Contrariwise obesity through organic food consumption in Malaysia: a signaling theory perspective.

BACKGROUND: THE CONTEXT AND PURPOSE OF THE STUDY: Unhealthy food consumption has raised an alarming situation of obesity among Asian nations and posing serious threats to human health. Recent studies have acknowledged that organic food consumption has been contrariwise associated with obesity. The consumption of healthy food has received research attention in social marketing and several antecedents and consequences have been identified. However, to date, there is a void in literature that how social, individual, and marketing elements together tradeoff in predicting a healthy lifestyle. Thus, the current investigation unfolds the antecedents of healthy foods' adoption in Asia by integrating the brand signaling and theory of planned behavior. METHODS: The data of 241 respondents were collected from selected social media Facebook communities through a survey using assessed 42 questions. For this purpose, participants' Facebook accounts were selected from the online healthy communities such as 'Diet Suku Suku Separuh' (469,000 followers), 'Hiking, and Camping around Malaysia' (351,200 followers), and 'Healthy Malaysia' (332 followers). The enumerator also engaged with the online community by liking posts and following health accounts. RESULTS: The data was analyzed using PLS (SEM) approach, the outcomes of hypotheses revealed interesting information that health consciousness not significantly predicts the purchase intention of healthy food. All antecedents were significant contributors to the prediction of foods' purchase intentions in this study. However, the findings indicated that no positive relationship exists between brand image identifications and brand credibility identifications, and healthy foods' purchase intentions identifications. The findings also indicated that no positive relationship exists between health consciousness identifications and healthy foods' purchase intentions identifications. Owing to the perilous increase in obesity among the general public in Asia. This study reinforced the factor that can help in the adoption of a healthy lifestyle. The study validated that a healthy lifestyle is reliant on the consumers' health consciousness, environmental concern, and innovativeness through motivating the consumers' healthy foods' purchase intentions. Surprisingly, the results highlighted that respondents have not identified brand image and credibility as an antecedent of purchase intention. Given that organic food brands are somewhat new in Asian markets and therefore, brands must endure crisis marketing practices to improve their brand recognition. Therefore, policymakers must facilitate the food promotional activities that are critical to enhancing the perceived benefits of organic food to combat issues like obesity. This paper offers a foundation for future empirical investigations in Asia and various stakeholders on how to promote a healthy lifestyle in Asia. Specifically, the results will help policymakers to offer positive policies and procedures for the improvement of a healthy lifestyle through the understanding of the antecedents and consequences of health-conscious consumers' healthy foods' purchase intentions.

Diagnostic accuracy of cerebrospinal fluid adenosine deaminase in detecting Tuberculous Meningitis.

OBJECTIVE: To determine diagnostic accuracy of Cerebro Spinal Fluid (CSF) Adenosine De-Aminase (ADA) in detecting Tuberculous Meningitis (TBM) keeping CSF Polymerase Chain Reaction (PCR) for Mycobacterium Deoxy Ribonucleic Acid (DNA) as gold standard. METHODS: This cross sectional validation study was conducted at Department of General Medicine of PNS Shifa Naval Hospital Karachi, Pakistan from Oct 2015 to Mar 2017 for a total duration of one and a half year. One hundred and thirty six patients were included. The diagnosis of TBM was based clinically on symptoms like fever, headache, altered mental state and signs of meningeal irritation with CSF findings of increased proteins, low glucose and lymphocytic pleocytosis. Lumbar puncture was done and approximately 4ml of CSF sample was withdrawn for analysis. Diagnosis of TBM was confirmed by doing CSF PCR test for mycobacterium tuberculosis DNA. RESULTS: Total 136 patients were enrolled in this study. Mean age in our study was 47.09±12.80 years, whereas frequency and percentages of male and female patients was 102 (75%) and 34 (25%) respectively. The diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of CSF ADA level in detecting TBM was 71.32%, 84.21%, 95.45%, 98.97% and 53.85% respectively. CONCLUSION: The study concludes that diagnostic accuracy of CSF ADA in detecting TBM is high which is proposed as an investigation to differentiate it from other causes of meningitis in places where PCR test is not available.

Does prior percutaneous endoscopic gastrostomy alter post-operative outcome after esophagectomy.

BACKGROUND: With the introduction of neoadjuvant chemoradiotherapy in patients with esophageal carcinoma, nutritional access has become essential to counter deleterious effects of dysphagia. Current NCCN guidelines do not recommend PEG prior to esophagectomy in these patients, but there is little evidence for this recommendation. The objective of this study was to compare outcomes in patients who underwent esophagectomy with or without prior PEG placement. METHODS: We retrospectively reviewed 96 patients who underwent esophagectomy between 2005 and 2012 for esophageal carcinoma. Patients were divided into two groups; Group I (PEG +ve) and Group II (PEG -ve). Patient characteristics, operative variables, and post-operative complications were compared. χ (2) and Fisher's test were used for categorical, while t test was used for interval variables. RESULTS: Median age was 51(18-70) years. Lower thoracic tumors were more common in Group I (69 vs. 63 %) (P = 0.04) and more patients underwent minimally invasive surgery in this group (50 vs. 2.6 %) (P < 0.0001). Mean blood loss (326 vs. 465 ml) (P = 0.02) and ICU stay (1.6 vs. 4.3 days) (P = 0.01) were significantly lower in Group I. There was no 30-day mortality in Group I versus 10.5 % in Group II (P = 0.01). No significant difference in anastomotic leak and stricture rate was observed. Gastric conduit was used in all patients for reconstruction. One patient had malignancy in PEG site biopsy. CONCLUSION: Percutaneous endoscopic gastrostomy before esophagectomy is safe and does not adversely impact post-operative outcomes.

Investigating the Psychological, Social, Cultural, and Religious Predictors of COVID-19 Vaccine Uptake Intention in Digital Age: A Media Dependency Theory Perspective.

Media exposure to health communication contents related to the COVID-19 pandemic alone is inadequate to measure the influence of media on individuals in adopting precautionary behaviors against COVID-19, such as vaccine uptake. Certain individuals may pay attention to and be influenced by communication content. However, literature has suggested other instrumental determinants in developing and adopting health precautionary measures, such as culture or religion, especially regarding vaccination. In times of crisis, such as the COVID-19 pandemic, it is valuable to examine the interrelationships among psychological, sociocultural, and informational factors. This can provide valuable insights for policymakers in developing effective communication strategies. Drawing an analogy between the Media dependency theory (MDT) and the Theory of Planned Behavior (TPB) model, this study unravels the factors underpinning the COVID-19 vaccine uptake intention among Pakistanis. The study utilized a cross-sectional research design and employed a survey method to gather data from a sample of 993 participants. The findings obtained from the PLS-SEM analysis confirmed that individuals relied on both traditional and social media to cope with the COVID-19 pandemic. The findings show that individuals rely more on the informational content disseminated through conventional media channels. The findings also suggest that individuals from Asian countries, such as Pakistan, tend to be more inclined toward collectivism. The findings about the moderating role of religiosity suggest that religious beliefs significantly shape individuals' reliance on traditional media. Hence, this study has uniquely contributed to public health and media management by providing a strategy for managers to address disseminating misinformation related to religion and its impact on vaccination-related health issues. The study has theoretically confirmed the principles of media dependency theory. As a result, it is recommended that various information sources be utilized to cultivate resilience among individuals to manage health crises effectively.

How Does Digital Media Search for COVID-19 Influence Vaccine Hesitancy? Exploring the Trade-off between Google Trends, Infodemics, Conspiracy Beliefs and Religious Fatalism.

Digital media has remained problematic during COVID-19 because it has been the source of false and unverified facts. This was particularly evident in the widespread misinformation and confusion regarding the COVID-19 vaccine. Past research suggested infodemics, conspiracy beliefs, and religious fatalism as potential threats to public COVID-19 vaccine hesitancy. However, the literature is primarily void of empirical evidence associating demographic attributes with efforts to build vaccine hesitancy. Therefore, this research uses two studies: (Study 1) Google Trends and (Study 2) survey method to provide inclusive empirical insight into public use of digital media during COVID-19 and the detrimental effects of infodemics, conspiracy beliefs, and religious fatalism as they were related to building COVID-19 vaccine hesitancy. Using Google Trends based on popular keywords the public searched over one year, Study 1 explores public digital media use during COVID-19. Drawing on this exploration, Study 2 used a cross-sectional national representative survey of 2120 adult Pakistanis to describe the influence of potential hazards such as infodemics on public vaccine hesitancy. Study 2 revealed that infodemics, conspiracy beliefs, and religious fatalism predict vaccine hesitancy. In addition, gender moderates the relationship between infodemics and conspiracy beliefs and vaccine hesitancy. This implies that there is a dispositional effect of the infodemics and conspiracy beliefs spread digitally. This study's findings benefit health and other concerned authorities to help them reduce religious fatalism, vaccine hesitancy, and conspiracy theories with targeted communication campaigns on digital media.

Assessing How Risk Communication Surveillance Prompts COVID-19 Vaccine Acceptance Among Internet Users by Applying the Situational Theory of Problem Solving: Cross-Sectional Study.

BACKGROUND: The World Health Organization has recently raised concerns regarding the low number of people fully vaccinated against COVID-19. The low ratio of fully vaccinated people and the emergence of renewed infectious variants correspond to worsening public health. Global health managers have highlighted COVID-19 vaccine-related infodemics as a significant risk perception factor hindering mass vaccination campaigns. OBJECTIVE: Given the ambiguous digital communication environment that has fostered infodemics, resource-limited nations struggle to boost public willingness to encourage people to fully vaccinate. Authorities have launched some risk communication-laden digital interventions in response to infodemics. However, the value of the risk communication strategies used to tackle infodemics needs to be evaluated. The current research using the tenets of the Situational Theory of Problem Solving is novel, as it explores the impending effects of risk communication strategies. The relationship between infodemic-induced risk perception of COVID-19 vaccine safety and risk communication actions to intensify willingness to be fully vaccinated was examined. METHODS: This study used a cross-sectional research design vis-à-vis a nationally representative web-based survey. We collected data from 1946 internet users across Pakistan. Participants voluntarily participated in this research after completing the consent form and reading ethical permissions. Responses were received over 3 months, from May 2022 to July 2022. RESULTS: The results delineated that infodemics positively affected risk perception. This realization pushed the public to engage in risky communicative actions through reliance on and searches for accurate information. Therefore, the prospect of managing infodemics through risk information exposure (eg, digital interventions) using the situational context could predict robust willingness to be fully vaccinated against COVID-19. CONCLUSIONS: These pioneering results offer strategic considerations for health authorities to effectively manage the descending spiral of optimal protection against COVID-19. This research concludes that the likelihood of managing infodemics using situational context through exposure to relevant information could improve one's knowledge of forfending and selection, which can lead to robust protection against COVID-19. Hence, more situation-specific information about the underlying problem (ie, the selection of an appropriate vaccine) can be made accessible through several official digital sources to achieve a more active public health response.

Effect of meteorological factors on the COVID-19 cases: a case study related to three major cities of the Kingdom of Saudi Arabia.

The COVID-19 pandemic affected the world through its ability to cause widespread infection. The Middle East including the Kingdom of Saudi Arabia (KSA) has also been hit by the COVID-19 pandemic like the rest of the world. This study aims to examine the relationships between meteorological factors and COVID-19 case counts in three cities of the KSA. The distribution of the COVID-19 case counts was observed for all three cities followed by cross-correlation analysis which was carried out to estimate the lag effects of meteorological factors on COVID-19 case counts. Moreover, the Poisson model and negative binomial (NB) model with their zero-inflated versions (i.e., ZIP and ZINB) were fitted to estimate city-specific impacts of weather variables on confirmed case counts, and the best model is evaluated by comparative analysis for each city. We found significant associations between meteorological factors and COVID-19 case counts in three cities of KSA. We also perceived that the ZINB model was the best fitted for COVID-19 case counts. In this case study, temperature, humidity, and wind speed were the factors that affected COVID-19 case counts. The results can be used to make policies to overcome this pandemic situation in the future such as deploying more resources through testing and tracking in such areas where we observe significantly higher wind speed or higher humidity. Moreover, the selected models can be used for predicting the probability of COVID-19 incidence across various regions.

Assessing Response Readiness to Health Emergencies: A Spatial Evaluation of Health and Socio-Economic Justice in Pakistan.

COVID19 pandemic has put the global health emergency response to the test. Providing health and socio-economic justice across communities/regions helps in resilient response. In this study, a Geographic Information Systems-based framework is proposed and demonstrated in the context of public health-related hazards and pandemic response, such as in the face of COVID19. Indicators relevant to health system (HS) and socio-economic conditions (SC) are utilized to compute a response readiness index (RRI). The frequency histograms and the Analysis of Variance approaches are applied to analyze the distribution of response readiness. We further integrate spatial distributional models to explore the geographically-varying patterns of response readiness pinpointing the priority intervention areas in the context of cross-regional health and socio-economic justice. The framework's application is demonstrated using Pakistan's most developed and populous province, namely Punjab (districts scale, n = 36), as a case study. The results show that ~ 45% indicators achieve below-average scores (value < 0.61) including four from HS and five from SC. The findings ascertain maximum districts lack health facilities, hospital beds, and health insurance from HS and more than 50% lack communication means and literacy-rates, which are essential in times of emergencies. Our cross-regional assessment shows a north-south spatial heterogeneity with southern Punjab being the most vulnerable to COVID-like situations. Dera Ghazi Khan and Muzaffargarh are identified as the statistically significant hotspots of response incompetency (95% confidence), which is critical. This study has policy implications in the context of decision-making, resource allocation, and strategy formulation on health emergency response (i.e., COVID19) to improve community health resilience.

Role of birth order, gender, and region in educational attainment in Pakistan.

We studied the effects of birth order and socioeconomic factors on educational attainment in Pakistan. We examined this relationship by using PSLM/HIES 2018-19 which is nationally representative household survey data. We found striking evidence that being born first as a male child is positively and significantly associated with educational attainment. Whereas in our girls' sample we found that being born first is significantly and negatively associated with educational attainment, and this effect does not persist for second-born female children if the firstborn is a male child. Such a difference in our estimates led us to investigate further the cohort and rural-urban dimensions. We concluded that urban areas in Pakistan are primarily responsible for resource rationing in favor of male children for younger cohorts. Therefore, the study recommends the targeted policy intervention to remove such differentials based on gender when it comes to the educational attainment of a child.

Fall Seven Times, Stand Up Eight: Linking Project Management Innovation, Project Governance, and High-Performance Work Practices to Project Success.

Project managers seem to be puzzled in resolving the global dilemma of project failures across industries. Hence, the present study introduces project management innovation (PMI) as a determinant of project success (PS) and explores whether project governance (PG) and high-performance work practices (HPWPs), strengthen this relationship. To confirm these propositions, study data using adapted scales were collected from project professionals representing software development companies in the emerging IT industry in Pakistan. Structural equation modeling (SEM) was employed to examine the hypothesized relationships and encourage PMI-guided solutions for project failures. SEM results statistically validated that project success is positively influenced by PMI, whereas this relationship is significantly strengthened through the moderating influence of PG and HPWPs, respectively. Theoretically, the present research is the first of its kind to introduce and empirically examine these untested relationships between PMI, PG, HPWPs, and PS in a single framework. These novel findings hold strategic value for both project managers and organizational leaders who oversee a range of project portfolios. Long-lasting advantages and superior achievements can be reinvigorated through PMI, after departure from traditional approaches and answering calls for new solutions to new problems in managing projects. Moreover, project governance and HPWPs should be reconfigured to oversee, as well as meet the special needs of each unique project.

A cross-cultural comparison of ethnocentrism and the intercultural willingness to communicate between two collectivistic cultures.

There is a prevalent notion regarding divergence in the extent of ethnocentrism and the intercultural willingness to communicate across cultures. Given this cultural divergence, research is replete with comparative studies of ethnocentrism and the intercultural willingness to communicate between individualistic and collectivistic cultures. However, to our knowledge, a comparison of these crucial cultural tendencies within and their consequences for collectivistic cultures has been overlooked. Thus, this study provides a cross-cultural comparison of ethnocentrism and the intercultural willingness to communicate among university students from two collectivist cultures, i.e., Pakistan and China. The researchers employed a cross-sectional design. A sample of 775 students was collected using a survey technique. The findings show that Pakistani students are more ethnocentric and have a lower intercultural willingness to communicate than Chinese students. Moreover, males were found to be more ethnocentric and less willing to communicate in intercultural settings than females in both countries. These findings validate the notion of ethnocentrism divergence across collectivistic countries and its influence on the intercultural willingness to communicate. Additionally, they demonstrate the role of demographic attributes in evolving ethnocentrism and the intercultural willingness to communicate. Accordingly, these findings also confirm the ecological assumption that contextual factors, such as demographic attributes (e.g., past interactions with foreigners), influence communication schemas. Therefore, concerning its management, these findings suggest that increased people-to-people interactions between the two focal countries can better foster their mutual understanding to reap an increased harvest of the fruits of the Belt and Road Initiative.

Exploring Influence of Communication Campaigns in Promoting Regenerative Farming Through Diminishing Farmers' Resistance to Innovation: An Innovation Resistance Theory Perspective From Global South.

Climate change and farming malpractices (e.g., harmful pesticides use) are harmful to the globe's productive soil and biodiversity, thereby posing a hazard to the survival of future generations. Innovative technologies provide continuous smart conservation solutions, such as regenerative farming, to confront the ongoing climate crisis and maintain biodiversity. Albeit, regenerative farming has the potential to conserve climate change by upgrading the soil's organic materials and reinstating biodiversity leading to carbon attenuation. However, a critical problem remains concerning adapting conservation farming practices that can assist low-income farmers. In this scenario, theoretical-driven communication campaigns are critical for addressing individuals' resistance to innovation. Thereby, this research uncovers the moderating influence of the numerous communication tools in determining the adoption of regenerative farming through diminishing farmers' resistance to innovation. The study employed a cross-sectional design vis-à-vis a survey method. A sample of 863 farmers participated by responding to the self-administrated questionnaire. In line with prior theories, the study's results identified that communication campaigns such as public service advertisements and informative scientific documentaries could reduce the resistance to innovation that increases the attitude toward the adoption of regenerative farming with varied intensity. Besides, informational support also remained a significant contributor in determining the intention to adopt regenerative farming. This specifies that implanting habits of conservation farming requires the initiation of communication campaigns using different media content. These results may be advantageous for policymakers to influence farmers' intentions to adopt regenerative farming.

Correlation Of Caregivers' Strain With Patients' Disability In Stroke.

BACKGROUND: Stroke results in serious long-term disability in fifty percent of the survivors, making them dependent on others for activities of daily living. Our study aims to study the effect of this dependence on care-givers. Cross sectional study. METHODS: It was a cross sectional study conducted at Combined Military Hospital Peshawar from September to November 2020. Self-administered questionnaires were used to interview 96 patients with stroke and their caregivers selected through convenience sampling technique. Barthel Index was used to measure disability among patients, whereas Modified Caregivers Strain Index (M-CSI) was used for the caregivers. An association between the two scores was analyzed through Pearson's coefficient of correlation (r) and linear regression. RESULTS: Mean ages of the patients and their caregivers were 66.13±11.32 and 36.32±13.71 years respectively. Median score of Barthel index was 1.00 (interquartile range 0.00- 9.75). Mean M-CSI score was 17.31±5.04. There was significant negative correlation between Barthel Index and M-CSI (R=0.542, p<0.001). No significant association was found between duration of stroke and history of recurrent stroke with Barthel Index (p=0.399 and p=0.527 respectively). CONCLUSIONS: Greater the dependence of patients for activities of daily living on their caregivers, higher is the level of strain among the latter. There is dire requirement of social support and rehabilitation centers to address the physical and mental needs of both the patients and their care providers.

Ingraining Polio Vaccine Acceptance through Public Service Advertisements in the Digital Era: The Moderating Role of Misinformation, Disinformation, Fake News, and Religious Fatalism.

Recently, misinformation and disinformation, as well as fake news, have become global threats to public health owing to their role in spreading viral health hazard information. The growing explosive religious fatalistic views presented on social media and widespread misinformation, disinformation, and fake news can result in detrimental outcomes in adopting protective behavior. The moderating implications of misinformation and religious fatalism can be severe, leading to adverse effects on polio vaccine acceptance. Consequently, this research provides brief empirical evidence on the efficacy of risk communication strategies to address polio vaccine reluctance in a digital age landscape, an area that remains understudied. This research argues that the spread of misinformation, disinformation, fake news, and religious fatalism is not solely the bane of the polio vaccine, but rather represents the absence of risk communication strategies. The study opines that polio vaccine acceptance can be improved using risk communication strategies. Recognizing these risk factors and counter-risk communication strategies, this research tested a theoretical model using the cross-sectional survey design. Overall, data was collected from 2160 parents with children aged below five years. The results, based on structural equation modeling, revealed that public service advertisements are an effective tool to counter the inverse impacts of misinformation, disinformation, fake news, and religious fatalism. Furthermore, the inverse moderating role of misinformation, disinformation, fake news, and religious fatalism has been verified to potentially diminish polio vaccine acceptance. These results suggest that healthcare providers must identify and address all forms of digitally disseminated information that encumbers public health behaviors. Accordingly, this research recognized the utilization of evidence-based strategic communication campaigns to cultivate and encourage the literacy necessary to counter health hazard information, including misinformation. This study's findings will benefit health and other concerned authorities in utilizing strategic communication on different media platforms to reduce or eradicate the polio endemic.

An Experimental Evidence on Public Acceptance of Genetically Modified Food through Advertisement Framing on Health and Environmental Benefits, Objective Knowledge, and Risk Reduction.

Owing to the emerging challenges on global food security and the decade of controversies over genetically modified food (hereafter GMF), the present study aims to explore the effects of advertisement framing on health and environmental benefits, sources of perceived risk reduction, and domain-specific knowledge on the acceptance of GMF. The study conducted a quasi-experimental factorial 2 (advertisement message framing: health vs. environmental benefits) × 2 (expert endorsement: present vs. absent) between-subject design involving 300 adult participants from Pakistan. Using a multi-group structural equation model, the four conditions were assigned to each participant group (n = 75) to test the hypothesized relationships. The quasi-experiment results suggested that the advertisement messages (ad-framed) incorporated with the health and environmental benefits, as delineated by experts, can be a viable communication strategy in developing effortless cognitive cues towards GMF acceptance. The pioneer findings validate the significant efficacy of advertisement messages (ad-framed with expert opinions) in reducing perceived risk through augmented objective knowledge that activates the mechanism of favorable development of attitude and acceptance of GMF. The study findings offer strategic directions to policymakers, marketers, and food technologists in raising greater awareness and acceptance towards GMF products.

An Experimental Evidence on Eco-Friendly Advertisement Appeals and Intention to Use Bio-Nanomaterial Plastics: Institutional Collectivism and Performance Orientation as Moderators.

Plastic waste management has become a serious environmental and health concern owing to large amounts of plastic deposits globally. Recently, innovative and sustainable solutions have been introduced (e.g., bio-nanomaterial plastics) to overcome the growing environmental threats. Hence, green marketers need to develop effective advertising campaigns to enhance the usage of bio-nanomaterial plastics. Past literature has suggested that cultural value-laden advertising appeals can give sustainable behavioral cues to consumers. Hence, this research unfolds the underlying cultural dimensions between the value-laden eco-friendly advertising appeals and intention to use bio-nanomaterial plastics (henceforth IBP). The present study proposes a moderating model in which two dimensions presented in the Global Leadership and Organizational Behavior Effectiveness (henceforth GLOBE) framework interact with the individuals' perception of eco-friendly advertising appeals (henceforth IPEA) to drive bio-nanomaterial plastics usage. The model was tested by conducting an experimental study on a sample of 364 Pakistani consumers. Findings of structural equation modeling show a significant difference in the relationship between IPEA and IBP, which is moderated by the performance orientation (henceforth PO) and institutional collectivism (henceforth IC) dimensions with diverse intensity. These findings validate the effectiveness of PO and IC (as cultural dimensions) and eco-friendly advertisements that can potentially promote the consumption of bio-nanomaterials plastic.

Can Communication Strategies Combat COVID-19 Vaccine Hesitancy with Trade-Off between Public Service Messages and Public Skepticism? Experimental Evidence from Pakistan.

The COVID-19 pandemic may have reached a turning point as the World Health Organization and the global community of nations step up plans for mass vaccination campaigns. However, the COVID-19 vaccine-related conspiracy theories (e.g., falsehoods about birth control, women infertility, surveillance, and microchip humanity, etc.) have built new momentum for vaccine hesitancy. To this end, several nations worldwide, including Pakistan, are struggling to boost public trust and enthusiasm to get vaccinated, especially in an anxious and complicated atmosphere propelled by multiple, new and the deadliest variants of COVID-19. To address this critical research gap during these intensifying conditions of vaccine hesitancy, the present study makes the first attempt to explore the potential effects of various communication strategies, including public service message (safety benefits versus fear appraisals), media types (i.e., traditional versus digital), self-efficacy, perceived benefits and threats (susceptibility and severity), on the willingness to get vaccinated for COVID-19. Importantly, the underlying effects of public skepticism (in a moderating role) on these relationships were empirically examined. Using four fictitious COVID-19 immunization campaigns in a series of experiments with 2 (media type: traditional vs. digital) X 2 (service attribute: health and safety benefits vs. fear) message frames (represented as Group one to Group four), the findings identified fear appraisal as the most viable communication strategy in combating vaccine hesitancy. Moreover, public skepticism negatively moderated the effects of media types and public service message attributes on willingness to get vaccinated in relatively high (i.e., Group two), moderate (i.e., Group one and four), and low intensities (i.e., Group three). The pioneering findings of this research offer new strategic insights for the global health authorities and vaccine promoters to proactively address the downward spiral of people's willingness to take the COVID-19 vaccine.

Investigating Binge-Watching Adverse Mental Health Outcomes During Covid-19 Pandemic: Moderating Role of Screen Time for Web Series Using Online Streaming.

BACKGROUND AND PURPOSE: Watching multiple episodes using streaming services, such as Netflix, Hulu, and Youku, has become widespread in recent years. While much attention has been paid to binge-watching, there is, however, a dearth of research on binge-watching and its adverse psychological effects during the COVID-19 pandemic. To the best of our knowledge, less attention has been paid to understanding the multiple influences of binge-watching on binge-watchers during the COVID-19 pandemic. Most of the past studies on this topic mainly underscored the individual's motivations for binge-watching. Also, past studies were limited and inconclusive as they mostly espoused only the underpinning adverse effects of binge-watching without looking into the association between binge-watching and screen time for web series through online streaming services during the COVID-19 pandemic. Therefore, this study sought to fill this gap by probing the association between binge-watching and psychological aftereffects. PARTICIPANTS AND METHODS: The study employed a cross-sectional research design vis-à-vis the survey method. A sample of 1089 adult respondents was collected through an online administrated questionnaire. RESULTS: The findings of this study demonstrated that extensive binge-watching is an antecedent of stress, loneliness, insomnia, depression and anxiety. Furthermore, it was found that screen time on binge-watching could intensify these adverse effects of binge-watching. Interestingly, the moderating effect of screen time on binge-watching was found to be insignificant for stress and loneliness. CONCLUSION: The findings of this study suggest that binge-watching correlates with psychological and mental health symptoms including stress, loneliness, insomnia, depression and anxiety. Hence, this study suggests that consumption of web series through online streaming services related literacy interventions are imperative to help the audience become critical about online streaming content and its comparison to the real social world.

Pain and satisfaction: the case of isolated COVID-19 patients of Pakistan.

BACKGROUND: Over 3 million people lost their lives across the globe due to the COVID-19 related pandemic. The unprecedented restrictions on mobility have imposed in the form of isolation, quarantines, and lockdowns to curb the profound effects of the pandemic and retain physical health. This study examined the relationship between various pain levels, demographic variables and patient satisfaction with COVID-19 during isolation. METHODS: The primary data in this study were collected from isolated patients during their isolation and treatment in a public hospital. We obtained information from patients with COVID-19 (N = 100) about their demographic characteristics, varying levels of pain, and satisfaction with the services provided during the isolation period. We computed the descriptive statistics to explain the profile of participants, ANOVA was used to find out the difference between various groups on patient satisfaction, and structural equation modeling was performed to examine the link between pain levels, demographic factors, and patient satisfaction. This analysis was performed with STATA and SmartPLS-3. RESULTS: The findings of this study ascertained that respondent's education (Beta, ß = 2.961, p = 0.003), assets such as possession of a house (ß = 4.563, p = 0.000), perception of income adequacy during the lockdown (=2.299, p = 0.022), and negligence in prevention (ß = 1.975, p = 0.049) significantly affects patient satisfaction during the isolation period. Moreover, satisfaction with life, physicians and medicine, income adequacy, and fear of the participants was significantly linked to the pain level (Model F-stat = 86.323, p = 0.0001). Patients who were satisfied with their treatment had significantly lower odds of having pain (OR 0.023, 95% CI [0.001-0.0452]). Patients who had enough income to meet their basic necessities were found to have significantly lower odds of having pain (OR 0.155, 95% CI [0.032-0.740]. DISCUSSION AND CONCLUSION: We conclude that a higher level of education, low income, and living in a rented house contributes significantly to the feeling of more satisfaction with the provided services. This implies that people with more affluent backgrounds are less likely to be satisfied with the provided services as low-income and living in rented house groups are more satisfied during isolation than others. The pain level is also affected by subjective factors such as fear and satisfaction which need to be considered while doing patient management. This study can be helpful in improving the delivery of public services of isolation centers by considering various characteristics and demographic factors of patients.

COVID-19: A Psychosocial Perspective.

The World Health Organization declares coronavirus disease 2019 (COVID-19) as a pandemic, and The World Economic Forum argues that the COVID-19-induced global lockdown is the biggest psychological experiment. This study is an attempt to empirically evaluate the possible adverse psychosocial effects caused by COVID-19-related lockdown, if any. To do so, a cross-sectional study is conducted based on a comprehensive online survey using snowball sampling to analyze the level of social and psychological impacts (i.e., stress, belief in stakeholders, fear of losing job, and life satisfaction) during the early stage of the outbreak in Pakistan. The questionnaire is filled out by the residents in Pakistan including working professionals and students (sample size is 428). We find that the development of stress due to COVID-19-induced lockdown is particularly because of mood swings. Additionally, a higher prevalence of stress in the children of highly educated mothers is evident (95% confidence). To assess the belief in stakeholders, we focus gender, demographics, and education. It is observed that parental education and age significantly affect the belief in several stakeholders (i.e., government, media, religious clerics, and family). The lockdown-induced fear of losing job is lower in female and male children whose fathers are graduates. Lastly, we observe that food storage and "no fear of losing job" significantly increases the odds of life satisfaction. These findings have important implications in the context of social insurance, parental education, and policy related to COVID-19 at various levels. This study further facilitates to understand the factors that might affect the mental health and life satisfaction of people during such pandemics.