Search Results (5,765)

This article examines online hate as a driver of cyberbullying and a barrier to inclusive schooling, integrating theoretical, philosophical and methodological perspectives. We approach hate speech as communicative practices that legitimise discrimination and exclusion and, once amplified by social media affordances, erode equity, belonging and well-being in educational settings. The study adopts a qualitative, exploratory–descriptive design using focus groups with pre-service teachers from initial teacher education programmes across several Chilean regions. Participants reflected on the presence, trajectories and classroom effects of cyberhate/cyberbullying. Data were analysed thematically with ATLAS.ti24. Findings describe a recurrent pathway in which anonymous posts lead to public exposure, followed by heightened anxiety and eventual withdrawal. This shows how online aggression spills into classrooms, normalises everyday disparagement and fuels self-censorship, especially among minoritised students. The analysis also highlights the amplifying role of educator authority (tone, feedback, modelling) and institutional inaction. In response, participants identified protective practices: explicit dialogic norms, rapid and caring classroom interventions, restorative and care-centred feedback, partnership with families and peers, and critical digital citizenship that links platform literacy with ethical reasoning. The article contributes evidence to inform anti-bullying policy, inclusive curriculums and teacher education by proposing actionable, context-sensitive strategies that strengthen equity, dignity and belonging. Full article

Against the backdrop of global agricultural transformation, rural China faces the critical challenge of reconciling economic development with environmental conservation and social well-being. This study, grounded in the rural revitalization strategy, investigates the internal mechanisms, level measurement, and sustainable development paths of rural industrial integration based on the “Triple Integration of Production, Livelihood and Ecology” (PLE) philosophy. Firstly, we discussed the suitability and the mechanisms of this philosophy on China’s rural industrial integration. Secondly, based on a textual corpus extracted from academic journals and policy documents, we employed an LDA topic model to cluster the themes and construct an evaluation indicator system comprising 29 indicators. Then, utilizing data from the China Statistical Yearbook and the China Rural Statistical Yearbook (2013–2022), we measured the level of China’s rural industrial integration using the entropy method. The composite integration index displays a continuous upward trend over 2013–2022, accelerating markedly after the 2015 stimulus policy, yet a temporary erosion of “production–livelihood–ecology” synergy occurred in 2020 owing to an exogenous shock. Lastly, combining the system dynamics model, we simulated over the period 2023–2030 the three sustainable development scenarios: green ecological development priority, livelihood standard development priority and production level development priority. Research has shown that (1) the “Triple Synergy of Production, Livelihood and Ecology” philosophy and China’s rural industrial integration are endogenously unified, and they form a two-way mutual mechanism with the common goal of sustainable development. (2) China’s rural industrial integration under this philosophy is characterized by production-dominated development and driven mainly by processing innovation and service investment, but can be constrained by ecological fragility and external shocks. (3) System dynamics simulations reveal that the production-development priority scenario (Scenario 3) is the most effective pathway, suggesting that the production system is a vital engine driving the sustainable development of China’s rural industrial integration, with digitalization and technological innovation significantly improving integration efficiency. In the future, efforts should focus on transitioning towards a people-centered model by restructuring cooperative equity for farmer ownership, building community-based digital commons to bridge capability gaps, and creating market mechanisms to monetize and reward conservation practices. Full article

Background: The digitalization of medical services is promoted as a solution for improving access, quality, and efficiency within healthcare systems. In this context, the study investigates the extent to which digitalization in Romania meets the current needs of patients through a convergent analysis of user perceptions and managerial perspectives. Based on the specialized literature, the research tests two hypotheses: (H1) the implementation of digital technologies significantly contributes to improving the quality of medical services and operational efficiency; (H2) digitalization has a positive impact on patient satisfaction by facilitating access to care and improving communication with medical personnel. Methods: The study adopted methodology is cross-sectional and mixed, including an online mixed-methods questionnaire for patients, distributed between 6 and 14 May 2025, and a qualitative questionnaire with open-ended questions distributed via e-mail to managers from public hospitals through The Administration of Hospitals and Medical Services of Bucharest, between 3 and 24 March 2025. Results: In total, 125 patients and 15 hospital managers participated in the study. Statistical analysis (χ², ordinal regression) and data triangulation highlight a predominantly positive, yet heterogeneous, patient perception of digitalization, with Hypothesis H1 only partially supported (weak, inconsistent, and in some cases negative associations between technology use and perceived service quality). By contrast, H2 was robustly validated, with patient satisfaction strongly linked to tangible benefits, particularly easier access and online appointment scheduling. However, use remains limited to administrative functions, while advanced technologies such as telemedicine or electronic health records are poorly adopted. From an institutional perspective, hospitals predominantly use IT systems for internal purposes, without real patient access to their own data, no interoperability between medical units, and marginal implementation of telemedicine. This reveals a significant gap between user perception and organizational realities, emphasizing the lack of a patient-oriented digital infrastructure. Conclusions: The results highlight the potential of digitalization to enhance patient experience and service efficiency, while also pointing out structural limitations that hinder the full realization of this potential. Patient satisfaction is strongly associated with tangible benefits, particularly easier access and online scheduling, whereas the effect on perceived quality is weaker and sometimes inconsistent. There are significant disparities in digitalization levels between healthcare providers, perceived by patients as public–private differences, and gaps among public hospitals are also confirmed by managerial data. These findings suggest that a successful digital transformation of the medical system in Romania must address both technological infrastructure gaps and organizational barriers, within a coordinated national strategy that ensures interoperability, patient-centered design, and sustainable implementation. Full article

Digital connectivity depends not only on infrastructure, but also on the material devices used to access networks. This study examines electronic devices’ availability and prices in Saint-Louis, a mid-sized Senegalese city, to address the lack of empirical research on African digital markets. With data on material connectivity being scarce, this paper provides a baseline description as grounds for future research. Using a participatory mapping approach over three weeks in September 2024, the research assessed the range, condition, and distribution of smartphones across central and neighborhood markets. Descriptive statistics and spatial analysis illustrate key trends. Results show a market heavily structured around second-hand smartphones, where device quality and prices adjust to economic power. Imported second-hand devices are often high-end, with prices above many new items of cheaper brands, while locally used items have much depreciated prices compared to either new or imported second-hand ones. Market locations are widespread for common items and clustered for specialized devices, consistent with central place theory. By documenting the material foundations of digital communication, this study provides new empirical evidence on African urban device markets and highlights the need to consider material access alongside infrastructure in digital connectivity debates. Full article

Introduction: Despite global improvements in immunization, major gaps persist. By 2024, an estimated 14.3 million infants, predominantly in low- and middle-income countries (LMICs), remained zero-dose (ZD), never having received even the first DTP vaccine. In 2022, 33 million children missed their measles vaccination (22 million missed the first dose, 11 million missed the second dose), highlighting entrenched structural, behavioral, and systemic barriers that continue to exclude marginalized populations. Addressing these inequities requires innovative, context-adapted approaches that strengthen primary health care (PHC) and extend services to the hardest-to-reach populations. Objectives: This study aims to document and synthesize implementation research (IR) projects on immunization programs in LMICs, identifying key enablers and effective strategies that reduce inequities, improve outcomes, and support efforts to reach ZD children. Methods: We conducted a retrospective multiple-case study of 36 IR projects across 13 LMICs, embedded within an evidence review framework and complemented by policy analysis. Data were drawn from systematic document reviews and validation discussions with project leads. A total of 326 strategies were extracted, coded using a structured codebook, and mapped to the WHO–UNICEF PHC Levers for Action. Descriptive analysis synthesized patterns across service delivery and policy outcomes, including coverage gains, improved microplanning, community engagement, and system integration. Results: Of the 326 immunization strategies identified, most (76.1%) aligned with operational PHC levers, particularly monitoring and evaluation (19.3%), workforce development (18.7%), and models of care (12%). Digital technologies (11.7%) were increasingly deployed for real-time tracking and oversight. Core strategic levers comprised 23.9% of strategies, with community engagement (8.9%) and governance frameworks (7.7%) emerging as critical enablers, though sustainable financing (4%) and private-sector engagement (0.9%) were rarely addressed. While the majority of projects focused on routine immunization (n = 32), only a few directly targeted ZD children (n = 3). Interventions yielded improvements in both service delivery and policy outcomes. Improvements in microplanning and data systems (23.5%) reflected the increased uptake of digital dashboards, GIS-enabled tools, and electronic registries. Community engagement (16.2%) emphasized the influence of local leaders and volunteers in building trust, while health system strengthening (15.7%) invested in cold chain, supervision, and workforce capacity. Coverage gains (10.6%) were achieved through delivery innovations, though sustainable financing remained a critical problem (3.4%). Conclusions: Reaching ZD children requires equity-driven strategies that combine digital innovations, community engagement, and resilient system planning. Sustained progress depends on strengthening governance, financing, and research. Embedding IR in immunization programs generates actionable evidence, supports context-specific strategies, and reduces equity gaps, offering practical insights that complement health system research and advance the Immunization Agenda 2030. Full article

This paper examines the evolving trajectory of the Social Determinants of Health (SDOH), tracing their development from early observational studies to contemporary, interdisciplinary frameworks that emphasize structural inequities and relational dynamics. It explores foundational milestones such as the Whitehall studies, the Heckler Report, and the World Health Organization’s conceptual models, which positioned SDOH as key drivers of population health. The paper highlights how upstream determinants—such as governance, policy, and socioeconomic systems—influence downstream health outcomes through mechanisms of social stratification and unequal access to resources. While SDOH are increasingly applied in clinical and educational settings, significant challenges persist, including underinvestment in community systems, fragmented care models, and political rollbacks of equity-centered policies. The paper critiques deterministic and deficit-focused framings of SDOH and underscores a shift toward more relational, context-sensitive, and agency-oriented approaches, reflected in the emerging concept of “social dynamics of health.” It highlights the importance of experiential education, competency-based curricula, and digital innovations in driving systemic transformation. Emphasis is placed on reimagining SDOH pedagogy and expanding interdisciplinary, data-driven research to bridge the gap between knowledge and practice. Amid shifting political landscapes, sustaining health equity efforts requires embracing adaptive, participatory models that acknowledge power, community agency, and structural change. Full article

The NewEcoSmart project addresses the need to foster inclusive green and digital transitions in rural habitat sectors by systematically assessing local socio-technical readiness and tailoring capacity-building interventions. We adapted the validated SCIROCCO Exchange Maturity Self-Assessment Tool—selecting eight dimensions relevant to environmental, technological and social innovation—and conducted a two-phase evaluation across three pilot sites in Italy, Portugal and Spain. Phase 1 mapped stakeholder evidence against predefined criteria; Phase 2 engaged local actors (45+ adults, SMEs and micro-firms) in a self-assessment to determine digital, green and entrepreneurial skill gaps. For each domain of the SCIROCCO Tool, local actors can assign a minimum of 0 to a maximum of 5. The final score of the SCIROCCO tool can be a minimum of 0 to a maximum of 40. Quantitative maturity scores revealed heterogeneous profiles (Pacentro and Majella Madre = 5; Yecla = 10; Adelo Area = 23), underscoring diverse ecosystem strengths and limitations. A qualitative analysis, framed by Smart Healthy Age-Friendly Environments (SHAFE) domains, identified emergent training needs that are clustered at three levels: MACRO (community-wide awareness and engagement), MESO (decision-maker capacity for strategic planning and governance) and MICRO (industry-specific practical skills). The adapted SCIROCCO tool effectively proposes the assessment of socio-technical maturity in rural contexts and guides the design of a modular, multi-layered training framework. These findings support the need for scalable deployment of interventions that are targeted to the maturity of the local ecosystems to accelerate innovations through equitable green and digital transformations in complex socio-cultural settings. Full article

With the rapid growth of digital interactions, safeguarding user privacy on websites has become a critical concern. This paper introduces a comprehensive framework that integrates both technical and policy-based factors to assess a website’s level of privacy protection. The framework employs a scoring system that evaluates key technical elements, such as HTTP security headers, email authentication protocols (SPF, DKIM, DMARC), SSL/TLS certificate usage, domain reputation, DNSSEC, and cookie practices. In parallel, it examines the clarity and GDPR compliance of privacy policies. The resulting score reflects not only the technical strength of a website’s defenses but also the transparency with which data processing practices are communicated to users. To demonstrate its effectiveness, the framework was applied to two similarly sized private hospitals, generating comparative privacy scores under a unified metric. The results confirm the framework’s value in producing measurable insights that enable cross-organizational privacy benchmarking. By combining policy evaluation with technical analysis, this work addresses a significant gap in existing research and offers a reproducible, extensible methodology for assessing website privacy posture from a visitor’s perspective. Full article

The advancement of smart grid technologies necessitates the integration of cutting-edge computational methods to enhance predictive energy optimization. This study proposes a multi-faceted approach by incorporating (1) Deep Reinforcement Learning (DRL) agents trained using data from digital twins (DTs) to optimize energy consumption in real time, (2) Physics-Informed Neural Networks (PINNs) to seamlessly embed physical laws within the optimization process, ensuring model accuracy and interpretability, and (3) blockchain (BC) technology to facilitate secure and transparent communication across the smart grid infrastructure. The model was trained and validated using comprehensive datasets, including smart meter energy consumption data, renewable energy outputs, dynamic pricing, and user preferences collected from IoT devices. The proposed framework achieved superior predictive performance with a Mean Absolute Error (MAE) of 0.237 kWh, Root Mean Square Error (RMSE) of 0.298 kWh, and an R-squared (R²) value of 0.978, indicating a 97.8% explanation of data variance. Classification metrics further demonstrated the model’s robustness, achieving 97.7% accuracy, 97.8% precision, 97.6% recall, and an F1 Score of 97.7%. Comparative analysis with traditional models like Linear Regression, Random Forest, SVM, LSTM, and XGBoost revealed the superior accuracy and real-time adaptability of the proposed method. In addition to enhancing energy efficiency, the model reduced energy costs by 35%, maintained a 96% user comfort index, and increased renewable energy utilization to 40%. This study demonstrates the transformative potential of integrating PINNs, DT, and blockchain technologies to optimize energy consumption in smart grids, paving the way for sustainable, secure, and efficient energy management systems. Full article

Introduction: This study explores the impact of logistics information technology (LIT) on supply chain relationships and distribution performance in small and medium-sized enterprises (SMEs) using South Africa as a case study. Although digital supply chain solutions are increasingly important, there is limited evidence of SME efficiency in emerging markets using LIT. Methods: This study utilises a survey of 313 SMEs from four South African provinces. Bayesian structural equation modelling (Bayesian SEM) was then used to examine LIT’s effects on distribution performances in terms of timeliness, product availability, and condition. Results: The results show that the adoption of LIT strengthens buyer–seller networks (β = 0.524, CI = [0.434, 0.613]) and improves distribution by enhancing both timeliness performance (β = 0.237, CI = [0.098, 0.372]) and product condition performance (β = 0.175, CI = [0.042, 0.259], β = 0.222, p < 0.001). However, it does not directly enhance product availability performance (β = 0.085, CI = [−0.030, 0.199]), signifying that LIT adoption by itself fails to improve product availability. The results also demonstrate that SME network relationships mediate the connection between LIT adoption and distribution performance metrics. Discussion: This study’s findings contribute to the literature and offer valuable information and guidance to policymakers as they underscore the importance for SMEs to invest in LIT integration and compatibility, as well as inventory optimisation and improved supplier communication to minimise transit time variation. Policymakers should support SMEs’ digital transformation through interventions including funding and training for LIT adoption. This study confirms the essential role of LIT in SME supply chains and illustrates that technology-facilitated relationships enhance distribution performance, which enhances SME competitiveness. Full article

Background: Mild cognitive impairment (MCI) is a precursor to dementia, with a prevalence of over 15% among community dwellers, with significant economic and social implications. Despite preserved autonomy in daily living, individuals with MCI face challenges in handling everyday technology and memory-related tasks, necessitating digital interventions, such as digital planning-based technologies to support cognitive functioning. Objective: The aim of this study is to identify and summarize available research literature on available digital planning-based technologies to support memory-related functioning in older adults with MCI. Specifically, this study seeks to (1) document the types and functions of these technologies, (2) report their effectiveness, and (3) identify gaps in the current evidence. Methods: A comprehensive literature search of four databases (Medline, Embase, APA PsycINFO, and CINAHL) was conducted in accordance with Arksey and O’Malley’s scoping review methodological framework from inception to February 6, 2024, without restrictions. Inclusion criteria focused on peer-reviewed studies involving adults aged 50 or older with diagnosed cognitive impairment, specifically using digital planning-based technologies for memory support. Results: From 1854 sources, 8 studies were included. Five categories of digital planning-based technologies were identified: (1) reminders and alarms, (2) electronic calendars, (3) digital memory notebooks, (4) digital visual mapping, and (5) smart-home integration. Several studies reported improved task performance, memory recall, and executive function, with digital memory notebooks and visual mapping software showing greatest impact on functional independence. While interventions were generally well-received, usability challenges and low adherence were common, often linked to technological familiarity and motivation. Conclusions: Digital planning-based technologies show promise in supporting memory-related functioning in older adults with MCI. While studies report positive outcomes, more research is needed to refine these tools, evaluate long-term effects, and ensure integration into daily life. Expanding the evidence base will be key to improving accessibility and effectiveness for this population. Full article

This paper explores how digital crowdsourcing platforms communicate sustainability-oriented innovation and mobilise stakeholder engagement. Through a directed content analysis of three platforms (OpenIDEO, San Francisco, CA, USA; Enel Innovation Hub, Rome, Italy; and InnoCentive, Waltham, MA, USA). The study examines communication strategies, participation models, and alignment with the United Nations Sustainable Development Goals (SDGs). Results show that communication is not neutral but functions as a governance mechanism shaping who participates, how innovation is framed, and what outcomes emerge. OpenIDEO fosters inclusive co-creation and SDG alignment, Enel Innovation Hub highlights technical readiness and energy transition, and InnoCentive relies on rewards and competition. Word-frequency analysis confirms these emphases, while interpretation through Motivation Crowding Theory, Social Exchange Theory, and Transaction Cost Theory explains how motivational framing, legitimacy signals, and participation structures affect engagement. The study contributes to research on open innovation and platform studies by demonstrating the constitutive role of communication in enabling or constraining sustainable collective action. Practical implications are outlined for platform designers, marketers, and policymakers seeking to align digital infrastructures with systemic sustainability goals. Full article

People with Autism Spectrum Disorder (ASD) face significant barriers to accessing and maintaining employment, many of which stem from work environments that fail to accommodate their neurological diversity. This article aims to analyze the occupational risks faced by autistic individuals in the workplace. A total of 39 scientific studies were reviewed, and the results identified nine predominant thematic categories of occupational risks. Particularly prominent were deficient communication, lack of structured support, cognitive overload, and difficulties coping with change. The reported situations were examined in detail, with attention paid to their specific contexts. A clear predominance of psychosocial risks over ergonomic ones was observed. The review also highlights several underexplored yet equally relevant risk factors, such as discontinuity in supported employment programs, difficulties in requesting reasonable accommodations, discrimination, a lack of professional recognition, and the negative effects of digital or remote environments, such as isolation. This study underscores the importance of recognizing unsafe conditions arising from the lack of neurodiversity-informed adjustments as a necessary step toward implementing organizational and social adaptations in the workplace. Full article

This study addresses a significant gap in the existing literature by introducing novel perspectives. First, it provides a comprehensive assessment of the impact of ESG sustainability and information and communication technology (ICT) on energy transition using updated quarterly data from 2002 Q3 to 2024 Q4. Second, it uniquely integrates climate policy uncertainty (CPU) and financial development (FD) as core explanatory variables, which have been largely neglected in prior research. Third, this study applies advanced quantile-based methodologies, including the Quantile Autoregressive Distributed Lag (QARDL) model and Quantile Cointegration (QC) techniques, to enhance empirical rigor and ensure policy relevance across the entire conditional distribution. The results showed that at lower quantiles (τ = 0.05–0.30), FD positively influences ET, supporting early-stage clean energy adoption. ICT shows a short-term negative effect (τ = 0.05–0.40). Based on these findings, policymakers should strengthen financial development to accelerate clean energy adoption at early stages, while addressing the short-term negative impacts of ICT by promoting supportive digital and energy policies that align technology use with sustainability goals. Full article

The recent shift from in-person to digital pharmacy services is transforming how patients interact with their pharmacists but has the potential to disadvantage older adults (aged ≥ 65) who often face barriers when using technology. This study aimed to assess digital inequalities affecting medication access among older adults. A Spanish-language questionnaire was developed and psychometrically validated, revealing a two-factor latent structure comprising: (1) Technology Use, and (2) Medication Access. Item discrimination analysis confirmed that all significantly differentiated between those that used technology to facilitate their medication access and those that did not (p < 0.001). Participants with higher education reported greater income levels (p < 0.001), and income was in turn related to both internet access and digital skills. Age played a key role in perceptions of technology. Participants who considered technology helpful were younger ($\overline{x}$ = 72.9) than those who did not ($\overline{x}$ = 76.6; p = 0.001). There was no significant relationship between perceived technological usefulness and reporting not being able to acquire medications because of technological barriers (p = 0.788). This newly created and validated questionnaire identified gaps related to digital pharmacy services and may be a useful tool in future clinical, community, and investigative contexts. Full article