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Search Results (447)

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15 pages, 516 KiB  
Article
Knowledge, Attitudes, and Practices Among Thoracic Healthcare Professionals Toward Postoperative Pulmonary Embolism
by Yuefeng Ma, Xin Xing, Shaomin Li, Jianzhong Li, Zhenchuan Ma, Liangzhang Sun, Danjie Zhang and Ranran Kong
Healthcare 2025, 13(15), 1771; https://doi.org/10.3390/healthcare13151771 - 22 Jul 2025
Viewed by 246
Abstract
Background: Postoperative pulmonary embolism (PPE) is a critical complication that can significantly affect patient outcomes. This study aimed to assess knowledge, attitudes, and practices (KAP) of thoracic healthcare professionals toward PPE. Methods: A cross-sectional study was conducted from September to December 2022. Results: [...] Read more.
Background: Postoperative pulmonary embolism (PPE) is a critical complication that can significantly affect patient outcomes. This study aimed to assess knowledge, attitudes, and practices (KAP) of thoracic healthcare professionals toward PPE. Methods: A cross-sectional study was conducted from September to December 2022. Results: A total of 222 thoracic healthcare professionals participated in the study; the majority were aged 30–40 years (40.54%) and had over 10 years of work experience (47.75%). Participants completed a self-designed questionnaire assessing demographic data and KAP scores: knowledge (0–11), attitudes (11–55), and practices (9–45). The main measures included the mean scores for knowledge, attitudes, and practices, along with correlation analyses and path analysis to assess relationships among the KAP components. Mean scores were 9.03 ± 1.13 for knowledge, 50.09 ± 4.23 for attitudes, and 35.78 ± 7.85 for practices. Participants showed strong awareness of PPE definitions and risk factors, but only 24.77% correctly identified its classic clinical triad. Attitudinally, while most expressed a willingness to engage in PPE training and risk assessment, 55.41% remained cautious about anticoagulation due to bleeding risks. In practice, although 72.52% consistently supported postoperative mobilization, only 30.63% frequently acquired updated PPE knowledge. Significant positive correlations were found between knowledge and attitudes (r = 0.218, p < 0.001) and between attitudes and practices (r = 0.234, p < 0.001). Path analysis showed that knowledge positively influenced attitudes (path coefficient 0.748, p = 0.002), and attitudes positively influenced practices (path coefficient 0.374, p = 0.003). Conclusions: Thoracic healthcare professionals exhibited adequate knowledge, positive attitudes, and proactive practices regarding PPE, indicating a strong foundation for enhancing postoperative care. Full article
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15 pages, 615 KiB  
Article
Reader Responses to Online Reporting of Tagged Bird Behavior
by Louise Hayward
Animals 2025, 15(14), 2053; https://doi.org/10.3390/ani15142053 - 11 Jul 2025
Viewed by 161
Abstract
This paper explores responses to online coverage of an avian tracking project. Researchers attached novel trackers to a small group of wild magpies (Gymnorhina tibicen). These were subsequently removed by conspecifics, an example of ‘rescue behavior’ that was recounted in several [...] Read more.
This paper explores responses to online coverage of an avian tracking project. Researchers attached novel trackers to a small group of wild magpies (Gymnorhina tibicen). These were subsequently removed by conspecifics, an example of ‘rescue behavior’ that was recounted in several media outlets. Online comments on three articles, from across the political spectrum (the Conversation, UK Guardian, and UK Daily Mail), were selected for thematic analysis. The resulting 680 comments were analyzed qualitatively and quantitatively to uncover predominant themes and the overall balance of positive and negative sentiments expressed about this tagging project or wildlife tagging generally. Topics occurring most frequently were themed into three interrelated areas: (1) sharing personal feelings and experiences, (2) comparing the merits of different species, and (3) sharing knowledge and opinion. Twenty-one percent (21%) of respondents expressed an opinion on the ethics of wildlife tagging. In the Daily Mail and Guardian, this opinion was more likely to be negative towards the use of tags. Opinion was more balanced for readers of the Conversation’s article. Willingness to comment on online news is low, and readers of this story were not asked directly for their opinion. Nevertheless, the data here illustrate some public perceptions of wildlife tagging, and there was a clear negative reaction from many responders. Widening the means through which people can engage with animal science has the potential to advance discussions around research ethics and animal welfare. Reactions to this story expose important questions for scientists seeking to engage with, and convince, the public of the merits of their work. Full article
(This article belongs to the Section Public Policy, Politics and Law)
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15 pages, 262 KiB  
Article
Volunteering in Environmental Organizations and Subjective Well-Being: Evidence from a Nationally Representative, Longitudinal Dataset in the US
by Onur Sapci, Aliaksandr Amialchuk and Jon D. Elhai
World 2025, 6(3), 94; https://doi.org/10.3390/world6030094 - 4 Jul 2025
Viewed by 534
Abstract
This study uses a nationally representative longitudinal dataset in the US to examine the long-term association of volunteering for environmental, recycling, and conservation groups with a person’s (a) willingness to continue to volunteer later in life and (b) several measures of their mental [...] Read more.
This study uses a nationally representative longitudinal dataset in the US to examine the long-term association of volunteering for environmental, recycling, and conservation groups with a person’s (a) willingness to continue to volunteer later in life and (b) several measures of their mental and physical well-being including perceived social status, optimism, psychological stress, suicidal thoughts and attempts, depressive symptoms and general self-reported physical health. By using Add Health data, we match responses to an environmental volunteerism question in Wave III (2002) with subjective well-being responses in Wave V (2016–2018) to examine the long-term association between these variables. After excluding missing responses, the analysis sample consists of 9800 individuals. After using linear survey regression analyses and several techniques based on propensity scores (stratification, weighting, matching) two key results emerged: first, being involved in environmental groups and organizations early in life showed a significant positive association with more hours spent on volunteering or community service work later in life; and second, people who volunteer in early adulthood are more optimistic, more sociable, have a higher perceived social status, display less stress and depressive symptoms. Full article
16 pages, 596 KiB  
Article
The Impact of Diversity Inclusion Practices in the Workplace Context: The Effect of Inclusive Leadership
by Silvia Platania, Claudio Maggio and Marcello Boccadamo
Eur. J. Investig. Health Psychol. Educ. 2025, 15(7), 121; https://doi.org/10.3390/ejihpe15070121 - 2 Jul 2025
Viewed by 452
Abstract
The present study explores the predictive role of organisational identification in shaping both positive and negative employee responses and the potential mediating influence of diversity climate and inclusive leadership within this relationship. Specifically, it examines how employees’ organisational identification influences their perceptions of [...] Read more.
The present study explores the predictive role of organisational identification in shaping both positive and negative employee responses and the potential mediating influence of diversity climate and inclusive leadership within this relationship. Specifically, it examines how employees’ organisational identification influences their perceptions of diversity climate and inclusive leadership and how these factors, in turn, mediate their responses to organisational dissatisfaction. This study involved 307 participants from the Italian public administration who were administered a questionnaire to measure organisational identification, inclusive leadership (Inclusive Leadership Scale), the diversity climate within the organisation, and behaviours according to the EVLN model. The results indicate a direct effect of organisational identification on both the positive (Voice and Loyalty) and negative (Exit and Neglect) responses of the EVLN model. Organisational identification has a positive effect on the diversity climate. Moreover, the diversity climate mediates the relationship between organisational identification and loyalty, while inclusive leadership mediates the relationship between organisational identification and both disengagement and the willingness to address issues. These findings underscore the central role of organisational identification in shaping employees’ behavioural responses to dissatisfaction by influencing their perceptions of diversity climate and inclusive leadership. This highlights the importance of strengthening organisational identification to foster constructive behaviours and mitigate negative responses in diverse and inclusive work contexts. Full article
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16 pages, 240 KiB  
Article
The Relationship Between Willingness to Forgive and Health-Related Quality of Life in Older Adults in Portugal and Spain
by Cristiane Pavanello Rodrigues Silva, Fausto J. Barbero-Iglesias, Luis Polo-Ferrero and José I. Recio-Rodríguez
Geriatrics 2025, 10(4), 90; https://doi.org/10.3390/geriatrics10040090 - 2 Jul 2025
Viewed by 795
Abstract
Objectives: To describe, understand, and correlate willingness to forgive with self-perceived health-related quality of life, including the components of quality of physical health and mental health. Methods: Conducted with 30 older individuals, ≥65 years old, with preserved cognitive abilities, literacy ≥ four years [...] Read more.
Objectives: To describe, understand, and correlate willingness to forgive with self-perceived health-related quality of life, including the components of quality of physical health and mental health. Methods: Conducted with 30 older individuals, ≥65 years old, with preserved cognitive abilities, literacy ≥ four years of education, living in Portugal and Spain. The 12-Item Short-Form Health Survey (SF-12) was used to assess self-perceived health-related quality of life, and the Heartland Forgiveness Scale (HFS) was used to measure willingness to forgive. Results: There was a direct positive correlation between willingness to forgive and perception of health-related quality of life, especially for the mental health component, educational level, cohabitation, and work activity. Conclusions: Forgiveness could play a significant role in the emotional health and quality of life of the elderly. Strategies to develop forgiveness can benefit the active aging process, contributing to improved health-related quality of life in older individuals. Full article
(This article belongs to the Topic Psychopathology and Developmental Trajectories)
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35 pages, 1453 KiB  
Article
Probabilistic Selling with Unsealing Strategy: An Analysis in Markets with Vertical-Differentiated Products
by Pak Hou Che and Yue Chen
Mathematics 2025, 13(12), 2036; https://doi.org/10.3390/math13122036 - 19 Jun 2025
Viewed by 493
Abstract
Probabilistic selling is a retail strategy in which consumers purchase products without knowing their exact identities until after purchase, with various applications like gaming and retail; a real-world practice involves retailers may unsealing and reselling goods to meet consumer demand for transparency. This [...] Read more.
Probabilistic selling is a retail strategy in which consumers purchase products without knowing their exact identities until after purchase, with various applications like gaming and retail; a real-world practice involves retailers may unsealing and reselling goods to meet consumer demand for transparency. This disrupts manufacturers’ strategies designed to adopt the uncertainty for segmentation and pricing. Using a vertically differentiated supply chain model structured as a Stackelberg game framework, this study examines how transparency from retailer unsealing affects profitability, consumer surplus, and market dynamics. Key findings include the following: (1) Unsealing increases retailer profits by aligning pricing with heterogeneous consumer willingness to pay. (2) Introducing a manufacturer’s direct channel reduces unsealing profits via price competition. (3) Unsealing creates conflicts between manufacturers’ design goals and retailers’ profit-driven incentives. By applying a Stackelberg game framework to model unsealing as a downstream transparency decision, this work advances the probabilistic selling literature by offering a structured approach to analyzing how downstream transparency and retailer strategies reshape probabilistic selling and supply chain dynamics. It highlights the need for manufacturers to balance segmentation, pricing, and channel control, offering insights into mitigating conflicts between design intentions and downstream market behaviors. Full article
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11 pages, 261 KiB  
Commentary
Thinking with Maria Puig de la Bellacasa’s Matters of Care: Concerns, Care, and Justice
by Fernando Santos, Marta Ferreira, Aldina Sofia Silva and Inês Gonçalves
Youth 2025, 5(2), 56; https://doi.org/10.3390/youth5020056 - 17 Jun 2025
Viewed by 465
Abstract
Social justice has become the panacea for all types of concerns and issues—providing a sense that all concerns are worthwhile, comprehensive, and matter for today’s world. Thus, developing alternative concepts, ideas, and imaginaries can potentially provide solid grounds for scholars to advance beyond [...] Read more.
Social justice has become the panacea for all types of concerns and issues—providing a sense that all concerns are worthwhile, comprehensive, and matter for today’s world. Thus, developing alternative concepts, ideas, and imaginaries can potentially provide solid grounds for scholars to advance beyond conventional understandings about social justice. Therefore, this manuscript aims to experiment with ethics of care as a conceptual device to disrupt Trumpism, as well as propose alternative worlds where sport, youth/athlete development, and social justice can connect otherwise. Specifically, efforts will be deployed to advance notions concerning sport–social justice in ways beyond our contemporary understandings. The work of feminist theorist and scholar Maria Puig de la Bellacasa (and many other human, non-human and more-than-human entities) is used to situate care as a relational doing. Moving forward, alternative worlds with alternative caring responsibilities matter if youth sport is to continuously thrive for justice. The conventional game of sport–social justice inquiry may have consequences and implications for caring that may be deemed unsustainable and continued sources of oppression. Therefore, caring becomes much more than a fact, a concern, or a concept. It becomes an ontological compromise, an ideal, and an ontological project for scholarly work, which implies a willingness to navigate towards the unknown and unprecedented—potentially our main caring responsibility as scholars. Full article
(This article belongs to the Special Issue Social Justice Youth Development through Sport and Physical Activity)
19 pages, 540 KiB  
Article
Navigating Employee Perceptions of Service Robots: Insights for Sustainable Technology Adoption in Hospitality
by Yuntugalage Wu, Minkyung Park and Jae Hyup Chang
Tour. Hosp. 2025, 6(2), 113; https://doi.org/10.3390/tourhosp6020113 - 16 Jun 2025
Viewed by 543
Abstract
The widespread deployment of service robots in industries such as hospitality has significantly transformed service delivery, influencing not only customers but also employees. This study examines the multi-dimensional impact of service robots on hotel employees, focusing on their attitudes, emotional responses, and willingness [...] Read more.
The widespread deployment of service robots in industries such as hospitality has significantly transformed service delivery, influencing not only customers but also employees. This study examines the multi-dimensional impact of service robots on hotel employees, focusing on their attitudes, emotional responses, and willingness to collaborate, as shaped by perceived benefits (service reliability, process efficiency, and job crafting) and risks (inefficiency, insufficient intelligence, and privacy concerns). Data were collected from 471 hotel employees in South Korea with experience working alongside service robots, and Hayes’ Process Macro Model 4 was employed for hypothesis testing. The findings reveal that perceived benefits positively influence employees’ attitudes, emotions, and willingness to collaborate, while perceived risks exert a negative impact. Furthermore, attitudes and emotional responses mediate these relationships. These findings provide theoretical and practical insights for managers, policymakers, and service robot manufacturers to address employee concerns, improve human–robot collaboration, and promote sustainable technological integration within the service industry. Full article
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18 pages, 270 KiB  
Article
The Impact of Pre-Retirement Occupational Characteristics on Social Participation in Later Life: A Life Course Perspective
by Juanjuan Sun and Kexin Sun
Soc. Sci. 2025, 14(6), 373; https://doi.org/10.3390/socsci14060373 - 13 Jun 2025
Viewed by 408
Abstract
Enhancing older adults’ social participation constitutes a critical strategy for actively addressing population aging. From a life course perspective, this study uses data from the 2023 China Longitudinal Aging Social Survey to analyze the impact of occupational characteristics of the pre-retirement of Chinese [...] Read more.
Enhancing older adults’ social participation constitutes a critical strategy for actively addressing population aging. From a life course perspective, this study uses data from the 2023 China Longitudinal Aging Social Survey to analyze the impact of occupational characteristics of the pre-retirement of Chinese older adults on their social participation in later life through linear probability models and Logit regression analysis. Key findings reveal that the pre-retirement work sector, occupational roles, and job intensity significantly influence older adults’ social participation. Older adults who previously worked in the public sector are less likely to participate in labor and recreational activities than their non-public sector counterparts. Those who held managerial positions before retirement exhibit higher probabilities of volunteering and recreational activity participation than non-managerial retirees. Additionally, greater pre-retirement job intensity correlates with reduced likelihoods of volunteering and recreational activity participation. Thus, this study identifies inadequate social security provisions as the primary endogenous driver for labor participation in later life. In China’s current developmental phase, gradually delaying the legal retirement age could effectively boost labor supply. Ensuring comprehensive labor protections throughout occupational trajectories and developing tailored interventions based on pre-retirement occupational characteristics prove essential for advancing social participation among older adults. Furthermore, improving information accessibility and participation opportunities serves as crucial pathways for transforming older adults’ participation willingness into concrete behavioral outcomes. Full article
(This article belongs to the Special Issue Active Aging Across the Life Course)
17 pages, 892 KiB  
Article
The Role of Human Capital in an Organisation—A Case Study of the ‘State Forests’ National Forest Holding in Poland
by Jacek Krawczyński, Marek Wieruszewski, Katarzyna Mydlarz, Marta Molińska-Glura, Jakub Glura, Wiesław Krzewina, Roman Jaszczak and Krzysztof Adamowicz
Sustainability 2025, 17(11), 5088; https://doi.org/10.3390/su17115088 - 1 Jun 2025
Viewed by 526
Abstract
Human capital is a key element necessary for the smooth operation of an organization based on sustainable development. It is not only important for building strategy but also affects the performance of day-to-day operations. Managers must constantly monitor the changes taking place around [...] Read more.
Human capital is a key element necessary for the smooth operation of an organization based on sustainable development. It is not only important for building strategy but also affects the performance of day-to-day operations. Managers must constantly monitor the changes taking place around the organization and make quick decisions in line with sustainability. They enable the organization to adapt to current market conditions and meet closed-loop requirements. These solutions are an important issue in forest management organizations. Considering the expanded mission of forests, it is clear that the role of forests today is much broader than just protecting biodiversity. Forestry institutions need adequate staff and human resources to effectively carry out forest management tasks and properly analyze trends and patterns of the sustainable use of forest resources. The purpose of the article was to analyze and evaluate human capital through its commitment to the organization’s tasks within the framework of sustainability. The research involved a sample for employees working in a selected unit of the State Forest Holding in Poland. The research was based on an anonymous employee survey on job engagement. The following aspects were assessed, commitment to the organization, sense of responsibility to the organization, interest in the work, and willingness to make sacrifices for the company in order to meet the demands of a modern forestry company oriented to the requirements of the new forestry strategy. Our reanalysis showed that gender and job type do not have a significant impact on commitment. However, an employee’s age and length of service do influence the behaviour and commitment of state forestry employees. Full article
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28 pages, 822 KiB  
Article
The Perception of Labor Control and Employee Overtime Behavior in China: The Mediating Role of Job Autonomy and the Moderating Role of Occupational Value
by Wei Dong, Yijie Wang and Tingting Zhao
Behav. Sci. 2025, 15(5), 691; https://doi.org/10.3390/bs15050691 - 17 May 2025
Viewed by 772
Abstract
While the transformation of and improvements in productivity are taking place under the guidance of new technologies, overtime work—which is still prevalent in the workplace—is simultaneously introducing substantial physical and mental burdens to workers. Based on baseline data from the China Labor Dynamics [...] Read more.
While the transformation of and improvements in productivity are taking place under the guidance of new technologies, overtime work—which is still prevalent in the workplace—is simultaneously introducing substantial physical and mental burdens to workers. Based on baseline data from the China Labor Dynamics Survey (CLDS), we analyze employees’ willingness to work overtime and their overtime cognition and intensity using labor process theory. It is observed that skill control directly increases the probability of employees’ objective overtime work, mandatory overtime work, and unconscious overtime work; furthermore, de-skilling prolongs working hours while hiding the prevalence and blurring the boundaries of overtime work. De-skilling also results in reduced employee job autonomy and further extends overtime hours, increasing the probability of mandatory overtime. Bureaucratic control reinforces the relationship between de-skilling and voluntary overtime, unconscious overtime, and overtime intensity by fostering employees’ career development orientation. It is necessary to accurately grasp the characteristics of new technologies in the changing labor environment of the new era, strive to create an equal and open labor market, and respect and protect the legitimate rights and interests of workers. Full article
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5 pages, 187 KiB  
Proceeding Paper
Consumers’ Willingness to Buy Novel Functional Food Products
by Panagiota Alvanoudi, Chrysanthi Charatsari, Fotios Chatzitheodoridis, Evgenia Karamouzi, Dimitra Lazaridou, Paraskevi Liakopoulou, Evagelos Lioutas, Efstratios Loizou, Maria Loizou, Fani Mantzouridou, Anastasios Michailidis, Anna Michailidou, Evangelia Michailidou, Stefanos Nastis, Smaragda Nikouli, Aikaterini Paltaki, Panagiotis Panopoulos, Dimitrios Tsolis and Antanina Valoshyna
Proceedings 2025, 117(1), 27; https://doi.org/10.3390/proceedings2025117027 - 13 May 2025
Viewed by 974
Abstract
Functional foods are products that have clinically evidenced health benefits for consumers due to one or more of their ingredients. While research indicates that consumers are highly interested in these products and are often willing to pay premium prices to buy them, stories [...] Read more.
Functional foods are products that have clinically evidenced health benefits for consumers due to one or more of their ingredients. While research indicates that consumers are highly interested in these products and are often willing to pay premium prices to buy them, stories of market failure are frequent for the specific category. Hence, a critical question is what determines consumers’ willingness to purchase functional food products. A hypothesis confirmed by many studies is that health concerns are positively associated with purchasing intentions. Nevertheless, other factors may also positively or negatively affect consumers’ willingness to buy functional foods. Our work examines this contention by focusing on a novel functional food product: yogurt enriched with sea buckthorn. The product, which is developing in the framework of an ongoing project, is expected to combine the health benefits of yogurt with the medicinal properties of sea buckthorn. Full article
15 pages, 2410 KiB  
Article
The Role of Experiencing Self-Efficacy When Completing Tasks—Education for Sustainable Development in Mathematics
by Michael Meyer, Carolin Kammrad and Ruben Esser
Sustainability 2025, 17(10), 4298; https://doi.org/10.3390/su17104298 - 9 May 2025
Viewed by 429
Abstract
A wide variety of requirements can be placed on tasks that deal with education for sustainable development in mathematics lessons. They should be as authentic as possible, use real problems as the mathematical learning material, and stimulate action, among other qualities. This article [...] Read more.
A wide variety of requirements can be placed on tasks that deal with education for sustainable development in mathematics lessons. They should be as authentic as possible, use real problems as the mathematical learning material, and stimulate action, among other qualities. This article discusses the role of self-efficacy and the experience of self-efficacy when working on modelling tasks that are geared towards a sustainable future. High school students in Germany worked in a STEM learning environment on different aspects of climate change and species extinction, including plastic waste, recycling, rainforests, and their deforestation. These aspects were analysed from a geographical, biological, physical, and mathematical perspective. In mathematics, specifically, tasks were used to address the learners’ self-efficacy. After completing the tasks, a questionnaire was distributed to assess the interest and motivation of the learners. The results show that even a slightly different use of self-efficacy, whether by focusing on what has already been achieved (sustainable successes that promote positive emotions) or on what can still be achieved, can influence the learners’ interest in completing the tasks. The learners’ experience of self-efficacy seems to have a positive influence on their willingness to solve tasks. Additionally, the results indicate a complex relationship between motivation and interest on the one hand and self-efficacy on the other. Full article
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24 pages, 1086 KiB  
Article
Green Transformational Leadership’s Impact on Employee Retention: Does Job Satisfaction and Green Support Bridge the Gap?
by Ibrahim A. Elshaer, Alaa M. S. Azazz, Chokri Kooli, Abdulaziz Aljoghaiman, Osman Elsawy and Sameh Fayyad
Adm. Sci. 2025, 15(5), 177; https://doi.org/10.3390/admsci15050177 - 9 May 2025
Cited by 1 | Viewed by 2739
Abstract
This study explores the impact of green transformational leadership (GTL) on employee retention in the hospitality sector, with a specific focus on the mediating roles of employee satisfaction and perceived green organizational support (PGOS). Grounded in self-determination theory and organizational support theory, the [...] Read more.
This study explores the impact of green transformational leadership (GTL) on employee retention in the hospitality sector, with a specific focus on the mediating roles of employee satisfaction and perceived green organizational support (PGOS). Grounded in self-determination theory and organizational support theory, the research examines both the direct and indirect effects of GTL on employee retention. GTL fosters a sustainability-driven work environment, motivating employees through shared environmental values, which enhances their job satisfaction and perceived organizational support. These factors, in turn, strengthen employees’ commitment and willingness to stay within the organization. Using SmartPLS 3 for structural equation modeling (SEM), data collected from hospitality employees were analyzed to assess the hypothesized relationships. The findings confirm that GTL positively influences employee retention, both directly and indirectly, through the mediating effects of employee satisfaction and PGOS. This study contributes to the growing body of knowledge on sustainable leadership by highlighting the crucial role of green leadership practices in improving employee retention in environmentally conscious organizations. Implications for managers and policymakers in the hospitality sector are discussed, emphasizing the need for sustainability-driven leadership approaches to enhance workforce stability. Full article
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12 pages, 763 KiB  
Article
Emergency Medical Services Clinicians and COVID-19 Booster Behavior—A Cross-Sectional National Evaluation
by Gregory Muller, Christopher B. Gage, Jonathan R. Powell, Sarah R. MacEwan, Laura J. Rush, Eben Kenah, Gennaro Di Tosto, Ann Scheck McAlearney and Ashish R. Panchal
Vaccines 2025, 13(5), 457; https://doi.org/10.3390/vaccines13050457 - 25 Apr 2025
Viewed by 580
Abstract
Background/Objectives: Emergency Medical Services (EMS) clinicians in the US have high COVID-19 vaccine hesitancy rates and often do not receive primary vaccinations or subsequent boosters. The extent of booster attrition following initial vaccination and first booster dose in EMS clinicians is unknown. Our [...] Read more.
Background/Objectives: Emergency Medical Services (EMS) clinicians in the US have high COVID-19 vaccine hesitancy rates and often do not receive primary vaccinations or subsequent boosters. The extent of booster attrition following initial vaccination and first booster dose in EMS clinicians is unknown. Our objective was to evaluate the prevalence and drivers of COVID-19 booster attrition in EMS clinicians. We hypothesized that booster attrition is common among EMS clinicians and associated with various EMS characteristics. Methods: This study was a cross-sectional analysis of nationally certified civilian EMS clinicians aged 18–85 years old. An electronic survey was distributed, which included an evaluation of vaccination status, booster acceptance, willingness to receive future boosters, perceived risk of contracting COVID-19 from the Understanding America Survey (8 items), and mistrust of healthcare organizations using the Medical Mistrust Index (MMI) (7 items). These data were combined with demographic and work-related characteristics from the National Registry of EMTs dataset. A multivariable logistic regression model (OR, 95% CI) was used to describe booster attrition associations between demographics, work-related characteristics, perceived risk, and medical mistrust. Results: A total of 1902 respondents met initial inclusion criteria. Within this group, 78% were COVID-19 vaccinated, and an additional 65% received a booster. Of these, 37% reported not planning to receive any other booster treatments following the first booster. Primary reasons for not continuing with subsequent boosters include confusion among experts on efficacy (59%), severe side effects (38%), the belief that COVID-19 is not a threat (26%), the belief in natural immunity (25%), and the belief that boosters are not required (23%). Odds of planning to receive another booster increased with receiving a flu vaccine (5.03, 3.08–8.22) and urban environment (1.96, 1.19–3.24, referent rural). In comparison, the odds of planning to receive another booster were lower for paramedics (0.56, 0.38–0.83, referent EMT) and fire agencies (0.53, 0.31–0.89, referent hospital). As the perceived risk of COVID-19 and medical mistrust decrease, the odds of planning to receive another booster increase (perceived risk: 1.98, 1.41–2.78; trust: 4.12, 3.21–5.28). Conclusions: The rate of booster attrition following receipt of one booster is high, at 37%. While there are associations with EMS demographic and workforce characteristics, further exploration is necessary to define the drivers and potential consequences of high booster attrition in the EMS clinician community. Full article
(This article belongs to the Section COVID-19 Vaccines and Vaccination)
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