Search Results (1,616)

The green renovation of existing residential buildings is a key way for the construction industry to achieve sustainable development and the dual carbon goals of China, which makes it urgent to make collaborative decisions among multiple stakeholders. However, because of divergent interests and risk perceptions among governments, energy service companies (ESCOs), and owners, the implementation of green renovation is hindered by numerous obstacles. In this study, we integrated prospect theory and evolutionary game theory by incorporating core prospect-theory parameters such as loss aversion and perceived value sensitivity, and developed a psychologically informed tripartite evolutionary game model. The objective was to provide a theoretical foundation and analytical framework for collaborative governance among stakeholders. Numerical simulations were conducted to validate the model’s effectiveness and explore how government regulation intensity, subsidy policies, market competition, and individual psychological factors influence the system’s evolutionary dynamics. The findings indicate that (1) government regulation and subsidy policies play central guiding roles in the early stages of green renovation, but the effectiveness has clear limitations; (2) ESCOs are most sensitive to policy incentives and market competition, and moderately increasing their risk costs can effectively deter opportunistic behavior associated with low-quality renovation; (3) owners’ willingness to participate is primarily influenced by expected returns and perceived renovation risks, while economic incentives alone have limited impact; and (4) the evolutionary outcomes are highly sensitive to parameters from prospect theory, The system’s evolutionary outcomes are highly sensitive to prospect theory parameters. High levels of loss aversion (λ) and loss sensitivity (β) tend to drive the system into a suboptimal equilibrium characterized by insufficient demand, while high gain sensitivity (α) serves as a key driving force for the system’s evolution toward the ideal equilibrium. This study offers theoretical support for optimizing green renovation policies for existing residential buildings in China and provides practical recommendations for improving market competition mechanisms, thereby promoting the healthy development of the green renovation market. Full article

Background: The progression of Alzheimer’s Disease (AD) deeply affects not only the diagnosed person but also their close relatives, who are often called to take on the role of informal caregivers. This transition is frequently unplanned and emotionally complex, yet poorly understood in its deeper processual dimensions. This study aims to explore and theorize the transition experienced by a family member becoming the primary informal caregiver for a person with advanced AD. Methods: A qualitative study based on the Constructivist Grounded Theory according to Charmaz’s approach (2006) was conducted. In-depth interviews were carried out with 10 participants who had become informal caregivers for a loved one with advanced AD. Data were analyzed using initial coding, focused coding, the constant comparative method, and theoretical coding. Results: Ten caregivers (mean age 39 years, range 35–54; nine females) of patients with advanced AD participated in the study. The analysis revealed a complex, emotionally intense caregiving experience marked by sacrifice, feelings of powerlessness, identity loss, and the necessity of sharing caregiving responsibilities. A core category emerged: A Silent and Certain Willingness to Care, representing the caregivers’ deep, often unconscious commitment to prioritize the care of their loved ones above their own needs. Four interconnected phases characterized the caregiving process: (1) The Changing Daily Life—involving significant sacrifices in personal and social life; (2) Feeling Powerless—confronting the inevitable decline without means to alter the course; (3) Losing Oneself—experiencing physical and psychological exhaustion and a sense of identity loss; and (4) Sharing with Others—seeking external support to sustain caregiving. These findings highlight the evolving nature of becoming a caregiver and the enduring dedication that sustains this role despite the challenges. Conclusions: The progression of AD deeply transforms the lives of caregivers, who become co-sufferers and active participants in the disease’s management. The results underscore the urgency of designing integrative care strategies—including psychological, social, and potentially technological support—that can enhance both patient outcomes and caregiver resilience. Grounded in real-world experiences, this study contributes to the broader neurodegeneration discourse by emphasizing caregiving as a critical factor in long-term disease management and therapeutic success. Full article

As artificial intelligence (AI) technology becomes increasingly widespread in organizations, its impact on individual employees’ psychology and behavior has garnered growing attention. Existing research primarily focuses on AI’s effects on organizational performance and job design, with limited exploration of its mechanisms influencing individual employees, particularly in the critical area of risk-taking behavior, which is essential to organizational innovation. This research develops a moderated mediation model grounded in social cognitive theory (SCT) to explore how AI usage affects the willingness to take risks. A three-wave longitudinal study collected and statistically analyzed data from 442 participants. The findings reveal that (1) AI usage significantly enhances employees’ willingness to take risks; (2) self-efficacy serves as a partial mediator in the connection between AI usage and the willingness to take risks; and (3) learning goal orientation moderates both the relationship between AI usage and self-efficacy, as well as the mediating effect. This research enhances our understanding of AI’s impact on organizational behavior and provides valuable insights for human resource management in the AI era. Full article

The European Union Council’s zero vision aims to eliminate workplace fatalities, while Industry 4.0 presents new challenges for occupational safety. Despite HR professionals assessing managers’ and employees’ competencies, no system currently exists to evaluate the competencies of workers’ representatives in occupational safety and health (OSH). It is crucial to establish the necessary competencies for these representatives to avoid their selection based on personal bias, ambition, or coercion. The main objective of the study is to identify the competencies and their components required for workers’ representatives in the field of occupational safety and health by following the steps of the DACUM method with the assistance of OSH professionals. First, tasks were identified through semi-structured interviews conducted with eight occupational safety experts. In the second step, a focus group consisting of 34 OSH professionals (2 invited guests and 32 volunteers) determined the competencies and their components necessary to perform those tasks. Finally, the results were validated through an online questionnaire sent to the 32 volunteer participants of the focus group, from which 11 responses (34%) were received. The research categorized the competencies into the following three groups: core competencies (occupational safety and professional knowledge) and distinguishing competencies (personal attributes). Within occupational safety knowledge, 10 components were defined; for professional expertise, 7 components; and for personal attributes, 16 components. Based on the results, it was confirmed that all participants of the tripartite system have an important role in the training and development of workers’ representatives in the field of occupational safety and health. The results indicate that although OSH representation is not yet a priority in Hungary, there is a willingness to collaborate with competent, well-prepared representatives. The study emphasizes the importance of clearly defining and assessing the required competencies. Full article

E-waste, a form of solid waste, contains many recyclable metals, but improper disposal can make it very harmful. Therefore, the recycling of e-waste is very important, and the willingness of residents to participate is crucial in e-waste recycling. Taking Jiangsu Province, China as an example, we used the theory of reasoned action (TRA) to construct a research model to investigate the factors influencing residents’ willingness to participate in e-waste recycling. The paper introduces impression management motivation and further reveals the application of the Hawthorne effect in e-waste recycling. The paper also introduces the awareness of benefits, which encompasses personal economic benefits, physical health benefits, and environmental benefits, with physical health benefits being ignored by most of the previous literature. In addition, knowledge and convenience are also introduced in this paper. A total of 400 valid responses were used to test the hypotheses of the structural equation model. It was found that all factors positively influenced residents’ willingness to engage in e-waste recycling. Attitude has a mediating role in the effects of convenience, knowledge, and awareness of benefits on willingness, and subjective norms have a mediating role in the effects of impression management motivation on willingness. The model explains 82.9% of the variance in residents’ willingness to recycle e-waste, surpassing the original TRA model’s explanatory power and confirming the strength of the extended framework. The study provides valuable policy implications for the government to promote e-waste recycling. Full article

The sustainable management of Municipal Solid Waste (MSW) relies heavily on community participation in separating it at the source and delivering it to collection systems. These practices are crucial for reducing pollution, protecting ecosystems, and maximizing resource recovery. However, in the Global South context, with conditions of socioeconomic vulnerability, community participation in the sustainable management of MSW remains limited, highlighting the need to generate context-specific interventions. MSW includes items such as household appliances, batteries, and electronic devices, which require specialized handling due to their size, hazardous components, or material complexity. This study implemented a Community-Based Social Marketing approach during the research and design phases of an intervention focused on promoting source separation and management of hard-to-manage MSW in five municipalities within the administrative region of Norte de Santander (Colombia), which borders Venezuela. Using a mixed-methods approach, we collected data from 1775 individuals (63.83% women; M _age = 33.48 years; SD = 17.25), employing social mapping, focus groups, semi-structured interviews, participant observation, and a survey questionnaire. The results show that the source separation and delivery of hard-to-manage MSW to collection systems are limited by a set of psychosocial, structural, and institutional barriers that interact with each other, affecting communities’ willingness and capacity for action. Furthermore, a prediction model of willingness to engage in separation and delivery behaviors showed a good fit (R2 = 0.83). The strongest predictors were awareness of the negative consequences of non-participation and perceived environmental benefits, with subjective norms contributing to a lesser extent. Based on these results, we designed a context-specific intervention focused on reducing these barriers and promoting community engagement in the sustainable management of hard-to-manage MSW. Full article

Background: Mental health issues among medical students have gained increasing attention globally, with studies indicating a high prevalence of psychological disorders within this population. The use of antidepressants and anti-anxiety medications has become a common response to these mental health challenges. However, it is crucial to understand the extent of their usage and associated effects on students’ mental health and academic performance. This cross-sectional study explored the use of antidepressants and anti-anxiety drugs and their impact on the mental health of medical students in Saudi Arabia. Methods: A cross-sectional survey of 561 medical students from 34 universities was conducted between March and July 2024. An anonymous online questionnaire was used to collect sociodemographic, mental health, and medication usage-related information. Results: Most of the participants were female (71.5%) and aged 21–25 years (62.7%). Approximately 23.8% of them used antidepressants, 5.6% reported using anti-anxiety medications, and 14.0% used both types of medication. Among the medication users, 71.7% were using selective serotonin reuptake inhibitors (SSRIs), and 28.3% were using other medications. Adverse drug reactions were reported by 58.8% of the participants, and 39.6% changed drugs with inadequate efficacy. Notably, 49.0% of the respondents who have ever used medications discontinued their medication without consulting a healthcare professional. Despite these challenges, 62.0% of the participants felt that their medications had a positive impact on their academic performance, 73.4% believed that the benefits outweighed the drawbacks, and 76.2% expressed a willingness to continue taking their medication. In particular, 77.6% agreed that treatment with these drugs could prevent mental breakdowns. Sleep duration, physical activity, and family history of psychiatric disorders were significantly associated with medication use, with p values of 0.002, 0.014, and 0.042, respectively. Conclusions: These results shed light on the need to understand the prescribing practices of antidepressant and anti-anxiety drugs among medical students while promoting the appropriate use of these medications among the students. There is a need to incorporate mental health interventions into counseling services and awareness programs to support students. Future longitudinal studies are needed to explore long-term trends. Full article

Background: Despite their high prevalence and potential for significant morbidity, hemorrhoidal symptoms remain underreported and undertreated. Misconceptions and stigma may delay care-seeking behaviors and negatively influence patient outcomes. Methods: We conducted a cross-sectional, questionnaire-based study in Romania to assess public awareness, attitudes, and barriers related to hemorrhoidal disease. The survey included 185 participants and evaluated variables such as symptom severity, understanding of the condition, perceived stigma, and willingness to consult a physician. Results: Only 30.8% of participants had sought medical advice for hemorrhoidal symptoms. Younger age (p < 0.001), male sex (p = 0.013), and lower levels of perceived severity were significantly associated with reluctance to seek medical care. The most frequently reported barriers were embarrassment and fear of invasive diagnostic procedures. Colonoscopy and digital rectal examination were identified as major deterrents by 39.5% and 38.9% of respondents, respectively. Educational level influenced both the perceived understanding of the disease (p = 0.001) and comfort in discussing anal symptoms (p = 0.002). Gender preference for physicians was significantly associated with respondent sex (p = 0.007) but not with education or age. Conclusions: Hemorrhoidal disease remains a stigmatized and underestimated condition. Public health efforts should prioritize educational interventions, destigmatization campaigns, and improved physician–patient communication to facilitate earlier diagnosis and better disease management. Full article

Studying consumers’ willingness to pay (WTP) for sustainable certification labels and preferences in consumption is a relevant issue for policymakers. Several studies have revealed a positive WTP a premium price for many certified products. The aim of this paper is to assess an overview of Italian consumers’ WTP for eight different sustainable certification labels and to collect information about their consumption preferences and perceptions in consumption. Participants were selected by stratified simple random sampling, using regional distribution, gender, and age as stratification criteria, to obtain a representative sample of n = 3600. Eight ordered logit models were estimated to understand how consumer sociodemographic characteristics influence the price premium. The results show important differences in WTP among different certification labels; a higher WTP emerged for ethical certifications than for environmentally focused labels. Younger individuals; women; and those with higher education, income and life satisfaction, as well as consumers in southern regions, were significantly more willing to pay premiums for certified products. However, a key finding for policymakers is that the stated price premium consumers are willing to pay falls significantly short of the actual higher costs of these products in supermarkets. Furthermore, insights into consumer perceptions and preferences revealed that quality and origin are perceived as key price drivers, while method of production holds less importance. It also emerged that consumers primarily seek a balance between quality and price, with only a small segment prioritizing certified products. Full article

Background/Objectives: Patients undergoing open aortic and valvular surgery often experience postoperative deconditioning, yet research on the role of inpatient cardiac rehabilitation (CR) in this population remains limited. This study aimed to examine the effects of inpatient CR on muscle strength, mobility, psychological well-being, and quality of life in patients recovering from open aortic surgery. Methods: We conducted a retrospective study using the medical records of patients who participated in inpatient CR after open aortic surgery. Functional and psychological outcomes were evaluated using the Medical Research Council (MRC) sum score, Timed Up and Go (TUG) test, Five Times Sit-to-Stand test (5STS), Six-Minute Walk Distance (6MWD), Berg Balance Scale (BBS), Modified Barthel Index (MBI), Patient Health Questionnaire-9 (PHQ-9), and the EuroQol-5D (EQ-5D). Pre- and post-rehabilitation scores were compared to assess changes in functional status, mobility, and quality of life. A post-discharge satisfaction survey was also analyzed. Results: A total of 33 patients were included. Significant improvements were observed in MBI (p < 0.001), MRC sum score (p < 0.001), 6MWD (p < 0.001), BBS (p < 0.001), TUG (p = 0.003), 5STS (p < 0.001), EQ-5D (p = 0.011), and PHQ-9 (p = 0.009) following inpatient CR. Patients with lower baseline mobility (6MWD ≤ 120 m) exhibited greater improvement in MBI (p = 0.034). Of the 33 patients, 26 completed the satisfaction survey; most reported high satisfaction, perceived health improvements, and willingness to recommend the program. Conclusions: Inpatient CR following open aortic and valvular surgery resulted in significant gains in muscle strength, mobility, psychological health, and overall quality of life. Patients with greater initial impairment demonstrated especially notable functional improvement, supporting the value of tailored CR in this population. Full article

Background: As population aging accelerates, the demand for professionals in older adult care continues to rise. Traditional teaching methods often fail to improve students’ willingness to serve older adults or foster teamwork. This study evaluated the effects of integrating a flipped classroom with project-based learning (PBL) and a hands-on clinical practicum into a health internship course. Methods: A mixed-methods design was adopted. Participants included 88 interdisciplinary university students enrolled in an 18-week, two-credit geriatric health internship course offered at a university in central Taiwan from August 2023 to July 2024. The course combined flipped classroom and PBL approaches, as well as clinical practicum activities. Data on willingness to serve older adults, teamwork skills, and learning outcomes were collected using structured questionnaires and analyzed with paired t-tests. Results: Significant improvements were found in willingness (from 68.93 to 73.15), teamwork (67.33 to 71.45), and learning outcomes (89.84 to 102.14) (p = 0.001). Qualitative findings further revealed increased empathy, improved teamwork, and enhanced ability to apply knowledge in real-world contexts. Conclusions: A teaching approach that integrates a flipped classroom, PBL, and a clinical practicum can effectively enhance students’ competencies in older adult care. Future research should explore long-term and cross-cultural impacts. Full article

Edible insects are emerging as a sustainable and eco-friendly alternative protein source, addressing global challenges in food security and environmental sustainability. This study investigates the willingness and acceptance of edible insects as sustainable alternative protein sources among Saudi participants, focusing on sociodemographic and attitudinal factors. A cross-sectional survey involving 2208 participants revealed that males and younger individuals (18–34 years) exhibited greater willingness to consume EIs, driven by environmental concerns, health benefits, and positive beliefs. Women and older participants showed higher levels of food neophobia, disgust, and uncertainty. Sociocultural barriers such as fear, a lack of familiarity, and perceptions of edible insects as unclean or forbidden were significant obstacles to acceptance and willingness. Interestingly, the education level did not significantly influence willingness, suggesting that cultural and religious norms may overshadow its impact. These findings underscore the need for targeted campaigns emphasizing the health, environmental, and sustainability benefits of edible insects, alongside culturally sensitive approaches to overcome psychological and social barriers. This research provides valuable insights to guide strategies for integrating EIs into Saudi diets as a step toward enhanced food security and environmental sustainability. Full article

Background: Tobacco use is disproportionately high in rural areas, contributing to elevated cancer mortality, yet it often goes untreated due to limited access to care, high poverty and uninsured rates, and co-occurring substance use disorders (SUDs). This study explored the utility of using rapid qualitative analysis (RQA) to guide the adaptation of a tobacco-free workplace program (TFWP) in Texas healthcare centers serving adults with SUDs in medically underserved areas. Methods: From September–December 2023 and May–July 2024, we conducted 11 pre-implementation, virtual semi-structured group interviews focused on adapting the TFWP to local contexts (N = 69); 7 with providers (n = 34) and managers (n = 12) and 4 with patients (n = 23) in 6 healthcare centers. Two qualified analysts independently summarized transcripts, using RQA templates of key domains drawn from interview guides to summarize and organize data in matrices, enabling systematic comparison. Results: The main themes identified were minimal organizational tobacco cessation support and practices, and attitudinal barriers, as follows: (1) the need for program materials tailored to local populations; (2) limited tobacco cessation practices and partial policies—staff requested guidance on enhancing tobacco screenings and cessation delivery, and integrating new interventions; (3) contradictory views on treating tobacco use that can inhibit implementation (e.g., wanting to quit yet anxious that quitting would cause SUD relapse); and (4) inadequate environmental supports—staff requested treating tobacco-use training, patients group cessation counseling; both requested nicotine replacement therapy. Conclusions: RQA identified key areas requiring capacity development through participants’ willingness to adopt the following adaptations: program content (e.g., trainings and tailored educational materials), delivery methods/systems (e.g., adopting additional tobacco care interventions) and implementation strategies (e.g., integrating tobacco cessation practices into routine care) critical to optimizing TFWP fit and implementation. The study findings can inform timely formative evaluation processes to design and tailor similar intervention efforts by addressing site-specific needs and implementation barriers to enhance program uptake. Full article

This study examines how beliefs about the causes of climate change relate to emotions, perceptions of its effects, and willingness to engage in collective action among residents of the Valparaíso Region in Chile, a territory particularly vulnerable to this phenomenon. A survey was conducted with 809 individuals using stratified probabilistic sampling. Analysis of variance revealed significant differences among those who attribute climate change to human, mixed, or natural causes. The results show that individuals who believe in the anthropogenic origin of climate change report higher levels of negative emotions, anxiety, perceived impacts, and willingness to participate in both direct and institutional collective actions. Moreover, these individuals perceive greater negative effects of climate change on their surroundings and daily lives. In contrast, those who attribute the phenomenon to natural causes show a lower predisposition to act and a lower risk perception. The study concludes that causal attribution of climate change significantly influences people’s emotional and behavioral responses, highlighting the importance of strengthening climate education and communication based on scientific evidence as key tools for fostering civic engagement in the face of the environmental crisis. The findings contribute to sustainability by strengthening environmental education, participatory governance, and collective action in vulnerable contexts. Full article

The willingness to pay (WTP) for green energy consumption not only indicates the public’s green energy consumption practices, but also affects the realization of China’s “dual carbon” goals and global green development. Based on data from the 2018 Chinese General Social Survey (CGSS), this study describes the WTP for green energy consumption of Chinese urban and rural residents in the context of “dual carbon”. Moreover, it provides an in-depth interpretation from the perspectives of capital endowment and energy cognition, guided by social practice theory (SPT). This study found that, firstly, the public’s WTP for green energy consumption needs to be strengthened urgently, and the percentage of the refusal to participate group reaches 41.44%, and shows significant urban–rural differences. Compared with rural residents, the proportion and amount of WTP for urban residents are 7.5% and 4.016 CNY/month higher, respectively. Secondly, capital endowment and energy cognition are important influencing factors. Among them, economic capital (β = 0.647, p < 0.01) and cultural capital (β = 0.358, p < 0.05) play a significant role for urban residents, while rural residents depend on the government support cognition of energy (β = 7.678, p < 0.001). Finally, the urban–rural divergence in WTP for green energy consumption mainly stems from the gap in capital endowment, which contributes 29.08%, significantly higher than the contribution of energy cognition (8.34%). Therefore, efforts should be made to enhance the capital endowment levels of urban and rural residents, implement a targeted energy knowledge dissemination system, build a comprehensive government support system, and break down institutional barriers through urban–rural integration to guard against the disadvantages of rural residents. Full article