Search Results (940)

Introduction: The increasing cultural diversity of patients poses new challenges for nurses. Cultural competence, especially knowledge of the cultural determinants of health and illness, is an important element of professionalism in nursing care. The aim of this study was to analyse nurses’ self-assessment of cultural knowledge, with a focus on the six dimensions of the Giger and Davidhizar model, prior to formal training in this area. Methods: A triangulation method combining qualitative and quantitative analysis was used. The analysis included 353 statements from 36 master’s student nurses. Data were coded according to six cultural phenomena: biological factors, communication, space, time, social structure, and environmental control. Content analysis, ANOVA, Spearman’s rank correlation, and cluster analysis (k-means) were conducted. Results: The most frequently identified that categories were environmental control (34%), communication (20%), and social structure (16%). Significant knowledge gaps were identified in the areas of non-verbal communication, biological differences, and understanding space in a cultural context. Three cultural knowledge profiles of the female participants were distinguished: pragmatic, socio-reflective, and critical–experiential. Conclusions: The cultural knowledge of the participants was fragmented and simplified. The results indicate the need to personalise cultural learning and to take into account nurses’ level of readiness and experience profile. The study highlights the importance of the systematic development of reflective and contextual cultural knowledge as a foundation for competent care. Full article

In recent years, online streaming has encountered the challenge of retaining its user base. This study considers the role of transaction cost economics theory in consumer choices to continue subscribing. Participants respond to their top three streaming services, resulting in 797 responses, accounting for multiple selections by each respondent. Respondents could choose their top three services from a list of Netflix, Disney, Hulu, Amazon Prime Video, HBO Max, and Apple TV+. The study’s conclusions highlight the impact of uncertainty, a negative measure of streaming quality, on online subscription-based video streaming. Additionally, asset specificity, reflecting uniqueness and exclusive content, is found to be positively related to continuing a subscription. This research distinguishes itself by examining individuals who are already subscribers to provide insights and guidance through the lens of Transaction Cost Economics, to help marketing professionals seeking a deeper understanding of consumer behavior in the online streaming landscape. Full article

Purpose: Exercise is recommended for survivors of breast cancer to alleviate adverse reactions and reduce the psychological burden. In recent years, however, environmental factors (e.g., pandemics and climate change) have made it difficult to exercise outdoors. Therefore, this study focused on the COVID-19 pandemic in Japan and evaluated the relationship between changes in physical activity (PA) and mental and physical health in breast cancer survivors. Methods: A questionnaire survey was conducted among 345 outpatient female breast cancer survivors aged between 29 and 69 years. The questionnaire was based on the International Physical Activity Questionnaire, the Patient Health Questionnaire-9, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire, and the Fear of COVID-19 Scale and included patient characteristics, changes in PA during pandemic restrictions, and needs for exercise support. The analysis categorized PA changes into two groups according to activity levels. The relationship between changes in PA and physical and mental health was evaluated using logistic regression analysis. Results: Patients with decreased PA accounted for 65.5% of the study population. Regardless of their activity level, these patients were aware of an increased susceptibility to COVID-19, showed a fear of the disease and a tendency for depression, and reported low life satisfaction and declined physical function. Of the patients who stopped exercising, 82.9% reported a decline in PA. Compared with those who had never exercised, those who stopped exercising saw their risk of depression increase by 15.6%. There was a high demand for personalized exercise support from healthcare professionals. Conclusions: Regardless of their activity level, decreasing PA during the pandemic decreased mental health and physical function in breast cancer survivors. There was a higher risk of depression among patients who stopped exercising. Because it is possible that similar situations may occur in the future, interventions by healthcare professionals must be considered in order to continue exercise. Full article

This study, based on engineering education accreditation standards, addresses the supply–demand imbalance in China’s cybersecurity talent cultivation by constructing a sustainable “education-industry-society” collaborative model. Through case studies at Huaihua University and other institutions, employing methods such as literature analysis, field research, and empirical investigation, we systematically explore reform pathways for an innovative cybersecurity talent development system. The research proposes a “three-platform, four-module” practical teaching framework, where the coordinated operation of the basic skills training platform, comprehensive ability development platform, and innovation enhancement platform significantly improves students’ engineering competencies (practical courses account for 41.6% of the curriculum). Findings demonstrate that eight industry-academia practice bases established through deep collaboration effectively align teaching content with industry needs, substantially enhancing students’ innovative and practical abilities (172 national awards, 649 provincial awards). Additionally, the multi-dimensional evaluation mechanism developed in this study enables a comprehensive assessment of students’ professional skills, practical capabilities, and innovative thinking. These reforms have increased the employment rate of cybersecurity graduates to over 90%, providing a replicable solution to China’s talent shortage. The research outcomes offer valuable insights for discipline development under engineering education accreditation and contribute to implementing sustainable development concepts in higher education. Full article

The historical evolution of auditing reflects an increasing complexity in organizational demands, culminating in the emergence of Audit 5.0—an approach that integrates emerging technologies with professional judgment. This study aims to analyze how technological adoption influences risk assessment and materiality determination in financial auditing within a practical, real-world context. The research, qualitative in nature, combines narrative and thematic analysis of the literature, ethnography in a professional setting, and task analysis, developed over four years of experience in a firm of Chartered Accountants. The findings reveal that although digital tools enhance efficiency and accuracy, professional judgment remains essential to ensure the ethics, reliability, and contextualization of audited information. This study contributes to the advancement of understanding regarding the complementarity between technology and the human factor, proposing paths toward more robust and digitally adapted auditing practices. Full article

Society’s adaptation to shared mobility services is a growing topic that requires detailed understanding of the local circumstances of potential and current users. This paper focuses on analyzing barriers to the adoption of urban bike-sharing systems in post-industrial cities, using a case study of the Silesian agglomeration in Poland. Methodologically, the article integrates quantitative survey methods with multivariate statistical analysis to analyze the demographic, socioeconomic, and motivational factors that underline the adoption of shared micromobility. The study highlights a detailed segmentation of users by income, age, professional status, and gender, as well as the observation of profound disparities in access and perceived usefulness. Of note is the study’s identification of a highly concentrated segment of young, low-income users (mostly students), which largely accounts for the general perception of economic and infrastructural barriers. These include the use of factor analysis and regression to plot the interaction patterns between individual user characteristics and certain system-level constraints, such as cost, infrastructure coverage, weather, and health. The study’s findings prioritize problem-specific interventions in urban mobility planning: bridging equity gaps between user groups. This research contributes to the current literature by providing detailed insights into the heterogeneity of user mobility behavior, offering evidence-based recommendations for inclusive and adaptive options for shared transportation infrastructure in a changing urban context. Full article

Background: Artificial intelligence (AI) is being increasingly promoted as a means to enhance diagnostic accuracy, to streamline workflows, and to improve overall care quality in primary care. However, empirical evidence on how primary care physicians (PCPs) perceive, engage with, and emotionally respond to AI technologies in everyday clinical settings remains limited. Concerns persist regarding AI’s usability, transparency, and potential impact on professional identity, workload, and the physician–patient relationship. Methods: This qualitative study investigated the lived experiences and perceptions of 28 PCPs practicing in diverse outpatient settings across Germany. Participants were purposively sampled to ensure variation in age, practice characteristics, and digital proficiency. Data were collected through in-depth, semi-structured interviews, which were audio-recorded, transcribed verbatim, and subjected to rigorous thematic analysis employing Mayring’s qualitative content analysis framework. Results: Participants demonstrated a fundamentally ambivalent stance toward AI integration in primary care. Perceived advantages included enhanced diagnostic support, relief from administrative burdens, and facilitation of preventive care. Conversely, physicians reported concerns about workflow disruption due to excessive system prompts, lack of algorithmic transparency, increased cognitive and emotional strain, and perceived threats to clinical autonomy and accountability. The implications for the physician–patient relationship were seen as double-edged: while some believed AI could foster trust through transparent use, others feared depersonalization of care. Crucial prerequisites for successful implementation included transparent and explainable systems, structured training opportunities, clinician involvement in design processes, and seamless integration into clinical routines. Conclusions: Primary care physicians’ engagement with AI is marked by cautious optimism, shaped by both perceived utility and significant concerns. Effective and ethically sound implementation requires co-design approaches that embed clinical expertise, ensure algorithmic transparency, and align AI applications with the realities of primary care workflows. Moreover, foundational AI literacy should be incorporated into undergraduate health professional curricula to equip future clinicians with the competencies necessary for responsible and confident use. These strategies are essential to safeguard professional integrity, support clinician well-being, and maintain the humanistic core of primary care. Full article

This paper introduces the concept of degenerative affordances to explain how social media can unintentionally destabilise family-run influencer businesses. While affordance theory typically highlights the enabling features of technology, the researchers shift the focus to its unintended, risk-laden consequences, particularly within family enterprises where professional and personal identities are deeply entangled. Drawing on platform capitalism, family business research, and intersectional feminist critiques, the researchers develop a theoretical model to examine how social media affordances contribute to role confusion, privacy breaches, and trust erosion. Using a mixed-methods design, the researchers combine narrative interviews (n = 20) with partial least squares structural equation modelling (PLS-SEM) on survey data (n = 320) from family-based influencers. This study’s findings reveal a high explanatory power (R² = 0.934) for how digital platforms mediate entrepreneurial legitimacy through interpersonal trust and role dynamics. Notably, trust emerges as a key mediating mechanism linking social media engagement to perceptions of business legitimacy. This paper advances three core contributions: (1) introducing degenerative affordance as a novel extension of affordance theory; (2) unpacking how digitally mediated role confusion and privacy breaches function as internal threats to legitimacy in family businesses; and (3) problematising the epistemic assumptions embedded in entrepreneurial legitimacy itself. This study’s results call for a rethinking of how digital platforms, family roles, and entrepreneurial identities co-constitute each other under the pressures of visibility, intimacy, and algorithmic governance. The paper concludes with implications for influencer labour regulation, platform accountability, and the ethics of digital family entrepreneurship. Full article

This paper explores the complex power dynamics of UK social work higher education through an autoethnographic account of a Black woman course leader’s experiences over a period of two years, focusing on issues related to race, internalized oppression, and class. Drawing on Critical Race Theory (CRT), narrative analysis, and lived experience, it examines how systemic inequities manifest through three interlinked themes: (a) academic contrapower harassment (ACPH), (b) internalized oppression and toxic team dynamics, and (c) the interplay of harassment, institutional failure, managerial inaction, and the marginalization of social work as a discipline. This study illustrates how the intersectionality of multiple identities—namely, race, gender, and professional identity—impacts career progression, well-being, and institutional inclusion. This study examines the tensions between social work’s ethical foundations and performance-driven academic environments, advocating for systemic and policy interventions to stimulate institutional reform and cultivate a more equitable culture that enhances educational outcomes and, ultimately, improves social work practice. Full article

One of the goals of Agenda 2030 is to increase the share of renewable energy in the global energy mix. In this context, photovoltaic systems play a key role in the transition to clean energy. According to the International Energy Agency, in 2023, solar photovoltaic alone accounted for three-quarters of renewable capacity additions worldwide. Designing a performing photovoltaic system requires careful planning that takes into account various factors, both internal and external, in order to maximize energy production and optimize costs. In addition to the technical characteristics of the system (internal factors), the positions and the shapes of external buildings and surrounding obstacles (external factors) have a significant impact on the output of photovoltaic systems. However, given the complexity of these environmental factors, they cannot be treated accurately in manual design practice. For this reason, this paper proposes a Building Information Modeling-based workflow for the design of a photovoltaic system that can guide the professional step-by-step throughout the design process, starting from the embryonic phase to the definitive, and therefore more detailed, one. The developed methodology allows for an in-depth analysis of the shading, the photovoltaic potential of the building, the performance of the photovoltaic system, and the costs for its construction in order to evaluate the appropriateness of the investment. The main aim of the paper is to create a standardized procedure applicable on a large scale for photovoltaic integration within Building Information Modeling workflows. The methodology is tested on two case studies, characterized by different architectural features and geographical positions. Full article

Health professionals and institutions, as users and influencers, use social networks to disseminate information and knowledge about health issues, in the case of organ donation and transplantation (ODT) to spread the social benefits of the process and increase the positive attitude towards ODT. The aim of this work was to analyse the perception and use of social networks by university students of health sciences to determine whether, in their opinion, social platforms are suitable for the promotion of ODT after participating in an educational programme specialising in ODT and communication. The students indicated that social networks are a good medium for disseminating messages about ODT, with WhatsApp standing out as the most appropriate after the programme. Eighty-six per cent say that social media can positively influence the attitude towards ODT and 65% have started to follow ODT institutional accounts on social media. Addressing communication in specialisation programmes in the field of health and ODT raises awareness of the responsible use of social media among university health students and strengthens their capacity as prescribers of the social benefits of ODT. Full article

Background and Objectives: This study explored the lived experiences of individuals with post-COVID condition (PCC) who participated in a 12-week exercise rehabilitation and recovery programme (PCCRRP) delivered by a professional football club community trust (FCCT). The aim was to understand the effects of the programme on physical function and quality of life (QoL). This study aims to address the gap in the literature of a lack of qualitative research exploring the experiences and perspectives of individuals engaging in exercise and physical activity as part of their recovery from PCC. Furthermore, it seeks to provide in-depth participant accounts to better understand outcome-level data. Methods: A qualitative approach was employed, involving semi-structured interviews with seven participants (mean age of 52 ± 8.54 years, with ages ranging from 45 to 60 years) following the 12-week PCCRRP to explore perceived changes in physical function and QoL. Thematic analysis was used to analyse the interview data, including participants’ narratives on their QoL experiences. Results: Participants reported improvements in exercise capacity, fatigue, and breathlessness, leading to enhanced physical function and QoL. They also experienced improvements in emotional well-being, including increased confidence and reduced anxiety. The programme’s focus on tailored exercise plans empowered participants to manage their symptoms and regain control over their lives. Conclusions: The PCCRRP delivered by an FCCT had positive effects on the physical function and QoL of individuals with PCC. This highlights the potential of FCCTs in providing effective rehabilitation and support for individuals with PCC. Full article

Artificial Intelligence (AI) and computer-aided diagnosis (CAD) have revolutionised various aspects of modern life, particularly in the medical domain. These technologies enable efficient solutions for complex challenges, such as accurately segmenting brain tumour regions, which significantly aid medical professionals in monitoring and treating patients. This research focuses on segmenting glioma brain tumour lesions in MRI images by analysing them at the pixel level. The aim is to develop a deep learning-based approach that enables ensemble learning to achieve precise and consistent segmentation of brain tumours. While many studies have explored ensemble learning techniques in this area, most rely on aggregation functions like the Weighted Arithmetic Mean (WAM) without accounting for the interdependencies between classifier subsets. To address this limitation, the Choquet integral is employed for ensemble learning, along with a novel evaluation framework for fuzzy measures. This framework integrates coalition game theory, information theory, and Lambda fuzzy approximation. Three distinct fuzzy measure sets are computed using different weighting strategies informed by these theories. Based on these measures, three Choquet integrals are calculated for segmenting different components of brain lesions, and their outputs are subsequently combined. The BraTS-2020 online validation dataset is used to validate the proposed approach. Results demonstrate superior performance compared with several recent methods, achieving Dice Similarity Coefficients of 0.896, 0.851, and 0.792 and 95% Hausdorff distances of 5.96 mm, 6.65 mm, and 20.74 mm for the whole tumour, tumour core, and enhancing tumour core, respectively. Full article

Workaholism and perfectionism have increasingly been identified as significant obstacles to effective lifelong learning and skills development, ultimately undermining long-term career adaptability and organizational resilience. This study explores the predictive role of perfectionism and professional workaholism, with a particular focus on their implications for continuous education and occupational sustainability—defined as employees’ ability to remain adaptable and resilient over time. Using a cross-sectional quantitative design, data were collected from 105 participants (54 IT professionals and 51 nurses) who completed standardized measures of perfectionism and workaholism and reported their cognitive–emotional readiness for further training. Four regression models were employed to assess the impact of the three perfectionism dimensions and profession on overall workaholism and its subcomponents (excessive work, compulsive work, supplementary work). Socially prescribed perfectionism emerged as a strong predictor, accounting for over one-third of the variance in workaholism (β = 0.37; R²_adj = 0.368; p < 0.001), while self-oriented perfectionism significantly predicted excessive work (β = 0.25; p = 0.015). Professional domain had no significant effect, indicating the trans-professional nature of these psychological barriers. Additionally, workaholism was associated with reduced cognitive–emotional availability for ongoing training, highlighting its detrimental effects on lifelong learning. Limitations include the cross-sectional design and reliance on convenience sampling. From a practical perspective, the findings support interventions targeting maladaptive perfectionism, aiming to enhance engagement in continuous professional education and foster sustainable work environments, in line with the United Nations Sustainable Development Goals (SDG 4 and SDG 8). Full article

Objective: There is growing interest in analyzing whether ethical climates influence the emotional states of organizational members. For this reason, the main objective of this study is to evaluate the relationship between a benevolent ethical climate, emotional exhaustion, and depersonalization, taking into account the mediating effect of job autonomy. Methodology: To evaluate the research hypotheses, data were collected from 448 people belonging to six organizations in the Colombian electricity sector. Statistical analysis was performed using two structural equation models (SEMs). Results: The results show that a benevolent climate and its three dimensions (friendship, group interest, and corporate social responsibility) mitigate the negative effect of emotional exhaustion and depersonalization. A work environment focused on people and society triggers positive moods that prevent the loss of valuable psychological resources. On the other hand, job autonomy is a mechanism that has a direct impact on the emotional well-being of employees. Therefore, being able to intentionally direct one’s own sources of energy and motivation prevents an imbalance between resources and demands that blocks the potential effect of emotional exhaustion and depersonalization. Practical implications: This study has important practical implications. First, an ethical climate that seeks to build a caring environment needs to strengthen emotional communication among employees through a high perception of support. Second, organizations need to grow and achieve strategic objectives from a perspective of solidarity. Third, a benevolent ethical climate needs to be nurtured by professionals with a clear vocation for service and a preference for interacting with people. Finally, job autonomy must be accompanied by the necessary time management skills. Social implications: This study highlights the importance to society of an ethical climate based on friendship, group interest, and corporate social responsibility. In a society with a marked tendency to disengage from collective problems, it is essential to make decisions that take into account the well-being of others. Originality/value: This research responds to recent calls for more studies to identify organizational contexts capable of mitigating the negative effects of emotional exhaustion and depersonalization. Full article