Search Results (375)

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

Person-centered navigation (PCN) in healthcare refers to a proactive collaboration among professionals, researchers, patients, and their families to guide individuals toward timely access to screening, treatment, follow-up, and psychosocial support. PCN—which includes professional, peer, and virtual guidance, is particularly crucial for rare cancers, where affected individuals face uncertainty, limited support, financial strain, and difficulties accessing relevant information, testing, and other services. The Canadian Cholangiocarcinoma Collaborative (C3) prioritizes PCN implementation to address these challenges in the context of Biliary Tract Cancers (BTCs). C3 uses a virtual PCN model and staffs a “C3 Research Navigator” who provides clinical and research navigation such as personalized guidance and support, facilitating access to molecular testing, clinical trials, and case reviews through national multidisciplinary rounds. C3 also supports a national network of BTC experts, a patient research registry, and advocacy activities. C3’s implementation strategies include co-design, timely delivery of support, and optimal outcomes across its many initiatives. Future priorities include expanding the C3 network, enhancing user engagement, and further integrating its innovative approach into routine care. Full article

(1) Background: The development of professional identity in future educators is a dynamic and multifaceted process, shaped by personal experiences, interpersonal relationships, role models, and the values internalized across diverse learning ecologies. This identity formation is closely intertwined with academic achievement, socio-educational integration, peer interactions, and the underlying motivations for choosing a particular educational and professional trajectory. This study explores the connections between students’ educational experiences and their motivation to pursue careers in pedagogy and social education. (2) Methods: Based on 138 autoethnographic narratives written by undergraduate students enrolled in Anthropology of Education courses at two [Spanish] universities. (3) Results: The analysis reveals how reflective engagement with personal educational histories enables students to reconstruct the relational foundations of their learning paths. These reflections inform their academic and career choices, which are understood not as static decisions, but as evolving trajectories shaped by a generational context characterized by uncertainty and change. (4) Conclusions: The findings highlight how students, through their narratives, articulate both their professional aspirations and a vision of the educator as an agent of change—one who emerges in response to, and often in critique of, the educational structures and practices. Full article

The COVID-19 pandemic fundamentally disrupted assumptions about entrepreneurship, career planning, and professional development. This study explored how the pandemic influenced the entrepreneurial intentions of undergraduate business students in the United States. Using a qualitative methodology based on in-depth interviews with 31 students at a public Midwestern university, the research interpreted student narratives through the lenses of effectuation theory, resilience theory, and the theory of planned behavior. Findings revealed that many participants reframed entrepreneurship as a strategy for navigating economic uncertainty and enhancing personal agency. Students reported valuing adaptability, resourcefulness, and opportunity recognition, often experimenting with side hustles during the pandemic as a means of resilience. Their entrepreneurial thinking shifted from purely economic motivations toward aspirations for flexibility, self-fulfillment, and purposeful work. The study highlights the formative role of crisis contexts in shaping entrepreneurial identity among emerging professionals. It suggests that entrepreneurship education should move beyond traditional models, fostering skills for navigating complexity and building resilience. In doing so, the findings contribute to broader conversations about youth entrepreneurship, post-pandemic career development, and the evolving demands of the labor market in times of disruption. Full article

Background/Objectives: Men choosing active surveillance (AS) for low- and intermediate risk prostate cancer (PCa) must weigh its harms and benefits against those of active treatment (AT). To understand factors influencing treatment decision-making (TDM) for and adherence to AS, we performed a systematic review. Methods: This systematic review followed the PRISMA guidelines and was registered with PROSPERO (ID CRD42024490427). A comprehensive search strategy from 1990 to 2024 was executed across multiple databases, including Medline and Embase. Studies were included if they examined factors influencing TDM for AS or active monitoring (AM) and adherence to AS/AM. Results: Of the 8316 articles identified, 223 articles were eligible for inclusion. The decision for AS was influenced by different factors, including comprehensive information about treatment options, social support, and wanting to avoid side-effects. Key reasons to choose AT over AS included a lack of information from healthcare professionals about AS and fear of disease progression. Reasons for adhering to the AS protocol included better quality of life and social support. While non-adherence to the AS protocol is prompted by, e.g., biopsy burden and uncertainty, AS discontinuation is generally a results of medical reasons (namely disease upgrading) or from anxiety and family pressure. Conclusions: Numerous factors influence men’s treatment pathway choices. Involving family members in shared decision-making and ensuring that patients have detailed information about AS as a treatment option could help to improve AS uptake. Addressing psychosocial challenges through education and family involvement could improve AS adherence. These insights can help healthcare providers by addressing men’s needs during TDM and AS. Full article

Background: The implementation of artificial intelligence (AI) has become a pivotal interdisciplinary challenge, creating new opportunities for sharing information, driving innovation, and transforming societal interactions with technology. While AI offers numerous benefits, its rapid evolution raises critical concerns about its impact on inclusion, diversity, equity, accessibility, and safety (IDEAS). Method: This pilot study aimed to explore these issues and identify ways to embed the IDEAS principles into AI design. A qualitative study was conducted with industrial and academic experts in the field. Semi-structured interviews gathered insights into the opportunities, challenges, and future implications of AI from diverse professional and cultural perspectives. Result: Findings highlight uncertainties in AI’s trajectory and its profound cross-sector influence. Key issues emerged, including bias, data privacy, transparency, and accessibility. Participants stressed the need for greater awareness and structured dialogue to integrate the IDEAS principles throughout the AI lifecycle. Conclusion: This study underscores the urgency of addressing AI’s ethical and societal impacts. Embedding the IDEAS principles into its development can help mitigate risks and foster more inclusive, equitable, and accessible technologies. Full article

Background/Objectives: The increased availability of naloxone underscores the urgent need for scalable, effective training interventions. While current training modalities show promise, critical challenges persist, particularly regarding the development of interactive, self-efficacious platforms that mitigate anxiety in real-world overdose response, especially among laypersons. Therefore, this study aimed to develop and evaluate the usability and acceptability of a novel, self-paced mixed reality-based training tool (ReviveXR). Methods: ReviveXR was designed using the Apple Vision Pro spatial computing headset and Unity platform, employing mixed reality technology to facilitate interaction with virtual overdose scenarios while maintaining awareness of the physical environment. The intervention included a simulated tutorial and interactive modules on overdose response, rescue breathing, and chest compressions. Field testing was conducted in two rounds across various settings with a heterogeneous sample (N = 25), including individuals who use drugs, bystanders, first responders, and technology specialists. Data collection involved pre- and post-intervention surveys and qualitative interviews. Results: Participants demonstrated significant improvements in knowledge related to overdose recognition, naloxone administration, rescue breathing, and chest compressions. ReviveXR increased participants’ confidence and intent to help overdose victims while reducing uncertainty during overdose reversal. Participants were predominantly from rural areas and primarily identified as White and male. Qualitative feedback emphasized the platform’s heightened engagement, realism, patient responsiveness, and capacity to enhance knowledge acquisition and behavioral preparedness compared with conventional training approaches. Conclusions: ReviveXR offers a scalable, cost-effective, engaging alternative to traditional naloxone training programs, demonstrating strong feasibility across diverse environments and participants. ReviveXR holds considerable promise for expanding and enhancing community overdose response capacities and training healthcare professionals and first responders. Full article

Background: Effective decision-making in supply chain contexts requires understanding how criteria interact to shape rational and transparent decision structures. This study investigates how behavioral aspects influence the structuring of decision-making logic and the interdependencies between key criteria in supply chain contexts. Methods: Using Fuzzy DEMATEL, the research models the interactions between five core criteria —classification, definition, specification, decision, and action feedback—based on inputs from experienced professionals in a global chemical company. The approach enables mapping of causal influences while accounting for subjectivity and uncertainty in expert judgments. Results: The analysis identified specification, definition, and action feedback as causal criteria, with classification and decision being primarily influenced by them. The modeling process supported clearer prioritization and revealed how expert-based interactions can reduce decision biases. Conclusions: This study demonstrates how structuring decision-making logic through causal modeling enhances clarity and reduces subjectivity. The findings contribute to the development of decision support tools applicable across strategic supply chain contexts, offering practical implications for professionals seeking to improve decision transparency and effectiveness. Full article

The reverse logistics of medical textiles has become a major concern in Morocco today, compelling authorities and professionals to develop a sustainable reverse logistics model. This study proposes a model for designing a sustainable closed-loop supply chain network in a fuzzy environment, using the medical textile life cycle as a case study. The model aims to generate economic gains, increase corporate social responsibility through job creation, and mitigate risks associated with the transportation of end-of-life products. In addition, the uncertainty of the model parameters is considered. The multi-objective model, formulated as a mixed-integer linear program, was solved using an exact approach, enabling strategic and tactical decision-making. Furthermore, the results demonstrate that accounting uncertainty can significantly impact strategic and tactical decisions in network design. Full article

As healthcare systems face mounting pressure to modernise payment infrastructure, fintech innovations have emerged as potential tools to improve affordability and efficiency. However, the adoption of these technologies in clinical settings remains limited. This study investigated the perceptions and resistance patterns of healthcare professionals toward Buy-Now-Pay-Later technology and blockchain in healthcare finance, using Innovation Resistance Theory as the guiding framework. Survey data collected from medical practitioners (N = 366) were analysed to identify knowledge gaps, perceived risks, and tradition-related barriers that influence adoption intent. The findings reveal that while interest in financial innovation exists, resistance is driven by institutional conservatism, regulatory uncertainty, and limited familiarity with decentralised finance systems. This research contributes to the literature by offering a theory-based explanation for why even high-potential financial tools face behavioural and structural resistance in healthcare environments. Full article

Inaccurate cost and schedule estimations in road infrastructure projects continue to be a critical source of contractual disputes and financial inefficiencies, particularly in developing countries. While quantitative risk analysis (QRA) methods such as Monte Carlo simulation (MCS) and schedule risk analysis (SRA) are well-established in the literature, their practical adoption remains limited in contexts with low technical capacity and limited access to advanced modeling tools. This study addresses this gap by proposing a practical and accessible quantitative risk analysis framework tailored to the needs of professionals with limited expertise in probabilistic techniques. The framework combines MCS and SRA using probability distributions (PERT, triangular, and normal) and was empirically validated through three road projects in Peru. Results indicated substantial reductions in uncertainty, achieving cost contingency estimates between 1.34% and 11% which were significantly lower than documented overruns of up to 32.29%. Schedule contingencies ranged from 28.71% to 91.67%, markedly improving accuracy. The novelty of this research lies in its context-adapted implementation strategy, offering a robust and easily replicable approach for similar infrastructure environments in Latin America and beyond. This contribution bridges the gap between theoretical risk modeling and its practical adoption, thus enhancing the reliability of infrastructure planning under resource-constrained conditions. Full article

Sustainable building construction (SBC) contributes immensely to attaining sustainable development initiatives. Nevertheless, SBC is not fully embraced among construction organisations in developing countries due to several challenges, suggesting the need for lasting solutions. However, uncertainty remains about the most vital characteristics/enablers that construction organisations need to adopt SBC. This study investigated the organisational enablers that contribute to SBC’s successful deployment. This study employed quantitative methodology using a structured questionnaire for data collection. With a convenient sample technique, a sample size of 281 was achieved from professionals working in the built environment in the Gauteng Province of South Africa (SA). Data were analysed with a four-step approach, including the relevant descriptive and inferential statistics. Relevant reliability and validity tests of the research instrument/measuring variables were observed, including pilot testing, Cronbach’s alpha test, Kaiser–Meyer–Olkin, and Bartlett’s sphericity test. Mean rankings followed this in conjunction with standard deviations. Likewise, the Kruskal–Wallis H-test was employed to determine statistically significant differences in the responses of the study’s respondents. Furthermore, confirmatory factor analysis (CFA) was used to confirm the variables’ goodness of fit in the measurement model or latent construct (organisational enablers), indicating their significance. According to their regression values, the top five variables included commitment to innovative construction, adequate project management culture, support from top management, sound intra-organisational leadership, and social responsibility to protect the environment. Generally, the study’s findings were supported by institutional theory and resource-based view theory. The study recommends carefully considering the findings among construction organisations and policymakers. This will assist in self-assessment and decision-making regarding direct improvement initiatives and curbing unsustainable practices. Similarly, this study is positioned to encourage further investigation of organisational enablers from the perspective of the enlisted theories. Full article

This study investigates the relationship between human resource management (HRM) practices and the phenomenon of brain drain in Greece during the period 2020–2024. In the context of economic uncertainty and demographic shifts, the emigration of skilled professionals has posed serious challenges to the country’s labor market and long-term development. Employing a mixed-methods approach, the research combines quantitative data from national labor force surveys and HR statistics with qualitative insights gathered through semi-structured interviews with HR professionals and expatriates. The study applies descriptive and inferential statistical methods, including regression analysis, to examine how key HRM dimensions—such as workplace flexibility, career development, and performance-based incentives—affect employee retention. Results reveal a significant inverse relationship between HRM quality and brain drain rates, with workplace flexibility and career development emerging as critical predictors. The findings highlight the need for strategic HRM reforms tailored to the Greek context and offer evidence-based recommendations for mitigating talent outflows. This research contributes to both academic discourse and policy design by clarifying the role of HRM in supporting workforce stability in crisis-prone economies. Full article

Background/Objectives: Vaccine hesitancy has increased during the coronavirus pandemic, a period marked by the spread of disinformation and conspiracy theories about COVID-19 vaccines. This qualitative study aimed to explore the beliefs and attitudes of Spaniards towards COVID-19 vaccines and analyze the role of information sources in this process. Methods: Semi-structured interviews were conducted with 35 residents of Spain who exhibited varying levels of vaccine hesitancy. Through thematic content analysis, the narratives supporting vaccination-related decisions, as well as the influence and trust in information sources, were examined. Results: Reasons for getting vaccinated included perceptions of it being “almost an obligation” and “fear of illness and death”. Conversely, reasons for not getting vaccinated included “uncertainty about vaccines”, the belief that “the risk is not real”, and the perception that “vaccination is a personal decision”. Regarding vaccine-related information sources, interviewees expressed distrust of the media, particularly television, as they considered news about vaccine effectiveness and characteristics to be contradictory and constantly changing, which created uncertainty about its reliability. Most interviewees were unsure if social media influenced their decision not to get vaccinated. However, those who acknowledged its impact mentioned trusting sources such as people with a university education. Additionally, close contacts—particularly healthcare professionals—had a significant influence on the decision not to get vaccinated. Conclusions: This study shows that the decision not to vaccinate is shaped by personal beliefs and sources of information—particularly social media and close acquaintances, including healthcare professionals. Full article

Due to new treatment options, the number of patients living longer with advanced cancer is rapidly growing. While this is promising, many long-term responders (LTRs) face difficulties adapting to life with cancer due to persistent uncertainty, feeling misunderstood, and insufficient tools to navigate their “new normal”. Using the Person-Based Approach, this study developed and evaluated a website in co-creation with LTRs, healthcare professionals, and service providers, offering evidence-based information and tools for LTRs. We identified the key issues (i.e., living with uncertainty, relationships with close others, mourning losses, and adapting to life with cancer) and established the website’s main goals: acknowledging and normalizing emotions, difficulties, and challenges LTRs face and providing tailored information and practical tools. The prototype was improved through repeated feedback from a user panel (n = 9). In the evaluation phase (n = 43), 68% of participants rated the website’s usability as good or excellent. Interview data indicated that participants experienced recognition through portrait videos and quotes, valued the psycho-education via written text and (animated) videos, and made use of the practical tools (e.g. conversation aid), confirming that the main goals were achieved. Approximately 90% of participants indicated they would recommend the website to other LTRs. The Dutch website—Doorlevenmetkanker (i.e., continuing life with cancer) was officially launched in March 2025 in the Netherlands. Full article