Search Results (4,125)

Background: This study examines how medical consumption is discussed in online communities among individuals who are blind or visually impaired using the Social Ecological Model (SEM) to capture multilevel healthcare experiences within digital discourse. Methods: A total of 428 posts and comments were collected from Reddit’s r/Blind community. Term frequency–inverse document frequency keyword extraction and a theory-driven LLM-based classification approach were applied to categorize texts into five SEM levels: intrapersonal, interpersonal, institutional, community, and public policy. Results: The findings show that intrapersonal (44.4%) and public policy (29.8%) levels were the most prominent, indicating a strong emphasis on personal coping experiences alongside structural constraints in healthcare access. Institutional-level discourse accounted for 15.8%, whereas interpersonal (6.2%) and community (3.8%) discourse were relatively limited. Keywords and qualitative analyses revealed themes related to emotional adaptation, social support, service accessibility, mobility constraints, and welfare policy barriers. The Jaccard similarity analysis indicated stronger associations between institutional and policy levels, whereas community-level discourse remained relatively distinct. Conclusions: These findings highlight the importance of understanding healthcare experiences, both individually and structurally, in online environments. This study also demonstrated the potential of integrating LLM-based classification with theory-driven frameworks to enable an interpretable and scalable analysis of complex health-related discourse. Full article

Education for Sustainable Development promotes educational approaches that integrate scientific knowledge, experiential learning, and critical reflection to address complex socio-environmental challenges. Within this framework, school gardens have been recognized as learning environments that foster interdisciplinary teaching, environmental awareness, and socio-emotional development. However, their integration into formal curricula remains limited due to structural constraints and insufficient teacher preparation. This study evaluated the implementation of a university–school partnership intervention model aimed at strengthening teacher training for the pedagogical integration of school gardens in basic education in Veracruz, Mexico. A sequential exploratory mixed-methods design was applied, combining an initial diagnostic survey with a subsequent intervention and evaluative phase. In the diagnostic phase, 71 teachers from preschool, primary, and secondary education participated in a survey to identify training needs and perceptions regarding the educational use of school gardens. Subsequently, 34 teachers participated in agroecological and pedagogical training workshops and evaluated a didactic guide designed to facilitate curricular integration. The results revealed high teacher motivation to implement school gardens despite limited institutional infrastructure. Participation in the training program strengthened teachers’ pedagogical capacities and promoted the use of school gardens as interdisciplinary learning environments. The findings suggest that structured university–school collaboration models can support sustainability-oriented teacher training and facilitate the integration of experiential learning into formal education. Full article

Background: Although pre-exposure prophylaxis (PrEP) has demonstrated strong clinical efficacy in preventing HIV infection among men who have sex with men (MSM), real-world utilization remains suboptimal. In South Korea, MSM constitute a major population within the domestic HIV epidemic; however, PrEP uptake has not increased pro-portionally to awareness. This discrepancy has been conceptualized as the “awareness–uptake gap,” reflecting multi-level barriers beyond individual knowledge. Purpose: This integrative review aimed to compare PrEP awareness, acceptance, and utilization among MSM populations in South Korea and international settings, and to identify structural, institutional, and psychosocial determinants contributing to the awaness, uptake gap. The study further sought to derive practical implications for nursing practice and health policy. Methods: An integrative literature review was conducted following Whittemore and Knafl’s five-step methodology and reported in line with PRISMA guidance. Electronic searches were performed in PubMed, Google Scholar, RISS, ScienceON, and DBpia for peer-reviewed studies published between 2015 and 2025 in English or Korean. The final search was completed on 31 January 2026. A total of 5952 records were identified, and 187 studies met the inclusion criteria after screening and duplicate removal. Quality appraisal was conducted using AXIS, Newcastle-Ottawa Scale, RoB 2.0, CASP, and MMAT according to study design, and the findings were synthesized within an environmental–structural–individual framework. Results: The included studies consistently showed that awareness of PrEP exceeded actual uptake. Across settings, the awareness–uptake gap was shaped by policy environment, service accessibility, stigma, privacy concerns, economic burden, institutional complexity, and provider preparedness. Comparative evidence from China, Thailand, Belgium and France, Brazil, and West Africa further suggested that awareness alone did not ensure uptake when service pathways were fragmented, culturally unsafe, or poorly understood. Conclusions: Closing the awareness–uptake gap requires integrated policy and practice strategies that extend beyond cost reduction. Strengthening confidentiality systems, simplifying service pathways, and enhancing provider competency—particularly through nurse-centered PrEP navigation and counseling models—may support more sustainable PrEP expansion among MSM populations in global settings. Full article

As the foreign direct investment (FDI)-driven catch-up model of eight Central and Eastern European (CEE-8) economies approaches its limits, strengthening the export capacity of small and medium-sized enterprises (SME) may play an important role in sustaining economic convergence within the European Union (EU). Despite deep integration into EU production networks, domestic SME participation in international trade remains limited. In this context, digitalization is increasingly seen as a factor that may reduce information, coordination, and administrative barriers associated with SME cross-border trade. This study examines how different dimensions of digitalization relate to intra-EU export performance of SMEs in the CEE-8, conceptualizing digitalization across three distinct but interacting layers: firm-level digital adoption, societal digital usage, and the institutional digital environment. Using a balanced panel dataset covering 2018–2023, the analysis employs a one-way fixed-effects estimator with wild cluster bootstrap inference to address the small-cluster setting. Results indicate that societal digital usage and digital public services for businesses are strongly and positively associated with SME intra-EU export performance. Firm-level digitalization shows a more complex pattern: internal digital tools display delayed positive associations after a maturation period, while e-commerce participation is consistently negatively associated with aggregate export volumes. Robustness checks using Driscoll-Kraay standard errors and alternative functional forms confirm the stability of the core findings. The results suggest that strengthening digital foundations and reducing cross-border digital frictions can support more effective CEE-8 SME participation in the EU Single Market. Full article

Early childhood is a critical period in which religious and moral foundations are established, and the materials used in this process directly influence the quality of learning. In Türkiye, institutional religious education for early childhood is provided through Qur’an courses for children aged 4–6 years, affiliated with the Presidency of Religious Affairs. This study examines the attitudes of instructors working in these courses toward material use and the types of materials preferred in the educational process. Designed within a quantitative research approach using a survey model, the study aimed to collect data from instructors working in Qur’an courses for 4–6-year-old children during the 2023–2024 academic year in Türkiye. Based on voluntary participation, 363 instructors took part in the study. Data were collected through the Material Use Questionnaire and the Attitude Scale Toward Material Use in the Classroom Environment questionnaire and analyzed using SPSS 22.0. Due to the non-normal distribution of the data, the Kruskal–Wallis H test and the Mann–Whitney U test were applied. The findings show that instructors have positive attitudes toward the use of instructional materials and that printed and auditory materials are the most frequently used in the educational process. Full article

This paper provides a comparative analysis of the economic crises in Argentina and Lebanon to derive policy-relevant lessons for the design of IMF-supported adjustment programs in fragile economies. Using a structured comparative case study approach, the study examines crisis dynamics, policy responses, and socioeconomic outcomes across both countries, with particular attention given to exchange rate collapse, banking sector distress, public debt, inflation, unemployment, and poverty. The findings suggest that programs centered primarily on macroeconomic stabilization and fiscal austerity, without adequate attention to institutional capacity, social protection, and debt restructuring, risk deepening economic contraction and social vulnerability. The Argentine experience shows that IMF-supported adjustment in institutionally fragile environments may fail to restore confidence or deliver sustainable recovery when reform sequencing is weak and complementary domestic policies are absent. For Lebanon, where the crisis is deeper and compounded by governance failures and geopolitical instability, IMF engagement appears necessary but insufficient on its own. The paper concludes that a sustainable recovery requires a hybrid strategy combining external financial support with country-specific reforms, including exchange rate unification, banking sector restructuring, debt resolution, stronger governance, and targeted social protection. Full article

Background: Workplace bullying constitutes a persistent psychosocial risk in public service settings, where hierarchical structures and limited exit opportunities may intensify employees’ psychological strain. Although previous research has documented associations between workplace bullying and burnout, less is known about the psychological processes through which bullying translates into emotional exhaustion and the contextual conditions under which these processes are activated, particularly in public sector contexts. Method: This study used survey data from 234 public service employees working in administrative, educational, and non-clinical healthcare institutions across three major cities in Türkiye (Istanbul, Ankara, and Izmir). Participants who were frequently exposed to workplace bullying were selected to examine the detrimental cycle that victims experience. A moderated mediation model (PROCESS Model 7) was tested to examine emotion-focused coping as a mediating mechanism between workplace bullying and burnout, operationalized through emotional exhaustion, and to assess whether this indirect effect was conditional on perceived bystander silence. Results: Findings indicated that workplace bullying was associated with increased reliance on emotion-focused coping only when perceived bystander silence was high. The conditional indirect effect of workplace bullying on burnout via emotion-focused coping was significant at higher levels of bystander silence, whereas no indirect effect emerged under low silence conditions. Conclusions: These findings suggest that burnout does not arise as an automatic consequence of bullying exposure but unfolds through coping processes that are activated in socially silent environments. By highlighting the conditional role of bystander silence, this study emphasizes the value of social context in shaping how public service employees respond to workplace bullying and how burnout develops. We discuss the practical implications for organizational interventions that aim to reduce bystander silence and support healthier coping processes in organizations. Full article

Digital trade is reshaping innovation incentives in emerging economies, yet whether digital trade policy can promote a sustainable upgrading of urban innovation structure—one that shifts the composition of innovative activity toward higher quality while contributing to broader societal goals—remains unclear. Exploiting the staggered rollout of China’s Cross-Border E-Commerce (CBEC) Comprehensive Pilot Zones as a quasi-natural experiment, this study examines how the policy is associated with changes in urban innovation composition using city-level panel data from 2010 to 2023. We construct a patent-text-based proxy for the disruptive orientation of urban innovation using TF-IDF analysis of patent abstracts—a methodological approach that captures textual distinctiveness as a dimension of innovation quality—and validate it against invention-patent intensity and highly cited patents. Using both conventional two-way fixed-effects and modern heterogeneity-robust estimators, we find that CBEC pilot-zone adoption is associated with a higher disruptive-innovation proxy share and a lower share of low-quality (strategic) patenting. The estimated increase in the disruptive-innovation proxy share is about 1.3 percentage points, equivalent to 40.6% of the sample mean. The effect is stronger in cities with weaker business environments, consistent with an institutions-as-substitutes interpretation, and is amplified by pre-existing local government attention to digital trade. Exploratory channel tests point to entrepreneurship, digital payment, and digitization as intermediate outcomes that respond to the policy. These findings contribute to the literature on digital trade policy, innovation composition, and sustainable upgrading by showing that a policy-induced compositional reallocation—rather than a simple increase in patent volume—may support a more quality-oriented, inclusive, and potentially more sustainable pattern of urban innovation in emerging economies. Full article

Rapid urbanization and the growth of data-driven planning have increased the need for tools that support integrated, transparent, and accountable urban governance. While Building Information Modeling (BIM) is well established in project delivery, its potential role in city-scale governance remains underexplored. This study conducts a structured qualitative evidence synthesis informed by PRISMA reporting principles and comparative case analysis to investigate how BIM, in combination with GIS, IoT, and AI, intersects with emerging digital governance practices. Through a synthesis of peer-reviewed research and documented case studies, the review evaluates how BIM supports data integration, interoperability, decision-making, regulatory compliance, collaborative governance, and sustainability. The findings suggest that BIM functions as a governance-support infrastructure when embedded within coordinated institutional frameworks, standardized data environments, and interoperable digital ecosystems. Based on these insights, the paper proposes a conceptual framework that organizes BIM governance into technical, institutional, social, and ethical–regulatory dimensions. The review suggests that BIM’s governance potential depends on institutional alignment, regulatory clarity, and sustained organizational capacity, rather than technological capability alone. Full article

Sustainable pedagogical reform requires more than teacher preparedness; it depends on how school leaders interpret and coordinate the conditions that enable change. This focus is particularly critical in contexts where Problem-Based Learning (PBL) is introduced within predominantly traditional, exam-oriented pedagogical environments, requiring careful consideration of leadership’s perception of system-level readiness to support such shifts. This study investigates how Chinese K–12 school leaders conceptualize readiness for institution-wide implementation of PBL. Using Q methodology with 42 school leaders, four distinct leadership logics were identified: leadership-mediated cultural readiness through recognition, belief-driven pedagogical practice, externally anchored system-level readiness, and experientially grounded cultural readiness. These viewpoints reveal different ways leaders prioritize cultural alignment, belief formation, structural coordination, and experiential learning when organizing reform conditions. Despite these differences, participants showed several areas of shared positioning, particularly around coordination, expertise-based responsibility distribution, evaluation alignment, and adaptive responses to reform conditions. The findings extend change readiness research beyond teacher-focused perspectives by demonstrating how leaders interpret readiness as a multidimensional and system-level phenomenon. By illuminating distinct leadership logics for coordinating reform within centralized governance contexts, this study highlights the importance of aligning beliefs, professional relationships, institutional structures, and student learning improvement goals to support sustainable pedagogical transformation. Full article

Recent advances in large language models, tool-using agents, and financial machine learning are shifting financial automation from isolated prediction tasks to integrated decision systems that can perceive information, reason over objectives, and generate or execute actions. The paper develops an integrative framework for analysing agentic finance: financial market environments in which autonomous or semi-autonomous AI systems participate in information processing, decision support, monitoring, and execution workflows. The analysis proceeds in three steps. First, the paper proposes a four-layer architecture of financial AI agents covering data perception, reasoning engines, strategy generation, and execution with control. Second, it introduces the Agentic Financial Market Model (AFMM), a stylised agent-based representation linking agent design parameters such as autonomy depth, heterogeneity, execution coupling, infrastructure concentration, and supervisory observability to market-level outcomes including efficiency, liquidity resilience, volatility, and systemic risk. Third, it presents an illustrative empirical application based on event studies of AI-agent capability disclosures and heterogeneous market repricing. It argues that the systemic implications of AI in finance depend less on model intelligence alone than on how agent architectures are distributed, coupled, and governed across institutions. The empirical application is intentionally exploratory: it does not validate the full AFMM but shows how one observable expectations channel can be studied using public data. In the near term, the most plausible equilibrium is bounded autonomy, in which AI agents operate as supervised co-pilots, monitoring systems, and constrained execution modules embedded within human decision processes. Full article

The accelerating global energy transition has substantially increased demand for critical minerals such as copper, nickel, and lithium, positioning mining firms as key actors in the decarbonization of energy systems. However, the expansion of mineral extraction raises important sustainability challenges because mining activities remain highly energy- and carbon-intensive. This study investigates whether green innovation can simultaneously improve environmental performance and financial performance in critical mineral mining firms and examines the moderating role of institutional governance. Using a balanced panel of 35 publicly listed mining companies from Australia, Canada, Chile, Brazil, and Indonesia over the period 2015–2024, the analysis applies fixed-effects panel regressions complemented by dynamic specifications and multiple robustness tests, including alternative variable definitions and System Generalized Method of Moments (GMM) estimation. The results show that green innovation significantly reduces carbon intensity, indicating that environmental investments in renewable energy integration, electrification, and process efficiency contribute to improving emissions performance in mining operations. Green innovation also enhances firm financial performance, although the benefits emerge gradually over time, suggesting delayed financial gains followed by long-term efficiency improvements. Furthermore, governance quality strengthens the positive relationship between green innovation and firm performance, highlighting the importance of institutional environments in shaping the economic returns of sustainability strategies. By providing firm-level evidence across major mineral-producing economies, this study contributes to the literature on critical minerals, environmental finance, and the institutional dimensions of the just energy transition. Full article

Background: Parental practices that support autonomy, provide structure, and foster warm relationships are associated with greater satisfaction of students’ basic psychological needs for autonomy, competence, and relatedness. In minority educational contexts, however, students’ psychological need satisfaction is also shaped by broader sociocultural conditions that may create additional pressures and sources of chronic stress. Within such environments, parental support may function as a protective factor that helps students cope with educational and cultural demands. Objective: The aim of this study was to explore how parental support contributes to the satisfaction of students’ basic psychological needs within a minority educational context where students from the Greek minority attend a bilingual school operating within a Turkish educational framework. Methods: A qualitative design was employed using three focus groups conducted in a minority school located in Gökçeada, Türkiye: one with parents (N = 5), one with lower secondary school students (N = 6), and one with upper secondary school students (N = 6). Interview questions were developed on the basis of Basic Psychological Needs Theory. Data were analyzed thematically by five members of the research team. Results: Findings indicated that parental support influenced students’ need satisfaction through practices related to autonomy (e.g., trust, space for mistakes), competence (e.g., encouragement, comparison), and relatedness (e.g., emotional presence, empathy). However, these practices were not experienced in a uniform way. Rather, their meaning and impact were shaped by contextual conditions associated with minority status, including bilingual educational demands, limited resources, and close-knit community dynamics. Conclusions: The study suggests that in minority school settings, parental support operates not simply as a general interpersonal resource but as a contextually mediated protective process. By showing how sociocultural and institutional conditions shape the enactment and experience of autonomy, competence, and relatedness, the findings extend existing BPNT research beyond majority settings and offer a more context-sensitive understanding of students’ psychological need satisfaction. Full article

Parental involvement is widely recognized as a key component of effective schooling, particularly in educational environments that emphasize community, developmental continuity, and holistic pedagogy. Alternative education models such as Waldorf schools have expanded internationally, yet empirical evidence on how parents perceive and structure their experiences within these institutions remains limited. This study investigates parental perceptions of Waldorf education in Hungary through a nationwide questionnaire survey of 585 parents whose children attend Waldorf schools. To explore the latent structure of parental evaluations, Exploratory Factor Analysis was conducted, followed by Confirmatory Factor Analysis to test the stability of the resulting model. The analyses identified four coherent dimensions of parental experience: Trust and Pedagogy, Community and Engagement, Perceived Long-Term Educational Prosperity, and Information and Transparency. Additional analyses examined how these dimensions vary according to institutional characteristics, parental participation in school community activities, and intentions regarding long-term enrollment. The results indicate that pedagogical trust constitutes a relatively stable evaluative dimension across institutions, while perceptions related to community engagement, long-term educational prospects, and transparency are more strongly associated with institutional maturity. Parents who intend to remain in Waldorf education until the completion of upper secondary schooling report consistently higher evaluations across all dimensions. By empirically identifying the structure of parental experiences in a European alternative education context, the study contributes to research on parental engagement, school choice, and the institutional cultures of alternative schooling. Full article

This study examines how regulatory heterogeneity in digital services trade relates to the carbon intensity of bilateral trade flows. Using a structural gravity framework estimated with Poisson pseudo maximum likelihood (PPML), we analyzed 10,719 bilateral observations from the Eora Multi-Region Input–Output (MRIO) database over 2014–2020. Bilateral gaps in the OECD Digital Services Trade Restrictiveness Index (DSTRI) were used as the main measure of regulatory heterogeneity, and the overall gap was decomposed into infrastructure-related hard barriers and institutional soft barriers. The results suggest that digital regulatory gaps are associated with a higher carbon intensity in trade while also being associated with lower total embodied emissions through reduced trade volumes. This indicates that lower aggregate emissions under regulatory divergence may reflect contraction in trade activity rather than genuine environmental improvement. The decomposition analysis further suggests that infrastructure-related misalignment is more closely associated with carbon inefficiency, whereas institutional divergence operates mainly through its association with trade volume. In addition, environmental policy stringency in the importing country appears to strengthen the positive association between institutional regulatory gaps and carbon intensity, consistent with the possibility of regulatory overload. The study contributes to the sustainability literature by showing that carbon intensity provides a more informative indicator of sustainable trade performance than aggregate emissions alone in fragmented regulatory environments. It also suggests that digital governance, trade policy, and environmental policy should be considered together in promoting more sustainable forms of international trade, particularly in the context of emerging policy frameworks such as WTO digital trade negotiations, OECD digital governance initiatives, and carbon border adjustment mechanisms (CBAMs). Full article