Search Results (9,867)

(1) Background: Previous studies have shown that increased Problematic Internet Use (PIU) is associated with higher Fear of Missing Out (FoMO). However, the role of gender in this association remains unclear. Evidence suggests that males and females may experience PIU and FoMO differently, warranting further examination of gender differences. (2) Methods: In this cross-sectional study, a total of 4370 U.S. adolescents aged 12–17 years (47% female) were recruited through Qualtrics research panels and completed a national online survey on adolescent health and technology. Demographic information collected included age, race, and gender. PIU was measured using the validated three-item Problematic and Risky Internet Use Screening Scale (PRIUSS-3), while FoMO was measured using a validated 10-item FoMO scale. Multiple linear regression analysis examined the relationship between PIU and FoMO, including an interaction term between PIU and gender to assess the potential gender moderation effect while adjusting for age and race. (3) Results: Gender significantly moderated the relationship between PIU and FoMO, indicating that males experience a stronger association between PIU and FoMO compared to females. While higher PIU scores were significantly associated with higher FoMO for both males and females, each unit increase in PIU corresponded to a 0.15 point increase in FoMO for females (SE = 0.01, p < 0.01), and an additional 0.03 point increase for males (SE = 0.01, p < 0.01). (4) Conclusion: These findings illustrate the complex relationship between PIU and FoMO, highlighting the importance of gender-specific strategies and targeted interventions for promoting healthy Internet use. Full article

The government’s adoption of cloud computing is critical for digital transformation, but it faces persistent concerns over information security, privacy, governance, and risk. This study examines the factors influencing a government’s intention to adopt cloud services, adapting the Unified Theory of Acceptance and Use of Technology (UTAUT) with constructs tailored to the public sector. A cross-sectional survey was conducted across 90 Nigerian government organisations, producing 230 valid responses from IT professionals, administrators, and policy personnel. The statistical analysis of the data was conducted using SPSS and structural equation modelling in AMOS. Validity and reliability were confirmed through composite reliability, Cronbach’s alpha, and discriminant validity measures. Findings show that privacy (β = 0.11, p < 0.05), governance framework (β = 0.34, p < 0.001), performance expectancy (β = 0.38, p < 0.001), and information security (β = 0.10, p < 0.05) significantly influence government intention to adopt cloud services. Performance expectancy emerged as the strongest predictor. Contrary to expectations, perceived risk did not significantly moderate the relationships, and interaction terms were non-significant. The final model explained 45% of the variance in adoption intention (R² = 0.45). The study highlights the importance of strengthening governance frameworks, emphasising tangible performance outcomes, and positioning information security and privacy as an enabler of adoption rather than a barrier. By adapting UTAUT to the government context and disentangling the role of perceived risk, the study offers both theoretical refinement and practical guidance for policymakers aiming to accelerate digital transformation and secure cloud adoption. Full article

Background/Objectives: Sciatica can adversely affect mental well-being; however, evidence regarding its psychological impact among Saudi women remains scarce, particularly concerning differential effects across specific mental health domains. This study examined the prevalence of sciatica and its associations with depression, anxiety, and stress among adult Saudi women. Methods: A cross-sectional online survey was conducted from February to March 2024 among Saudi women aged ≥18 years. Participants (n = 706) completed the Arabic Depression, Anxiety, and Stress Scale (DASS-21) and provided sociodemographic and health information. Sciatica status was based on self-report. Multivariable linear regression analyses identified independent predictors of each mental health domain. Results: Sciatica prevalence was 11.0% among 706 participants (mean age 29 ± 11 years; mean BMI 24 ± 6.5 kg/m²). Sciatica was the strongest independent predictor of stress (β = 6.87, 95% CI: 4.57–9.17, p < 0.001). No significant associations were observed with depression (β = 1.80, p = 0.183) or anxiety (β = 0.45, p = 0.481). Additional stress predictors included lower-back pain, diabetes, lower–middle income, and daily phone use >8 h, while bachelor-level education was protective. Arthritis independently predicted anxiety (β = 1.52, p = 0.008). Conclusions: In this convenience sample of Saudi women, sciatica was significantly associated with higher stress symptom scores, while associations with depression and anxiety did not reach statistical significance. The observed pattern suggests that stress screening and management should be considered within biopsychosocial care for sciatica patients, pending confirmation in prospective studies. Full article

Background/Objectives: This study aimed to investigate how the disparities in unmet medical needs between immigrants to South Korea and native-born populations evolved during the COVID-19 pandemic. Methods: Using nationally representative cross-sectional data from the 2018 and 2020 Surveys on Immigrants’ Living Conditions and Labor Force in South Korea, we compared unmet medical needs among immigrants at two time points (N = 12,227 in 2018; N = 18,530 in 2020). Standardized prevalence ratios (SPRs) were calculated. Analyses were stratified according to work status, gender, Korean language proficiency, education level, and duration of stay. Results: Working immigrants had lower SPRs for unmet medical needs than Korean nationals (2018: 0.879; 2020: 0.745) but non-workers had consistently higher SPRs (2018: 1.117; 2020: 1.128). The SPRs for male and female non-workers increased and decreased, respectively. The SPRs were persistently higher among individuals with poorer Korean language proficiency, lower education, and shorter duration of stay. Conclusions: Systemic disruptions, such as the COVID-19 pandemic, may exacerbate pre-existing healthcare inequalities among immigrant populations. The persistence and widening of these disparities call for targeted policies that address structural barriers and ensure equitable healthcare access during future public health crises. Full article

Since 2022, numerous H5N1 highly pathogenic avian influenza virus (HPAIV) detections have been reported in wild and domestic mammals in North America. Although H5N1 HPAIV detections in dogs are rare, hunting dogs that retrieve waterfowl are at increased exposure risk due to their physical contact with reservoirs (waterfowl) and contaminated environments. A cross-sectional survey of hunters was conducted during 2024 to characterize hunting procedures, disease prevention practices, and interactions between humans and their hunting dogs to identify potential risks for zoonotic disease transmission. Descriptive analysis (N = 112) indicated a majority of participants considered their hunting dog as part of the family (93.8%), and less than half considered their dog a pet (42.9%). Of the 112 individuals, 96.4% did not utilize personal protective equipment (PPE) when handling a sick dog and 81.3% did not use PPE when handling harvested birds. This research demonstrated complex, sustained physical and personal connections between individuals and their hunting dogs. Additional research utilizing a One Health approach is necessary to define H5N1 HPAIV risk factors in hunting dogs and the environment’s role in the transmission of viruses among wildlife and domestic animals. Understanding zoonotic disease transmission in these populations can inform approaches to mitigate viral exposure. Full article

Background/Objectives: To examine the association of social determinants of health (SDOHs) with primary and cost-related medication nonadherence among adults with diabetes. Methods: A retrospective cross-sectional analysis was conducted using 2021 data from the Medical Expenditure Panel Survey (MEPS), a nationally representative sample of the United States civilian noninstitutionalized population. Adults aged ≥ 18 years with a diagnosis of diabetes in 2021 were included. The outcomes include primary medication nonadherence (no antidiabetic prescriptions filled) and cost-related medication nonadherence (delaying prescriptions due to cost). The exposure variables include SDOHs such as financial stress, food insecurity, transportation barriers, social support, access to medical care in the neighborhood, and healthcare discrimination. Weighted multivariable logistic regression analyses were conducted to assess the association between SDOHs and medication nonadherence. Results: Among 21.9 million patients with diabetes, 6.5% reported cost-related nonadherence and 17.4% exhibited primary nonadherence. Difficulty paying rent or mortgage (OR 2.32, 95% CI: 1.27–4.23), food insecurity (OR 2.13, 95% CI: 1.27–3.58), and transportation barriers (OR = 2.15; 95% CI: 1.20–3.63) were significantly associated with cost-related nonadherence. In the Medicare subgroup, both difficulty paying rent or mortgage (OR = 2.41, 95% CI: 1.03–5.64) and food insecurity (OR = 2.16, 95% CI: 1.18–3.96) significantly increased cost-related nonadherence. Conclusions: Financial strain, food insecurity, and transportation barriers are associated with cost-related nonadherence. These findings suggest considering social and economic factors in strategies supporting diabetes medication adherence across populations, including Medicare beneficiaries. Full article

Background: Supply chain management (SCM) research has expanded across the Middle East and North Africa (MENA), yet the field remains fragmented. Limited synthesis exists on how regional conditions shape research themes, theories, and methods. Methods: This study applies the PRISMA 2020 protocol to review SCM articles indexed in Scopus and Web of Science from January 2000 to March 2025. After screening and eligibility assessment, 512 peer-reviewed studies were retained. Bibliometric mapping and thematic coding were used to identify publication trends, research streams, theoretical lenses, and methodological patterns. Results: SCM research increased sharply after 2015, reflecting national diversification agendas, logistics reform, digitalization, and exposure to global supply chain disruptions. Three dominant streams were identified: resilience, sustainability, and digital transformation. Research output is concentrated in Saudi Arabia and the United Arab Emirates, while cross-country comparative studies remain scarce. Empirical studies rely mainly on cross-sectional surveys and SEM-based analysis, with limited longitudinal, qualitative, mixed-method, and comparative work across the region. Conclusions: The study develops an integrative SCM capability framework linking regional structural conditions, capability development, and supply chain outcomes. The findings support managers and policymakers seeking resilient, sustainable, and digitally enabled supply chains, and define clear future research priorities for the MENA region. Full article

Despite growing recognition that organizational culture shapes nursing practice, the linking of ethical climate to sustainable environmental health literacy (SEHL) remains poorly understood. This study examined whether moral courage statistically mediates the relationship between perceived ethical climate and self-reported environmental health literacy among Egyptian nurses, rather than observed competencies or clinical actions. A cross-sectional correlational design was employed with 743 nurses recruited from government, private, and university-affiliated hospitals. Participants completed the Hospital Ethical Climate Survey, the Nurses’ Moral Courage Scale, and the Environmental Health Literacy Scale. Mediation analysis used Hayes’ PROCESS macro with 5000 bootstrap samples. Ethical climate demonstrated strong positive associations with moral courage (r = 0.81) and SEHL (r = 0.86), while moral courage and SEHL were also strongly correlated (r = 0.82). Ethical climate explained 74% of variance in SEHL and 66% of variance in moral courage. Moral courage was associated with partial statistical mediation of the ethical climate–SEHL relationship, accounting for 33.4% of the total effect (β = 0.31, 95% CI [0.26, 0.37]), while the direct effect remained substantial (66.6%). These findings suggest that supportive ethical climates may be associated with nurses’ environmental health literacy via two statistical pathways: one directly linked to environmental learning and another indirectly linked to moral courage. Healthcare organizations should prioritize ethical climate development alongside moral courage training as potentially promising approaches to advance climate-responsive nursing practice. Full article

Background: Soil-transmitted helminth (STH) infections are a recognized public health challenge, particularly in rural and island settings. Despite the implementation of national control programs, epidemiological data from geographically isolated communities remain limited. In this study, we aimed to determine the prevalence of STH infections and identify associated risk factors among adults in Koh Yao Islands, southern Thailand. Methods: A community-based cross-sectional survey was conducted in three subdistricts of Koh Yao, Phang Nga Province, from January to September 2024. Demographic data and information on potential risk factors were collected using structured questionnaires. Stool specimens were analyzed using the formalin–ethyl acetate concentration technique and the modified Kato–Katz method. Associations were assessed using univariate and multivariate logistic regression analyses. Results: A total of 241 adults participated in the study, with females accounting for 68.9% and males for 31.1%. The overall prevalence of STH infections was 2.49%, with hookworms and Trichuris trichiura identified as the predominant species. All infected individuals had an educational level lower than a bachelor’s degree. Univariate analysis showed that participants who did not use hygienic toilets at home had a significantly higher likelihood of developing STH than those who did (crude odds ratio = 46.80; 95% confidence interval [CI]: 2.55–859.00; p = 0.010). Multivariable logistic regression analysis confirmed that the absence of hygienic toilet use at home was independently associated with STH infection (adjusted odds ratio = 30.69; 95% CI: 1.17–804.65; p = 0.040). Conclusions: This study documents low overall prevalence of STH infections in the study area, with hookworms and T. trichiura as the predominant organisms. These findings support continued targeted public health measures, including periodic deworming and health education initiatives, to strengthen hygiene practices, particularly in high-risk populations. Future investigations should incorporate environmental assessments and longitudinal monitoring to evaluate the durability of current control strategies. Full article

Climate change is increasingly recognized as a source of psychological distress, yet the prevalence, predictors, and behavioral implications of climate anxiety remain unevenly understood. This study examines climate anxiety, its key drivers, and associated behavioral responses in a multi-country sample of adults. A cross-sectional online survey was conducted across 21 countries using the Climate Change Anxiety Scale (CCAS), alongside measures of awareness, coping strategies, social support, and food-related behaviors, including food waste reduction, increased plant-based food consumption, and home or community gardening. Analyses included descriptive statistics, exploratory factor analysis (EFA), and multivariable regression. Given the uneven country-level representation, results are reported as pooled patterns with a few exploratory cross-country comparisons. Climate anxiety was widely reported, with over 60% of participants indicating that climate challenges were emotionally overwhelming. Regression analyses showed that climate awareness and frequency of climate-related thinking were positively associated with higher anxiety, although the effect sizes were small and explanatory power was limited (R² = 0.055). EFA identified two related dimensions: cognitive concern about future impacts and affective distress. Climate anxiety across countries showed modest variation (2.44–3.23) and no statistically significant differences, despite variation in awareness. A gap between concern and climate action was evident: only 39.1% reported environmentally motivated dietary changes. Cost, limited availability, and lack of information were the main barriers to climate action, and only 24.4% reported frequent social support. These findings indicate that climate anxiety is shaped by both psychological and structural factors, and that reducing it requires not only increasing awareness but also enabling conditions that support meaningful climate action. Full article

Background/Objectives: Artificial intelligence (AI) shows promise in supporting mammography interpretation and triaging referrals, potentially enhancing breast screening. However, successful AI integration depends on patient acceptance and trust. This study explores patient and public perceptions of AI in breast imaging and clinical decision-making to identify knowledge gaps and guide communication strategies. Methods: Paper surveys were distributed to women attending the Breast Care Unit at Queen’s Hospital, Burton, and the London Breast Institute between August and December 2025. Demographic data, levels of trust and comfort with AI, and concerns about AI were collected. Responses were analysed using descriptive statistics, Pearson’s Chi-square tests with Cramér’s V and thematic analysis. Results: One hundred and twenty participants completed the survey. Fifty percent would accept AI alongside clinicians for interpretation of mammograms or ultrasound scans, significantly associated with no previous breast cancer diagnosis (p = 0.02; Cramér’s V = 0.22, 2 degrees of freedom (df)) and technological comfort (p < 0.001; Cramér’s V = 0.42, 1 df). Lower acceptance was found among those with prior diagnosis and low comfort with technology. Acceptance of AI-assisted triage (44.5%) was also significantly associated with technological comfort (p = 0.008; Cramér’s V = 0.30, 1 df). Eighty percent reported no knowledge of AI use in breast clinics, and only 37% would trust AI findings. Qualitative analysis identified three themes: (1) clinician oversight as indispensable, (2) the knowledge gap as a barrier to acceptance, and (3) concerns about operational risks and accountability. Conclusions: Although patients were generally receptive to AI, acceptance was conditional on clinician supervision. Limited awareness and concerns about diagnostic accuracy remain barriers to implementation. Educational initiatives should precede widespread adoption to support informed and confident patient acceptance of AI-assisted imaging and decision-making. Full article

Community disaster resilience is increasingly guiding risk-reduction investments, but in many Southeast European settings, comparable subnational data remain scarce. This study assesses perceived community disaster resilience across Serbia by combining BRIC–DROP dimensions into a single index and analyzing differences across hazard types and sociodemographic factors. A cross-sectional household survey was conducted using multistage random sampling and the “next birthday” method for respondent selection. The final sample included 1200 adults from 22 local government units across four regions: Belgrade, Vojvodina, Šumadija & Western Serbia, and Southern & Eastern Serbia. Participants evaluated preventive measures and societal resilience for ten hazard types and considered five social dimensions: social structure, social capital, social mechanisms, social equity/diversity, and social beliefs. Descriptive statistics, bivariate analyses (including Pearson correlations, t-tests, and ANOVA), and multiple linear regression identified key predictors of preventive behavior and perceived resilience. Composite scores highlighted spatial resilience differences. Overall perceptions were generally low, mostly falling below the midpoint of the scale. Furthermore, the highest ratings for implemented preventive measures were recorded for pandemics/epidemics, storms/hail, and floods, whereas the lowest were observed for environmental pollution and droughts. Perceived resilience was highest for snowstorms, storms/hail, and pandemics/epidemics, and lowest for environmental pollution and droughts. Also, respondents reported relatively strong family ties and favorable perceptions of communication and access to basic supplies, but weak institutional capacity, particularly in budget allocation, early warning and public notification, rapid decision-making, and evacuation and shelter readiness. Regression results were statistically significant but explained only a small portion of the variance. Age and public-sector employment positively predicted perceived resilience; fear, income, and, to a lesser extent, education were negatively associated. These findings highlight the structural and psychosocial factors that shape perceptions of resilience. The BRIC–DROP composite indicates generally low perceived preparedness and resilience, especially in risk communication, evacuation and shelter readiness, and financing—the key bottlenecks in strengthening local resilience. The results recommend combining institutional reform with targeted risk communication to reduce fear and build trust, especially focusing on hazard areas with the lowest confidence, such as environmental pollution and drought. Full article

Women’s advancement into leadership roles remains uneven in many post-socialist labor markets despite high levels of female education and workforce participation. While prior research has emphasized structural barriers and national institutional conditions, less is known about how firm-level organizational environments shape women’s evaluations of leadership as a viable career pathway. This study aims to examine how firm type shapes women’s managerial aspirations across career stages in post-socialist Mongolia. Using cross-sectional survey data from 191 employed women in Ulaanbaatar, aspiration patterns were compared across three organizational contexts: foreign-owned firms, domestic private firms, and public-sector organizations. Career aspirations were operationalized as three states—high aspiration, constrained aspiration, and low aspiration—to capture differences between leadership motivation and perceived feasibility. Pearson’s chi-square tests and Cramér’s V were used to assess associations between firm type, career stage, and aspiration categories. The results show that women in foreign-owned firms are more likely to sustain leadership aspirations, whereas constrained and low aspirations are more prevalent in domestic private firms and the public sector, particularly at mid-career stages. These findings suggest that leadership aspirations reflect organizationally shaped feasibility assessments rather than individual motivation alone, and that firm type operates as a critical meso-level opportunity structure within shared post-socialist institutional conditions. Full article

Despite growing emphasis on democratic citizenship education in South Korea, limited research has examined the social and psychological factors influencing children’s democratic citizenship—defined here as awareness of and willingness to engage in societal issues as responsible community members. This study examines the relationship between parent–child communication and democratic citizenship, focusing on the mediating roles of growth mindset and peer relationships among South Korean elementary school students. A total of 212 students in grades four to six completed a cross-sectional survey assessing parental communication, democratic citizenship (operationalized as civic awareness and community engagement), growth mindset, and peer relationships. Serial-multiple-mediation analysis was conducted to evaluate the mediating effects of growth mindset and peer relationships. The results indicated that positive parent–child communication was associated with higher levels of democratic citizenship and that growth mindset and peer relationships jointly mediated this relationship in a serial manner. These findings highlight the importance of fostering open parent–child communication, encouraging a growth mindset, and promoting positive peer relationships to enhance democratic citizenship development in children. Given the cross-sectional design, causal inferences should be interpreted with caution, and longitudinal studies are needed to confirm these relationships. Full article

There is growing concern that antimicrobial use (AMU) in livestock may contribute to antimicrobial resistance (AMR) in humans and lead to the consumption of animal-derived foods contaminated with antimicrobial residues. As stakeholders in the livestock industry, farmers must participate in the joint effort to reduce AMU. This cross-sectional study, based on a survey questionnaire, was conducted to evaluate the biosafety measures implemented on small ruminant farms and to assess the knowledge, attitudes and practices (KAP) of small ruminant farmers regarding AMU, AMR and residues. The mean biosafety score obtained was 8.4 points on a 0–17 scale. Some biosafety measures appeared difficult to implement, namely vehicle disinfection, requiring visitors to change clothing and footwear at the farm entrance, cleaning and disinfecting farm facilities, using high-pressure washing equipment, and requiring employees to change clothing and footwear upon entering the farm. Although farmers self-reported moderate levels of knowledge (4.9 points on a 0–7 scale) and positive attitudes (5.8 points on a 0–7 scale), significant gaps in knowledge about antibiotics and antimicrobial stewardship persisted. Practices received lower scores (4.7 on a 0–7 scale), especially regarding medication recording, leftover antibiotic management, and waste disposal. Cluster analysis identified distinct farmer profiles with different patterns of knowledge and practices. These findings underscore the importance of considering farmer heterogeneity when designing interventions aimed at improving AMU. Full article