Telehealth has become an integral component of mental health care delivery worldwide. Understanding provider perceptions is essential to guiding its continued implementation. This international study used quantitative and qualitative methodologies to examine and broaden our understanding of the benefits and concerns related to telehealth for mental health care. An internet-based survey was conducted during the COVID-19 pandemic between November 11 and December 18, 2020, among mental health professionals, primarily psychiatrists and psychologists, registered with the World Health Organization's Global Clinical Practice Network. Clinicians completed the survey in 1 of 6 languages (Chinese, English, French, Japanese, Russian, or Spanish). Descriptive statistics and logistic regressions were used to analyze quantitative survey data on concerns and implementation of telehealth. Responses to an open-ended question about providers' perspectives on the benefits of telehealth were analyzed qualitatively. In total, 847 participants completed the telehealth section of the survey, and 496 provided a response to the open-ended question. Quantitative data on telehealth use and concerns revealed that clinicians' primary concerns focused on technical issues and clinical effectiveness relative to in-person services, specifically, loss of clinical information (eg, nonverbal behavior) and challenges with establishing a therapeutic alliance. Findings varied by profession, World Health Organization region, and telehealth training and experience. Qualitative data examining benefits fell into 3 major areas: accessibility and reach of mental health services, efficiency and flexibility for clinicians, and enhancement of clinical processes and outcomes. Taken together, findings revealed a trade-off between telehealth benefits and disadvantages. From the perspective of mental health professionals, telehealth practice comes with key challenges and valuable benefits. Findings offer important considerations for the implementation of telehealth systems, including the importance of training and education and balancing trade-offs to optimize care.

Purpose Employees play an essential role in the implementation and success of organizations' environmental initiatives (EIs). This study tested an expanded theory of planned behavior (TPB) model of employees' participation in their organizations' EIs, examining the effects of employees' perceptions of the costs and benefits of participation (to themselves, their organization and society) on their attitudes to participation, intentions to increase participation and reported increases in participation two months later. Design/methodology/approach Aligning with TPB research best practices, purpose-specific scales were developed and piloted. A sample of 206 employed US workers then completed a survey measuring the model's variables. Two months later, 110 participants completed an additional survey measuring increases in initiative participation. Findings Confirmatory factor analysis demonstrated a good fit between the data and the measurement model. Structural equation modeling similarly demonstrated a good fit with the theoretical model. Personal and organizational benefits predicted attitudes to participation in EIs and indirectly predicted intentions to increase participation. Personal, organizational and societal costs and societal benefits, showed limited predictive ability. Originality/value Employees' cost and benefit perceptions are understudied antecedents to workplace pro-environmental behaviors. Our unique model, including costs and benefits at the personal, organizational and societal level, was supported and provides a foundation for further research on costs' and benefits' effects on initiative participation. Drawing employees' attention to personal and organizational benefits of initiative participation through internal marketing, or enhancing actual benefits, may increase participation and help organizations to achieve their sustainability goals.

Psychiatry currently lacks clinically relevant biomarkers, though recent developments in this field have shown promise. Nevertheless, a noticeable gap exists in understanding parental perspectives regarding such technologies. Thus, this study aimed to investigate parental perceptions about mental health biomarker (MHB) testing for adolescents, as they play a pivotal role in guiding decisions about their children's healthcare.An online survey was conducted in Finland, targeting 1500 parents of adolescents aged 10-17. A 20-item questionnaire was used to assess parental perceptions of the benefits and risks associated with MHB testing. Psychometric measures were applied to validate the questionnaire, and a Multivariate Analysis of Variance (MANOVA) was performed to examine parental perspectives across various demographic factors.Based on 174 questionnaire responses, parents were modestly supportive of the perceived benefits and expressed marginally lower concern about the possible risks associated with MHB testing. MANOVA indicated that some demographic variables were significantly associated with perceived benefits and risks. Notably, higher perceived benefits of adolescent MHB testing were reported by relatively younger parents and those with an undergraduate degree. Additionally, parents with a family history of mental health problems reported greater perceived benefits and lower perceived risks.The findings suggest that perceptions of the benefits and risks of MHB testing differ, with demographics influencing these perceptions. However, further research is warranted to explore the impact of these perceptions on the utility and acceptance of MHB testing among parents and adolescents.

ABSTRACT This study investigates the interrelationships between camping motivation, benefit perception, camping tourism image, and camping intention among Vietnamese youth, using ExpectancyValue Theory (EVT) as a theoretical framework. A quantitative, cross-sectional survey was conducted with 346 participants aged 18–30, recruited through online platforms and oncampus distribution using a non-probability convenience sampling technique. Data were collected via a structured, self-administered questionnaire and analyzed using Partial Least Squares Structural Equation Modeling (PLSSEM) and FIMIXPLS segmentation. Results reveal that social interaction, skill development, and relaxation significantly influence benefit perception, which positively affects both camping tourism image and camping intention. The camping tourism image also mediates and moderates the relationship between benefit perception and intention. Notably, intellectual stimulation did not significantly impact benefit perception. Importantly, as a key result, the FIMIX-PLS analysis revealed two distinct latent segments with different motivational configurations: one driven primarily by social interaction-oriented benefits and the other emphasizing relaxation and stress-relief motivations, highlighting meaningful heterogeneity within the youth camping market. These findings offer theoretical contributions to EVT and practical insights for tourism stakeholders to design targeted, appealing camping experiences that align with young travelers’ preferences.

Living farewells-ritualized pre-death gatherings enabling life review and relational closure-represent an emerging psychosocial practice in Asian palliative care, yet empirical evidence remains absent. This exploratory cross-sectional study (N = 165 Taiwanese adults) developed and validated a 25-item instrument assessing attitudes toward living farewells through exploratory factor analysis, identifying four dimensions: Positive Perceptions, Potential Concerns, Legal & Economic Considerations, and Leisure & Ritual Acceptance. Multiple regression revealed that positive perceptions of dignity and meaning-making benefits constituted the strongest predictor of willingness to host living farewells (β = .541, p < .001), while pragmatic concerns facilitated rather than inhibited engagement. Findings reflect attitudinal coherence rather than clinical outcomes, requiring longitudinal validation in terminally ill populations. Integrating Terror Management Theory with collectivistic cultural frameworks, this study advances thanatological research by demonstrating how indigenous Asian practices can inform evidence-based palliative care. This study provides the first quantitative foundation for incorporating culturally resonant end-of-life practices into evidence-based palliative care protocols.

The study discusses pulmonary tuberculosis as a chronic infectious disease that is still a global health problem, with Indonesia ranking third in the world. The increase in tuberculosis cases is influenced by drug resistance, limited access to health services, and poor environmental hygiene conditions. Kudus Regency, especially the work area of the Japanese Health Center, is an area with a relatively high number of tuberculosis cases. This disease not only has an impact on the physical condition, but also affects the mental and social aspects of the patient, so that self-management skills are an important factor in the success of treatment. The Health Belief Model explains that an individual's perception of susceptibility, disease severity, benefits, and barriers to health measures plays a role in shaping health behavior. In addition, good self-acceptance can improve treatment adherence and coping ability of patients. Self-management includes medication adherence, symptom management, and lifestyle changes influenced by social support, education level, and understanding of disease. This study used a correlational design with a cross sectional approach and involved 53 respondents who were selected through purposive sampling techniques. The research instruments include the Health Belief Model questionnaire, self acceptance, and self-management. Data analysis was carried out univariate and bivariate using the chi square test. The results showed that most of the respondents had a high health belief of 79.2 percent and a high self-acceptance of 75.5 percent. The majority of respondents' self-management was in the good category, namely 94.3 percent. The bivariate test showed a significant relationship between health belief and self-management with a p value of 0.044 and an odds ratio of 9.111. In addition, there was a significant relationship between self acceptance and self-management with a p value of 0.02 and an odds ratio of 1.193. The conclusion of this study shows that health belief and self acceptance are meaningfully related to the self-management behavior of tuberculosis clients, so education and psychosocial support need to be improved on an ongoing basis.

This study developed and validated the Perceived Benefits of Municipal Parks (PBMP) Scale, a 7-item unidimensional measure of residents' perceptions of park benefits. Data collected from 309 residents across three neighborhoods in Norfolk, Virginia, underwent structural equation modeling and reliability testing. The PBMP Scale demonstrated strong psychometric properties and utility for both practitioners and researchers. Analyses revealed significant correlations between PBMP scores, and park use, access, and overall perception. Gender and user/non-user differences were found in PBMP scores, while no differences emerged across neighborhoods or racial groups. The scale provides a quantitative tool for assessing park benefits, evaluating equity, justifying investments, and informing evidence-based park management strategies. The PBMP Scale's ability to capture residents' perceptions of park benefits offers valuable insights for urban planners and policymakers. Future research could explore how PBMP scores relate to other quality of life indicators.

The rapid growth of digital banking services has transformed the financial industry, particularly in attracting younger consumers who are highly dependent on technology. However, understanding the behavioral factors that influence digital banking adoption remains a critical challenge for financial institutions. This study aims to analyze the determinants of Generation Z’s intention to use digital banking services by applying the Technology Acceptance Model, with a particular focus on the mediating role of attitude. Using a quantitative research design, data were collected from 100 Generation Z respondents through purposive sampling. The study examines the relationships among perceived usefulness, attitude, and intention to use digital banking. The results indicate that perceived usefulness has a positive and significant effect on both attitude and intention to use, while attitude significantly mediates the relationship between perceived usefulness and usage intention. The findings demonstrate that users’ perceptions of functional benefits, efficiency, and convenience play a crucial role in shaping favorable attitudes and strengthening adoption behavior. This study highlights the importance of integrating technological value and user-centered design in digital banking services. By providing empirical evidence on Generation Z’s technology acceptance behavior, this research contributes to the literature on digital finance and offers practical implications for banks in developing effective digital strategies to enhance customer engagement and long-term adoption.

Objectives A post-hoc, mixed methods analysis of a randomized controlled trial of a 12-month psychosocial and psychoeducational telehealth intervention to support dementia caregivers of cognitively impaired relatives living in residential long-term care settings (the Residential Care Transition Module/RCTM) was conducted to identify and test potentially new mechanisms and outcomes of the RCTM. Method Two hundred and forty caregivers were randomly assigned to the RCTM treatment condition or to usual care as the control group and were administered quarterly surveys. Participants in the treatment condition provided qualitative data on perceptions of intervention benefits on follow-up surveys and semi-structured interviews conducted after the 12-month intervention (n = 30). New mechanisms and outcomes identified in the qualitative analysis were mapped onto existing items and scales (e.g. single items from the Short Sense of Competence Questionnaire) and re-analyzed quantitatively using general linear models. Results The mixed methods analysis suggested that dementia caregivers in the RCTM group were more confident in their ability to obtain information about and arrange services (e.g. legal and financial planning, long-term care ombudsman) than controls and were less likely to report annoyance with care recipients’ behaviors. Conclusion The mixed methods results advance our understanding of the RCTM’s potential efficacy, and the adoption of similar methodologies may yield greater insights into how and why dementia care interventions are beneficial, even in the face of initial null findings.

This study investigates the key factors shaping users’ intention to continue using public Wi-Fi networks, examining the tension between the convenience of constant connectivity and concerns over privacy and security. Grounded in Privacy Calculus Theory (PCT), the research integrates rational decision-making models with psychological dimensions, particularly fear of missing out (FoMO), to understand how users weigh benefits against risks in this context. The study addresses the central paradox of public Wi-Fi: its widespread use despite well-known security vulnerabilities. Employing a quantitative approach with structural equation modeling, the analysis tests the relationships among critical constructs. The results show that perceived value is the strongest driver of continued use, surpassing the role of trust. Moreover, FoMO exerts a paradoxical influence, simultaneously amplifying perceptions of both benefits and risks. These findings emphasize the importance of accounting for both utilitarian and emotional factors when developing digital security policies and point toward promising directions for future research.

Ossiculoplasty Grading Scales and Outcomes - Reporting and Patient Counseling.

The social phenomenon of university students learning agriculture rather than pursuing it, understanding agriculture rather than choosing agriculture, is a major challenge for the sustainable development of agricultural talents in China. This research paper investigates the impact and mechanism of practical education in agricultural schools on students’ intention to start agricultural businesses using OLS, Probit, and mediation effect models. Data from a survey of 1612 Chinese students from Sichuan Agricultural University, Nanjing Agricultural University and other 6 agricultural universities was analyzed, with instrumental variable probit model (IV-Probit) utilized to tackle endogeneity issues. The results showed that (1) The implementation of rural social practice, volunteer service, entrepreneurship competition, and agricultural labor education by universities can significantly boost university students’ interest in starting their agricultural businesses. Additionally, for every additional type of practical education students receive, they are 11.0% more likely to want to start business in agriculture. (2) Practical education will affect individual entrepreneurial effectiveness perception, including economic benefit perception, social status perception and professional value perception. Among these, the mediating effect of professional value perception is the strongest, with a ratio of 16.1%. (3) The results suggest that entrepreneurship support policy play a role in moderating the connection between individuals’ economic benefit, social status perceptions and their intentions. (4) The intentions of university students to start agricultural businesses are significantly correlated with their control variables, including major selection, students cadre experience, agricultural cognition, household registration, and family members’ occupation. Therefore, it is suggested that there should be a focus on enhancing practical education in agricultural universities, fostering students’ confidence in agricultural entrepreneurship, and optimizing sustainable policy support for university students’ entrepreneurial endeavors.

Childhood myopia has emerged as a growing public health concern, adversely affecting both visual function and vision-related quality of life (VR-QoL). This study examined the relationships among parent engagement, primary school children's eye care behaviors, and vision-related quality of life based on the Health Belief Model (HBM). In 2022, a total of 2,139 parent-child dyads were recruited from six primary schools in Hangzhou City, China, using stratified cluster sampling. Both children and their parents completed validated, self-administered questionnaires assessing eye care behaviors, engagement efficacy, and HBM variables. Multiple regression analyses were conducted to examine the associations among parent and child health beliefs, parent engagement practices, children's eye care behaviors, and VR-QoL. The participated children were aged from 9.24 to 10.19 years old. After adjusting for sociodemographic factors, parents with greater eye care knowledge, fewer perceived barriers, and stronger engagement efficacy were more likely to support their children's eye care behaviors. Among children, higher levels of eye care knowledge, perceived severity of myopia, and perceived benefits of protective practices were significantly associated with more frequent engagement in eye care behaviors. Children with stronger perceptions of severity and benefits, lower susceptibility, fewer barriers, and better eye care behavior reported higher VR-QoL. Health belief variables were significantly associated with parent engagement, children's eye care behaviors, and VR-QoL. These findings highlight the importance of considering both parent- and child-level cognitive and behavioral factors when examining childhood eye health. Theory-informed assessments can inform the development of contextually appropriate vision health promotion strategies.

Rhythmic auditory cueing (RAC) improves spatiotemporal gait parameters in older adults, often using isochronous rhythmic cues (i.e., with constant inter-beat-intervals). However, healthy gait contains fractal-like variability, (i.e., with persistent long-range correlations; LRC) which is disturbed when walking to isochronous cues. Embedding auditory cues with a fractal structure increases LRC in gait among young and older adults, though middle-aged adults are under researched. Walking requires greater cognitive resources with increased age, though how different cue-types interact with attentional load during RAC is under researched. This may depend on beat perception, as those with better beat perception benefit more from RAC. The aim of this study was to investigate the optimal parameters for RAC across the adult lifespan. We predicted that 1) walking to fractal cues would increase LRC in gait across the adult lifespan; 2) increasing attentional load would decrease LRC in gait, particularly for older adults. Moderating effects of beat perception on the impact of cue-type on LRC were also explored. Young, middle-aged, and older adults (n = 62) walked around an elliptical track in silence and in three cued walking conditions of increasing attentional load. Tones were presented in isochronous and fractal rhythms. Fractal cues increased LRC in gait, with qualitatively greater increase among middle-aged adults. Attentional load had no effect on LRC in gait. Isochronous cues resulted in decreased LRC in gait, particularly for those with better beat perception. The optimal parameters of RAC therefore depend on age, beat perception, and the target gait parameter.

BackgroundPatients undergoing cancer treatment experience a significant symptom burden. The standard process of symptom management includes patient reporting and clinical response following symptom escalation. Emerging predictive symptom models use artificial intelligence (AI) components of machine learning and deep learning to identify the risk of symptom deterioration, facilitating earlier intervention to prevent downstream effects. However, integrating predictive symptom models into clinical practice will require oncology nurses to adopt innovative approaches.ObjectiveThis study aims to explore oncology nurses’ perceptions of the use of predictive symptom models in cancer care and the factors influencing the adoption of this symptom care innovation.MethodsThe evaluation was guided by the Rogers Diffusion of Innovation Theory, which describes the process of how individuals adopt new technologies. The investigators developed an interview guide that asked oncology nurses to rate their perceptions of AI symptom models on a Likert scale. Participants were also asked to provide qualitative comments to support their ratings for each question, in order to better understand the key factors that would influence AI predictive model adoption. Investigators analyzed demographic data and Likert ratings with descriptive statistics. Qualitative analysis of participant comments included content analysis and inductive coding to identify themes. Nurses’ perception of factors that would influence the adoption of AI symptom models, based on the Rogers theory, included relative advantage, compatibility, complexity, trialability, and observability.ResultsResponses of 15 oncology nurses with more than 1 year of experience in oncology were analyzed. There was high agreement among nurse participants that an AI model could improve symptom management for patients with cancer (n=10, 67%) and increase early intervention to prevent the escalation of symptoms (n=12, 86%). All participants (N=15) agreed that receiving symptom information would be helpful. Nearly three-quarters of participants (n=11, 73%) endorsed that the information would save time. Most (n=12, 80%) recommended that clinicians receive information about the predicted symptom deterioration of their patients. Among open-ended responses, key themes were consistent with factors identified in the Diffusion of Innovation theory including: (1) perceptions related to the AI model (compatibility or complexity), (2) nurses’ perception of patients' benefit (observability), (3) improved clinical processes (relative advantage or observability), (4) apprehension over model accuracy and impact (compatibility or trialability or observability), and (5) implementation or adoption (trialability or complexity or observability).ConclusionsOncology nurses agree that predictive symptom models could help improve symptom management for patients undergoing cancer treatment. However, nurses noted that transparency in the factors included in the AI model was essential, that nurses should be involved in the development and testing of models, and that the observability of the benefit in symptom care would need to be evident for ultimate adoption.

ABSTRACT We investigate the effects on the public of government and companies acting responsibly to a threat of an emerging pandemic by use of an adaptation of the theory of dyadic morality. The effects of positive actions by government and companies are mediated by gratitude, a positive moral emotion, en route to its impact on felt benefits. Benefits then influence positive word of mouth, a kind of action tendency, but the effects are moderated by the degree of political ideology of the public. For the government, as benefit perceptions increase, positive word of mouth is higher for liberals than conservatives. For companies, positive word of mouth is greater for conservatives than liberals when benefits are perceived as low. These nuanced moderated effects reflect differences between conservatives and liberals, where liberals value social responsibility more than conservatives, whereas conservatives value company profitability more than liberals. Hypotheses are tested experimentally on two random samples of US adults (N 1 = 177, N 2 = 156). Results are discussed in the light of their implications for the theory of dyadic morality and responses to a new pandemic by government and company organisations as regulated by political ideology.

BackgroundDespite progress in childhood vaccination, many children in low- and middle-income countries, including Ethiopia, remain unvaccinated, presenting a significant public health challenge. The Immunization Agenda 2030 (IA2030) seeks to halve the number of unvaccinated children by identifying at-risk populations, but effective strategies are limited. This study leverages machine learning (ML) to identify Ethiopian children aged 12-35 months who are at higher risk of being zero dose (ZD). By analyzing demographic, socioeconomic, and health care access data, the study developed predictive models using different algorithms. The findings aim to inform targeted interventions, ultimately improving vaccination coverage and health outcomes.ObjectiveThis study aimed to develop an ML model to predict ZD children and to identify the most influential predictors of ZD in Ethiopia.MethodsWe examined how well the predictive algorithms can characterize a child at risk of being ZD based on predictor variables sourced from the recent National Immunization Evaluation Survey data. We applied supervised ML algorithms with the survey datasets, which included 13,666 children aged 12-35 months. Model performance was assessed using accuracy, area under the curve, precision, recall, and F1-score. We applied Shapley Additive analysis to identify the most important predictors.ResultsThe Light Gradient Boosting Machine (LGBM), Random Forest, Extreme Gradient Boosting (XGBoost), and AdaBoost classifiers effectively identified most ZD children as being at high risk. Among these, LGBM demonstrated the best performance, achieving an accuracy of 93%, an area under the curve of 97%, a precision of 94%, and a recall of 91%. The most significant features impacting the model included poor perception of vaccination benefits, lack of antenatal care utilization, distance from immunization services, and absence of maternal tetanus toxoid vaccinations.ConclusionsThe developed ML models effectively predict children at risk of being ZD, with the LGBM model showing the best performance. This model can guide targeted interventions to reduce ZD prevalence and address vaccination inequities. Key predictors include access to immunization sites, maternal health service utilization, and perceptions of immunization benefits. By focusing on these vulnerable groups, public health efforts can tackle disparities in vaccination coverage. Enhancing maternal care, raising caregiver awareness, and improving immunization access through outreach can significantly reduce the number of ZD children.

Adolescents' and adults' perceptions and intentions to use e-cigarettes following FDA authorization: insights from two survey experiments.

Despite the ubiquity of recurrent connections in the brain, their role in visual processing is less understood than that of feedforward connections. Occluded object recognition, an important cognitive capacity, is thought to rely on recurrent processing of visual information, but it remains unclear whether and how recurrent processing improves recognition of occluded objects. Using convolutional models of the visual system, we demonstrate how a distinct form of computation arises in recurrent-but not feedforward-networks that leverages information about the occluder to "explain-away" the occlusion-i.e., recognition of the occluder provides an account for missing or altered features, potentially rescuing recognition of occluded objects. This occurs without any constraint placed on the computation and is observed both across a systematic architecture sweep of convolutional models and in a model explicitly constructed to approximate the primate visual system. In line with these results, we find evidence consistent with explaining-away in a human psychophysics experiment. Finally, we developed an experimentally inspired recurrent model that recovers fine-grained features of occluded stimuli by explaining-away. Recurrent connections' capability to explain-away may extend to more general cases where undoing context-dependent changes in representations benefits perception.

This study aims to identify the factors that affect Perceived Value (PV) among thrifting behavior. PV is understood as the consumer’s perception of product benefits compared to the sacrifices made, including price, time, and potential risk. The population in this study comprised all consumers who made purchases within the last six months, totaling 1,426 transactions. From this population, 201 respondents were selected using an accidental sampling technique. The analysis method used in this study is exploratory factor analysis with Principal Component Analysis extraction method. The findings revealed six main factors that affect PV based on extraction value, namely personal value (0.701), service value (0.655), shopping experience (0.627), image value (0.619), price (0.571), and perceived risk (0.520). Results indicate that consumers’ PV is more strongly shaped by psychological aspects, shopping experiences, and service quality rather than the physical attributes of products. These findings strengthen the understanding that consumer behavior in thrift stores is not only driven by price, but also by social identity, emotional satisfaction, and positive store image, which can serve as a basis for more targeted marketing strategies.