Purpose Whilst the use of artificial intelligence (AI) partners in the workplace has become more pervasive in recent years, the effects of teamwork partner type (human vs AI) on collaboration proficiency, especially for temporary tasks, remain unclear. Based on the computers are social actors (CASA) paradigm, we identify the mechanism to explain how partner type and partners' emotion influence collaboration proficiency when dealing with temporary tasks. Design/methodology/approach Through an online experiment, hypotheses were examined using data collected from 861 employees working in the online retail industry. Findings The results indicate that the type of teamwork partner does not significantly influence collaboration proficiency. However, emotion plays a significant moderating role in the relationship between partner type and collaboration proficiency. Additionally, several mediation effects are identified. Specifically, teamwork partner type moderates the effect of service empathy on collaboration proficiency whilst service empathy mediates the association between emotion and collaboration proficiency. Originality/value This study is the first to reveal, from the employee's perspective, the outcomes of human–human and human–AI collaborations when dealing with temporary tasks in a virtual context. These findings can empower managers to more effectively select and pair teamwork partners, while also creating work environments that are more attuned to and supportive of emotional dynamics.

Social physical activity and sedentary behaviour as key determinants of humour expression and loneliness in older adults: a cross-sectional study using bayesian variable selection approach.

Background: Insufficient physical exercise is a growing public health concern in China, where only 30.3% of adults exercise regularly. Exploring the key factors associated with physical exercise participation is essential for promoting healthier lifestyles. Method: This study utilized data from the 2021 China General Social Survey (CGSS) to apply a progressive framework of dimensionality reduction, machine learning prediction, and SHAP-based interpretability analysis. A total of 19 potential factors were considered, with LassoCV used for feature selection and multiple models constructed for comparison. Results: The SVM model showed the best predictive performance. SHAP analysis revealed that watching sports events, household registration, educational attainment, subjective well-being, smoking, age, sleep quality, social activities, and residence suitability for physical exercise are the most important factors influencing participation. Higher education, greater subjective well-being, urban residency, frequent sports viewing, and residence suitability for physical exercise were positively associated with participation, while smoking and poor sleep quality were negatively associated with it. Conclusion: This study highlights the value of combining machine learning with interpretability methods to uncover the key predictors of physical exercise. The findings provide new evidence on the social, psychological, and environmental factors associated with Chinese adults’ exercise behavior, offering insights for targeted health promotion strategies.

In recent years, insecurity has emerged as a significant challenge in tertiary institutions across South East Nigeria, negatively affecting students’ academic performance, psychological well-being, and overall campus experience. Reports of kidnapping, cult activities, armed robbery, and inadequate security measures have heightened students’ fear and anxiety, leading to emotional stress, reduced concentration, and withdrawal from social and academic activities. The study employed a descriptive survey design. A multi-stage sampling technique produced a sample of 3,000 students (1,812 males and 1,188 females). Data were collected using a validated structured questionnaire covering demographics, insecurity experiences, psychological behaviour, and school environment. Responses were measured on a four-point Likert scale. Data analysis involved frequencies, percentages, means, and standard deviations. Gender comparisons were conducted using group statistics, while bootstrap analysis with 1,000 resamples ensured robust estimates and confidence intervals. Results show that students experienced a moderate to high level of insecurity, with notable gender differences. Female students consistently reported higher insecurity than males in key areas such as fear of kidnapping (Male: M = 1.61; Female: M = 3.22), terrorism threats (Male: M = 1.81; Female: M = 3.09), and community insecurity affecting academic focus (Male: M = 1.52; Female: M = 2.81). Both genders reported high insecurity related to cult activities (Male: M = 3.42; Female: M = 3.54), night-time movement on campus (Male: M = 3.05; Female: M = 3.32), and inadequate security patrols (Male: M = 3.32; Female: M = 3.19), indicating widespread insecurity across tertiary institutions. The study concluded that enhancing campus security and fostering supportive school environments are vital for safeguarding students’ psychological well-being and improving academic focus.

This article provides a critical review of ethnography, as a qualitative research method, with a focus on its utility, flexibility, and methodological challenges. Ethnography allows one to study people and cultures within their natural contexts, documenting the meanings, behaviors, and social discussions that make up human experience. Using insights from fifteen key pieces of research, this article points to the power of ethnography in providing rich, contextualized, and holistic views of social life. The article also mentions reliability and validity as issues deriving from its naturalistic and interpretive quality. Despite reliability and validity issues that may arise, ethnography persists as an important and under-utilized method of studying complex social phenomena and demonstrates a capacity to provide richer insight into culture, identity, and lived experience with observation, participation, and interpretation of social actors.

Introduction: Urinary incontinence (UI) is one of the most common pelvic floor disorders after childbirth and depends on hormonal changes, anatomical damage that occurs after childbirth, muscle and connective tissue weakness, fascia and nerves. UI is distinguished into three subtypes, including stress urinary incontinence (SUI), urgent urinary incontinence (UUI) and mixed urinary incontinence (MUI). Aim: The purpose of this review is to collect and summarize the results of studies related to the risk factors of urinary incontinence, to disseminate this information to scientists so that this major issue can be prevented, identified and managed. Methodology: This review followed the methodology of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PECO eligibility criteria were used. We included studies published up to 2025 and not before 2019. The review was limited to studies published within the last six years in order to reflect contemporary diagnostic criteria, assessment tools and current postpartum care practices related to urinary incontinence. We searched PubMed, Google Scholar and Scopus for studies concerning the relationship between risk factors and postpartum UI. Results: A total of 1321 citations were identified. Following our exclusion criteria, 36 papers were selected to identify the risk factors for UI. All the research focused on the associated factors of any type of urinary incontinence. Vaginal and instrumental delivery, obesity, maternal age and the neonate’s birth weight were the main risk factors. The multiparity and incontinence symptoms before and during pregnancy were also strong risk factors. Heterogeneity across studies in assessment tools, in outcome measures and timing of postpartum assessment are some of the limitations of the study. Restriction to English-language publications and the absence of protocol registration were some of the additional limitations of the study. Conclusions: This problem affects the inclusion of women in society, the family, limits social activities and even their ability to work. Detection of the type of urinary incontinence by healthcare professionals, lifestyle modifications, monitoring women’s body weight and encouraging them to follow a program of pelvic floor muscle exercises should be a priority for professionals. The strategy of developing prognostic models in the coming years will be the only way to ensure the early identification and follow-up of women at high risk for urinary disorders.

Estimating treatment effects can assist decision-making in various areas, such as commerce and medicine. One application of the treatment effect estimation is to predict the effect of an advertisement on the purchase result of a customer, known as individual treatment effect (ITE). In online websites, the outcome of an individual can be affected by treatments of other individuals, as people often propagate information with their friends. This is referred to as interference. Prior studies have attempted to model interference for accurate ITE estimation under a static network among individuals. However, the network usually changes over time in real-world applications due to complex social activities among individuals. In this case, the outcomes of individuals can be interfered with not only by treatments for current neighbors but also by past information and treatments for past neighbors, which we refer to as dynamic interference . In this work, we model dynamic interference by developing an architecture to aggregate both the past information of individuals and their neighbors. Specifically, our proposed method contains an attention-based historical aggregation, which models interference received by individuals from previous time stamps, and an attention-based neighbor aggregation, which captures interference received by individuals within every time stamp. Since information about individuals changes over time, we propose a parameter evolution trick to adaptively update the parameters of the model, which enables the model to capture the dynamics effectively. In our experiments on multiple datasets with dynamic interference, our method outperforms existing methods for ITE estimation because they cannot capture dynamic interference, which corroborates the importance of dynamic interference modeling.

Value-based healthcare emphasizes outcomes that matter to patients, and patient-centred outcomes sets are vital to its success. For psoriasis, initial work proposed a patient-centred outcomes set in Belgium, but it requires further validation to ensure international applicability. This scoping study aimed to refine the outcomes set in collaboration with patient representatives and dermatologists, in preparation for international validation through a Delphi consensus process. An international Working Group of patient representatives and dermatologists was established through the International Federation for Psoriasis Associations (IFPA) and the International Psoriasis Council (IPC). Experts participated in three discussion meetings and subsequent surveys to discuss and recommend outcomes important to people living with psoriasis, their measurement and case-mix variables. The systematic review of patient-relevant outcomes was updated as well and outcome measurement instruments were selected corresponding to the COSMIN criteria. The Working Group included 35 experts (12 patient representatives and 23 dermatologists) from 22 countries. A total of three discussion meetings and two subsequent surveys informed the refinement of the outcomes set. 'Acceptable costs of care for society' was excluded as an outcome, four outcomes were merged into 'psoriasis clearance' and 'social activity', and 'communication' and 'confidence in care' were reclassified as patient experiences. 'Feelings of stigmatization' and 'number of flare-ups' were added based on patient recommendations. These changes resulted in a revised set of 18 patient-relevant outcomes and 2 patient experiences. After selecting outcome measurement instruments, a heatmap was compiled to assess overlap, quality and feasibility. Finally, 50 case-mix variables were proposed based on the literature and expert opinions. This scoping study convened an international Working Group of patient representatives and dermatologists to establish the fundamentals for a patient-centred outcomes set. The subsequent Delphi process will finalize consensus, advancing value-based psoriasis management worldwide.

The spatial and planning solutions of underground spaces in business centers are considered, combining the functions of shelters and parking. This approach promotes the efficient use of limited urban areas, which is highly relevant for modern urban development. Such multifunctional complexes not only address the issue of parking shortages but also integrate into the city’s infrastructure, creating opportunities for economic and social activity. The integration of shelters and parking facilities is a logical step that optimizes land use and provides civil protection for the population, highlighting the dual value of such structures. Designing these spaces requires an understanding of construction standards, safety requirements, and ergonomics to ensure maximum functionality and comfort. Efficient use of underground areas also reduces the load on surface land, freeing it up for green zones and sustainable urban development. These spaces serve not only as parking facilities but may also include commercial, administrative, and technical zones that meet the demands of the urban environment. The shelter function is fundamental in contemporary design amid conflicts and emergencies. Underground parking facilities can be quickly transformed into fully functional civil protection shelters equipped with life-support systems. This dual-purpose use of space demands a special approach to planning and engineering systems to ensure rapid transformation and compliance with safety regulations (DBN). Such solutions increase urban resilience and population safety. Underground spaces are equipped with modern engineering systems: water supply, ventilation, fire safety, heating, cooling, and automation. These systems enhance both efficiency and safety. Ventilation ensures air quality, while fire safety systems provide automatic suppression and evacuation. Automation optimizes system operations and reduces energy consumption. Modern monitoring systems and intelligent parking management improve functionality. The implementation of BIM technologies supports coordination and resource management. The design of underground spaces is based on the principles of flexibility and adaptability. Their function can change without significant capital investment. For example, part of a parking facility can be temporarily converted for exhibitions or events. This flexibility is valuable for business centers aiming to maximize asset utilization. The combination of functionality and engineering solutions defines the current trend in underground space design — the creation of multifunctional and adaptable environments. These can serve various purposes: parking, retail spaces, gyms, or data centers. This reflects the global trend toward multifunctionality in urban spaces and sustainable development. The development of such projects requires the involvement of highly qualified specialists. The implementation of new technologies is an integral part of the process. Ultimately, these underground complexes become key elements of modern infrastructure, contributing to economic growth, quality of life, and urban resilience.

Abstract Introduction Measuring extended Activities of Daily Living (eADLs) is an important part of functional assessment. Several eADL scales are currently used, resulting in heterogeneity and lack of standardisation. Existing scales are potentially outdated, containing activities which are no longer considered relevant by older people. We aimed to explore the perspectives of older adults and healthcare professionals on eADL assessment to inform new approaches to eADL measurement. Method Semi-structured qualitative interviews were undertaken with older adults and healthcare professionals. Perspectives were gathered on preferences around eADL assessment, scale administration and activities that could be included in a new scale. We also explored the contribution of education and digital literacy. Thematic analysis was used to develop themes from verbatim interview transcripts. Results A total of 41 interviews (online and in-person) were conducted with 21 older adults (>60 yrs) and 20 professionals representing different members of the multidisciplinary team. Five themes were developed from interview data. Older adults identified that both physical and social activities should be included in eADL scales, and that technology has changed how eADLs are carried out. They also highlighted that views on the acceptability of receiving help must be considered to ensure accurate scoring. Professionals acknowledged that while eADL assessments could be conducted by a machine, face to face communication has key benefits. Inclusivity was consistently prioritised, with gender roles and financial factors identified as key influencing factors in eADL assessment. Conclusions Participants identified priorities for future approaches to eADL assessment that will offer a holistic assessment of eADLs and be inclusive to all, whilst reflecting the contemporary activities of life in the 21st century. This requires attention to sources of bias which can arise around inequities in education, access and finance. Further research is needed involving older people who are not digitally confident.

This study was conducted to determine phubbing, public speaking anxiety, and the need for social approval among young adults. This study was conducted using a cross-sectional design. The study was completed with 1,063 young adults aged 18-26 from various cities in Turkey. Data were collected using a personal information form, the General Phubbing Scale, the Public Speaking Anxiety Scale, and the Need for Social Approval Scale. Multiple linear regression analysis and linear regression analysis were used to analyse the data. According to the results of multiple linear regression analysis, the model explains 39.5% of the variance in public speaking anxiety and is statistically significant (p < 0.001). It has been determined that the level of phubbing is positively and significantly related to public speaking anxiety and the need for social approval. An increase in phubbing scores is associated with an increase in public speaking anxiety and social approval need scores. Furthermore, phubbing explains 14.1% of the variance in social approval need and significantly predicts this variable (p < 0.001). This study demonstrates that phubbing behaviour in young adults is associated with public speaking anxiety and the need for social approval. An increase in phubbing negatively impacts both variables. The findings indicate that a decrease in face-to-face communication may have significant effects on the psychological well-being of young adults. Accordingly, it is recommended that young adults engage in social activities and receive information aimed at reducing phubbing.

Abstract Background The global population of people aged 65 years and over is expected to rise from 761 million in 2021 to 1.6 billion by 2050. Many of these older adults have multiple comorbidities and functional impairments that make them particularly vulnerable during acute hospitalisation. Engagement in meaningful activities can be vital to older people’s care, particularly in acute hospitals. Evidence suggests that such engagement can have a positive impact on the patients’ hospital journeys. To ensure individualised support, it is important to understand the purpose of meaningful activities for older adults in acute hospital settings, including their definitions, implementation methods, and impact on patients. Objectives The aims and objectives of this scoping review were to: Methods The review stages identified in the Arksey and O’Malley framework were used. The electronic databases MEDLINE, CINAHL and PsycINFO were searched to discover relevant articles on meaningful activities/older adults in acute hospital care. The results are reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) extension for scoping reviews. A total of 3466 titles were identified in an initial search that used the term ‘meaningful activity.’ Screening these articles using the keywords ‘older adults’ and ‘acute care setting’ cut this figure to 34. Some of these were duplicates or the studies had not been carried out in the UK; after excluding these, 24 articles related to the research interests remained. These 24 articles were screened and six were found to apply to adults 65 years and older. These six were analysed in the review. Findings and Conclusion The findings regarding the meaningful activity experiences of older adults in acute hospitals indicate that comprehensive models of care that embrace physical, psychological, social and spiritual frameworks are required. Summarisation of the data led to the identification of three themes: ‘physical, social and art activities,’ ‘the benefits of meaningful activities,’ and ‘the desire for meaningful activity.’ Regarding the latter, patients in the studies highlighted the importance of taking part in meaningful activities during their acute hospital journeys. Regarding the first two themes, the reported observations and reviews of the evidence indicate that interventions that include physical exercise, music and art therapy improve mental health and well-being and alleviate anxiety and depression in older adults. Loneliness and isolation among some older patients may be eradicated through social interaction. However, implementation of such models in acute hospital settings poses a challenge, given the shortage of staff, particularly those trained in meaningful activity.

The global rise in life expectancy is accompanied by an increase in the prevalence of mental health conditions among older adults, including mild cognitive impairment (MCI), dementia, delirium, depression, anxiety, and other severe mental illness. These conditions significantly impact independence, increase healthcare costs, and increase mortality risk. Mounting evidence underscores the central role of modifiable lifestyle factors-particularly physical activity and diet-in the prevention and management of these conditions. This consensus, developed under the auspices of the European Interdisciplinary Council on Ageing (EICA), synthesizes current evidence and expert perspectives. Regular exercise, ranging from aerobic and resistance training to mind-body practices, improves cognition, mood, and physical resilience, while also mitigating cardiometabolic and functional risks. Similarly, adherence to dietary patterns such as the Mediterranean or MIND diets has been consistently associated with reduced incidence of cognitive decline, Alzheimer's disease, and comorbid chronic illnesses, although much of the evidence is observational. Landmark multidomain trials, including the Finnish FINGER and U.S. POINTER studies, have shown that combined interventions targeting diet, physical activity, cognitive stimulation, and social activity can slow cognitive decline in at-risk populations. Lifestyle strategies that promote brain health may enhance functional outcomes in dementia and, in turn, mitigate the risk of delirium. However, widespread implementation of such strategies faces numerous barriers, including physical frailty, socioeconomic constraints, health system fragmentation, and stigma. To overcome these barriers, caregivers, healthcare and public health professionals, policymakers, and community organizations must collaborate in designing accessible, culturally sensitive, and sustainable interventions at a policy level. Emerging digital tools, group-based programs, and co-designed approaches offer novel opportunities to enhance adherence and impact. Integrating lifestyle interventions into standard healthcare pathways represents an urgent, cost-effective strategy to promote mental health and resilience in ageing populations worldwide. This document provides actionable recommendations to guide policy, research, and clinical implementation across diverse health systems.

This study aims to explore and analyze the relationship between the ideal symbol of Bundo Kanduang in Minangkabau and the ethics of care. The ethics of care is not only a personal affective expression but also a form of social action essential for maintaining communal harmony. This study adopts a qualitative design grounded in ethnographic methods. Ethnography enables the researcher to engage directly with the community’s social life, observing daily practices and uncovering the symbolic meanings embedded within them. Data were collected through purposive interviews with Bundo Kanduang and customary leaders, participant observation in traditional events over an extended period, and systematic documentation of oral traditions. These narratives are approached as cultural texts, interpreted through an anthropological lens that highlights the ethics of care as a central value in Minangkabau society. The findings reveal that Minangkabau women enact the ethics of care in two distinct but interconnected dimensions: first as an affective orientation reflected in attentiveness to the needs of family members, particularly regarding education, and second as embodied practices including caring for ill relatives and providing childcare. Within this framework, the figure of Bundo Kanduang functions as a moral symbol that integrates gender relations, authority, and care ethics, thereby contributing to broader scholarly discussions on the interplay between gender, power, and moral practice in socio-cultural systems. However, the revitalization of the role of Bundo Kanduang must be accompanied by a broader social transformation, so that concern does not only become a gender identity but also becomes a collective foundation in building a just and civilized society.

This article analyzes the creation process of the Pico do Marumbi State Park (PEPM), between the 1940s and 1990s, with emphasis on environmental struggles, legal processes, conflicts, and alliances among different political and social actors, which converged in the official establishment of the park in 1990 through State Decree nº 7,300. The protected area, covering 2,342 hectares, is located in the Paraná section of the Serra do Mar mountain range and includes the municipalities of Morretes, Piraquara, and Quatro Barras, within the Marumbi Area of Special Tourist Interest. The research is grounded in Claude Raffestin's relational theory, which supports the interpretation of power relations and strategic interactions among subjects with distinct interests. Methodologically, this is an applied, exploratory, and documentary study with a qualitative approach. Data collection was based on document analysis, conducted in two stages: collection and processing of historical documents, followed by interpretation using content analysis techniques. The results highlight three main dimensions: the legal and administrative processes surrounding the park’s creation; the roles played by social, political, and environmental actors; and the conflicts between environmental preservation and economic interests along the coast of Paraná. It is concluded that the creation of PEPM resulted from a complex articulation of forces, in which environmental discourses gained strength amid territorial disputes.

Cognitive dysfunction is prevalent in patients with heart failure (HF). Subjective cognitive concerns (SCC) refer to an individual's concerns, worries, and difficulties about their own perceived cognitive dysfunction, which may or may not be consistent with scores on objective cognitive assessments (eg, neuropsychological tests). However, little is known about SCC in patients with HF. The purpose of this study was to characterize SCC in patients with HF by identifying the prevalence and severity (aim 1), influencing factors (aim 2), and potential outcomes (aim 3). An integrative literature review was conducted by searching CINAHL, PubMed, PsycINFO, and EMBASE. Search keywords were heart failure, subjective, cognit*, concerns, and associated synonyms in combination. Of 453 articles retrieved, 9 were included in this review. The articles reviewed included 567 individuals with HF (ranges of mean age = 49-63 years, female = 0%-49%). The prevalence of SCC in patients with HF was 40% to 91%. Severity of SCC was reported to be mild to moderate. Factors significantly influencing SCC were worse HF severity, more psychological distress (ie, depressive and anxiety symptoms, and perceived stress), multimorbidity (ie, chronic obstructive pulmonary disease, insomnia, higher body mass index), and worse objective cognitive function. Outcomes significantly associated with SCC in HF were poorer quality of life and health-related quality of life, less participation in meaningful activities (ie, instrumental, leisure, and social activities) and increased efforts to maintain HF self-care. In this sample, SCC were highly prevalent in HF, with mild to moderate severity. Potentially influencing factors and outcomes may guide future studies identifying at-risk individuals for SCC and improving health outcomes in HF.

The increasing crackdown on illegal cigarettes at the regional level demands cross-institutional synergy. This study aims to analyze the collaboration process between the Bayur Port Customs Office and the Local Government of Padang Pariaman Regency in tackling the circulation of illegal cigarettes. The analysis is based on the five dimensions of collaboration framework by Thomson and Perry (2006), which include governance, administration, autonomy, mutuality, as well as norms of trust and reciprocity. This research employs a descriptive qualitative method. Data collection was conducted through in-depth interviews with stakeholders from the Bayur Port Customs Office, the Civil Service Police Unit (Satpol PP), and the Regional Financial Management Agency (BPKD) of Padang Pariaman Regency. The findings indicate that the collaboration operates pragmatically and functionally asymmetrically. Weaknesses in governance and administrative dimensions, characterized by the absence of written agreements (MoU/SOP) and the dominance of informal communication, are compensated by strong institutional autonomy and interpersonal trust between actors. The mutuality formed is calculative, driven by the need to absorb 10% of the Tobacco Excise Revenue Sharing Fund (DBHCHT) for law enforcement. Supporting factors include the complementarity of resources, where the Bayur Port Customs Office provides legal authority, while the Local Government of Padang Pariaman Regency offers social legitimacy and sociological proximity to the community. In contrast, inhibiting factors to collaboration include the lack of formal institutionalization and regional fiscal rigidity. The conclusion of this study indicates that although the collaboration is effective in practice, it faces collaborative fragility that could stagnate if there is a change in officials. Therefore, institutionalizing the cooperation through an Annual Work Plan (RKT) and intelligence data exchange is necessary for the effectiveness of socialization activities.

The advancement of social media platforms, especially TikTok, has drastically changed the behavioral patterns and lifestyles of Generation Z. One psychological impact of intensive social media use is Fear of Missing Out (FoMO), which is the worry of missing out on news, trends, or viral social activities. This study aims to reveal how FoMO affects the lifestyle of Generation Z active on TikTok, focusing on aspects of mental health, shopping habits, and the balance of social interactions. This research uses a literature study approach with a qualitative descriptive method, through in-depth analysis of 21 scientific articles published between 2019 and 2025. The findings show that FoMO is associated with increased anxiety, depression, personal dissatisfaction, and excessive social media use among Generation Z. Furthermore, FoMO also drives impulsive consumption patterns and purchases triggered by online trends as well as the desire for social approval. On the other hand, internal factors such as self-confidence and self-control ability have proven to reduce the level of FoMO and its negative effects. This study concludes that FoMO is a complex phenomenon that impacts the mental health and lifestyle of Generation Z, thus requiring measures such as increasing digital literacy, strengthening self-control, and using social media wisely to reduce the negative impacts of FoMO in the long term.

This study investigates determinants of self-reported SARS-CoV-2 infection, addressing a gap in understanding how social and care-related factors are associated with infection risk among older people. We analyzed the baseline wave of “Gesundheit 65+”, a German nationwide population-registry survey. This wave was performed between June 2021 and April 2022, with a sample of 3450 participants aged 65 to 100 living in private households. SARS-CoV-2 infection prevalence was 3.5% (95% confidence interval, CI 2.6–4.5), slightly higher among those aged 85+, and higher among those receiving home care, and not having double vaccination. We identified with multivariable logistic regression that not having double vaccination (odds ratio, OR = 9.72; CI 4.81–19.61), receiving in-person visits (OR = 2.96; CI 1.12–7.80), and not living alone (OR = 1.96; CI 1.02–3.76) were independently associated with SARS-CoV-2 infection, but receiving formal or informal care at home, and participating in work and social activities were not. Our results emphasize the importance of vaccination and caution during in-person interactions. Despite receiving formal or informal care at home implying close personal contact, we did not detect increased infection risk in those receiving care at home.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-026-37108-7.

Introduction This study aimed to investigate the associations among social participation, sleep quality, multidimensional frailty, and activities of daily living (ADL) in older adults with knee osteoarthritis (KOA), and to further evaluate whether sleep quality and frailty jointly mediate these relationships. Methods A cross-sectional study was conducted among 288 older adults with KOA recruited via convenience sampling. Validated scales were used to assess social participation, sleep quality, multidimensional frailty, and ADL. Statistical analyses were performed using SPSS 26.0 and the PROCESS 4.1 macro, including descriptive statistics, correlation analyses, and mediation modeling. Results Social participation was significantly associated with sleep quality, multidimensional frailty, and ADL (all p &amp;lt; 0.001). Sleep quality was significantly associated with frailty and ADL, and frailty was also associated with ADL. Mediation analysis indicated that sleep quality and frailty each partially mediated the association between social participation and ADL, and jointly formed a significant chain mediation pathway. The combined indirect effect was 0.315, accounting for 42.51% of the total effect. Discussion Social participation was significantly associated with ADL in older adults with KOA, both directly and indirectly through sleep quality and multidimensional frailty. These findings suggest that enhancing social engagement and addressing sleep and frailty issues may be important for maintaining functional independence in this population. Future longitudinal and interventional studies are needed to validate these findings and inform targeted strategies for improving daily functioning among older adults with KOA.