Key Constructs Research Articles

From alternative health media to vaccine misbeliefs: the roles of medical folk wisdom and institutional trust

ABSTRACT Although alternative health (AH) digital media plays a substantial role in disseminating misinformation and contributing to misconceptions about health-related topics, the intermediary mechanisms and boundary conditions of this relationship need further investigation. In this study, we focus on two key constructs that are related to beliefs and attitudes about the healthcare system, (1) belief in medical folk wisdom (MFW) and (2) trust in health institutions, to find out how they mediate and condition the relation between AH digital media exposure and belief in vaccine misinformation. Evidence from a cross-sectional survey with N = 1,150 participants showed that (1) there was a positive association between AH digital media exposure and vaccine misinformation belief, and (2) MFW partially mediated this association. Moreover, trust in health institutions conditioned this relationship: higher trust weakened the direct path from AH media to vaccine misinformation belief but strengthened the mediated path. Additionally, the moderating role of trust in health institutions depended on the type of institutions. In sum, we document the mediating role of MFW as a facilitating factor in AH media on misinformation belief, and demonstrate the complex moderating role of trust in health institutions, serving as a simultaneously facilitating and counteracting factor.

Intratumoral microbiota-aided fusion radiomics model for predicting tumor response to neoadjuvant chemoimmunotherapy in triple-negative breast cancer

BackgroundNeoadjuvant chemoimmunotherapy (NACI) has emerged as the standard treatment for early-stage triple-negative breast cancer (TNBC). However, reliable biomarkers for identifying patients who are likely to benefit from NACI are lacking. This study aims to develop an intratumoral microbiota-aided radiomics model for predicting pathological complete response (pCR) in patients with TNBC.MethodsIntratumoral microbiota are characterized by 16S rDNA sequencing and quantified through experimental assays. Single-cell RNA sequencing is performed to analyze the tumor microenvironment of tumors with various responses to NACI. Radiomics features are extracted from tumor regions on longitudinal magnetic resonance images (MRIs) scanned before and after NACI in the training set. On the basis of treatment response (pCR or non-pCR) and intratumoral microbiota scoring, we select key radiomics features and construct a fusion model integrating multi-timepoint (pre-NACI and post-NACI) MRI to predict the efficacy of immunotherapy, followed by independent external validation.ResultsA total of 124 patients are enrolled, with 88 in the training set and 36 in the validation set. Tumors from patients who achieves pCR present a significantly greater intratumoral microbiota load than tumors from patients who achieve non-pCR (p < 0.05). Additionally, tumors in non-pCR group exhibit greater infiltration of tumor-associated SPP1+ macrophages, which is negatively correlated with the microbiota load. On the basis of intratumoral microbiota scoring, we select 17 radiomics features and use them to construct the fusion radiomics model. The fusion model achieves the highest AUC of 0.945 in the training set, outperforming pre-NACI (AUC = 0.875) and post-NACI (AUC = 0.917) models. In the validation set, this model maintains a superior AUC of 0.873, surpassing those of pre-NACI (AUC = 0.769) and post-NACI (AUC = 0.802) models. Clinically, the fusion model distinguishes patients who achieve pCR from those who do not with an accuracy of 77.8%. Decision curve analysis demonstrates the superior net clinical benefit of this model across varying risk thresholds.ConclusionsOur intratumoral microbiota-aided radiomics model could serve as a powerful and noninvasive tool for predicting the response of patients with early-stage TNBC to NACI.

Employee Job Satisfaction in Aviation Industry: An Exploratory Study on Workplace Dynamics.

This exploratory research investigated the determinants of job satisfaction within the aviation industry, a sector characterized by a high-pressure environment and critical employee roles. Drawing from a comprehensive literature review and primary data collected from 350 aviation employees across various roles, the research identified key constructs influencing job satisfaction: employee engagement, work environment, compensation and benefits, and stress management. The study employed Partial Least Squares Structural Equation Modelling (PLS-SEM) to evaluate the interrelationships among these constructs. Employee engagement emerged as the most significant driver of job satisfaction, promoting higher levels of motivation and organizational commitment. A supportive work environment was found to mitigate challenges like irregular schedules, while effective stress management programs enhanced employee resilience. Compensation and benefits, though vital, need to be paired with non-monetary incentives for holistic job satisfaction. These findings provide actionable recommendations for airline management, emphasizing the need for targeted interventions such as career development programs, stress reduction initiatives, and enhanced employee recognition systems to boost satisfaction and reduce turnover rates. Future researchers should consider longitudinal studies to track job satisfaction trends over time and expand the scope to include diverse roles, such as ground staff and maintenance crews. Comparative studies across different countries and cultural contexts could further refine strategies for improving employee well-being globally.

Development and Early Validation of A Survey Instrument for Measuring Patient Engagement in Pain Management

Efforts to improve patient engagement in pain management are often hindered by inconsistent definitions and measurements. To address this gap, we developed and pilot-tested the 15-item Patient Engagement in Pain Management survey. A systematic review of 77 survey instruments identified 6 key constructs of patient engagement, and semi-structured interviews with 36 patients and 3 providers from the Johns Hopkins Personalized Pain Program informed its development. The initial 33-item survey was refined to 15 items, and usability and test-retest reliability were evaluated with 60 Personalized Pain Program patients. The median completion time was 3.5 minutes, with minimal missing data (&lt;0.5%). Most respondents (96–100%) found the questions relevant, with higher average scores for patient-provider communication (3.6–4.5 on a 5-point scale) and lower scores for adherence challenges. Although the Patient Engagement in Pain Management survey demonstrated good usability and applicability, further studies are needed to enhance its test-retest reliability and psychometric validation.

The Role of Artificial Intelligence and Blockchain Technology in Crisis Management, Startup Growth, and Sustainable Future

This study examines the impact of artificial intelligence (AI) and blockchain technology on crisis management, startup growth, and sustainability in the Indian business landscape. Using a quantitative, cross-sectional research design, data was collected from 123 research and development (R&amp;D) employees across various enterprises. The study employs Partial Least Squares Structural Equation Modeling (PLS-SEM) to analyze relationships between key constructs. The results indicate that AI plays a crucial role in enhancing crisis management and business resilience (β = 0.553, p = 0.000), while effective crisis management positively influences long-term sustainability (β = 0.272, p = 0.000). Additionally, blockchain technology is a key driver of startup growth (β = 0.684, p = 0.000), and growing startups significantly contribute to a sustainable future (β = 0.689, p = 0.000). The findings highlight the transformative potential of AI and blockchain in navigating business uncertainties, fostering innovation, and driving sustainable development. The study offers practical implications for business leaders, policymakers, and entrepreneurs in leveraging emerging technologies for long-term resilience and success.

Analysis of Evaluation Index System for Safety Resilience in Major Railway Projects Based on AISM

Major railway projects are large-scale infrastructure investments facing significant safety challenges due to complex geological conditions, extreme environments, and uncertain risks. This study integrates resilience theory into railway construction safety management, shifting from traditional risk management (Safety-I) to resilience-based management (Safety-II). A resilience evaluation framework was developed using the 4Rs (robustness, redundancy, resourcefulness, rapidity) and ARRA (absorptive, resistant, restorative, adaptive) capabilities. Adversarial Interpretative Structural Modeling (AISM) and systematic clustering analysis were applied to identify key safety resilience factors and construct an evaluation index system. The findings highlight that optimized personnel allocation, adaptive machinery, standardized material use, comprehensive emergency response, and a stable construction environment are crucial for enhancing safety resilience. The proposed framework provides practical insights for improving safety strategies, minimizing risks, and ensuring sustainable railway infrastructure development.

The Person-centred Nursing Framework: a mid-range theory for nursing practice.

Person-centredness is a global movement in healthcare that prioritises the human experience. Person-centred care has a long association with nursing; however, the implementation of person-centredness as a philosophy of practice remains challenging and requires a sustained focus on the development of healthful workplace cultures. This is a discussion paper that focuses on the theoretical development of person-centred nursing, drawing out the uniqueness of the Person-centred Nursing Framework (PCNF) to the discipline of nursing and its relevance as a middle-range theory for nursing practice. The PCNF highlights the complexity of person-centred nursing, and through the articulation of the key constructs, emphasises the contextual, attitudinal and moral dimensions of humanistic caring practices. The development of the framework as a means of operationalising person-centredness in practice has been integral to the establishment of a research programme spanning over two decades. The programme has privileged research that focuses on the implementation of person-centred nursing in a variety of healthcare contexts, illustrating outcomes that focus on enhanced care experience for both patients and nurses. The theoretical development of nursing through the lens of the PCNF highlights the uniqueness of person-centredness to the discipline of nursing.

The role of attachment and parental bonding in the psychosocial assessment of transplant candidates: a cross-sectional study

BackgroundKidney transplant involves profound psychological, relational, and social changes for both the patients and their family context. Occasionally, the family or social support can be deemed "dysfunctional" as it fails to fully comprehend the patient's needs and requirements. Attachment style, which pertains to the motivation to seek proximity and care in relationships with caregivers, has a significative role in the social support system for transplant, therapeutic adherence, and maintenance of the transplanted organ.We sought to assess attachment styles among patients awaiting transplantation using psychosocial measures in order to study their impact on psychopathology, quality of life, and transplant eligibility.MethodsEighty-five patients with chronic kidney disease awaiting transplantation were recruited at the Italian Transplant Center and were administered the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), the Attachment Style Questionnaire (ASQ), the Parental Bonding Instrument (PBI), the Short Form Health Survey-36 (SF-36), and the Middlesex Hospital Questionnaire (MHQ). Measures were entered in blocks in a stepwise multiple regression.ResultsThe SIPAT score was significantly associated with key psycho-physical constructs. SIPAT was negatively predicted by maternal care (β = -.35, p = .001), secure attachment (i.e., confidence) (β = -.23, p = .029), and general physical health (β = -.25, p = .016) – which could be considered protective factors for transplant suitability. Conversely, anxiety symptoms were positively associated with SIPAT (β = .32, p = .001) and may serve as a risk factor for post-transplant issues.ConclusionsThese findings highlight that in the evaluation of kidney transplant candidates, greater attention should be paid to parental bonding, adult attachment, and psychopathological symptoms, as these factors may play a key role as protective or risk factors for post-transplant issues. A timely assessment of these constructs may improve the evaluation of psychosocial suitability for transplantation, as well as allow the provision of targeted psychotherapeutic interventions to enhance the acceptance and management of illness in patients awaiting kidney transplants.

Bridging AI and human interaction: How trust and social presence affects chatbot acceptance

This study examines the factors driving chatbot adoption among customers. Integrating the Technology Acceptance Model with social presence, perceived performance, and trust, the research investigates how these variables influence customers' attitudes and intentions to use chatbots. The findings confirm the importance of conversational commerce, particularly for millennials, and support the Social Presence Theory, highlighting the positive impact of human-like interactions on trust and attitudes towards chatbots. Key constructs such as trust, perceived usefulness, ease of use, and behavioral intention are validated as influential factors in consumer decisions regarding chatbot technology. The study offers practical implications for businesses seeking to enhance chatbot experiences by focusing on usability, usefulness, and performance. Future research should consider a broader population, explore additional variables like ethical considerations, cross-cultural differences, and personalization, and investigate potential moderating factors such as personality traits and prior technology experience.

The effectiveness of a transtheoretical model based on health education intervention on adherence to methadone maintenance treatment: a quasi-experimental study

BackgroundTreatment adherence is one of the major challenges in methadone maintenance treatment (MMT). This study aimed to investigate the effect of educational intervention using a transtheoretical model (TTM) on adherence to MMT.MethodsThis quasi-experimental educational intervention study was conducted in Shiraz, Fars Province, Iran (2019), with 114 men aged 20 to 50 years. Participants were recruited using a two-stage cluster random sampling method. The mean age of the participants in the intervention group (n = 58) was 36.98 ± 7.76 years, while the control group (n = 56) had a mean age of 39.44 ± 6.54 years. The intervention group attended five educational sessions based on the Trans theoretical Model (TTM). Data analysis was conducted using SPSS with a significance level set at < 0.05. Statistical methods included Chi-square, paired t-test, independent t-test, and non-parametric tests when the data were not normally distributed.ResultsThe results indicated no significant difference between the two groups in terms of self-liberation, counter-conditioning, helping relationships, stimulus control, reinforcement management, temptation, confidence, and adherence to MMT before the intervention (p > 0.05). However, two months after the intervention, the intervention group showed a significant increase in each of the mentioned constructs (p < 0.05) except counterconditioning and MMT adherence.ConclusionThe study’s findings indicate that the educational program successfully improved participants’ knowledge and skills regarding the processes of change, as well as their self-efficacy, which was assessed through two key constructs: temptation and confidence. However, the program did not succeed in enhancing participants’ adherence to treatment. Policymakers should consider integrating structured educational programs based on the Theory of Planned Behavior (TPB) into existing Medication Management Therapy (MMT) services. This approach aims to enhance patients’ understanding of their treatment processes and promote adherence. Furthermore, since the intervention positively impacted self-confidence and self-efficacy, it is advisable to develop policies that focus on educating patients to bolster their self-efficacy in resisting drug-related temptations. Future studies should also aim to include diverse populations, such as women and individuals from various age groups, to assess the generalizability of the findings beyond the male participants from specific regions.

Strategic Agility—An Urgent Capability for Successful Business Model Innovation? A Conceptual Process Model and Theoretical Framework

ABSTRACTStrategic agility (SA) has become an essential capability for established firms to successfully navigate the challenges of business model innovation (BMI) in dynamic environments. This study develops both a conceptual process model and a theoretical framework to explore the interplay between SA and BMI. The conceptual process model provides a practical, stage‐by‐stage analysis of how the three meta‐capabilities of SA—strategic sensitivity (SS), leadership unity (LU), and resource fluidity (RF)–enable the initiation, ideation, integration, and implementation stages of BMI. The theoretical framework expands on this by exploring the relationships between these meta‐capabilities and incorporating moderating factors such as market dynamism and enabling factors such as digital capabilities. Through a theorizing approach, the study synthesizes foundational and recent literature to derive key constructs and propositions, offering new insights into the dynamic interactions between SA and BMI. The findings contribute to the literature by addressing gaps in the integration of SA and BMI research and by providing actionable guidance for practitioners to enhance organizational agility and innovation. Additionally, the study highlights the importance of fostering synergy among SA meta‐capabilities and outlines how contextual factors influence the effectiveness of BMI processes. By presenting both a conceptual process model and a theoretical framework, this paper bridges the gap between theoretical advancement and practical applicability, offering a comprehensive perspective for researchers and practitioners alike. The study concludes with implications for future research and managerial practice.

Establishment and validation of an immune-related genes diagnostic model and experimental validation of diagnostic biomarkers for autoimmune thyroiditis based on RNA-seq.

Establishment and validation of an immune-related genes diagnostic model and experimental validation of diagnostic biomarkers for autoimmune thyroiditis based on RNA-seq.

Relational Ethics and Differentiation of Self: An Empirical Study of the Key Constructs of Contextual Theory and Bowen Family Systems Theory

ABSTRACTContextual therapy, concerned with equity of responsibility and relational balances, seeks to reintroduce the truth of personal uniqueness and genuine dialogue in meaningful relationships by establishing a bridge between individual therapy and family therapy. Bowen family systems theory, on the other hand, is an approach that considers differentiation as a concept involving the degree to which a person becomes individuated from the parents. This process emerges from relational‐family experiences, in accordance with the regulation of the emotions experienced and the balance achieved between the forces of autonomy and togetherness. We analyzed the connection between relational ethics and differentiation of self, as well as comparing these variables in a non‐clinical sample (N = 1230) and a clinical one (N = 241) to whom we administered the Spanish Relational Ethics Scale and the Differentiation of Self Inventory. The empirical results suggest that relational ethics and differentiation of self are highly interconnected and linked to health and to the achievement of mature individuation, contributing to our empirical knowledge of the two constructs. Our findings suggest that these two frameworks and their respective constructs may be viewed as mutually supportive, offering a potential opportunity to thoughtfully integrate them into clinical practice where appropriate.

Temporal Stability and Predictive Validity of the Alternative Model of Personality Disorders Among Older Adults

Abstract: The alternative model of personality disorders (AMPD) contains two diagnostic criteria: personality functioning and pathological personality traits. This study examined the temporal stability and predictive validity of the AMPD’s key constructs among older adults. A sample of older adults ( n = 172) completed AMPD and psychosocial functioning measures 3 months apart. Results indicated mixed evidence of the AMPD’s temporal stability among older adults. Predictive validity was supported, indicating that AMPD may be an adequate prognostic indicator in late life. This study provides further evidence in support of the validity and clinical utility of the AMPD among an older adult population, although some important areas of improvement remain. We discuss the findings in light of the broader PD, AMPD, and older adult personality literature.

Associations Between Peer Relationships and Depressive Symptoms in Rural Children: Undirected and Bayesian Network Analyses.

Previous studies have noted links between peer relationships and depressive symptoms, but few have explored the subtle internal connections and inherent directionalities of these associations. Undirected and Bayesian network analyses were utilized to explore the interrelationships among key constructs in this study, which focused on 802 Chinese rural children (Mage= 12.16 years, SD = 0.83, 46.13% boys). Undirected network analysis revealed that Self-hatred, Sadness, and Loneliness were central nodes within the networks of peer relationships and depressive symptoms. Mutual support, Friendship skills, and Popularity emerged as key nodes linking peer relationships with the network of depressive symptoms. Bayesian network analysis demonstrated that Sadness and Popularity act as triggering nodes within the network, which are ultimately leading to depressive symptoms such as Pessimism, School difficulty, Indecisiveness, and Feeling unloved. These findings provide supports for the development of targeted interventions to reduce depressive symptoms in rural children, with a focus on different aspects of peer relationship.

Designing a Motivational Model for Applying Blended Learning to Faculty Members in Universities of Medical Sciences

Background: The advent of digital technology has profoundly impacted the field of education, effectively removing limitations and enhancing the learning environment. Blended learning, which combines face-to-face instruction with online components, addresses barriers to learning and fosters higher-order cognitive skills, resulting in increased student satisfaction and improved outcomes in medical education. Objectives: This study aimed to identify the key motivational components and construct a comprehensive model that can effectively support faculty members in implementing blended learning within medical universities. Methods: A qualitative grounded theory (GT) approach was used to explore this phenomenon. Faculty members from medical universities in region 4 were recruited using purposeful sampling. Data were collected through semi-structured interviews conducted between November 2023 and March 2024. A three-stage coding process — open, axial, and selective — was applied to analyze the data. Rigor was ensured through measures addressing credibility, confirmability, transferability, and dependability. Results: Interviews with 14 faculty members revealed five primary categories influencing the adoption of blended learning: Learner-professor, infrastructure, structural, environmental factors, and rules and regulations. These findings informed the development of a motivational framework that highlights critical components for promoting faculty engagement in blended learning. Conclusions: The model provides actionable insights for medical schools to enhance educational outcomes and innovate teaching practices in healthcare education.

How Social Desirability Influences the Relationship between Measures of Personality and Key Constructs in Positive Psychology

Does socially desirable responding produce exaggerated correlations between self-ratings of personality and positive psychology constructs? We operationalized social desirability as the tendency to react to evaluative content in questionnaire items and related one standard measure and one evaluatively neutralized measure of the Big Five to measures of five key positive psychology constructs (optimism, purpose in life, satisfaction with life, well-being and sense of coherence). Structural equation modelling (N = 439) revealed substantially different relationships between the Big Five and positive psychology constructs when the evaluative factor was accounted for. The results indicated that although the Big Five still predict the positive psychology constructs when the evaluative factor is accounted for, their influence is strongly reduced and the evaluative factor itself a major predictor. Arguably, this suggests that when the evaluative factor is not accounted for, the use of self-ratings invites social desirability to inflate the estimated relationships between personality traits and evaluatively loaded constructs in positive psychology. Alternative interpretations of the evaluative factor are discussed, as well as the importance of probing different solutions to measurement issues surrounding evaluative psychological constructs.

Sociocultural constructs and sensorimotor control: a scoping review examining implications for anterior cruciate injury

ObjectiveThere is a need to explore the many factors that may have a more subtle influence on, or relationship with, sensorimotor control as it pertains to anterior cruciate ligament injury...

Consumer Adoption of Virtual Reality in Indonesia Through Lens of Diffusion of Innovation Theory and Technology Acceptance Model

This research explores the prospective adoption of Virtual Reality technologies in the Indonesian consumer market by identifying key factors and constructs that influence the consumer adoption in Indonesia. The study considers the successful efforts of Virtual Reality technology manufacturers to create consumer-level hardware within the price range of household electronic devices. In this case, we measure the willingness of the Indonesian mass consumer market to adopt this technology. Quantitative survey analyzed using the combined framework of Diffusion of Innovation Theory and Technology Acceptance Model is used for this study. The study concludes that Observability and Social Influence are the major factors of new technology adoption in the Indonesian consumer market, among others. In general, Indonesia consumer market has good attitude towards future Virtual Reality technology adoption. Therefore, it is recommended that any attempts to capture the Indonesian market by Virtual Reality manufacturers consider these factors. A Go-To-Market strategy applying the learnings from this study is also provided within this study.

Commentary for the Special Issue on Innovations and Strategies for Addressing the COVID-19 Pandemic: A Focus on Measurement and Methodological Challenges.

This commentary explores challenges and innovations in prevention science that arose during the COVID-19 pandemic, with a focus on measurement issues and the contextual influences on data collection and intervention delivery. The pandemic necessitated a rapid shift to remote data collection and virtual interventions, many of which proved effective and scalable, as demonstrated by studies in this special issue. Innovations such as remote observational assessments improved reliability, reduced costs, and increased accessibility. However, the pandemic also revealed how contextual factors influence measurement properties for key constructs, with examples from this issue showing shifts in scale dimensionality and item functioning over time. These findings underscore the importance of considering context when designing and interpreting quantitative measures. I argue that by embracing heterogeneity in exposures and outcomes, prevention researchers can improve the precision and relevance of their work.