Search Results (205)

Framed within the lens of systems theory and sociotechnical systems thinking, this systematic review examines telehealth as a complex adaptive system and dynamic health system shaped by the interactions between interconnected technological, social, and institutional components. Recognizing telehealth as part of a complex adaptive system, the review identifies how interdependent factors, such as digital literacy, connectivity, and policy, evolve and influence access to and the emergent properties of care. A systematic review was conducted following the PRISMA 2020 guidelines and PROSPERO registration (CRD420251103608), analyzing 42 peer-reviewed articles published between January 2020 and June 2025, identified through the MEDLINE, Web of Science, EBSCOhost, ACM Digital Library, PsycINFO, and Scopus databases. Key findings include sustained but reduced telehealth use after the pandemic peak, as well as a small yet statistically significant positive effect of telehealth interventions on cognitive emergent properties, defined here as measurable outcomes like memory, attention, executive function, and processing speed (SMD = 0.29; 95% CI [0.04, 0.54]) with very low heterogeneity (I² = 0%). Significant system components such as digital illiteracy, poor internet connectivity, and complex technology interfaces disproportionately affected economically disadvantaged, minority, and rural older adults. Practical strategies rooted in systems thinking include digital literacy programs, simplified interfaces, caregiver support, improved broadband infrastructure, hybrid healthcare models, and supportive policies. Future research should focus on evidence-based, system-level interventions across diverse settings to bridge the digital divide and promote equitable access to telehealth for older adults. Full article

Conventional frameworks often reduce architectural production to a linear sequence of deterministic technical and managerial stages. This study challenges that paradigm, arguing that such a view overlooks the adaptive, multi-layered, and context-responsive nature of contemporary built environment creation. Grounded in systems theory, biomimicry, and human physiology, a novel “Building Anatomy” model is proposed that treats architectural practice as a living organism. This conceptual framework is first established, and its validity is then tested through a mixed-methods empirical study conducted with 126 Turkish architects, analyzing the continuous feedback loops between internal (e.g., designer identity, team dynamics) and external (e.g., regulations, socio-cultural currents) factors. It was confirmed that the dynamic interaction between these internal and external factors is central to architectural processes. “Systemic dysfunctions” were identified and diagnosed that arise from breakdowns in these metabolic feedback loops, providing empirical evidence for the model’s explanatory power. By offering a systemic lens, this study shifts the focus from a product-centric to a process-oriented view of design. The Building Anatomy model demonstrates its potential for diagnosing “metabolic failures” and redefining the architect’s agency, ultimately advocating for more adaptive, responsive, and resilient architectural outcomes. Full article

This research aims to evaluate and highlight the potential mesostructured architecture of established behaviours and operational practices based on the working model change imposed by the pandemic emergency in the public sector. After the intervention of an exogenous shock, the readiness, perceived usefulness and ease-of-use of technologies made the Technology Acceptance Model [TAM] verifiable. Concurrently, it is also possible to verify the Theory of Planned Behaviour [TPB] in the motivation and intention to change employees’ working habits under the lens of complexity and urgency, involving a From Knowledge To Knowledge Strategy [FKTKS]. The research protocol encompasses semi-structured interviews with public managers in Italy, alongside a perceptual and sentiment trend analysis of 70 public employees [35 females and 35 males] regarding their sentiments on digital transition and smart/hybrid working habits before, during, and after the pandemic. In the public sector, change is perceived as a shock-generative tension. In this way, the research aims to answer the genderised issue related to the perception and the persistence of using digital tools in the workplace during the post-urgency period as a regular habit based on perceived usefulness and ease-of-use. The study highlights a gender-specific trend in the use of the smart/hybrid working model after the health emergency. This propensity may also be attributable to the gender traits defined by Hofstede, within whose paradigm the interpretative dynamic provided is embedded. The during-COVID-19 acceptance and usage behaviours define an element related to masculinity because of its urgency and pressing deadlines. In contrast, endurance connects to femininity, emphasising resilience and long-term goals. This approach prioritises resilience and comprehensive well-being, focusing on achieving a good work–life balance [WLB] rather than just addressing immediate issues. Full article

This paper explores the concept of diasporic hybridity through Hanshan’s (Cold Mountain) life and poetry during the Tang dynasty (618–907). Departing from traditional diaspora models of forced migration, Hanshan’s voluntary exile from the Confucian-dominated capital to the spiritually diverse Tiantai Mountain reveals how internal dislocation can foster hybrid religious identities. Through a close reading of his poetry and spiritual journey, this study argues that Hanshan embodies the Chinese philosophy of Hehe (和合), which is a model of religious pluralism grounded in “harmony through difference.” By integrating Homi Bhabha’s “third space” theory and Arjun Appadurai’s “diaspora landscape,” the paper demonstrates how Hanshan’s engagement with Confucianism, Buddhism, and Daoism presents a dynamic framework for understanding interreligious dialog. Hanshan’s hybrid spiritual identity thus offers a transhistorical lens for reimagining religious pluralism in both historical and contemporary contexts. Full article

This study establishes an impact pathway hypothesis connecting street environments, safety perception, and women’s stay behaviors based on spatial cognition theory and the lens model theory. It examines the driving factors behind female environmental perception and behavioral patterns in urban streetscapes by integrating street view imagery and facility point data. Random forest models and questionnaire surveys were employed to evaluate the sense of security, and structural equation modeling was used to quantify environmental features, safety perception, and behavioral indicators. The results demonstrate that four street environment dimensions, functionality formats, interface morphology, spatial quality, and street facilities, exert varying degrees of positive or negative influences on women’s safety perception and behaviors. Perceived safety serves as a significant mediator in the environment–behavior pathway, with functionalities, spatial quality, and interface morphology exhibiting sequentially decreasing effect magnitudes in this mediated relationship, while street facilities indirectly affect staying behaviors exclusively through the safety perception mechanism. Full article

This paper proposes a formal descriptive model for understanding the evolution of characters in detective fiction from the 19th to the 20th century, using methodologies and technologies from the Semantic Web. The integration of Digital Humanities within the theory of comparative literature opens new paths of study that allow for a digital approach to the understanding of intertextuality through close reading techniques and ontological modelling. In this research area, the variety of possible textual relationships, the levels of analysis required to classify these connections, and the inherently referential nature of certain literary genres demand a structured taxonomy. This taxonomy should account for stylistic elements, narrative structures, and cultural recursiveness that are unique to literary texts. The detective figure, central to modern literature, provides an ideal lens for examining narrative intertextuality across the 19th and 20th centuries. The analysis concentrates on character traits and narrative functions, addressing various methods of rewriting within the evolving cultural and creative context of authorship. Through a comparative examination of a representative sample of detective fiction from the period under scrutiny, the research identifies mechanisms of (meta)narrative recurrence, transformation, and reworking within the canon. The outcome is a formal model for describing narrative structures and techniques, with a specific focus on character development, aimed at uncovering patterns of continuity and variation in diegetic content over time and across different works, adaptable to analogous cases of traditional reworking and narrative fluidity. Full article

Background/Objectives: Emotional competence is a crucial skill in nursing education, yet it remains underdeveloped in academic curricula. This study aims to (1) propose and preliminarily apply the TRI-COM model as a conceptual and educational framework to operationalize the definition of emotions within nursing contexts, and (2) explore the multidimensional structure of emotional competence among nursing students. Methods: A cross-sectional study was conducted with 233 nursing students (M_age = 23.79, SD = 5.19) from various Italian universities, with 82.8% identifying as female. The participants completed an online questionnaire including the Toronto Alexithymia Scale (TAS-20) and the Jefferson Scale of Empathy—Health Profession Student (JSE-HPS) version. Descriptive statistics, t-test, ANOVA, and Pearson’s correlation analyses were performed. Results: The overall mean TAS-20 score was 60.36 (SD = 11.22), which is close to the clinical threshold (cut-off = 61). The EOT subscale showed the highest mean (M = 26.48, SD = 3.16), suggesting a tendency toward externally oriented thinking. The mean JSE-HPS total score was 87.05 (SD = 7.88), with higher scores for Perspective Taking (M = 60.95, SD = 7.42) than Compassionate Care (M = 18.92, SD = 6.40). A significant gender difference was found in Perspective Taking (female: M = 61.54, male: M = 58.10; p = 0.007). The ANOVA results showed no significant differences in empathy across academic years, but the DIF subscale of TAS-20 showed a trend near significance (p = 0.053). Significant negative correlations were observed between age and TAS-20 scores (e.g., age–TAS-20 total: r = −0.23, p < 0.001). Conclusions: The findings suggest a general tendency toward rationalization and emotional detachment among students, possibly as a coping strategy in emotionally demanding contexts. The TRI-COM model—an original pedagogical framework inspired by tripartite theories of emotion—was used as a conceptual lens, providing a preliminary framework to interpret emotional competence in nursing education. Further research is needed to validate its educational relevance and explore practical applications within curricula. Full article

As protected areas (PAs) expand globally at an accelerating rate, reconciling biodiversity conservation with socioeconomic development in adjacent communities has become a critical challenge for landscape sustainability. This systematic review synthesizes literature (1990–2025) to trace three interconnected transitions: (1) the conceptual evolution from exclusionary to inclusive PA–community paradigms, grounded in shifting perceptions of cultural landscapes; (2) the governance transformation from tokenistic participation to power-sharing co-management frameworks; and (3) the spatial planning progression from fragmented “island” models to integrated protected area networks (PANs) leveraging ecological corridors. Our analysis reveals that disconnected PA–community relationships exacerbate conservation–development conflicts, particularly where cultural landscapes are undervalued. A key finding is that cultural–natural synergies act as pivotal mediators for conservation efficacy, necessitating context-adaptive governance approaches. This study advances landscape planning theory by proposing a rural landscape network framework that integrates settlement patches, biocultural corridors, and PA matrices to optimize ecological connectivity while empowering communities. Empirical insights from China highlight pathways to harmonize stringent protection with rural revitalization, underscoring the capacity of PANs to bridge spatial and socio-institutional divides. This synthesis provides a transformative lens for policymakers to scale locally grounded solutions across global conservation landscapes. Full article

Objectives: Patients with rare diseases in China face extremely high medical expenses. The current coverage framework remains inadequate in terms of coverage depth and proactive risk control, underscoring an urgent need for institutional reform. Methods: This study employs a policy content analysis approach to review the current landscape of rare disease protection in China. Drawing on risk management theory and the health capital model, it constructs an analytical framework to examine potential institutional reforms through the lens of risk response pathways and the efficiency of health investment. Results: The findings reveal that basic medical insurance (BMI) provides limited financial protection for patients with rare diseases. Among China’s 31 provincial-level administrative centers, 24 have set general outpatient reimbursement ceilings under the urban and rural resident basic medical insurance (URRBMI) at 1000 RMB or less. In comparison, 24 cities have set outpatient reimbursement limits under the urban employee basic medical insurance (UEBMI) at 6000 RMB or less. The security system relies predominantly on the BMI, while supplementary mechanisms have failed to provide effective support or continuity in coverage. Current policies are generally reactive, with coverage typically triggered only after a confirmed diagnosis and often lacking early intervention or preventive strategies. Conclusions: China’s rare disease security system urgently requires structural improvements in coverage depth and proactive risk management. The proposed Dedicated Insurance Scheme for Rare Diseases (DISRD) presents a feasible and sustainable model for China’s multi-tiered system of securing rare diseases. It provides valuable institutional insights for other countries and regions seeking to build public health systems with proactive risk control capabilities. Full article

As new technologies shape education, helping students develop historical consciousness remains a challenge. Building on Nordic curricula that emphasize students as both “history-made” and “history-making” citizens, this paper proposes an approach that integrates artificial intelligence (AI) with implicit digital game-based learning (DGBL) to learn and develop historical consciousness in education. We outline how traditional, lecture-driven history teaching often fails to convey the abstract principles of historicity (the idea that individual identity, social institutions, values, and ways of thinking are historically conditioned) and the interpretation of the past, understanding of the present, and perspective on the future. Building on Jeismann’s definition of historical consciousness, we identify a gap between the theory-rich notions of historical consciousness and classroom practice, where many educators either do not recognize it or interpret it intuitively from the curriculum’s limited wording, leaving the concept generally absent from the classroom. We then examine three theory-based methods of enriching teaching and learning. Game-based learning provides an interactive environment in which students assume roles, make decisions, and observe consequences, experiencing historical consciousness instead of only reading about it. AI contributes personalized, adaptive content: branching narratives evolve based on individual choices, non-player characters respond dynamically, and analytics guide scaffolding. Implicit learning theory suggests that embedding core principles directly into gameplay allows students to internalize complex ideas without interrupting immersion; they learn by doing, not by explicit instruction. Finally, we propose a model in which these elements combine: (1) game mechanics and narrative embed principles of historical consciousness; (2) AI dynamically adjusts challenges, generates novel scenarios, and delivers feedback; (3) key concepts are embedded into the game narrative so that students absorb them implicitly; and (4) follow-up reflection activities transform tacit understanding into explicit knowledge. We conclude by outlining a research agenda that includes prototyping interactive environments, conducting longitudinal studies to assess students’ learning outcomes, and exploring transferability to other abstract concepts. By situating students within scenarios that explore historicity and temporal interplay, this approach seeks to transform history education into an immersive, reflective practice where students see themselves as history-made and history-making and view the world through a historical lens. Full article

Despite high expectations for Fintech growth, its real-world expansion has fallen short due to its inherent complexity. Although Fintech is innovative, its multidimensional nature has made it difficult for companies to develop effective, tailored solutions for its diverse user groups. To foster the development of effective and practical Fintech solutions that can expand the user base, a novel and integrative approach is required. Therefore, this study aims to explore specific solutions to enhance Fintech use by holistically combining and intertwining various attributes. Based on the diffusion of innovation theory and the information systems success model, we propose a conceptual Fintech model consisting of three dimensions: innovation, financial service, and information technology. To investigate this model, we adopt fuzzy-set qualitative comparative analysis (fsQCA), a set-theoretic method suited to identifying combinations of Fintech attributes that lead to specific outcomes. The results reveal that the configurations of Fintech attributes leading to high Fintech use differ across four user groups: Infrequent users, Lurkers, Task-driven users, and Power users. The findings also show that information technology plays multifaceted roles depending on its combination with other Fintech attributes. This study explains the interdependencies among Fintech attributes and their combined effects on Fintech use, offering deeper insights into Fintech research through a configurational lens. Full article

In South Africa, small enterprise development is at the top of the government agenda. However, a significant issue lies in the type of skills and support necessary to develop SMMEs through the various phases of the business cycle. This study addresses a knowledge gap regarding whether SMME support interventions comprehensively address all managerial functions as per the P-O-L-C model. Guided by the Resource-Based Theory (RBT), and the Human Capital Theory (HCT), data was collected from 350 SMMEs in the Eastern Cape province using a structured self-administered questionnaire. Multiple regression analyses revealed that non-financial support from both the public (R² = 0.089, p = 0.215) and private (R² = 0.161, p = 0.207) sectors was not significantly associated with SMME success. Furthermore, while private sector support explained 14.8% (R² = 0.148, p < 0.001) and public sector support 7.6% (R² = 0.076, p < 0.001) of the variation in meeting SMME needs, support in key functional areas remains fragmented and poorly targeted. These findings highlight a systemic disconnect between the supply and demand sides of the SMME support ecosystem. To address this, this study proposes an integrative support model that aligns RBT and HCT within the P-O-L-C managerial framework, ensuring phase-appropriate, function-specific support. This framework departs from prior applications by reconceptualizing managerial support not as a generic intervention, but as a strategically sequenced process aligned with the business lifecycle. The model contributes a new lens for theorizing support efficacy and offers practical guidance for more targeted intervention design. This framework offers both theoretical and practical contributions toward improving the design and implementation of business interventions in South Africa. Full article

This paper explores the integration of financial and operational flows in Supply Chain Finance (SCF) through the lens of Information Processing Theory (IPT). Despite increasing adoption of SCF solutions like reverse factoring and trade credit, existing literature lacks a unified theoretical framework that captures both financial and organizational complexities. Drawing from 47 peer-reviewed articles in leading supply chain journals, this study identifies key SCF dimensions—task characteristics, environment, and interdependence—as primary sources of uncertainty and information processing needs. It then examines how IT systems, coordination mechanisms, and organizational design enhance processing capacity, enabling firms to build SCF capabilities such as risk assessment, supplier onboarding, and financial process standardization. These capabilities facilitate financial supply chain integration through data connectivity, embedded flows, and collaborative planning. The study contributes a comprehensive conceptual model that connects SCF uncertainties, processing strategies, and performance outcomes, addressing theoretical and managerial gaps. It further provides a foundation for future empirical research and strategic design of SCF systems to enhance supply chain resilience and financial efficiency. Full article

This study investigates the psychological and emotional mechanisms underlying women’s reactions to breast cancer awareness advertisements through the dual lens of Protection Motivation Theory (PMT) and neuromarketing methods, addressing a gap in empirical research on the integration of biometric and cognitive approaches in health marketing. Utilizing a lab-based experiment with 78 women aged 40 and older, we integrated Facial Expression Analysis using Noldus FaceReader 9.0 with semi-structured post-exposure interviews. Six manipulated health messages were embedded within a 15 min audiovisual sequence, with each message displayed for 5 s. Quantitative analysis revealed that Ads 2 and 5 elicited the highest mean fear scores (0.45 and 0.42) and surprise scores (0.35 and 0.33), while Ad 4 generated the highest happiness score (0.31) linked to coping appraisal. Emotional expressions—including fear, sadness, surprise, and neutrality—were recorded in real time and analyzed quantitatively. The facial analysis data were triangulated with thematic insights from interviews, targeting perceptions of threat severity, vulnerability, response efficacy, and self-efficacy. The findings confirm that fear-based appeals are only effective when paired with actionable coping strategies, providing empirical support for PMT’s dual-process model. By applying mixed-methods analysis to the evaluation of health messages, this study makes three contributions: (1) it extends PMT by validating the emotional–cognitive integration framework through biometric–qualitative convergence; (2) it offers practical sequencing principles for combining threat and coping cues; and (3) it proposes cross-modal methodology guidelines for future health campaigns. Full article

Unregulated herbal products marketed via digital platforms present escalating risks to consumer safety and regulatory effectiveness worldwide. This study positions the case of Jindamanee herbal powder—a banned substance under Thai law—as a lens through which to examine broader challenges in digital health governance. Drawing on a dataset of 1546 product listings across major platforms (Facebook, TikTok, Shopee, and Lazada), we applied Latent Dirichlet Allocation (LDA) to identify prevailing promotional themes and compliance gaps. Despite explicit platform policies, 87.6% of listings appeared on Facebook. Medical claims, particularly for pain relief, featured in 77.6% of posts, while only 18.4% included any risk disclosure. These findings suggest a systematic exploitation of regulatory blind spots and consumer health anxieties, facilitated by templated cross-platform messaging. Anchored in Information Manipulation Theory and the Health Belief Model, the analysis offers theoretical insight into how misinformation is structured and sustained within digital commerce ecosystems. The Thai case highlights urgent implications for platform accountability, policy harmonization, and the design of algorithmic surveillance systems in global health product regulation. Full article