Behavioral Model Research Articles

Utilization of Sexual Reproductive Health Services Among Youths in Malaysia: A Cross-Sectional Study Applying Andersen’s Behavioral Model of Healthcare Utilization

Utilization of Sexual Reproductive Health Services Among Youths in Malaysia: A Cross-Sectional Study Applying Andersen’s Behavioral Model of Healthcare Utilization

Clinical value of cognitive behavioral nursing model to patients with congenital glaucoma.

There have been studies on the use of cognitive behavioral nursing intervention (CBNI) but the main subjects were patients with secondary glaucoma and there are fewer studies on the care of congenital glaucoma. To explore the clinical value of cognitive behavioral nursing model in patients with congenital glaucoma. One hundred and fifty-three postoperative patients with congenital glaucoma treated in our hospital between January 2021 and December 2022 were prospectively selected for the study and randomly divided into a control group (n= 77) and an observation group (n= 76). The control group was given routine nursing, and the observation group was given cognitive behavioral nursing mode on the basis of the control group. Anxiety self-assessment scale (SAS), depression self-assessment scale (SDS), Connor-Davidson toughness scale, and treatment adherence evaluation scale were used to evaluate the psychological state, mental toughness, treatment adherence, treatment effect and nursing care satisfaction in the two groups before and after 2 weeks of intervention. The efficacy of the treatment was also assessed by determining the visual acuity (VA), intraocular pressure (IOP), and mean defective (MD) value of the visual field of the two groups of patients. After nursing, the SDS score (46.33 ± 6.16 versus 53.21 ± 5.94) and SAS score (44.41 ± 5.6 versus 52.82 ± 6.31) in the observation group were lower than those in the control group (P< 0.05). The scores of optimism (11.55 ± 1.90 versus 8.20 ± 1.95), self-improvement (22.05 ± 3.60 versus 17.60 ± 4.30), tenacity (37.45 ± 3.10 versus 28.90 ± 4.55) and total score (71.35 ± 8.00 versus 56.85 ± 8.50) in the observation group were higher than those in the control group (P< 0.05). After care, the VA of the observation group (0.95 ± 0.22) was greater than that of the control group (0.84 ± 0.16), and the IOP (14.25 ± 0.58 versus 15.89 ± 0.67) and the MD (5.42 ± 0.46 versus 6.68 ± 0.49) of the observation group were less than that of the control group. The difference between the two groups was statistically significant (P< 0.05). The compliance (96.05% versus 85.71%) and nursing satisfaction (96.10% versus 85.71%) of the observation group were higher than those of the control group (P< 0.05). Cognitive-behavioural nursing care for glaucoma patients can improve patients' mental toughness, improve visual acuity, reduce intraocular pressure and mean visual field defect values, and have a positive effect on enhancing patients' treatment adherence and nursing satisfaction.

Factors associated with the use of annual health checkups in Thailand: evidence from a national cross-sectional health and welfare survey

IntroductionThailand has provided free annual health checkups (AHC) since universal health coverage began in 2002. However, evidence regarding the equitable use of AHC is scarce. Thus, this study explored factors associated with the use of AHC in Thailand.MethodsA cross-sectional study was conducted using data from the national 2015 Health and Welfare Survey. Respondents aged 15 years or above (n = 57,343) were selected as the study sample. Descriptive statistical analysis and multivariable binary logistic regression were conducted to examine the association between the use of AHC and factors selected on the basis on Andersen’s Behavioral Model of Access to Medical Care.ResultsAmong the study sample, approximately 4.9% (n = 2,815) had used AHC during the past year. Regarding predisposing factors, the use of AHC was positively related to age (e.g., over 61 vs. 15–30: AOR = 2.90 [95% CI = 2.40–3.52], p &amp;lt; 0.001) and female sex (AOR = 1.23 [95% CI = 1.12–1.35] p &amp;lt; 0.001). For enabling factors, the AHC use was positively associated with income (e.g., Q4 vs. Q1: AOR = 1.98 [95% CI = 1.75–2.25], p &amp;lt; 0.001), education (e.g., high vs. low: AOR = 3.11 [95% CI = 2.75–3.51], p &amp;lt; 0.001), being married (e.g., vs. single: AOR = 1.27 [95% CI = 1.11–1.46], p &amp;lt; 0.001), and urban residency (AOR = 1.12 [95% CI = 1.04–1.22], p = 0.006). For need-for-care factors, the AHC use was positively related to chronic disease (AOR = 1.26 [95% CI = 1.15–1.38], p &amp;lt; 0.001), non-smoking (e.g., vs. daily: AOR = 1.18 [95% CI = 1.03–1.36], p = 0.015), non-drinking (e.g., vs. 3–4 times per week: AOR = 1.26 [95% CI = 1.04–1.53], p = 0.016), and vegetable consumption (e.g., over 5 ladles vs. below 1 ladle: AOR = 1.86 [95% CI = 1.50–2.31], p &amp;lt; 0.001).ConclusionThe results indicate that health awareness could play a significant role in the use of AHC. Individuals with high socioeconomic status (e.g., high-income people) and those with low-risk health behaviors (e.g., non-smokers) generally have a high interest in health and well-being. This may have been the primary reason for the high use of AHC among these groups. Thus, the government should continue to promote the public’s health awareness through various public campaigns and education programs to increase the use of AHC.

The Uncontrollable Mortality Risk Hypothesis: Theoretical Foundations and Implications for Public Health

Abstract The ‘Uncontrollable Mortality Risk Hypothesis’ employs a behavioural ecological model of human health behaviours to explain the presence of social gradients in health. It states that those who are more likely to die due to factors beyond their control should be less motivated to invest in preventative health behaviours. We outline the theoretical assumptions of the hypothesis and stress the importance of incorporating evolutionary perspectives into public health. We explain how measuring perceived uncontrollable mortality risk can contribute towards understanding socioeconomic disparities in preventative health behaviours. We emphasise the importance of addressing structural inequalities in risk exposure, and argue that public health interventions should consider the relationship between overall levels of mortality risk and health behaviours across domains. We suggest that measuring perceptions of uncontrollable mortality risk can capture the unanticipated health benefits of structural risk interventions, as well as help to assess the appropriateness of different intervention approaches.

Peer Ambassador Perspectives in a Culturally Tailored Self-Management Intervention for African Americans with Type 2 Diabetes: A Qualitative Study

Objective: Diabetes disproportionately affects African Americans, leading to higher morbidity and mortality. This study explores the experiences of African American adults who successfully self-manage their type 2 diabetes (called Peer Ambassadors) and provided phone-based peer support in a 6-month culturally tailored diabetes self-management program for African Americans guided by the information–motivation–behavioral skills model. Design: A group discussion using a semi-structured discussion guide was conducted. Qualitative content analysis was used to identify the facilitators and barriers to completing the role of a Peer Ambassador and to develop strategies for overcoming possible challenges in the future. Setting: Key informant discussions were conducted in a community location to gain insights into Ambassadors’ motivations and challenges in delivering peer support. Participants: Three Peer Ambassadors completed ethics training and peer mentor training and received a phone call guide before providing support to their peers. Results: There were four core themes related to Peer Ambassador experiences: (1) Motivation to be a Peer Ambassador, (2) program elements that supported Peer Ambassador role, (3) key elements of achieving engagement, and (4) challenges related to being a Peer Ambassador. Conclusions: This study showed Peer Ambassadors in a culturally tailored peer supported self-management program found fulfillment in sharing experiences and supporting peers. They highly valued educational group sessions for knowledge updates and sustaining their health-related goals, suggesting the potential benefits of recognizing milestones or providing advanced training for future program sustainability. Findings suggest the importance of recruiting motivated patients and providing effective facilitation for peer support roles, including addressing barriers such as time commitment and lack of socialization opportunities.

ST-2560, a selective inhibitor of the NaV1.7 sodium channel, affects nocifensive and cardiovascular reflexes in non-human primates.

The voltage-gated sodium channel isoform NaV1.7 is a high-interest target for the development of non-opioid analgesics due to its preferential expression in pain-sensing neurons. NaV1.7 is also expressed in autonomic neurons, yet its contribution to involuntary visceral reflexes has received limited attention. The small molecule inhibitor ST-2560 was advanced into pain behaviour and cardiovascular models to understand the pharmacodynamic effects of selective inhibition of NaV1.7. Potency of ST-2560 at NaV1.7 and off-target ion channels was evaluated by whole-cell patch-clamp electrophysiology. Effects on nocifensive reflexes were assessed in non-human primate (NHP) behavioural models, employing the chemical capsaicin and mechanical stimuli. Cardiovascular parameters were monitored continuously in freely-moving, telemetered NHPs following administration of vehicle and ST-2560. ST-2560 is a potent inhibitor (IC50 = 39 nM) of NaV1.7 in primates with ≥1000-fold selectivity over other isoforms of the human NaV1.x family. Following systemic administration, ST-2560 (0.1-0.3 mg·kg-1, s.c.) suppressed noxious mechanical- and chemical-evoked reflexes at free plasma concentrations threefold to fivefold above NaV1.7 IC50. ST-2560 (0.1-1.0 mg·kg-1, s.c.) also produced changes in haemodynamic parameters, most notably a 10- to 20-mmHg reduction in systolic and diastolic arterial blood pressure, at similar exposures. Acute pharmacological inhibition of NaV1.7 is antinociceptive, but also has the potential to impact the cardiovascular system. Further work is merited to understand the role of NaV1.7 in autonomic ganglia involved in the control of heart rate and blood pressure, and the effect of selective NaV1.7 inhibition on cardiovascular function.

Presenting the AI models in predicting the settlement of earth dams using the results of spatiotemporal clustering and k-means algorithm

In this work, the results of instrumentation over 8 years, including the phases of construction, first impounding, and operation, have been used to analyze the location of the Eyvashan Dam settlement. Mohr–Coulomb behavioral model and numerical model of Plaxis 2D software were used to verify the monitoring results. The results demonstrated that settlement of the dam has increased in the dam's core since the beginning of construction, and they eventually stabilized during the operation phase. After the completion of the construction phase, the maximum settlement of the dam core was recorded as 809 mm, which is equivalent to 1.2% of the height of the dam at the middle level. Also, an approach to interpreting the settlement behavior of earth dams has been presented that is based on spatiotemporal clustering. Also, RF, MARS, and GMDH models were created based on a proposed scenario to predict settlement using points located in a cluster. Therefore, the settlement location of the studied dam was determined using the results of the k-means clustering algorithm in the aforementioned AI models. The high accuracy of the results of the proposed method confirms the proper performance of using AI models in predicting and diagnosing the settlement of earthen dams using the results of k-means spatiotemporal clustering algorithm. The evaluation of the models shows that the ENN model is a more suitable and efficient tool in this field and can be useful in monitoring the settlement of earth dams.

Study of defensive behavior of a venomous snake as a new approach to understand snakebite

Snakebites affect millions of people worldwide. The majority of research and management about snakebites focus on venom and antivenom, with less attention given to snake ecology. The fundamental factor in snakebites is the snakes’ defensive biting behavior. Herein we examine the effects of environmental variables (temperature, time of day, and human stimulus) and biological variables (sex and body size) on the biting behavior of a medically significant pit viper species in Brazil, Bothrops jararaca (Viperidae), and associate it with the epidemiology of snakebites. Through experimental simulations of encounters between humans and snakes, we obtained behavioral models applicable to epidemiological situations in the State of São Paulo, Brazil. We found a significant overlap between behavioral, morphological, environmental, and epidemiological data. Variables that increase snakebites in epidemiological data also enhance the tendency of snakes to bite defensively, resulting in snakebites. We propose that snakebite incidents are influenced by environmental and morphological factors, affecting the behavior of snakes and the proportion of incidents. Thus, investigating behavior of snakes related to snakebite incidents is a valuable tool for a better understanding of the epidemiology of these events, helping the prediction and, thus, prevention of snakebites.

Determinants of the optimal selection of vascular access devices: A systematic review underpinned by the COM-B behavioural model.

Optimal selection of vascular access devices is based on multiple factors and is the first strategy to reduce vascular access device-related complications. This process is dependent on behavioural and human factors. The COM-B (Capability, Opportunity, Motivation, Behaviour) model was used as a theoretical framework to organize the findings of this systematic review. To synthesize the evidence on determinants shaping the optimal selection of vascular access devices, using the COM-B behavioural model as the theoretical framework. Systematic review of studies which explore decision-making at the time of selecting vascular access devices. The Medline, Web of Science, Scopus and EbscoHost databases were interrogated to extract manuscripts published up to 31 December 2021, in English or Spanish. Among 16 studies included in the review, 8/16 (50%) focused on physical capability, 8/16 (50%) psychological capability, 15/16 (94%) physical opportunity, 12/16 (75%) social opportunity, 1/16 (6%) reflective motivation and 0/16 (0%) automatic motivation. This distribution represents a large gap in terms of interpersonal and motivational influences and cultural and social environments. Specialist teams (teams created for the insertion or maintenance of vascular access devices) are core for the optimal selection of vascular access devices (75% physical capability, 62% psychological capability, 80% physical opportunity and 100% social opportunity). Specialist teams predominantly lead all actions undertaken towards the optimal selection of vascular access devices. These actions primarily centre on assessing opportunity and capability, often overlooking motivational influences and social environments. A more implementation-focused professional approach could decrease inequity among patients and complications associated with vascular access devices. Optimal selection of vascular access devices is the primary strategy in mitigating complications associated with these devices. There is a significant disparity between interpersonal and motivational influences and the cultural and social environments. Furthermore, specialized teams play a pivotal role in facilitating the optimal selection of vascular access devices. The study can benefit institutions concerned about vascular access devices and their complications. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. No Patient or Public Contribution. WHAT DOES THIS ARTICLE CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Optimal selection of vascular devices remains a growing yet unresolved issue with costly clinical and patient experience impact. Interventions to improve the optimal selection of vascular devices have focused on training, education, algorithms and implementation of specialist vascular teams; alas, these approaches do not seem to have substantially addressed the problem. Specialist vascular teams should evolve and pivot towards leading the implementation of quality improvement interventions, optimizing resource use and enhancing their role.

Evacuation information methodology that combined a flooded environment and pedestrian behavioral model

Disaster information influences decision-making. Wireless internet and location-based services, aided by recent technological advances, have laid the foundation for providing personalized disaster information. Despite the provision of simple disaster forecasts and warnings, provision of specific evacuation actions (“where” and “how,” i.e., location and reachability of safe areas) and location-based personalized information that consider real-time disaster situations are a pressing priority. Thus, this study proposed and developed a three-step methodology for providing disaster information during floods that combined a flooded environment and pedestrian behavioral model, namely, 1) prediction of the flooded environment, 2) analysis of evacuation routes based on the movement time of evacuees according to the flood depth, and 3) provision of evacuation information by selecting the optimal evacuation route. This model was demonstrated in the Gangnam Station area in Seoul, Korea. Flooded environment prediction modeling of the target area was performed by applying the 100-year rainfall design to the Storm Water Management Model. The optimal evacuation route, according to the flood depth, was selected by applying the behavioral model (movement time calculation formula) for each evacuee derived through an evacuation behavior experiment. The pre- and post-flooding age- and gender-wise total evacuation distance and time were compared and analyzed. Post-flooding, the evacuation distance and time increased by 168.3% (381.34 m) and 172.3% (3.16 min) on average, respectively, indicating that evacuees must travel farther and longer. The analysis of post-flooding evacuation route change types revealed changes in evacuation distance and time in cases where shelters and evacuation routes and time were significantly different depending on evacuee characteristics (age and gender). This indicated that specific and visual disaster information can be provided according to evacuees’ age and gender using the proposed methodology. This study can serve as the basis for designing an advanced and personalized disaster information system that can provide specific evacuation actions to aid fast evacuation decision-making during floods.

Impact of Perceived Parenting Styles on Happiness and Aggression among Youth

Abstract: This study explores the complex relationship between perceived parenting styles, aggressiveness, and happiness, with a particular emphasis on how these relationships affect young adults' emotional and psychological health. The home environment, which is frequently regarded as a testing ground for emotional growth, is investigated as a major factor in determining how young people view parents. Happy people experience emotional stability,positive behavioural modelling, and open communication—all of which are essential for a child's healthy development. Happiness is a key motivator for these significant outcomes. On the other hand, family violence has long-term consequences that affect not just the victim's immediate emotional reaction, but also their behaviour patterns and interpersonal relationships. This study sheds light on the complex relationships between these emotionaldynamics, as well as their long-term impact on young people' psychological development. The study's findings pave the way for targeted treatments, support networks, and legislativerecommendations aimed at promoting emotionally supportive family environments

Model of negative affect induced by withdrawal from acute and chronic morphine administration in male mice

Opioid use disorder (OUD) is a chronic relapsing disorder that is a major burden for the lives of affected individuals, and society as a whole. Opioid withdrawal is characterized by strong physical symptoms, along with signs of negative affect. Negative affect due to opioid withdrawal is a major obstacle to recovery and relapse prevention. The mechanisms behind negative affect due to either spontaneous or antagonist-precipitated opioid withdrawal are not well known, and more animal models need be developed. Here, we present behavioral models of negative affect upon naloxone-precipitated morphine withdrawal in adult male mice. Social, anxiety, and despair-like deficits were investigated following naloxone administration in mice receiving morphine under three dosing regimens; acute, chronic constant dose and chronic escalating doses. Social behaviour in the three-chamber social preference test was decreased following withdrawal from chronic and escalating but not acute morphine. Anxiety-like behaviour in the open field was increased for all three treatments. Despair-like behaviour was increased following withdrawal from chronic and escalating but not acute morphine. Altogether, these animal models will contribute to study behavioural and neuronal circuitries involved in the several negative affective signs characterizing OUD.

Tiebout, Coase and urban scaling

AbstractA growing body of urban research takes a natural science perspective on systems of cities as self-organising human clusters. From a systems perspective, this work, particularly the growing number of city scaling studies, introduces a determinism to studies of city size, efficiency and performance that may not sit well with regional science and urban economic planning models. It finds that agglomeration economies seem to follow regular scale-free power laws that reflect competitive dynamics within an entire interacting human system of cities and that a city’s performance is therefore statistically bounded by the whole system. Where does this leave empirical models of individual city performance and behavioural models of urban political economy that underpin them? The paper links two seminal economic models of the 20th century that were motivated to demonstrate the possibility of preference revelation for the ‘unpriceables’ that give cities their value. Tiebout’s and Coase’s models of social order both concern natural clustering principles, governed by voting with feet, voice and price. Voting with feet is a much more animalistic social ordering mechanism than voting with voice and the paper introduces the idea of scale-free Tieboutian models—natural science models of revealed preference for local public expenditure.

Alzheimer's Disease and Related Dementias Diagnosis in the United States Among US-Born and Foreign-Born White, Black, Hispanic, and Asian Older Adults.

Timely clinical diagnosis of Alzheimer's disease and related dementias (ADRD) is important for resource allocation, mitigating safety concerns, and improving quality of life. While studies have examined ADRD diagnosis disparities by race/ethnicity, few include its intersection with nativity. Our aims were to (1) estimate the odds of diagnosed ADRD among US- and foreign-born racial/ethnic groups compared to US-born White older adults and (2) make comparisons by nativity within each racial/ethnic group. We linked 2000-2017 National Health Interview Survey (NHIS) and 2001-2018 Medical Expenditure Panel Survey (MEPS) data (65 + years; n = 38,033). Race/ethnicity and nativity were measured using NHIS data. Diagnosed ADRD was determined using ICD-9 (290/294/331/797) or ICD-10 (F01/F03/G30/G31) billing codes created from self-reports during MEPS household interviews. Bivariate and multivariable analyses were adjusted for covariates based on Anderson's behavioral model of health services use. US-born Black (OR = 1.74; 95% CI = 1.48-2.05), Hispanic (OR = 1.62; 95% CI = 1.14-2.29), and foreign-born Hispanic (OR = 1.63; 95% CI = 1.24-2.15) older adults, but not foreign-born Black or Asian older adults, had higher odds of diagnosed ADRD compared to US-born White older adults after adjusting for age and sex. After additional adjustment for education, health insurance, usual source of care, and chronic conditions, only US-born Black older adults continued to show higher odds (OR = 1.54; 95% CI = 1.27-1.87) of diagnosed ADRD compared to US-born White older adults. There were no differences in ADRD diagnosis by nativity within each racial/ethnic group. Findings highlight the need for including nativity in studies comparing racial/ethnic groups to Whites to fully capture the ADRD burden among US-born Black older adults.

Putting the Vicious Cycle to the Test: Evidence for the Cognitive Behavioral Model of Persistent Somatic Symptoms from an Online Study.

In clinical practice, persistent somatic symptoms are regularly explained using a cognitive-behavioral model (CBM). In the CBM, predisposing, perpetuating, and precipitating factors are assumed to interact and to cause the onset and endurance of somatic symptoms. However, these models are rarely investigated in their entirety. We conducted an online-survey during the Corona pandemic. 2,114 participants from the general German population completed questionnaires that measured different factors of the CBM. We used state negative affectivity and neuroticism as predisposing factors, fear of a COVID-19 infection as precipitating factor, and somatic symptoms, misinterpretation of bodily symptoms, attention allocation to bodily symptoms, and health anxiety as perpetuating factors. Moreover, we added safety and avoidance behavior as endpoints to the model. We conducted a psychological network analysis to exploratively study the relationships between the model's different factors and tested the assumptions of the CBM by evaluating a structural equation model (SEM) that incorporated all factors of the model. Network analyses revealed clustering in our data: Health anxiety and different cognitive factors are closely related, while somatic symptoms and state negative affectivity are strongly associated. Our SEM showed adequate fit. Our findings from an exploratory and a confirmatory approach give empirical support for the CBM, suggesting it as a suitable model to explain bodily symptoms in the general population and to possibly guide clinical practice. The network model additionally indicates the necessity to apply an individualized CBM for patients, depending on a preponderance of either persistent somatic symptoms or health concerns.

Dementia Care in Rural Appalachia: Multilevel Analysis of Individual and County-level Factors.

Home- and community-based services (HCBS) are underutilized, despite offering significant health benefits to both care recipients and caregivers. Drawing upon Andersen's extended behavioral model of health services use, we examined individual and county-level factors influencing HCBS utilization for dementia care in rural Appalachia. We analyzed data from telephone interviews with 123 dementia family caregivers in rural Appalachian counties (Mage = 64.7, SDage = 12.2). Multilevel analyses were conducted to examine the effects of individual-level and county-level factors on the use of home-based services (home health care and personal care services) as well as community-based services (adult day care and transportation services). Results indicated that caregivers' receipt of informal support from family or friends were associated with more use of home-based services (B = 0.42, p = 0.003). Conversely, longer travel times to service providers were linked to use of fewer community-based services (B = -0.21, p < .001). Residing in counties with more home health agencies was associated with higher utilization of home-based services (B = 0.41, p = 0.046). However, higher county tax expenditures for HCBS were not linked to home-based or community-based service use. Findings suggest that informal support in caring for the person living with dementia enables HCBS use in rural Appalachia. In contrast, limited geographic accessibility and service availability can impede HCBS use in rural regions. Policymakers are urged to allocate direct public funding to service providers to expand service availability in under-resourced rural regions.

Maternal and child health care access to skilled delivery services among Ghanaian rural mothers

IntroductionMost new-born babies are born at home in rural communities which is not new phenomenon due to lack of access to primary healthcare services and trained skilled health attendants, exposing mothers and children to a high risk of labour complications. The purpose of this study was to better understand factors influence rural women's access to primary health care and skilled delivery services as well as their reasons for using or not using maternal health care and skilled delivery services.MethodsThe study employed a social survey design with a quantitative approach to data analysis. Cluster Sampling was used, possibly based on rural communities, to efficiently collect data from different geographic locations. Simple random sampling individuals from each cluster ensures that all eligible individuals have an equal chance of being included in the study. This enhances the representativity of the sample. A total of 366 mothers were selected from four rural communities in the North East Region of Ghana. The choice of sample size considered factors like the study's objectives, available resources, and the desired level of statistical power. Data was primarily gathered through the administration of a questionnaire to the respondents. Factors considered for achieving representativity include, geographic representation, accessibility, healthcare infrastructure and healthcare professionals’ attitudes.FindingsThe study found that distance to health centres limits women's access to skilled delivery services. Lack of primary health facilities in the rural communities hamper maternal and child care services delivery. The attitude of health care professionals determines a mother’s utilisation of maternal health care and skilled delivery services.ConclusionThe study contributes to the limited research on maternal health services and their impact on mother and child health in the study area. This study is one of the first to investigate into maternal health care as a key predictor of mother and child health in the study area. The study's theoretical lens was the Andersen and Newman Health Behavioural Model theory, which supports the explanation of distance, lack of primary health centres, attitudes and lack of skilled personnel to the non-utilisation of maternal and health services in rural communities. The study recommended that primary healthcare facilities and trained health professionals should be a priority of government in rural communities to promote maternal and child healthcare.

A Behavioral Model of Responsible Sourcing in Supply Chains: The Role of Dual-Sourcing Bias

Decision on what consumer reactions (support or boycott) to promote is important for nongovernmental organizations and policymakers looking to influence firms’ adoption of corporate social responsibility practices. We study how consumer reactions—paying more for certified products or boycotting in the event of responsibility violations—are effective in improving a firm’s uptake of responsibility practices in the sourcing domain. We first build a stylized model to study how consumer reaction affects a firm’s incentives toward responsible sourcing and find that only boycotting reactions by consumers reliably increases a firm’s sourcing from responsible suppliers. We then include behavioral aspects to our stylized model to derive a more nuanced understanding of how consumer reactions affect responsible sourcing. Through behavioral experiments, we first show that a supporting consumer reaction induces a dual-sourcing bias in firms’ sourcing decisions. We then develop a behavioral model of responsible sourcing, incorporating this dual-sourcing bias. Our analysis modifies the normative predictions of the stylized model by showing that a supporting reaction, irrespective of magnitude, always improves responsible sourcing if the boycotting reaction from the market is weak, and that promoting a boycotting reaction always improves responsible sourcing, irrespective of the product type. Our results lead us to a comprehensive and applicable insight for practice: in the supply chains of products with few brand substitutes, creating a supporting reaction in the market is the way to improve firms’ responsible sourcing, and in supply chains of products with many brand substitutes, promoting a boycotting reaction among consumers will lead to more responsible sourcing.

The Development of the Berliner as a Political Person under the Influence of the Urban Cultural Environment

 Introduction. The article explores the reasons for the emergence of ethnic diversity in the   city of Berlin, encompassing political, historical, geographical, anthropological, and sociological aspects of the urban environment. It also outlines the current issues in German   society that shape the political culture of its people. The relevance of the topic is driven by   the political radicalization of migrants in Germany, particularly in Berlin, resulting from   cultural globalization that impacts traditional political institutions and behavioral models of   the city's residents. The crisis of the liberal-democratic model and the increase in the   number of Eurosceptics also play a significant role in the transformation of the political   culture of contemporary Berliners. Solving the problem of political radicalization of migrants   is equally important for the Russian Federation, especially in St. Petersburg, combining   characteristics of the European urban environment and the polyethnic Russian state, whose   residents consider themselves Russians despite national and cultural differences.   Methodology and sources. The research is grounded in Ernest Burgess's model of   concentric zones. The study relies on research methods such as synthesis, comparison,   analysis, and sociological approaches. Data from the Federal Statistical Office of Germany,   the results of the 2016 elections to the Berlin House of Deputies, the 2021 elections, and the   subsequent 2023 elections, historical data, and findings from other researchers on the topic   served as sources for the study.  Results and discussion. The study identifies features of urban culture shaping the   polyethnic Berlin society, including the ethnic diversity of residents, unique self-identification   of Berliners, the presence of distinct urban districts, squatter movements, and the influence   of architectural and spatial characteristics on the formation of human social behavior. Some   city problems were also highlighted, such as the crisis of formation of a distorted perception   of right and left currents among Berliners, the failure of multiculturalism policies, the   migration crisis, and housing shortages.   Conclusion. The development of a Berliner as a political being is influenced by the   characteristics of the urban environment and certain issues facing the city, where the   residential district, properties of the city's political culture, and ethnic background impact   the political views of its inhabitants 

Forecasting using reference prices with exposure effect

AbstractReference prices (RPs) are consumers' subjective perceptions of prices that have important influences on purchase decisions. The standard RP formulation, which defines RP as an exponentially weighted average of past prices, ignores a certain asymmetry in weights between the regime of a price decrease and that of a price increase, which can be observed by the demand trend during the few days after a price decrease or increase. Such oversight usually leads to overestimation in demand as we illustrate by empirical evidence. We introduce the novel concept of RP with exposure effect (RPEE) that captures such asymmetry in RP formulation by imposing a weight proportional to how much the price is exposed to consumers. The exposure effect can be measured by clickstream data that are available for most e‐retailing platforms. We develop a customer behavioral model that can explain the formation of standard RP, and extend it in a natural way to provide foundation to the use of RPEE, especially for products with few repeat purchases. We then establish empirically the extensive benefit of forecasting from RPEE for e‐retailers that sell thousands of products. We demonstrate that RPEE exhibits significant and consistent improvement over standard RP for products, with around reduced weighted mean absolute percentage error.