The primary objective of this study was to assess employee performance among individuals working remotely, considering the mediating role of digital literacy and the moderating influence of technostress within public universities in Malaysia. A structured questionnaire was used to gather 320 responses from university lecturers. The data were analyzed using the partial least squares structural equation modelling (PLS-SEM) technique through smartPLS-4. The findings indicate that work-from-home (WFH) does not exhibit a direct significant relationship with employee performance, except for an indirect relationship mediated by digital literacy. Conversely, technostress significantly and negatively moderated the relationship between digital literacy and employee performance. Moreover, technostress moderated the indirect relationship between WFH and employee performance through digital literacy. Consequently, digital literacy is essential for the successful implementation of effective work-from-home strategies that enhance employee performance and well-being at work. University management should prioritize enhancing digital literacy before implementing remote work strategies. Additionally, management should address employee technostress levels, as it can influence both digital literacy and employee performance. Future research should explore these findings in other service sectors, such as information technology and customer services.

Social Participation and Digital Health Literacy Among Older Adults in the Community: The Mediating Roles of Self-Efficacy and Technophobia.

The dual role of digital literacy in EFL writing: Unmasking its direct and self-efficacy-mediated effects on anxiety among Chinese tertiary learners.

To describe the development and early implementation of the Digital Health Equity & Literacy Program (D-HELP), a student-led quality improvement initiative to promote digital health engagement in the emergency department (ED). Trained student volunteers at Rush University Medical Center delivered in-person education on Epic MyChart and Rush On Demand telehealth services in English and Spanish. Eligible adult patients were identified through the EHR and engaged when clinically appropriate. Over 4 months, 94 patients were approached, with 64 (68%) patients receiving some level of intervention. Volunteers documented encounter type, interpreter use, and unsolicited patient feedback. MyChart invitations were sent to 27 patients, with 7 registering on-site. D-HELP demonstrated feasibility, flexibility, and strong patient receptiveness in the ED setting. The model's low-resource, student-driven design supports scalability and provides a framework for expanding digital health literacy initiatives across diverse clinical settings while addressing social determinants of digital access.

This study aims to analyze how audiences interpret the flexing content of a local skincare brand owner and the role of digital literacy in this process. Using a qualitative netnographic approach, data was obtained through analysis of the brand owner's TikTok content and in-depth interviews with four informants who are both audience members and consumers. The results show that flexing as a symbolic branding strategy is interpreted in various ways, ranging from admiration to suspicion. Digital literacy plays a crucial role in filtering information, assessing content credibility, and influencing purchasing decisions. The contrasting reactions in netizen comments confirm that digital literacy levels determine how society, particularly the lower-middle class, forms perceptions of flexing practices on social media.

Is Online Oriented-Centred Information About Dry Mouth Trustworthy? An Infodemiologic Study.

School-level digital support and reading achievement: Evidence from the PIRLS 2021 U.S. sample

"Moving through Uncertain Pathways": Health Professionals' perspectives on novel technologies for continuing care in high-risk pregnancy using the technology acceptance model.

Background Artificial Intelligence (AI) is increasingly integrated into oncology, offering opportunities to improve diagnostics, treatment planning, and operational efficiency. However, patient perspectives on AI, especially regarding data protection and ethical implications, remain underexplored. Objective The objective of this study is to investigate cancer patients' attitudes toward the use of Artificial Intelligence (AI) in healthcare, focusing on their awareness of data protection, perceived risks and benefits, and the conditions under which AI is considered acceptable. Additionally, the study aims to examine how demographic and educational factors influence patients' views within the context of an Italian comprehensive cancer center. Methods A cross-sectional survey was conducted with 117 cancer patients who completed a 28-item online questionnaire. The survey evaluated levels of AI knowledge, perceptions of data privacy, concerns about AI in medical contexts, and willingness to share health data for research. Results Most participants demonstrated moderate awareness of AI (70.1%) and its medical applications (85.5%), with higher familiarity observed among younger and more educated individuals. While data protection understanding varied, 76.9% were willing to share personal health data for research aimed at improving cancer care. Concerns included reduced physician autonomy (52.1%) and diminished physician-patient interaction (63.3%). However, 82.9% of respondents found AI acceptable when clinical decisions remained under physician control. AI was most favorably viewed for administrative support and care process optimization. Conclusion Cancer patients generally view AI in healthcare positively, especially when it maintains physician oversight and safeguards data privacy. To ensure equitable and informed adoption, targeted educational initiatives and transparent communication strategies should address generational, educational, and digital literacy differences.

Institutional transformation within the Indonesian National Police (Polri) requires a comprehensive strengthening of human resource capacity as its fundamental foundation. Rapid social changes, rising expectations for public accountability, and increasingly complex forms of modern crime demand the adoption of visionary leadership, enhanced personnel competencies, a strong professional culture, and a transparent, adaptive oversight system. This study analyzes the simultaneous contribution of these four pillars in driving institutional reform within Polri. The research uses a literature review method, drawing from empirical and theoretical studies published over the past decade encompassing police leadership, human resource management, organizational culture, and oversight mechanisms. The findings show that visionary leadership provides a clear direction for change, strengthens innovation, and improves internal trust. Personnel competencies particularly technical expertise, ethical conduct, and digital literacy contribute significantly to improving the quality of public service. A professional culture reduces behavioral deviations and enhances institutional legitimacy, while an effective oversight system promotes transparency, continuous evaluation, and accountability. The synergy of these four pillars forms a strategic framework that accelerates Polri’s reform agenda. The study concludes that strengthening human resource capacity is not merely a supportive component but a key catalyst for shaping a modern, responsive, and publicly trusted police institution.

This study investigated the factors affecting the business performance of women-owned Small and Medium Enterprises (SMEs) in Calapan City, specifically examining the roles of financial literacy, dynamic business environment, financial capability, and digital financial capability. Utilizing a quantitative descriptive-correlational research design, data were gathered from 75 women-owned SMEs through a self-structured survey questionnaire. Data analysis was conducted using PROCESS Model 1 to determine both the direct and moderating effects of the variables. The results revealed that financial literacy and the dynamic business environment do not have statistically significant direct effects on SME performance, suggesting that neither financial knowledge alone nor environmental shifts guarantees improved business outcomes. Furthermore, financial capability was found to have no significant moderating effect on the relationship between financial literacy and performance. However, Digital Financial Capability emerged as a significant moderator of the relationship between a Dynamic Business Environment and SME Performance (p < .05). This indicates that women entrepreneurs who effectively leverage digital financial tools are better equipped to respond to market volatility, technological advancements, and competitive pressures. These findings highlight the critical role of digital proficiency in enhancing the resilience and sustainability of women-led enterprises. Consequently, the study proposes the "Womentum Program for Women of Calapan," a digital financial literacy training framework designed to empower women entrepreneurs with the practical digital competencies necessary to thrive in a dynamic economy.

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>Indonesia’s National Health Insurance system (BPJS Kesehatan) continues to face persistent administrative challenges in primary healthcare, including limited accessibility, bureaucratic complexity, long waiting times, and patient dissatisfaction. To address these issues, digital transformation initiatives have introduced electronic modules (e-modules) aimed at improving administrative efficiency, service quality, and data accuracy. This qualitative study collected data through in-depth interviews with twenty participants: twelve BPJS beneficiaries and eight primary healthcare officers from four community health centers in Sibolga City, North Sumatra. Participants were purposively selected based on their experience with BPJS e-module services. Interviews were transcribed verbatim and analyzed thematically using NVivo 12 through open coding, categorization, and theme development. Four themes emerged: 1) Administrative accessibility improved as e-modules simplified access to procedural information; 2) Service efficiency increased through shorter waiting times and faster processing; 3) User satisfaction improved, especially among digitally literate participants who perceived greater transparency and predictability, and 4) Administrative accuracy strengthened due to standardized digital documentation, reducing manual errors. Nonetheless, barriers persisted, including limited digital literacy, uneven internet connectivity, and insufficient technical support at facility level. E-modules represent an effective administrative innovation that reduces procedural complexity and enhances service consistency in primary healthcare. However, uneven benefits resulting from infrastructural constraints, organizational inertia, and varying user capacity underscore the need to align technological implementation with institutional readiness and user support to prevent widening service disparities</em><em></em></p><p><em> </em></p></td></tr></tbody></table></div><strong><em>Keywords: BPJS Health, Primary Healthcare, E-Module, Digital Health Administration, Service Quality</em></strong>

The rapid digitization of education has transformed adult learning environments, with institutions increasingly deploying learning management systems, mobile learning platforms, and analytics-driven instructional tools to improve accessibility and flexibility. Despite these advancements, adult education programs continue to experience inconsistent technology adoption, uneven learner engagement, and significant dropout rates. Adult learners differ from traditional students in that they often balance education with employment, family responsibilities, and varying levels of digital literacy, which can influence their interaction with educational technologies. Consequently, understanding the determinants of technology adoption and sustained participation within adult education systems has become a critical research challenge. This study investigates technology adoption dynamics in adult education through predictive modeling of learner participation and retention patterns within digital learning environments. Using learner interaction logs, course engagement metrics, and demographic variables collected from adult education platforms, machine learning models are developed to predict technology usage intensity and the likelihood of learner persistence throughout course completion. The modeling framework evaluates behavioral indicators such as login frequency, content interaction, assignment submission patterns, and peer collaboration signals to identify predictors of retention outcomes. By linking behavioral learning analytics with predictive modeling, the study provides a systematic approach for identifying early risk signals of disengagement and technology abandonment. The findings offer actionable insights for designing adaptive adult education platforms that support sustained learner participation and improved retention outcomes.

The rapid expansion of Artificial Intelligence (AI) in educational settings has transformed writing practices, assessment structures, patterns of student engagement, and underlying epistemological assumptions about knowledge production. While AI systems offer unprecedented opportunities for cognitive scaffolding, emotional regulation, and inclusive participation, they simultaneously challenge traditional notions of authorship, intellectual agency, and pedagogical authority. The integration of AI into school practice therefore requires robust theoretical grounding, ethical governance, and organizational coherence. This article develops a comprehensive, human centered framework that connects AI literacy, critical digital literacy, collaborative digital writing, metacognition, emotional intelligence, and organizational culture in secondary education. Drawing upon interdisciplinary research in areas such as AI and adolescent emotional well being, AI and school related anxiety, collaborative ICT based inclusion, digital tools as cognitive instruments, technology as cultural bridge building practice, organizational culture and school vision, metacognition and emotional intelligence models, theory of mind in ICT contexts, digitally assisted mindfulness, and psychoanalytic cultural theory, the study proposes a multilayered instructional model for AI supported collaborative digital writing. The article argues that AI literacy must be cultivated not merely as technical competence but as epistemic responsibility embedded within reflective, relational, and culturally coherent school ecosystems. Collaborative digital writing emerges as a pedagogically optimal environment for fostering metacognitive regulation, socio emotional awareness, critical evaluation, and inclusive participation. The study concludes that AI integration in education must be guided by visionary leadership, organizational culture, ethical transparency, and human centered pedagogical design.

The quick development of digital communication platforms has opened up new areas where people’s behavior is profoundly and frequently shaped by online anonymity. This paper looks at the psychological understanding of online anonymity and how it can lead to harmful behaviors like hate speech, harassment, cyberbullying, and flaming. In order to provide a thorough understanding of why people behave differently when protected by anonymity in digital environments, the study shows findings from theoretical literature, drawing on important theoretical frameworks. The research paper shows three main factors of toxic online disinhibition: anonymity, invisibility and lack of eye-contact. The long-held belief that toxic behavior is solely motivated by anonymity is challenged by experimental findings showing that the single biggest cause of negative disinhibition is absence of eye-contact. The study also shows how cyberbullying appears in online forums, how anonymity is adversely correlated with aggressive attacks, and how algorithmic amplification and social media platform design amplify these effects. The study recognizes the dual nature of anonymity in addition to the risks: although it encourages toxic behavior, it also decreases barriers to self-disclosure, assists vulnerable people seeking mental health support, and creates positive anonymous networks. The effects of toxic online behavior are examined at the individual level, such as despair, anxiety, and suicidal thoughts among victims, as well as at the communal and societal levels, such as the dissemination of false information and heightened social division. AI-powered content filtering, digital literacy instruction, identity verification systems, and platform design reform are some of the methods to lessen toxic behavior that are covered.

Background: The growing integration of technology in education has made digital health literacy an essential skill for healthcare students. Academic stress and burnout are widely reported among healthcare undergraduates; however, their relationship with digital health literacy remains insufficiently explored, particularly in developing countries such as Pakistan. Objective: This study examined the association between digital health literacy, academic stress, and burnout among undergraduate healthcare students and assessed whether digital health literacy predicts burnout after controlling for demographic factors. Methodology: A cross-sectional analytical study was conducted from January to June 2025 among 300 undergraduate healthcare students from private universities in Pakistan. Data were collected using a self-administered online questionnaire including demographics, the Digital Health Literacy Instrument, Perceived Stress Scale-10, and Maslach Burnout Inventory-Student Survey. Descriptive statistics, Shapiro–Wilk normality testing, Pearson correlation, and multiple linear regression analyses were performed to identify predictors of burnout after adjusting for demographic variables, with statistical significance set at p<0.05. Results: The mean age of participants was 21.4±1.8 years, with females comprising 62% of the sample. Digital health literacy was significantly negatively correlated with academic stress (r= −0.34, p<0.001) and burnout (r= −0.29, p<0.001). Academic stress showed a strong positive correlation with burnout (r=0.63, p<0.001) and was the strongest predictor of burnout (β=0.56, p=0.001). Digital health literacy independently predicted lower burnout (β= −0.18, p=0.002). The model explained 46% of the variance in burnout. Conclusion: Higher digital health literacy is associated with reduced academic stress and burnout. Integrating digital health literacy training may improve student well-being and academic resilience.

This review explores the integration of artificial intelligence (AI) in mobile health applications for diabetes care. It focuses on key AI methodologies - machine learning, deep learning, and natural language processing - and their roles in glucose monitoring, personalized self-management, risk prediction, and clinical decision support. Drawing on recent literature (2018-2024), the study outlines the benefits of AI in improving accuracy, engagement, and precision in diabetes treatment. Challenges such as data privacy, algorithmic bias, and regulatory barriers are also examined. A new section discusses when AI technologies may become burdensome, especially in low-resource settings or for users with limited digital literacy. The review concludes with directions for enhancing model explainability and integrating AI with wearable and Internet of Things devices, emphasizing the need for ethical and equitable implementation in future diabetes management strategies.

Despite the critical importance of COVID-19 vaccination for older adults, vaccine hesitancy has been observed within this population. At the same time, internet use among older adults has increased substantially, making it important to understand how digital engagement shapes access to vaccination-related information. This study examines the associations between internet usage, self-estimated level of internet knowledge, and mistrust in online information with COVID-19 vaccination uptake and hesitancy among adults aged 60 + in Switzerland during the pandemic. The analytical sample includes 986 Swiss respondents from the Survey of Health, Ageing, and Retirement in Europe (SHARE) Corona Questionnaire 2 (2021). The associations in this article were estimated using probit regressions, controlling for socio-demographic, health, and regional characteristics. The findings reveal a higher likelihood of vaccination among older adults who use the internet as a source of information on COVID-19 and related regulations. Additionally, respondents with greater confidence in their internet knowledge are more inclined to get vaccinated. Conversely, those who find it challenging to differentiate between truthful and misleading information online are less likely to choose vaccination. Our findings highlight the potentially crucial role of internet use and digital literacy in shaping COVID-19 vaccination behavior among older adults in Switzerland. Promoting digital literacy and enhancing trust in reliable online health information could be key strategies to reduce vaccination hesitancy in this population. Addressing concerns about misinformation is also essential for improving vaccination uptake.

Mobile health (mHealth) is a novel model of care that may overcome barriers to pulmonary rehabilitation (PR) access. This study determined if mHealth PR was equivalent to centre-based PR (CB-PR) in improving exercise capacity and health status in people with chronic obstructive pulmonary disease (COPD). Single-blinded, multicentre, randomised controlled equivalence trial using an intention-to-treat analysis. Participants completed 8 weeks of either mHealth PR, using the mobile PR (m-PR) application and supported by telephone calls, or CB-PR. Co-primary outcomes, measured at baseline and end-intervention, were change in 6 minute walk distance (6MWD) and COPD assessment test (CAT) score, with an equivalence margin of 30 m and 2 points, respectively. 90 participants were randomised (mean (SD), m-PR n = 44: age 75 (7) years; forced expiratory volume in one second (FEV1) 58 (15) % predicted; CB-PR n = 46: age 75 (6) years; FEV1 55 (14) % predicted) with 38 m-PR participants and 42 CB-PR participants completing at least one primary outcome. At end-intervention, there was no between-group difference in 6MWD (mean difference (MD) 13 m, 95% CI -6 to 31), indicating equivalence of m-PR to CB-PR. There was a significant between-group difference in CAT score (MD -4.9 points, 95% CI -7.2 to -2.6), with both limits of the CI exceeding the equivalence margin, indicating superiority of m-PR. An mHealth PR programme resulted in equivalent improvements in exercise capacity and superior improvements in health status when compared with CB-PR in people with COPD. mHealth PR could be effective as a management option for people with COPD with adequate digital literacy. ACTRN12619001253190.

Digital media consumption among adolescents raises significant concerns, particularly regarding the circulation of violent material in peer communication spaces. This study investigates how Spanish teenagers interact within WhatsApp groups and how such interactions contribute to the dissemination and normalisation of violence during a critical stage of psychosocial development. Data were collected from 164 secondary school students (mean age 14.4 years) through open-ended questionnaires, and a reflexive thematic analysis was conducted to explore their experiences with digital content shared in messaging groups. Participants reported frequent exposure to explicit material involving physical and sexual violence, hate speech, and, in some cases, self-harm. Clear gender differences emerged: boys were more likely to circulate such content, while girls more often reported feelings of rejection, discomfort, and emotional distress. Humour frequently functioned as a discursive strategy to legitimise the material, thereby reducing its perceived seriousness and reinforcing its normalisation within everyday peer interactions. The absence of adult supervision in these digital environments further exacerbated the problem, facilitating the persistence and reach of harmful content. Findings highlight the risks inherent in unregulated digital spaces and underscore the need for targeted educational and policy interventions. Promoting empathy, strengthening digital literacy, and fostering prosocial values appear essential to counteract processes of desensitisation and to mitigate the detrimental emotional and social consequences of violent content exposure during adolescence.