Search Results (1,904)

Background/Objectives: Patient-level factors strongly influence antimicrobial resistance (AMR) through the pressure applied to healthcare professionals to prescribe antibiotics even for self-limiting viral infections, enhanced by knowledge and attitude concerns. This includes Africa, with high levels of AMR. However, validated measurement tools for African primary healthcare (PHC) are scarce. This study evaluated the reliability, structural validity, and interpretability of the Community Antimicrobial Use Scale (CAMUS) in South Africa. Methods: A cross-sectional survey was conducted with 1283 adults across 25 diverse public PHC facilities across two provinces. The 30-item theory-based tool underwent exploratory and confirmatory factor analysis (EFA/CFA), reliability, and validity testing. Results: EFA identified a coherent five-factor structure: (F1) Understanding antibiotics; (F2) Social and behavioural norms; (F3) Non-prescribed use; (F4) Understanding of AMR; and (F5) Attitudes. Internal consistency was strongest for knowledge and misuse domains (alpha approximation 0.80). Test–retest reliability was good-to-excellent (ICC: 0.72–0.89). CFA confirmed acceptable composite reliability (CR ≥ 0.63). Although average variance extracted (AVE) was low for broader behavioural constructs, indicating conceptual breadth, it was high for AMR knowledge (0.737). Construct validity was supported by positive correlations with health literacy (r = 0.48) and appropriate use intentions (r = 0.42). Measurement error metrics (SEM = 1.59; SDC = 4.40) indicated good precision for group-level comparisons. Conclusions: CAMUS demonstrated a theoretically grounded structure with robust performance in knowledge and misuse domains. While social and attitudinal domains require refinement, we believe the tool is psychometrically suitable for group-level antimicrobial use surveillance and programme evaluation in South African PHC settings and wider to help with targeting future educational programmes among patients. Full article

This article reports on a comparative case study that examined the ground rules used to facilitate a dialogic space in two discrete and diverse research studies: Year 5 & 6 children learning to code with ScratchMaths as part of their mathematics programmes, and crop farmers in rural east Africa developing their practice through various communications. The intention was to see if there were common actions or principles important for the establishment of ground rules in dialogic spaces in general. Understanding the nature of dialogic space has become increasingly important in many areas of education. STEM subjects, particularly when integrated, frequently involve collaborative interaction, and utilise a dialogical approach. Some initial aspects of ground rules were collaboratively identified, with both studies then independently analysed to identify emerging themes related to these ground rules. Several key elements emerged: developing the processes for interaction and communication; developing trust between participants; developing respectful dialogue; teacher roles; and facilitating collaborative work and the co-construction of meaning. The comparative case study suggested that these were important for other education work when establishing dialogic space. Full article

The industrial heritage of the Third Front construction (hereafter referred to as Third Front industrial heritage) serves as a significant physical manifestation of China’s urban society, economy, and culture during a unique historical period. Its widespread abandonment not only constitutes a waste of social resources but also accelerates the erosion of collective memory surrounding the Third Front initiative. As one of Sichuan Province’s (including present-day Chongqing) key Third Front construction regions during that era, Guangyuan City possesses a substantial legacy of Third Front industrial heritage sites. These sites are predominantly idle and face ongoing risks of deterioration, necessitating comprehensive and systematic research into their classification, protection, and regeneration. This paper focuses on 39 Third Front industrial heritage sites in Guangyuan City, employing architectural typology to construct a ‘type-medium-value’ research framework integrating field research with strategic distribution analysis at the urban level, spatial form analysis at the settlement level, and spatial combination analysis at the building level to quantitatively identify and qualitatively deconstruct the spatial logic of these sites. This enables the analysis of the functional characteristics, structural logic, and spatial intent embodied by different types, thereby exploring the multidimensional value implications of Third Front industrial heritage through this value medium. Ultimately, this research proposes targeted adaptive mechanisms and revitalisation pathways for Third Front industrial heritage. It aims to promote the cultural legacy of this heritage and perpetuate the Third Front spirit within the context of strengthening the Chinese national community consciousness in the new era, while aligning with the Party and state’s development strategies. This approach aims to provide a reference for revitalising and utilising Third Front industrial heritage in other underdeveloped regions. Full article

This study examines the social factors shaping solar energy transitioning in Zambia’s mining sector, a key contributor to the national resource economy. It focuses on how policies, incentive systems, communication channels, training and skills development, and stakeholder engagement and partnership influence the sector’s readiness to adopt solar energy and support more reliable operations. A quantitative design was used, with a 5-point Likert-scale questionnaire administered to 192 respondents from mining companies, regulatory bodies, energy suppliers and local authorities. Data were analysed using descriptive statistics, reliability tests and hierarchical regression. The results show that stakeholder engagement and partnership and incentive systems are the strongest predictors of transition intentions, underscoring their role in improving energy security and supporting sustainable production. Policies, communication and training had weaker effects, indicating the need for stronger institutional coordination and targeted capacity building. Overall, the findings illustrate how social conditions shape renewable energy adoption and contribute to more resilient mining activities. Full article

Breastfeeding is universally regarded as the cornerstone of infant feeding, as it is the ideal infant feeding choice for optimal nutrition and development. Socio-structural factors of breastfeeding in child health play an important role in guiding women’s decisions on options to feed their babies. A cross-sectional study was conducted among mothers with infants aged 0–6 months in Mthatha, Eastern Cape, with the aim of assessing the role of socio-structural factors in shaping feeding intentions and practices among mothers with infants. Written Informed consent was obtained in accordance with the Declaration of Helsinki from the participants prior to data collection. Data was gathered with a validated designed questionnaire as well as analyzed using Social Sciences (SPSS) version 29. A total of 181 mothers were enrolled. Only 45.9% reported that they exclusively breastfed their babies, of which the highest proportion of exclusive breastfeeding (EBF) was observed among the 21–29 age group at 51.8%, and the lowest among those aged 20 years and below (3.6%). Marital status (p = 0.005) and employment status (p < 0.001) were significantly associated with exclusive breastfeeding, with higher EBF rates observed among married mothers and those who were self-employed. Both the EBF mothers and non-EBF mothers shared a common belief that colostrum was not beneficial for infants (p = 0.854), whereas their views differed significantly on the amount of water given to infants before they reached six months (p = 0.001). There was no significant relationship between EBF status and having a family member who had breastfed in the past six months (p = 0.815); also, a weak association was noted for having a friend who had breastfed recently (p = 0.057). The difference in EBF practice between those receiving antenatal care (ANC) breastfeeding education and those not receiving it was not statistically significant (p = 0.591). A statistically significant association was found between the support level and exclusive breastfeeding status (p < 0.001). This study highlights that the successful practice of exclusive breastfeeding (EBF) is strongly associated with high levels of social support. Interventions are needed to engage active partners, family members, and community members in creating a supportive environment for breastfeeding mothers. Full article

This study explores the factors that influence Gen Z consumers’ green purchasing behavior, addressing a gap in current research by combining the Theory of Planned Behavior, the Theory of Consumption Values, and Generational Theory, and applying them to the touristic accommodation context. Based on a quantitative survey of Gen Z tourists from Spain, Norway, and Lithuania, the study examined traditional constructs of the Theory of Planned Behavior alongside subjective knowledge, environmental consciousness, perceived value, and green trust. Using Partial Least Squares Structural Equation Modeling (PLS-SEM), the results indicate a significant role for price-based functional value and emotional value in shaping Gen Z’s attitudes toward sustainable accommodation. Furthermore, subjective knowledge and environmental consciousness strengthen green trust, which in turn contributes to a more positive attitude toward sustainable touristic options. Attitude, subjective norms, and perceived behavioral control significantly predict behavioral intention, while both perceived behavioral control and behavioral intention directly influence actual purchasing behavior. The findings suggest that tourism marketers should focus on enhancing price-related and emotionally meaningful value propositions, while also fostering trust through clear communication of environmental performance. Overall, the study offers a comprehensive understanding of the drivers behind Gen Z’s sustainable accommodation choices and provides practical implications for promoting environmentally responsible tourism. Full article

Background: The acceptance of new vaccines under uncertainty—such as during the COVID-19 pandemic—poses a major public health challenge because efficacy and safety information is still evolving. Methods: We propose an integrative analytical framework that combines a theory-based model of vaccine acceptance—the cognitive–affective–normative (CAN) model—with machine-learning techniques (decision tree regression, random forest, and Extreme Gradient Boosting) and SHapley Additive exPlanations (SHAP) integrated into an importance–performance map (IPM) to prioritize determinants of vaccination intention. Using survey data collected in Spain in September 2020 (N = 600), when the AstraZeneca vaccine had not yet been approved, we examine the roles of perceived efficacy (EF), fear of COVID-19 (FC), fear of the vaccine (FV), and social influence (SI). Results: EF and SI consistently emerged as the most influential determinants across modelling approaches. Ensemble learners (random forest and Extreme Gradient Boosting) achieved stronger out-of-sample predictive performance than the single decision tree, while decision tree regression provided an interpretable, rule-based representation of the main decision pathways. Exploiting the local nature of SHAP values, we also constructed SHAP-based IPMs for the full sample and for the low-acceptance segment, enhancing the policy relevance of the prioritization exercise. Conclusions: By combining theory-driven structural modelling with predictive and explainable machine learning, the proposed framework offers a transparent and replicable tool to support the design of vaccination communication strategies and can be transferred to other settings involving emerging health technologies. Full article

Background/Objectives: Seasonal influenza imposes a significant burden on pediatric public health. Despite official recommendations and full insurance coverage, vaccination rates among children in Slovakia remain critically low. This study aims to analyze the attitudes, beliefs, and determinants of parental hesitancy regarding childhood influenza vaccination in the post-pandemic context. Methods: A single-center cross-sectional survey was conducted between February and March 2025 using convenience sampling among parents of children attending a pediatric immunoallergology center. An anonymous questionnaire collected data on demographics, risk perception, and attitudes. Data from 301 parents were analyzed using descriptive statistics, chi-squared tests, and odds ratios (OR) to identify key predictors of hesitancy. Results: Only 27.6% of parents expressed willingness to vaccinate their children, while 42.5% were opposed and 29.9% hesitant. Statistical analysis revealed no significant association between parental university education and vaccination intent (p > 0.05), indicating that vaccine hesitancy in this specific setting was present across all educational backgrounds. However, the source of information proved to be a critical determinant: consulting a pediatrician significantly increased the odds of acceptance (OR = 6.32; 95% CI: 3.54–11.28), whereas reliance on the internet and social media was a significant predictor of refusal (OR = 0.29; 95% CI: 0.17–0.50). The primary reported barrier was fear of adverse effects (70.4%), which significantly outweighed doubts about efficacy (30.2%). Conclusions: Parental hesitancy in Slovakia is a widespread phenomenon pervasive across all educational backgrounds, driven primarily by safety concerns and digital misinformation. The contrast between the protective influence of pediatricians and the negative impact of digital media underscores that clinical encounters are currently the most effective firewall against hesitancy. Public health strategies must therefore pivot from general education to empowering pediatricians with active, presumptive communication strategies. Full article

From an interbehavioral and contingential perspective, family dialogues about sexuality are understood as patterns of verbal interaction regulated by social, gender, and caregiving contingencies rather than as individual attitudes or intentions. Background: This study analyzes the functional conditions under which family dialogues about sexuality occur between mothers and their adolescent sons and daughters, considering caregiving roles and gender norms that regulate these interactions. The research aimed to identify the functional relations between communicative practices and the social contingencies that maintain or inhibit them. Methods: A qualitative approach grounded in interbehavioral psychology was employed, using semistructured interviews with 40 mothers of students from a public middle school in Puebla, Mexico. Data were analyzed through contingency analysis, distinguishing micro- and macrocontingential systems related to family sexual education. Results: Results show that, although patterns of avoidance and discourse displacement toward schools or peers persist, families exhibit increasing openness toward comprehensive sexuality education and recognize its preventive value against violence, adolescent pregnancy, and misinformation. Functional delegation and adolescent mediation of dialogue were identified, along with emerging inclusive macrocontingencies linked to the acceptance of diverse families and LGBTIQ+ themes. Conclusions: It is concluded that households function as self-regulated interbehavioral systems in which historical and gender contingencies restrict sexual dialogue, yet gradual functional changes toward respect, inclusion, and shared educational responsibility are observed. Full article

In recent years, the application of augmented reality digital technology in brands has transformed the way consumers interact with brands. This study focuses on the impact of augmented reality (AR) technology on consumption behavior and brand communication related to intangible cultural heritage products, integrating the TAM and UTAUT2 theories to construct a research model. This study employed a time–location sampling method, utilizing SPSS and AMOS software for data analysis based on valid questionnaires completed by 305 AR-experiencing consumers in Changsha City, Hunan Province. Results indicate that the presence and novelty of AR technology significantly and positively influence consumers’ attitudes toward using AR technology, which in turn affects their purchase intent, social media sharing behavior, and brand attitudes. The study confirms that emotional factors and consumer perceptions play a guiding and decisive role in the new consumption reality enabled by AR technology. These research findings have practical significance and value for ICH brand building and AR marketing, demonstrating that AR is an effective means to enhance the visibility and influence of the ICH brand. They inject new vitality into promoting more sustainable ICH protection and popularization, as well as the development of the digital creative industry. Full article

Background: Intentional tooth replantation (ITR) is a promising treatment option for preserving teeth in cases where conventional endodontic therapy is challenging, or when previous endodontic treatment and apicoectomy have been unsuccessful. The procedure involves extracting the compromised tooth, preserving the alveolar socket and root surface, performing extraoral endodontic therapy, and replanting the tooth in the alveolar socket. Objective: An increase in evidence-based support for ITR has improved the viability of ITR as a treatment option for patients. This review aims to further establish and provide new areas of potential research for ITR with respect to root morphology, extraction, and surgical techniques, maintenance of the tooth socket, and methods for post-op stabilization. Materials and Methods: A literature review was performed across PubMed from 1 January 1980 to 1 July 2025, with a focus on oral surgery techniques, atraumatic extraction techniques, topographical discrepancies in root system anatomy, and ITR procedural outcomes. Conclusions: Although ITR is not a common procedure performed in contemporary clinical practice, gathering sufficient data on the variables influencing the procedure may help patient outcome and improve communication between the endodontist and oral surgeons. Full article

Households are the major contributor to food waste generation in the European Union according to the recently published data from Eurostat. Promoting food systems sustainability and aspiring to achieve the United Nations SDG 12.3 requires a better insight to the underlying drivers of the household food waste occurrence. The present study presents the combination of a well-established method of acquiring information, the questionnaire surveys, with a state-of-the-art technology for data imputation and interpretation using machine learning (ML). The Food Loss and Waste Prevention Unit (FLWPU) of the municipality of Halandri employed two surveys within the framework of the European funded projects Food Connections and FOODRUS. The first questionnaire was designed for rapid completion, to maximize response rates and minimize respondent burden, ensuring the collection of a consistent core dataset. A total of 154 replies were collected. The second questionnaire, associated with FOODRUS, was more detailed, enabling the participants to provide more in-depth information on their household food waste (HHFW) practices. In total, 43 responses were collected. ML algorithms were applied for data enhancement and data clustering. Specifically, ML and statistical techniques are applied for data imputations. An XGBoost algorithm was trained so as to capture complex relationships between variables. Behavioral intentions and effective strategies for reducing food waste at the community level are identified from the responses of both questionnaires, while a clustering of respondents in five groups emerged by using k-means, thus providing valuable insight into targeted HHFW prevention action plans. Full article

The electronic word of mouth (eWOM) has emerged as a communication tool that significantly influences consumers’ attitudes and purchasing behavior in the online market. Research indicates that the effect of eWOM sources, such as (strong ties, weak ties, and influencers) varies in terms of perceived value components (price, quality, emotional, and social value) and purchase intention, particularly with regard to gender. This study, which is based on the SOR framework; examines the role of eWOM as a stimulus affecting student responses and considers the mediating role of perceived value components and the moderate effect of gender. A sample of 901 students from Westbank universities was analyzed using Smart PLS software. The findings reveal that strong ties and influencer eWOM are positively associated with perceived value components and purchase intention, while weak tie eWOM does not directly correlate with purchase intention. Mediation analyses show that perceived quality and social value act as mediators of purchase intent towards eWOM sources, while emotional value specifically mediates strong relationships and influencers. Notably, price value exerts only a mediating effect on purchase intention when communicated through influencers, highlighting the unique role of the influencer in shaping price perceptions and its broad impact on all components of perceived value. Gender differences were observed in students’ responses to eWOM content; particularly in terms of price, quality, and emotional appeal but not in terms of social factors. The outcomes of this study underscore the significance of considering both the source of the message and the characteristics of the audience when formulating targeted marketing strategies. Full article

Research on Cooperative Driving Automation (CDA) has advanced to overcome the limited perception range of onboard sensors and the difficulty of inferring surrounding vehicles’ intentions by leveraging vehicle-to-everything (V2X) communications. This paper models how an autonomous vehicle receives cooperative sensing and cooperative maneuvering information generated at an edge roadside unit (edge RSU) that integrates roadside units (RSUs) with multi-access edge computing (MEC), and how the vehicle fuses this information with its onboard situational awareness and path-planning modules. We then analyze the performance gains of edge RSU-enabled services across diverse traffic environments. In a highway-merging scenario, simulations show that employing the edge RSU’s sensor sharing service (SSS) reduces collision risk relative to onboard-only baselines. For unsignalized intersections and roundabouts, we further propose a guidance-driven Hybrid Pairing Optimization (HPO) scheme in which the edge RSU aggregates CAV intents/trajectories, resolves spatiotemporal conflicts via lightweight pairing and time window allocation, and broadcasts maneuver guidance through MSCM. Unlike a first-come, first-served (FCFS) policy that serializes passage, HPO injects edge guidance as soft constraints while preserving arrival order fairness, enabling safe concurrent passage opportunities when feasible. Across intersections and roundabouts, HPO improves average speed by up to 192% and traffic throughput by up to 209% compared with FCFS under identical demand in our simulations. Full article

Active music and movement engagement has been widely integrated in human socialization across history and cultures, and is particularly prevalent in early childhood play and learning. For clinical populations, music therapy is known to support social skills and wellbeing for young children. However, there is less evidence for the value of active music engagement for non-clinical populations in terms of supporting social and behavioral wellbeing in the early years. This study reports results from the Rhythm and Movement for Self-Regulation (RAMSR) program delivered by generalist kindergarten teachers in low socioeconomic communities. This randomized control trial involved 213 children across eight preschools in disadvantaged communities in Queensland, Australia. The intervention group received 16 to 20 sessions of RAMSR over eight weeks, while the control group undertook usual preschool programs. Data was collected through teacher report at pre and post intervention, and again six months later once children had transitioned into their first year of school. Robust mixed models accounting for repeated measures and clustering of children within kindergartens (random effects), evidenced significant intervention effects across the three time points for improved prosocial skills (p = 0.04, n_p² = 0.02), and reduced externalizing (p < 0.01, n_p² = 0.03) and internalizing behavior problems (p = 0.04; n_p² = 0.02), with small to moderate effect sizes. These findings highlight the valuable role that intentional active music engagement in universal settings such as preschool can play in terms of social and behavioral wellbeing. The importance of these results lies in the fact that children from lower socioeconomic backgrounds are more likely to experience risks to social and behavioral development, requiring additional supports, yet experience inequities in access to high-quality music and movement programs. Full article