Search Results (1,343)

Background and Objectives: Depression is a leading cause of disability globally, with treatment challenges including limited access, stigma, and poor adherence. Gamification, which applies game elements such as points, levels, and storytelling into non-game contexts, offers a promising strategy to enhance engagement and augment traditional treatments. Our research is the first study designed to explore the implementation of gamification within the Malaysian context. The objective was to explore the feasibility of implementation of gamification as an adjunctive treatment for adults with depression. Materials and Methods: Focus group discussions were held with five mental health professionals and ten patients diagnosed with moderate depression. The qualitative component assessed perceptions of gamified interventions, while quantitative measures evaluated participants’ depressive and anxiety symptomatology. Results: Three key themes were identified: (1) understanding of gamification as a treatment option, (2) factors influencing its acceptance, and (3) characteristics of a practical and feasible intervention. Clinicians saw potential in gamification to boost motivation, support psychoeducation, and encourage self-paced learning, but they expressed concerns about possible addiction, stigma, and the complexity of gameplay for some patients. Patients spoke of gaming as a source of comfort, escapism, and social connection. Acceptance was shaped by engaging storylines, intuitive design, balanced difficulty, therapist guidance, and clear safety measures. Both groups agreed that gamification should be used in conjunction with standard treatments, be culturally sensitive, and be presented as a meaningful therapeutic approach rather than merely as entertainment. Conclusions: Gamification emerges as an acceptable and feasible supplementary approach for managing depression in Malaysia. Its success depends on culturally sensitive design, robust clinical oversight, and seamless integration with existing care pathways. Future studies should investigate long-term outcomes and establish guidelines for the safe and effective implementation of this approach. We recommend targeted investment into culturally adapted gamified tools, including training, policy development, and collaboration with key stakeholders to realistically implement gamification as a mental health intervention in Malaysia. Full article

Transportation is often cited as a significant barrier to healthcare access by Veterans, particularly those from minority groups, who have disabilities, or live in rural areas. Autonomous shuttles (AS) offer a potential solution, yet limited research has explored Veterans’ experiences with this technology. This study qualitatively investigated Veterans’ lived experiences with AS through focus groups, enrolling participants aged 18+ from Gainesville, The Villages, and Lake Nona, Florida. Via a directed content analysis, six key themes were identified: Perceived Benefits, Safety, Experience with Autonomous Vehicles (AV), AS Experience, AV Adoption, and Perception Change. Among 26 participants (aged 30–85; 77% men; 88% urban residents), prominent themes included Safety (n = 161), Perceived Benefits (n = 153), and AS Experience (n = 118), with predominantly positive counts in all themes except AS Experience. Participants acknowledged safety advantages and multitasking potential of AS over human-operated vehicles while recommending improvements to the shuttle’s slow speed, availability and convenience. While the AS ride was positively received overall, some participants noted issues with comfort and braking, emphasizing the need for further technological enhancements. Real-world exposure to AS appeared to influence acceptance positively, offering insights for policymakers and industry stakeholders aiming to optimize AS deployment for mobility-vulnerable Veterans. Full article

Introduction: Low medication adherence and low hypertension control are a public health challenge, particularly in low- and middle-income countries (LMICs). Healthcare system- and patient-related barriers hinder the successful management of hypertension. This study aimed to identify the perceptions of barriers and facilitators to hypertension management among health system stakeholders in Santander, Colombia. Materials and Methods: We conducted a qualitative, phenomenological, and interpretative study, comprising five focus groups, to explore the barriers and facilitators to managing people with hypertension. Each focus group was formed by stakeholders from territorial entities, healthcare insurers, or healthcare providers. Meetings were held between December 2022 and February 2023. The sessions were recorded and transcribed using NVivo Transcription and analyzed using NVivo version 1.6.1. Results: Seven categories of barriers and facilitators were identified: strategies, resources, access, risk assessment, cross-sector collaboration, articulation, and stewardship. Of these categories, articulation and stewardship emerged as the main barriers, as revealed through axial coding and cluster analysis, which highlighted deficiencies in stewardship practices, a lack of clear objectives, and misalignment with public policy frameworks. Conclusions: Multisectoral actions extending beyond healthcare providers and aimed at improving coordination and intersectoral collaboration are essential for enhancing hypertension control in LMICs, such as Colombia. Addressing social determinants and strengthening primary healthcare through community-based strategies are critical, making stewardship and improved access key priorities. Full article

Ensuring sustainable food systems is an urgent global priority as populations grow and environmental pressures mount. Technological innovations such as genetic engineering (GE) and nanotechnology (nano) have been promoted as promising pathways for achieving greater sustainability in agriculture and food production. Yet, the sustainability of these technologies is not defined by technical performance alone; it hinges on how they are perceived by key stakeholders and how well they align with broader societal values. This study addresses the critical question of how expert stakeholders evaluate the sustainability of GE and nano-based food and agriculture (agrifood) products. Using a multi-method online platform, we engaged 42 experts across academia, government, industry, and NGOs in the United States to assess six real-world case studies—three using GE and three using nano—across ten different dimensions of sustainability. We show that nano-based products were consistently rated more favorably than their GE counterparts in terms of environmental, economic, and social sustainability, as well as across ethical and societal dimensions. Like prior studies, our results reveal that stakeholders see meaningful distinctions between nanotechnology and biotechnology, likely due to underlying value-based concerns about animal welfare, perceived naturalness, or corporate control of agrifood systems. The fruit coating and flu vaccine—both nano-enabled—received the most positive ratings, while GE mustard greens and salmon were the most polarizing. These results underscore the importance of incorporating stakeholder perspectives in technology assessment and innovation governance. These results also suggest that responsible innovation efforts in agrifood systems should prioritize communication, addressing meaningful societal needs, and the contextual understanding of societal values to build trust and legitimacy. Full article

Workforce transformation is one of the most pressing challenges in the AI-driven construction industry, as traditional skilled labour roles are rapidly evolving into more interdisciplinary, digitally enabled positions. This study aims to investigate how AI is fundamentally reshaping skill requirements within the construction sector, to analyse stakeholder perceptions and adaptive responses to workforce transformation, and to explore strategies for optimizing construction workforce development to facilitate the critical transition from traditional “skilled workers” to contemporary “smart talent.” It employs phenomenological qualitative research methodology to conduct in-depth interviews with 20 stakeholders in Chongqing, and uses NVivo 14 to conduct thematic analysis of the data. The findings indicate that AI has penetrated all areas of the construction process and is transforming jobs to more likely be digitalized, collaborative, and multi-faceted. However, significant cognitive disparities and varying adaptive capacities among different stakeholder groups have created structural imbalances within the workforce development ecosystem. Based on these key findings, a four-pillar talent development strategy is proposed, encompassing institutional support, educational reform, enterprise engagement, and group development, while stressing the necessity for systemic-orchestrated coordination to reimagine a smart talent ecosystem. This study advances theoretical understanding of digital transformation within construction labour markets, while offering real pathways and institutional contexts for developing regions that desire to pursue workforce transformation and sustainable industrial development in the AI era. Full article

Over a three-year R&D project, the perception of mobile phone use in Spanish secondary schools shifted from initial tolerance to increasingly prohibitive policies. Drawing on the Actor–Network Theory, this study examines how mobile phones—alongside institutional discourses and school and family concerns—acted as dynamic actants, shaping public and political responses. The research adopted a qualitative design combining policy and media document analysis, nine semi-structured interviews with key stakeholders, ten regional case studies, and twelve focus groups. The study concluded with a public multiplier event that engaged the broader educational community. The Madrid region, among the first to adopt a restrictive stance, contributed two school-based case studies and three focus groups with teachers, students, and families. Findings suggest that the turn toward prohibition was motivated less by pedagogical evidence than by cultural anxieties, consistent with what it conceptualizes as a techno-pessimistic shock. This shift mirrors the historical patterns of societal reaction to disruption and technological saturation. Rather than reinforcing binary framings of promotion versus prohibition, such moments invite critical reflection. The study argues for nuanced, evidence-based, and multilevel governance strategies to address the complex role of mobile technologies in education. Full article

A university’s reputation is a key indicator of the quality of its education, the competitiveness of its alumni, its institutional influence in society, and its degree of global recognition, including its ranking and rating among higher education institutions (HEIs) around the world. This not only enhances institutional standing and secures positions in international rankings but also promotes sustainable education practices. In addition, students, their parents, and their partners select universities due to their trust in the reliability of a university’s public reputation and ranking. This study proposes a model to assess a university’s reputation based on specific factors. In this research, the dependent variable is university reputation, the mediating variable is university social responsibility, and the independent variables include the teacher reputation, alumni reputation, research and innovation, and cooperation. A survey of 5902 respondents—including alumni, employers, and parents—offers diverse perspectives on university reputation. Data were analyzed using structural equation modeling tools (Smart PLS 4.1 and SPSS 25.0). The findings confirm that social responsibility has a strong and positive influence on university reputation. Furthermore, faculty and alumni reputation, research and innovation, and external collaboration directly enhance universities’ social responsibility. This suggests that social responsibility serves as a key mediating variable in the relationship between institutional capacity and reputation. This study represents the first empirical assessment of university reputation in Mongolia, addressing a notable gap in the literature. By incorporating context-specific insights and stakeholder perspectives, the research offers both theoretical contributions and practical implications. The results provide a foundation for developing regionally responsive strategies to improve the quality of higher education and advance sustainable development goals. Full article

Although consumption is a key engine of economic growth, it is also one of the main drivers of environmental degradation. In this context, a deeper understanding of consumers’ perceptions and behavior regarding sustainable products is essential for promoting a more sustainable future, with behavioral change being crucial to achieving it. This research study explores consumer behavior regarding sustainable egg consumption, a sector where production is frequently associated with environmental and ethical concerns such as animal welfare and intensive resource use. Based on a sample of 197 valid responses from Portuguese egg consumers collected through an online survey distributed between 27 February and 17 March, of the year 2025, and applying the Theory of Planned Behavior (TPB) framework through a structural equation modeling (SEM) approach, this study finds that consumers’ intention to consume sustainable eggs is influenced by their attitudes and subjective norms. Furthermore, actual consumption behavior is driven by both the intention to consume sustainable eggs and perceived behavioral control. By providing an in-depth analysis of consumer behavior related to sustainable egg consumption, this study contributes to the advancement of the scientific literature on the subject. It also aims to support policymakers and other stakeholders in designing and implementing more effective strategies to promote environmentally responsible consumption practices. Full article

Urban food markets are increasingly being recognized not only as centres of cultural identity and tourism but also as pivotal spaces for promoting urban sustainability. This study explores the role of urban markets in advancing sustainable cultural tourism, using Obor Market in Bucharest as a case study. As a historic marketplace and cultural landmark, Obor Market embodies Bucharest’s traditional commercial practices and community-oriented values. Through a mixed-methods approach, combining Geographic Information Systems (GIS) mapping and systematic surveys, we evaluate the location of markets, cultural authenticity, and visitor satisfaction. The quantitative findings reveal meaningful correlations between demographic factors (particularly nationality and age) and visitor perceptions, highlighting the market’s appeal through its authentic culinary offerings and immersive sensory experience. However, this study also identifies shortcomings in current promotional strategies employed by local stakeholders. The results suggest that urban food markets can serve as sustainable urban assets, fostering cross-cultural integration, supporting local economies, and encouraging environmentally conscious tourism behaviours. We argue for data-informed urban cultural policies that enhance the visibility, accessibility, and sustainability of such spaces, reinforcing their dual role as economic drivers and cultural touchstones. Full article

(1) Background: Plastic and microplastic pollution in freshwater systems has emerged as a significant environmental and human health concern, yet limited research has explored how affected communities perceive these risks and support related policy interventions. This study addresses this gap by comparing the perceptions of pollution risk and preferred policy responses among stakeholders and the general public associated with the Tennessee River—one of the most plastic-polluted rivers globally. (2) Methods: Using an online survey, we collected data from 419 public respondents and 45 local stakeholders. Participants assessed perceived environmental and human health risks posed by six common pollutants and expressed support for a range of policy solutions. (3) Results: Results indicate that the public consistently perceives higher risks from pollutants than stakeholders, particularly for plastics, E. coli, and heavy metals. Surprisingly, stakeholders demonstrated significantly stronger support for regulatory policy interventions than the public, despite perceiving lower levels of pollution risk. Importantly, perceived harm from microplastics emerged as the most consistent predictor of policy support across all policy types. (4) Conclusions: These findings suggest that risk perceptions, particularly regarding microplastics, play a critical role in shaping policy preferences and highlight the importance of stakeholder engagement in designing effective freshwater pollution mitigation strategies. Full article

Background/Objectives: Robot-led rehabilitative exercise offers a promising avenue to enhance the care provided by exercise specialists (ESs). ESs, such as physical and occupational therapists, prescribe exercise regimens to clinical populations to improve patients’ adherence to prescribed exercises outside the clinic, such as at home. Collaborative efforts among roboticists, clinical ESs, and patients are essential for developing interactive, personalized exercise systems that meet each stakeholder’s needs. This work builds upon research involving individuals with Parkinson’s disease (PD) that evaluated a robotic rehabilitative exercise system designed to address strength and flexibility deficits. Methods: To complement the findings of our previous work in people with PD (PWP), we conducted a pilot user study in which 11 ESs evaluated a novel robot-led exercise system for PWP, focusing on perceptions of the system’s efficacy and acceptance. Utilizing a mixed-methods approach, including technology acceptance questionnaires, task load questionnaires, and inductively coded semi-structured interviews, we gathered comprehensive insights into ES perspectives and experiences after interacting with the system. Results: Findings reveal a broadly positive reception, which highlights the system’s capacity to augment traditional rehabilitative exercise for PD, enhance patient engagement, and ensure consistent exercise support. We also identified two key areas for improvement: incorporating more human-like feedback systems and increasing the robot’s ease of use. Conclusion: This research emphasizes the value of incorporating robotic assistants into rehabilitative exercise for PD, offering insights that can guide the development of more effective and user-friendly rehabilitation technologies. Full article

South Africa’s bioeconomy strategy identifies bio-innovation as a key driver of economic growth and social development, with plant breeding playing a central role in improving food security through the development of high-yielding, resilient, and high-quality crops. However, consumer perceptions of recent advances, particularly new breeding techniques (NBTs), remain underexplored. This study examines South African consumer attitudes towards plant breeding innovations, using a mixed-methods approach. The initial focus group interviews informed the development of a structured quantitative survey examining familiarity, perceptions, and acceptance of plant breeding technologies. Consumer awareness of plant breeding principles was found to be limited, with 67–68% of respondents unfamiliar with both conventional and modern plant breeding procedures. Despite this information gap, consumers expressed conditional support for modern breeding techniques, especially when associated with actual benefits like increased nutritional value, environmental sustainability, and crop resilience. When favourable effects were outlined, support for general investment in modern breeding practices climbed from 45% to 74%. Consumer purchase decisions emphasised price, product quality, and convenience over manufacturing techniques, with sustainability ranked last among the assessed factors. Trust in the sources of food safety information varied greatly, with medical experts and scientists being ranked highly, while government sources were viewed more sceptically. The results further suggest that targeted education could improve customer confidence, as there is a significant positive association (R² = 0.938) between familiarity and acceptance. These findings emphasise the significance of open communication strategies and focused consumer education in increasing the adoption of plant breeding breakthroughs. The study offers useful insights for policymakers, researchers, and industry stakeholders working on engagement strategies to facilitate the ethical growth and application of agricultural biotechnology in support of food security and quality in South Africa. This study contributes to a better understanding of South African consumers’ perceptions of plant breeding innovations and food safety. The research findings offer valuable insights for policymakers, researchers, and industry stakeholders in developing effective engagement and communication strategies that address consumer concerns and promote the adoption of products derived from diverse plant breeding technologies. Full article

The sustainable supply chain management (SSCM) literature does not directly address Scope 3 emissions despite their role as primary drivers of greenhouse gas emissions. This study aims to provide an overview of the main themes through which the SSCM literature has considered Scope 3 emissions and identify further avenues for research. A systematic literature review (SLR) was conducted. Scopus and Web of Science were the databases considered. Sixty-one papers were included in the analysis. Most papers focus on assessing and estimating Scope 3 emissions, followed by papers that discuss the reporting of Scope 3 emissions. These papers shed light on how firms may not report Scope 3 emissions if the information is negative to improve investors’ perception of the firm. The last group of papers discusses practices and strategies to manage Scope 3 emissions. The main challenge identified in establishing strategies to manage Scope 3 emissions is engagement with stakeholders, as, generally, only one or two tiers of the value chain cooperate. This study is the first to organize the literature on Scope 3 emissions under the lens of SSCM. If supply chains are to become more sustainable, focal enterprise coordination must be effective and leverage practices such as Scope 3 emissions metrics and measurement, data sharing, and green product development for all stakeholders. Full article

Light pollution, most visible in large cities through the absence of star-filled night skies, has become a growing issue of concern across many disciplines. It is not just an esthetic or astronomical problem, but a complex phenomenon with widespread effects on various sectors. The scientific literature highlights several key areas impacted either directly or indirectly by light pollution: astronomy, ecology and biodiversity, the environment and climate change, human health and well-being, the ongoing energy crisis, economy, tourism, public safety and security, and finally politics. A survey was conducted to explore two main objectives. The first was to evaluate public awareness of light pollution, particularly how individuals perceive its impact across different societal sectors. The second objective was to consult lighting experts to obtain detailed insights into how severely each sector is affected by light pollution. The data collected from both the general public and lighting experts were analyzed and compared to provide a clearer picture of light pollution’s actual consequences. This dual-perspective approach aims to identify potential gaps between public perception and expert knowledge. Understanding these gaps is essential for shaping effective awareness campaigns and informing policy decisions. Ultimately, this research serves as a foundational step toward prioritizing mitigation strategies. By aligning scientific data with social understanding, stakeholders can develop targeted interventions that reduce light pollution’s negative effects while promoting sustainable lighting practices for the future. Full article

This study investigates the operational performance of fruit-picking robots under varying terrain slopes and soil moisture conditions, with a focus on comparing wheeled and tracked locomotion systems. A modular robot platform was designed and tested in both controlled environments and actual mountainous orchards in Shandong, China. The experiments assessed key performance metrics—average speed, slip rate, and path deviation—under combinations of four slope levels (0°, 8°, 18°, 28°) and three soil moisture levels (dry 10%, moderate 20%, wet 35%). Results reveal that wheeled robots perform optimally on dry and flat terrain but experience significant slippage and path deviation under steep and wet conditions. In contrast, tracked robots maintain better stability and terrain adaptability, demonstrating lower slip rates and more consistent trajectories across a wide range of conditions. A synergistic deterioration effect was observed when high slope and high soil moisture co-occur, significantly degrading the performance of wheeled systems, while tracked systems mitigated these effects. Complementary semi-structured interviews with 20 orchard stakeholders—including farmers, growers, and hired pickers—highlighted key user expectations: robust traction, terrain adaptability, reduced physical labor, and operational safety. The findings suggest that future agricultural robots should adopt adaptive hybrid mobility systems and integrate environmental perception capabilities to enhance performance in complex agricultural scenarios. These insights contribute practical and theoretical guidance for the design and deployment of intelligent fruit-picking robots in diverse field environments. Full article