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This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and substance use policies in all 50 states in the USA.

This study describes MOUD receipt among pregnant people with an opioid use disorder (OUD) in 2018. The authors explored sociodemographic differences in MOUD receipt, referrals and co-occurring mental health disorders. The authors included a comparison of MOUD receipt among states that have varying substance use policies and examined the impact of these policies and the political affiliation on MOUD. The authors used multilevel binary logistic regression to examine effects of individual and state-level characteristics on MOUD.

Among 8,790 pregnant admissions with OUD, the majority who received MOUD occurred in the Northeast region (71.52%), and 14.99% were referred by the criminal justice system (n = 1,318). Of those who were self-referred, 66.39% received MOUD, while only 30.8% of referrals from the criminal justice system received MOUD. Those referred from the criminal justice system or who had a co-occurring mental health disorder were least likely to receive MOUD. The multilevel model showed that while policies were not a significant predictor, a state’s political affiliation was a significant predictor of MOUD.

The study has some methodological limitations; a state-level analysis, even when considering the individual factors, may not provide sufficient description of community-level or other social factors that may influence MOUD receipt. This study adds to the growing literature on the ineffectiveness of prenatal substance use policies designed specifically to increase the use of MOUD. If such policies are consistently assessed as not contributing to substantial increase in MOUD among pregnant women over time, it is imperative to investigate potential mechanisms in these policies that may not facilitate MOUD access the way they are intended to.

Findings from this study aid in understanding the impact that a political affiliation may have on treatment access; states that leaned more Democratic were more likely to have higher rates of MOUD, and this finding can lead to research that focuses on how and why this contributes to greater treatment utilization. This study provides estimates of underutilization at a state level and the mechanisms that act as barriers, which is a stronger assessment of how state-specific policies and practices are performing in addressing prenatal substance use and a necessary step in implementing changes that can improve the links between pregnant women and MOUD.

To the best of the authors’ knowledge, this is the first study to explore individual-level factors that include mental health and referral sources to treatment that lead to MOUD use in the context of state-level policy and political environments. Most studies estimate national-level rates of treatment use only, which can be useful, but what is necessary is to understand what mechanisms are at work that vary by state. This study also found that while substance use policies were designed to increase MOUD for pregnant women, this was not as prominent a predictor as other factors, like mental health, being referred from the criminal justice system, and living in a state with more Democratic-leaning affiliations.

The existing technology acceptance models have not yet investigated functional and motivational factors impacting trust in and use of conversational artificial intelligence (AI) by integrating the feedback and sequential updating mechanisms. This study challenged the existing models and constructed an integrated longitudinal model. Using a territory-wide two-wave survey of a representative sample, this new model examined the effects of hedonic motivation, social motivation, perceived ease of use, and perceived usefulness on continued trust, intended use, and actual use of conversational AI.

An autoregressive cross-lagged model was adopted to test the structural associations of the seven repeatedly measured constructs.

The results revealed that trust in conversational AI positively affected continued actual use, hedonic motivation increased continued intended use, and social motivation and perceived ease of use enhanced continued trust in conversational AI. While the original technology acceptance model was unable to explain the continued acceptance of conversational AI, the findings showed positive feedback effects of actual use on continued intended use. Except for trust, the sequential updating effects of all the measured factors were significant.

This study intended to contribute to the technology acceptance and human–AI interaction paradigms by developing a longitudinal model of continued acceptance of conversational AI. This new model adds to the literature by considering the feedback and sequential updating mechanisms in understanding continued conversational AI acceptance.

Drawing from the literature on internationalization, higher education marketing and place branding, this paper aims to link the internationalization of higher education to country branding. It explores the impact of internationalization within the higher education system on Egypt’s destination brand equity. This investigation offers insights for decision-makers in both the higher education and country branding sectors.

This empirical paper adopts an exploratory approach and serves as an initial step for researchers. It utilizes a quantitative methodology, employing a survey with 366 responses, to examine the effects of internationalization efforts in higher education on country brand equity.

The results reveal a direct correlation between student engagement and the brand equity of international branch campuses (IBCs), as well as a link between IBCs and Egypt’s brand equity. Notably, the study highlights the mediating role of IBC brand equity in the relationship between student engagement and the overall brand equity of Egypt.

This paper is innovative in its method of assessing the impact of internationalization efforts in higher education, specifically at IBCs in Egypt, on Egypt’s destination brand equity. Additionally, the study identifies student engagement as an antecedent to IBC brand equity.