Search Results (572)

Background: Contraceptive counseling is a critical component of reproductive healthcare, directly influencing method uptake, continuation, and user satisfaction. While global health guidelines increasingly emphasize person-centered, rights-based approaches to counseling, wide variations in practice persist, with significant implications for equity and autonomy. Objective: This narrative review aims to synthesize current evidence on the strengths, limitations, and future opportunities of contraceptive counseling within person-centered care frameworks, with particular attention to adolescents and other populations facing structural or sociocultural barriers to equitable care. Methods: A comprehensive literature search was conducted across six indexed databases (PubMed, Scopus, Embase, Web of Science, CINAHL, and PsycINFO) for peer-reviewed articles published between January 2010 and April 2025. Eligible studies included original quantitative, qualitative, and mixed-methods research examining contraceptive counseling practices, user experiences, provider–client communication, counseling interventions, or implementation strategies in reproductive healthcare settings. Results: Emerging strengths in the field include the increasing adoption of shared decision-making, motivational interviewing, and culturally tailored counseling approaches, all of which contribute to improved client satisfaction and method adherence. Digital tools and mHealth platforms have expanded the reach of counseling and show promise in supplementing in-person care. However, significant gaps remain. Provider bias, limited training, communication barriers, and a lack of socio-cultural tailoring frequently undermine the quality of care, especially for adolescents, migrants, women with disabilities, and socially vulnerable populations. Ethical challenges—such as coercion, inadequate informed consent, and structural inequities—persist in many healthcare settings. Moreover, contraceptive counseling is often treated as a one-time event rather than an ongoing, adaptive process. Conclusions: To maximize its impact, contraceptive counseling must be reframed as a longitudinal, relational, and ethically grounded practice. Future efforts should prioritize the development of structured training programs, integration into broader health services, and qualitative research that centers patient experiences. Embedding counseling within reproductive justice frameworks will be essential for advancing equity and autonomy. High-quality contraceptive counseling, when informed by evidence and empathy, is a strategic tool for reproductive empowerment and public health advancement. Full article

This study assessed community process and empowerment in a Primary Healthcare Island Unit in the Azores to support the implementation of Epidemiological Surveillance of Nursing Diagnoses (ESND), focusing on three priority areas: tobacco use, drug dependence, and adolescent decision-making related to sexuality and life planning. Strengthening the visibility of nursing-sensitive phenomena requires integrating nursing diagnoses into epidemiological surveillance systems. A multimethod descriptive study was conducted between September and November 2025, combining document analysis, a community empowerment assessment, and a structured questionnaire. The total population included 328 nurses, with 172 participants (response rate: 52.4%) using a non-probabilistic sampling approach. Data were analyzed using descriptive statistics (frequencies, percentages, means, and standard deviations). Priority nursing foci were identified according to the ICNP^® 2019 classification: tobacco use, drug dependence, and decision-making process related to sexuality and life planning. Results showed that all three dimensions of the MAIEC were weak: community leadership was limited, particularly in knowledge indicators; participation was constrained by unclear organizational structures and insufficient communication; and coping capacity was insufficient due to limited training and experience. Empowerment assessment confirmed structural weaknesses in leadership, organizational support, and resource mobilization. Overall, the community process and empowerment profile indicate that the conditions required to sustain ESND are not yet sufficiently developed. Strengthening leadership, improving communication, and expanding training in ESND and ICNP^® documentation are essential to support nurse-centered surveillance and enhance the visibility of nursing contributions to population health. Full article

The energy transition constitutes not only a technological and regulatory challenge but also a communicative and cultural one, in which corporate narratives play a decisive role in shaping social understanding, legitimacy, and trust. This study examines how major energy companies operating in Spain construct the narrative of the energy transition through their corporate discourse and evaluates the extent to which these narratives integrate pedagogical and relational dimensions oriented toward society. Using a qualitative content analysis approach supported by lexical frequency analysis as a heuristic tool, the study analyzes the CEO or Chair letters published in sustainability reports by four energy companies—Iberdrola, Endesa, Naturgy, and Holaluz—over a five-year period (2020–2024), comprising a total of 20 reports, from which 18 CEO/Chair letters were extracted and treated as a single analytical unit. Two reports (Iberdrola and Naturgy, 2024) adopted the ESRS/CSRD format directly, eliminating the traditional chairperson’s letter. To triangulate and contextualize the documentary analysis, a two-round Delphi study was conducted with 11 independent experts. The findings reveal a predominantly technical and self-referential discourse focused on corporate strategy, performance, and regulatory compliance, with a limited presence of explanatory or citizen-oriented narratives. Despite increasing terminological convergence driven by regulatory standardization, the analysis reveals persistent divergence in narrative framing, with the challenger company articulating purpose-driven and citizen-empowerment frames largely absent from incumbent discourse. The Delphi results reinforce these findings, emphasizing the need to strengthen pedagogical clarity, accessibility, and relational orientation in energy communication. On this basis, the study proposes a relational model of energy communication that highlights narrative mediation, social intelligibility, and stakeholder-oriented discourse as key factors for enhancing legitimacy and trust in the context of the energy transition. The analysis further identifies a structural tension between regulatory standardization and narrative capacity, exemplified by the elimination of the CEO letter in one company’s 2024 report following ESRS adoption. Full article

Against the backdrop of the deep advancement of the carbon peak and carbon neutrality goals and the superposition of the transportation power strategy, leveraging the spatial restructuring of highway networks to optimize the low-carbon layout of county-level industries has become a crucial lever for balancing economic quality improvement with carbon intensity control. This study selects panel data from 129 counties in Yunnan Province spanning 2015–2024, constructing a comprehensive highway network development index from four dimensions: highway density, road network connectivity, weighted hierarchical structure, and county accessibility. Using a two-way fixed effects benchmark model, a stepwise mediation effect testing framework, and a regional heterogeneity identification strategy, the paper systematically examines the marginal effects, transmission pathways, and spatially differentiated characteristics of highway network development on county-level industrial carbon emission intensity. Key findings are as follows: Enhanced highway network development significantly suppresses the increase in county-level industrial carbon emission intensity, and a well-developed road network can provide long-term empowerment for the low-carbon transformation of county-level industries. Mechanism analysis confirms that highway network development reduces emissions through two core pathways: first, a direct emission reduction effect achieved by optimizing the county-wide freight organization system, reducing inefficient transport energy consumption, and improving overall transport efficiency; second, an indirect low-carbon enabling effect realized by breaking down administrative barriers in county markets, lowering cross-regional business transaction costs, deepening industrial division of labor and collaboration, and forcing resource allocation improvements. Heterogeneity analysis reveals that the low-carbon dividends of highway network development exhibit significant gradient differentiation: the emission reduction enabling effect is strongest in counties within the Central Yunnan urban agglomeration, followed by cultural tourism counties in western Yunnan and border counties in southern Yunnan, with the weakest marginal enabling effect observed in traditional agricultural counties in northeastern Yunnan. Full article

Purpose: This study investigates the mediating role of internal marketing (IM) in the relationship between artificial intelligence (AI) applications and quality of work life (QWL). Methodology: A quantitative cross-sectional research design was employed. Data were collected via self-administered questionnaires from a sample of 418 employees across service ministries in Saudi Arabia and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) as the analytical instrument. Findings: The results reveal that the direct association between AI applications and QWL was not statistically significant. However, a significant indirect relationship was established, indicating that the effect operates entirely through IM. Specifically, AI applications are positively associated with IM practices, which in turn strongly predict higher QWL in the tested model. Originality/Contributions: The study advances current literature by empirically validating IM as the critical organizational mechanism required to translate AI deployment into employee well-being within public-sector institutions. Practical Implications: Decision-makers must couple AI adoption with targeted IM strategies—such as continuous training, job empowerment, and effective internal communication—to ensure a sustainable, human-centered digital transformation. Full article

Female empowerment in post-conflict rural contexts is strategic for food security and socioeconomic resilience. This study analyzed the relationship between women’s productive empowerment and food security in 40 rural women involved in pig production in Santa Rosa del Sur, Bolívar, Colombia. A mixed approach with a descriptive–exploratory design and longitudinal scope was used. Data collection employed adapted versions of the Women’s Empowerment in Agriculture Index (A-WEAgI) and the Household Food Insecurity Access Scale (HFIAS), alongside participant observation and reflective thematic analysis. Quantitative data were analyzed via descriptive statistics and Spearman correlation. The baseline revealed low empowerment regarding income, resources, technical capacities, and time. The global A-WEAgI reached 21%, while HFIAS showed moderate food insecurity in 52% of households. Spearman analysis (CS) indicated moderate negative correlations between food insecurity and income (CS = −0.56), access to resources (CS = −0.51), and technical capacities (CS = −0.49), suggesting that greater women´s empowerment was associates with lower food insecurity. Post-intervention, improvements occurred in technical skills, leadership, and organizational participation. Qualitative findings showed increased confidence in Agroindustry activities, though limitations in economic autonomy, commercialization, and domestic workloads persisted. Gender-focused rural strategies enhance productive capacities and food resilience; however, structural barriers related to economic autonomy and gender inequality persist. Full article

This study aims to address the need to operationalize Industry 5.0 (I5.0) by developing a comprehensive Assessment Framework for the adoption of the Human Centricity, Environmental Sustainability, and Industrial Resilience pillars. While existing models largely focus on technological maturity, they fail to provide measurable tools for evaluating I5.0 adoption. To bridge this gap, the paper proposes an Assessment Framework based on a structured set of Key Performance Indicators (KPIs) developed within the EU-funded PROSPECTS 5.0 project. The methodology combines an extensive literature review, a workshop with relevant stakeholders, a Delphi survey with experts, and empirical refinement conducted through workshops involving 14 companies across multiple sectors and of varying sizes. The results highlight that organizations predominantly measure traditional indicators such as health and safety, energy consumption, and supply chain robustness, while underestimating emerging dimensions such as human empowerment, social inclusion, circularity, and advanced human–machine collaboration. The framework introduces a set of KPIs for each of the I5.0 pillars, supporting structured assessment across different industrial contexts while allowing sector-specific adaptation. The findings reveal a gap between the perceived importance of several sustainability and human-centric metrics and their actual implementation. This framework allows organizations to self-assess their practices, guide strategic decisions, and align technological growth with societal and environmental goals. Full article

Psychological empowerment is associated with women’s well-being, yet how it translates into life satisfaction in high-informality Latin American settings remains untested—as does whether empowerment must cross a threshold before any benefit appears. We tested mediation and moderation hypotheses as separate questions with 251 women aged 18–44 from three northern Peruvian regions using PLS-SEM with 5000 bootstrap resamples. Coping engagement fully mediated the empowerment–life satisfaction relationship (indirect β = 0.134, 95% CI [0.065, 0.213]; VAF = 87.6%; R² [engagement] = 0.070, R² [life satisfaction] = 0.285); the direct path was non-significant (β = 0.019, p = 0.754). Mediation and moderation were examined as separate analytical questions; the formal index of moderated mediation was non-significant, indicating that the indirect effect did not differ significantly across subgroups. In exploratory threshold analyses, empowerment predicted life satisfaction only above a normative cut-point anchored to the IMWE scoring manual (≥136; β = 0.382, p < 0.001); below it, the association was flat (β = 0.047, p = 0.547). This pattern is instrument-anchored rather than empirically derived and should be treated as hypothesis-generating pending replication with an independently optimized cut-point. Age moderated the engagement–satisfaction link (β = −0.239, p = 0.031), with stronger effects among younger women; motherhood amplified the negative impact of disengagement on satisfaction (β = −0.272, p = 0.021). Tentatively, programs that move participants only modestly along the empowerment continuum may under-deliver on well-being outcomes, though firm prescriptions require independent confirmation; tailored design for mothers and younger women is warranted. Full article

Digital twin technology is becoming a core enabler for the intelligent transformation of civil engineering. This review adopts an integrated mixed-method design that combines a reproducible bibliometric protocol with structured content analysis to connect macro-level knowledge evolution with domain-specific engineering implementation. Based on the Web of Science Core Collection, the study analyzes publication trends, collaboration patterns, highly cited studies, keyword co-occurrence, network centrality, and citation bursts, and then reviews application status and technical pathways across five thematic areas: intelligent construction, bridge engineering, tunnel engineering, smart water conservancy, and other infrastructure. Key findings include: rapid growth in publication volume after 2021, three dominant keyword clusters (model/system construction, structural health monitoring and sensing, and AI-enabled optimization/decision-making), and an evolution of research frontiers from concept introduction to engineering scenario deepening and further to three-dimensional reconstruction, knowledge fusion, and intelligent decision-making. The content analysis shows differentiated technical pathways across sub-domains and identifies data heterogeneity/interoperability as the most urgent bottleneck because it constrains model updating, cross-platform integration, and engineering-scale deployment. Future directions should focus on data standardization, hybrid modeling, platform interoperability, artificial intelligence empowerment, and full-lifecycle cross-system coordination. This review provides a quantitatively supported panoramic reference for digital twin research in civil engineering. Full article

Background: Women remain the primary caregivers globally, especially in rural, low-resource settings plagued by poverty, unemployment, low education and poor infrastructure. These factors limit caregiving capacity, heighten vulnerability and increase the risk of food insecurity in female-headed households. Objective: To establish a baseline profile of caregivers of primary school children. Methods: Phase 1 (baseline) of the study was conducted using a quantitative, exploratory cross-sectional survey design among 75 female caregivers of children aged 7–13 years in Qwa-Qwa, Free State Province. Participants were recruited using convenience sampling. Data were collected with a structured, pre-validated questionnaire on socio-demographics, alongside anthropometric measurements. Data were analysed using descriptive statistics. Results: Most participants were unemployed (73.3%) and had low educational attainment, with 86.7% having completed primary school or less. A substantial proportion of households (80.0%) reported a monthly income below R1000. Food insecurity was common, with 69.3% of caregivers reporting experiences of food shortages. Household infrastructure was limited, particularly in refuse removal services (96.0% without access). Despite these socio-economic constraints, a high prevalence of overweight and obesity (72.5%) was observed amongst the participants. Conclusions: Caregivers experience severe, overlapping socio-economic and environmental vulnerabilities alongside a high prevalence of overweight and obesity. The study highlights the need for multi-sectoral interventions focused on poverty reduction, rural infrastructure development, improved service delivery, women’s empowerment and strengthened livelihood opportunities to improve household nutrition and resilience. Full article

This research analysed how circular economy practices in the cacao value chain foster socio-economic empowerment and create sustainable employment for Awajún women in Imaza, Amazonas. The overall objective was to determine the association of circular practices with the empowerment and economic benefits of women producers. A quantitative approach was used, employing a non-experimental cross-sectional design and a sample of 55 women, who were administered a structured questionnaire; the data were processed using Spearman’s correlations and multiple linear regression models with robust standard errors. The main results showed a positive and significant correlation between circular economy practices and income and employment generation (rho = 0.702; p < 0.001). Furthermore, the econometric models confirmed that these practices are positively associated with socio-economic empowerment and economic benefits. It is concluded that the circular economy constitutes a viable strategy for improving the living conditions of Awajún women, although its scale up requires overcoming financial, technical and time-related barriers. Full article

As China experiences rapid population aging, promoting high-quality tourism for older adults has become essential for enhancing elderly well-being, improving inclusive and age-friendly tourism services, supporting culture–tourism integration, and fostering sustainable destination development. Drawing on the global literature on smart tourism, digital inclusion for older adults, and service quality in aging societies, this study investigates how digital empowerment (DE) influences the high-quality development of silver tourism (HDST) in Hubei Province, China. Partial least squares structural equation modeling (PLS-SEM) was applied to survey data from 702 elderly respondents, incorporating cultural tourism integration (CTI), age-friendly service adaptation (ASA), and perception of silver tourists (PST), with family support (FS) and policy support (PS) as key moderating variables. The results indicate that DE significantly promotes HDST through ASA and PST, while FS and PS play important moderating roles. These findings provide practical guidance for tourism practitioners and policymakers seeking to enhance age-friendly digital services, improve the tourism experience for older adults, and support the sustainable development of silver tourism. Full article

Transformational leadership (TL) remains a dominant framework in educational leadership, yet its effectiveness appears inconsistent across institutional contexts, including higher education (HE). This study develops a contingent explanation of TL using the Motivation–Ability–Opportunity (MAO) lens. Drawing on an integrative review of 19 empirical studies, the analysis examines how TL practices interact with organisational conditions to produce transformational or symbolic outcomes. The findings indicate that TL operates through three interdependent mechanisms: motivational alignment, capability development, and structural empowerment. However, these mechanisms are fragile and contingent upon contextual factors including governance autonomy, resource infrastructure, organisational culture, leadership-system maturity, and strategic orientation. When these conditions are aligned, TL fosters sustained engagement, innovation, and institutional learning. When they are misaligned, TL can devolve into rhetorical or symbolic practice, generating cynicism and inertia. The study contributes to the theory and practice of leadership in HE by reconceptualising TL as a conditional system rather than a universally effective leadership style, highlighting the importance of organisational context in enabling or constraining leadership impact. Full article

Against the backdrop of economic growth and the transition toward a green, low-carbon economy, the coordinated advancement of digital intelligence and green development has become a crucial pathway to promoting high-quality industrial development. Using panel data from 30 Chinese provinces from 2013 to 2023, this study employs two-way fixed-effects models, mediation models, and threshold regression models to conduct an empirical analysis. The results indicate that, during the sample period, both the level of digital intelligence and industrial green transformation efficiency increased steadily across Chinese provinces, exhibiting significant temporal and spatial heterogeneity. A significant positive relationship is identified between the two variables, with industrial structure and green technological innovation serving as mediating mechanisms. The effect of digital intelligence on industrial green transformation efficiency exhibits a nonlinear pattern, with the provincial average enterprise size functioning as the threshold variable. Furthermore, this effect exhibits significant regional heterogeneity. These findings provide novel empirical evidence on the relationship between digital intelligence and industrial green transformation. Full article

This study examines the systemic structures that limit inclusivity, diversity, equality, and accessibility (IDEA) in South Africa’s construction industry. It develops an empirically grounded framework, linking digital platform/tool (software tools and systems that facilitate construction processes) adoption to the institutional changes needed to advance gender equity. Building on a literature review, an online survey of 112 Construction Industry Development Board (Cidb)-registered practitioners was analyzed in SPSS v26 using descriptive and inferential statistics and principal component analysis (PCA). Results show that gender differences in mastery of core digital tools were not statistically significant (p > 0.05 across tool categories). The regression model predicting perceived career growth showed weak explanatory power and was not statistically significant (R² = 0.068; F(10,100) = 0.734; p = 0.691). Accordingly, the non-significant model is interpreted as indicating that the predictors included are insufficient to explain perceived career growth in this sample, and that other organizational and structural factors may be more influential. PCA produced a three-component digital inclusivity ecosystem composed of operational fairness, technical empowerment, and integrative leadership, demonstrating 62.84% variance explained and a three-pillar systemic architecture for equity composed of legislative frameworks, socioeconomic support, and organizational practice. Leadership representation remained skewed (73.83% male overall; 78.64% at the director level). The study concludes that progress toward IDEA is more likely to result from combining digital adoption with multi-level institutional reforms. Practical implications include integrated policy interventions and organizational practices that address structural barriers while leveraging digital platforms for inclusion. Full article