Value Orientation (CVO), and Technological Awareness (TA), to examine how these factors work in concert to shape consumers’ intentions to accept Digital Product Passports (DPPs). Data were collected from US consumers through an online survey, yielding 425 valid responses. Participants were recruited from a professional consumer panel managed by a market research firm. Structural equation modeling was conducted to test the proposed research model and hypotheses. The results reveal that Perceived Usefulness (PU) emerges as the most influential determinant of consumers’ acceptance of Digital Product Passports. Both Ethical–Sustainability Orientation (ESO) and Circular Value Orientation (CVO) demonstrate significant direct effects on adoption intention and indirect impacts through PU. Technological Awareness (TA) exhibits only a modest direct effect, suggesting that its role in shaping adoption behavior is comparatively limited. This study broadens the geographic and cultural scope of existing research on Digital Product Passports (DPPs) by providing empirical evidence on consumer acceptance in a non-European context. The findings advance the theoretical understanding of DPP adoption while offering practical implications for fashion brands and policymakers seeking to facilitate the global implementation of DPP systems within the fashion industry. Full article

In academia, innovation intentions among students are a highly sought-after outcome due to their overarching positive impacts on performance and well-being, especially in the higher education context. This research addresses entrepreneurial education and its influence on innovation intentions across several universities in Beirut, Lebanon. The research also examines the indirect effects of opportunity recognition and psychological capital as mediators and fear of failure as a moderator. Through the lens of the theory of planned behavior, the stimulus-organism-response model, and the entrepreneurial event model, a survey was designed. A total of 263 samples were collected from the students of three universities in Beirut where the academic setting was English, and international students were present. Using Partial Least Squares—Structural Equation Modeling, the data was analyzed, and the hypotheses were supported. Results suggest that the learning environment in universities is a major determinant of innovative outcomes for students. However, implementation of entrepreneurial education alone cannot be as effective as it needs to be; it must be complemented by initiatives that enhance perceptions and internal capabilities of students to achieve innovation in their behaviors. This highlights the vitality of psychological capital and fear of failure in this context. Full article

Personalized travel experiences have become a growing priority for tourists, while the built environment increasingly shapes tourists’ behavior. However, limited research has integrated behavioral drivers with algorithmic travel route optimization, particularly in the context of Generation Z tourists. To address this gap, this study proposes a hybrid framework that combines behavioral modeling with enhanced algorithmic techniques to generate customized travel itineraries for Generation Z. A behavioral influencing factors model is first constructed based on the Theory of Planned Behavior (TPB) and Social Influence Theory (SIT), identifying media influence (MI), subjective norms (SNs), and perceived built environment (PBE) as potential determinants of travel behavioral intention (BI). A Structural Equation Model (SEM) is then applied to empirically validate the hypothesized relationships. Results reveal that all three factors have a significant and positive impact on BI (p < 0.05). Building on this behavioral mechanism, an interest-based Ant Colony Optimization (ACO) algorithm is implemented by incorporating point-of-interest (POI) preferences and distance matrices to improve personalized route generation. Comparative analysis using social media keyword data demonstrates that the proposed method outperforms conventional travel route planning approaches in terms of route relevance and overall path satisfaction. This study offers a novel integration of psychological theory and computational optimization, providing both theoretical insights and practical implications for urban tourism planning and the development of smart tourism services. Full article

Entrepreneurship has long been a key driver of economic development across various countries. Investigating the determinants of entrepreneurial behaviour is essential for making a meaningful contribution to sustainable development. This study investigated the determinants of entrepreneurial behaviour among university of technology and TVET college students in South Africa, utilising the modified theory of planned behaviour. Specifically, the study explored how risk-taking propensity, financial and non-financial support, media, and gender influence perceived behavioural control, entrepreneurial intention, and behaviour. Additionally, the study tested the direct effects of perceived behavioural control on both entrepreneurial intention and entrepreneurial behaviour, as well as the direct effect of entrepreneurial intention on entrepreneurial behaviour. An online, structured, self-administered questionnaire was utilised to gather data from 496 finalyear diploma students at a university of technology and a TVET college, using a convenience sampling technique. Partial least squares structural equation modelling (PLS-SEM) was applied to analyse the data and test the postulated hypotheses. The findings revealed that non-financial support positively affected entrepreneurial intention, perceived behavioural control, and entrepreneurial behaviour, while financial support did not. Risk-taking propensity significantly influenced perceived behavioural control, entrepreneurial intention, and entrepreneurial behaviour. The results revealed that the gender was negatively related to perceived behavioural control, and female students exhibited lower perceived behavioural control than their male counterparts. However, gender showed no significant association with entrepreneurial intention or entrepreneurial behaviour. Media had a positive influence on both entrepreneurial intention and perceived behavioural control but did not significantly affect entrepreneurial behaviour. Additionally, both entrepreneurial intention and entrepreneurial behaviour were positively influenced by perceived behavioural control, while entrepreneurial intention also was positively associated with entrepreneurial behaviour. These findings underscore the critical role of fostering a supportive entrepreneurial environment in shaping entrepreneurial behaviour. This study provides valuable insights for policymakers and educators to cultivate an environment that supports students in developing as entrepreneurs. The results can inform policymakers in implementing support interventions aimed at enhancing entrepreneurial capacity among the youth. Promoting entrepreneurship is vital in achieving sustainable development goals through job creation and poverty alleviation. Full article

In the online shopping context, brands aim to achieve a high level of profit by providing better customer satisfaction by using various artificial intelligence tools. They try creating a satisfactory customer experience by creating a system that provides never-ending customer support by using dialog-based chatbots, especially in the field of customer service. However, there is a lack of research investigating the impact of business and customer-based chatbot activities together on online purchase intention and the intention to reuse chatbots. This research considers the use of chatbots as a marketing tool from both customer and business perspectives and aims to determine the factors that affect the customers’ intention to purchase online and reuse chatbots. Accordingly, the impact on customer satisfaction with chatbot usage, which is based on chatbots’ communication quality and customers’ motivations to use chatbots, on online purchase intention and intention to reuse chatbots was examined. Through an online questionnaire with two hundred and ten participants, employing structural equation modeling, we revealed that customer satisfaction with chatbot usage has a greater impact on the intention to reuse chatbots than on online purchase intentions. In addition, chatbot communication quality has a greater impact on customer satisfaction with chatbot usage than customers’ motivation to use chatbots. To solidify these findings, confirmatory factor analysis, along with reliability and validity assessments, were implemented within the analytical framework to provide robust support for the study’s hypotheses. These findings not only provide empirical evidence and implications for companies in online shopping but also extend the understanding of AI tools in marketing, highlighting their subtle impact on consumer decision-making in the dynamic digital marketplace. Full article

Human blood is one of the most valuable and irreplaceable goods in modern medicine. Although its necessity increases daily, one of the most significant challenges we have to overcome is a scarcity of willing blood donors. Volunteer motives and attitudes have been studied for decades, but it is now considered vital to grasp the many aspects that will increase the effectiveness of attracting new blood donors. This study focuses on the impact of emotional arousal produced by advertising messages, as well as the determining role of altruistic and egoistic incentives in deciding behavior. We also incorporated the element of personality to investigate how personality traits influence behavioral intention to donate blood. To this end, a quantitative non-experimental correlational 2 × 2 experimental design (positive vs. negative emotional appeal; altruistic vs. egoistic message) was implemented with the participation of 462 respondents who were shown a total of 12 advertisements (ads) promoting blood donation. The data were analyzed using structural equation modeling, with a focus on the direct impacts on donation intentions, the role of emotional arousals and attitude towards the ads as mediators and the moderating effect of the message. The empirical results of our hypotheses revealed that only Honesty–Humility had a strong direct impact on behavioral intention to donate, while Emotionality and Agreeableness did not have any direct effect. On the other hand, attitudes towards advertisements significantly and directly influenced positive and negative emotional arousals, respectively. Furthermore, if we consider these two variables alone, they can be found to exert a direct impact on BI. Mediation analysis showed that attitudes towards the advertisements and emotional arousals partially mediated the relation between Honesty-Humility and Behavioral Intention, thus confirming partial mediation. With respect to Emotionality and Agreeableness, mediation was found to be full since these factors only affected BI through a mediated path, which confirmed full mediation. Furthermore, the moderation analysis highlighted that the type of message (altruistic vs. egoistic) significantly moderated the relationship between both emotional arousals and BI. In particular, positive emotional arousal’s influence is strengthened when it is aligned with altruistic messages, while negative emotional arousal’s influence is weakened if it follows an altruistic message. These findings illustrate that using positive emotions will be more beneficial for increasing people’s donation intentions than bringing negative ones, which implies that message framing has a hidden impact on donation decisions. Full article

Due to increasing concern about plastic waste and its impact on the ecosystem, it is vital to understand tourists’ behavioral intentions about plastic waste reduction on beaches. There have been several studies that have used the theory of planned behavior to investigate pro-environmental behaviors or intentions, but there are few specific research studies that have extended the theory of planned behavior by adding awareness of consequences to explain the power of behavioral intention. Accordingly, this paper aimed to investigate how awareness of consequences, subjective norms, attitudes, and behavioral control dimensions influence plastic waste behavioral intention on Jeddah’s beaches, in Saudi Arabia. This was performed on a random sample of 390 local tourists in Jeddah city from June to August 2023. A total of 340 of them agreed and answered the questionnaire, yielding a percentage response rate of 87%. This produced 271 valid questionnaires for data analysis after closely examining the survey. A self-complete questionnaire was used for data collection in using multiple statistical analyses to examine the hypotheses. The results demonstrated a positive influence of subjective norms, perceived behavioral control, and consequence awareness on environmental behavioral intention. On the other hand, attitude did not significantly contribute to predict environmental behavioral intention. This study’s findings made clear how crucial it is to consider any potential negative effects while making plans to cut down on plastic trash. Educating people about the possible harm that using plastic products on beaches is anticipated to cause to the environment might also be beneficial. It is intended that, through understanding behavior and behavior determinants, governmental bodies, pro-environmental organizations, businesses, and communities will be able to implement appropriate strategies to reduce the use of plastic in Saudi Arabia to protect marine life. Full article

Background: Music festivals are part of the cultural industry, and have become an ever-growing phenomenon. It is essential for organisers to identify whether the marketing strategies implemented are positive and effective in generating a competitive advantage. The aim of this study is to identify the elements that make up the brand equity of an emerging music festival, and to find out whether the overall brand equity determines the satisfaction and subsequent behaviours of festival-goers. Methods: Quantitative research was used by conducting an ad hoc structured survey during the development of a live music festival in May 2022. The questionnaire collects information about dimensions that make up the global brand value and how they influence satisfaction and behavioural intentions, consisting of a total of 33 indicators.; Results: Awareness, perceived quality, and loyalty are the most influential dimensions in shaping the brand of a festival. There is a correlation between the overall brand value and the satisfaction of the attendees, and that the latter influences the subsequent loyalty and recommendation of the event. Conclusions: The causal relationships between the dimensions of brand equity and overall brand equity are shown, where three of the four hypotheses are accepted. Similarly, the three hypotheses related to the influence of overall brand image and behavioural intentions are also accepted. Full article

Given the complexities surrounding vaccine acceptance of COVID-19 and other vaccines, it is important to determine the underlying health beliefs of patients in order to bridge gaps and promote vaccine confidence. With pharmacies as key hubs for vaccinations and vaccine conversations, examining patient perspectives through the lens of community pharmacy may provide a targeted insight into their patient populations. The primary objectives of this study were to measure COVID-19 vaccine intention and compare vaccine acceptance at pharmacies and clinics between California and Ohio. The secondary objectives included subgroup comparisons of vaccine intention and vaccine acceptance based on demographic characteristics. A previously validated survey instrument (5C survey tool) was administered at pharmacy sites in California and Ohio to examine respondents’ vaccine acceptance (confidence, complacency, constrains, calculation, and collective responsibility). Additional items were added to capture flu and COVID-19 vaccine intention. Reliability and confirmatory factor analysis were completed for the 13-item 5C. Comparisons were made between sites and within different demographic groups. Good reliability (Cronbach’s alpha = 0.768) was found, with nearly all items loading on their hypothesized domains. Respondents from Ohio had significantly higher complacency and constraints domain scores. Highest acceptance was revealed in females, individuals with a Master’s degree or higher, and individuals with the intention to receive a flu vaccine. The adapted 5C is a reasonable tool to measure vaccine intention in English-speaking populations in the US. Certain demographic groups may have lower vaccine acceptance; pharmacists could consider implementing a tool, such as the 5C tool, to identify low acceptance. Given that the 5C tool gathers information on different domains of vaccine acceptance, healthcare professionals could utilize these results to improve trust and vaccine confidence in their patient populations; focused conversations concerning any of the respective domains could best address individual concerns and barriers about vaccinations, notably the COVID-19 and flu vaccines. Full article

Personal health records (PHR) systems are designed to ensure that individuals have access and control over their health information and to support them in being active participants rather than passive ones in their healthcare process. Yet, PHR systems have not yet been widely adopted or used by consumers despite their benefits. For these advantages to be realized, adoption of the system is necessary. In this study, we examined how self-determination of health management influences individuals’ intention to implement a PHR system, i.e., their ability to actively manage their health. Using an extended technology acceptance model (TAM), the researchers developed and empirically tested a model explaining public adoption of PHRs. In total, 389 Saudi Arabian respondents were surveyed in a quantitative cross-sectional design. The hypotheses were analysed using structural equation modelling–partial least squares (SEM-PLS4). Results indicate that PHR system usage was influenced by three major factors: perceived ease of use (PEOU), perceived usefulness (PU), and security towards intention to use. PHR PEOU and PHR intention to use were also found to be moderated by privacy, whereas usability positively moderated PHR PEOU and PHR intention to use and negatively moderated PHR PU and PHR intention to use. For the first time, this study examined the use of personal health records in Saudi Arabia, including the extension of the TAM model as well as development of a context-driven model that examines the relationship between privacy, security, usability, and the use of PHRs. Furthermore, this study fills a gap in the literature regarding the moderating effects of privacy influence on PEOU and intention to use. Further, the moderating effects of usability on the relationship between PEOU, PU, and intention to use. Study findings are expected to assist government agencies, health policymakers, and health organizations around the world, including Saudi Arabia, in understanding the adoption of personal health records. Full article

During the COVID-19 pandemic, telemedicine was broadly adopted for patient care. Considering this experience, it is crucial to understand the perceptions of teleclinic healthcare professionals. In Saudi Arabia, telemedicine literature was restricted to physicians working in government and private hospitals. This study examined perceptions in relation to telemedicine among physicians and other healthcare professionals practicing in Saudi Arabian military hospitals in the Taif region. During COVID-19, telemedicine was implemented in military hospitals; consequently, this study assists in evaluating introduced practices and the perceptions of health professionals regarding these new practices. A quantitative, descriptive, correlational, and cross-sectional study was undertaken on healthcare professionals (N = 153). Twenty (20) items based on standardized measures were used to collect data using an online questionnaire. The measures contained three subscales: perceived usefulness, perceived ease, and behavioral intention. It was hypothesized that the perception of teleclinic usefulness and ease score by healthcare providers would be significantly correlated with behavioral intention. Descriptive statistics for mean, frequency, and standard deviation, as well as a Pearson correlation coefficient and regression analysis, were conducted to assess the relationship and predictive association between variables. In addition, a focus group discussion was organized to collect information directly from healthcare professionals. Most of the participants were approximately 40 years of age, Saudi Nationals (63%), medical specialists (62%), and were involved in teleclinic practices before the COVID-19 pandemic (60%). The reliability of all three scales was determined to be acceptable (α = 0.75–0.91). Perceived usefulness and perceived ease were shown to be significantly correlated with behavioral intention (r = 0.877, p = 0.05). In addition, the regression analysis indicated that perceived usefulness and perceived ease are predictors of the behavioral intention (R² = 0.777, F (2,152) = 261.76, p = 0.001) of teleclinic practices among healthcare professionals. The positive perception of telemedicine integration in healthcare systems revealed by this study is a major catalyst for continuous adoption. On the other hand, certified telemedicine platforms, on-the-job training, Internet of things, and a flexible approach are required to find opportunities and enhancements in telemedicine interactions. Full article

In this paper, the authors aim to analyze entrepreneurial intention and focus on sustainable entrepreneurial strategies, which consider the responsible use of resources while avoiding the strong exploitation of materials and workers, and which use a long-term approach. This consideration is important in the current era, especially when considering that the incorrect hypercompetitive approaches implemented among business organizations in recent years have caused many problems around the world both ecologically and socio-economically. In this research, the authors administered questionnaires to 743 university students. These questionnaires measured considerations of future consequences, considerations of immediate consequences, environmental awareness, personal norms for acting in a pro-environmental way, sustainable entrepreneurial attitudes, subjective norms, perceived behavioral control, and sustainable entrepreneurial intentions. When combining these independent, dependent, and moderating variables, it emerged that considerations of future consequences, considerations of immediate consequences, environmental awareness, and personal norms for acting in a pro-environmental way have a positive influence on sustainable entrepreneurial attitudes; the authors also considered the influence on the other variables, and it was determined that sustainable entrepreneurial attitudes, subjective norms, and perceived behavioral control have a positive influence on sustainable entrepreneurial intentions. Using partial least squares structural equation modeling (PLS-SEM), all of the proposed hypotheses were verified, with the exception of influence between entrepreneurial attitudes and sustainable entrepreneurial intentions. Full article