Search Results (291)

Background/Objectives: Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental disorder characterized by social, communication, and behavioral challenges. complementary and alternative medicine (CAM) is widely used by parents worldwide, yet research exploring parents’ experiences, particularly in Arab countries, is limited. This study explored mothers’ perceptions and experiences of CAM use for children with ASD, information-seeking behaviors and challenges encountered. Methods: A qualitative study using semi-structured interviews was conducted among twenty mothers at Autism Academy of Jordan in 2024. Inclusion criteria were mothers with children diagnosed with ASD for at least six months and those who had used at least one CAM therapy. Interviews were conducted via Skype, transcribed verbatim, and analyzed using NVivo 12 with inductive thematic analysis. Results: Three major themes emerged in this qualitative study: (1) mothers’ experiences with CAM and perceptions of benefit; (2) sources of information and decision-making processes; and (3) main challenges in selecting and implementing CAM. Mothers reported using therapies such as honey, black seed, camel milk, Hujama, olive oil, supplements, and region-specific programs like Andalosiah. Faith, cultural beliefs, and the desire for natural, safe interventions strongly influenced CAM selection. Internet searches and social media groups were primary information sources. Challenges included financial, logistical, emotional burdens, and lack of trustworthy, Arabic-language information sources. Conclusions: Mothers in Arab countries navigate CAM use for their children with ASD through culturally and religiously informed practices. Interventions should focus on developing evidence-based guidance, culturally sensitive counseling, and accessible information to support families in safe, informed CAM use. Full article

The building sector is significantly responsible for the world’s energy consumption and carbon emissions. Net-zero energy buildings (NZEBs) have become an effective solution to move towards sustainability, maximizing energy efficiency, and minimizing carbon footprint. However, achieving net-zero energy targets requires a comprehensive understanding of building performance from the perspectives of technologies, materials, and strategies, for which existing studies have a knowledge gap. This study aims to bridge the knowledge gap within existing studies through an empirical investigation. Based on a review of the literature, this study employs semi-structured interviews in the United Kingdom (UK) with industrial professionals experienced in NZEBs. The qualitative data collected from interview participants are analyzed minutely using NVivo to identify key themes and patterns, including 14 technologies, 12 materials, and seven strategies for NZEBs. Based on the literature review and, more importantly, the interview analysis, a conceptual framework is well established to describe an NZEB as a complex system that must incorporate appropriate technology adoption, careful material selection, and successful strategy implementation into consideration. This study provides a comprehensive understanding of NZEBs from a systematic point of view. It also contributes to the full fulfillment of Sustainable Development Goals (SDGs) established by the United Nations (UN). Full article

COVID-19 significantly disrupted the progress of the SDGs globally, including in Saudi Arabia. This study explores the progression of SDGs in Saudi Arabia during and after COVID-19, focusing on four dimensions: financial, socioeconomic, health, and environmental. A qualitative approach was employed, involving 19 semi-structured interviews conducted in two rounds (during and post COVID-19). Thematic analysis, conducted using NVivo 14.0, identified four main themes and 16 subthemes, which align with the SDG dimensions. The study revealed significant disruptions across four SDG dimensions during the pandemic. These included economic downturns, increased poverty, strained healthcare systems, and environmental changes. Guided by systems theory as an analytical lens, the study findings indicate that while COVID-19 caused disruptions across SDGs, it also acted as a catalyst for transformational shifts across interconnected SDG domains. The post-pandemic period has shown recovery, including economic growth, enhanced gender equality, improved mental health services, and a renewed focus on sustainability. Six cross-thematic themes emerged: (1) economic recovery and employment, (2) gender equity and education, (3) mental health and healthcare, (4) poverty reduction and food security, (5) environmental sustainability, and (6) digital transformation resilience. Based on these insights, the study provides recommendations for Saudi policymakers to align SDG progress with Saudi Vision 2030 in line with pragmatic sustainability. Full article

This study critically examines the technological feasibility, regulatory challenges, and societal acceptance of Pilotless Passenger Aircraft (PPAs) in commercial aviation. A mixed-methods design integrated quantitative passenger surveys (n = 312) and qualitative pilot interviews (n = 15), analyzed using SPSS and NVivo to capture both statistical and thematic perspectives. Results show moderate public awareness (58%) but limited willingness to fly (23%), driven by safety (72%), cybersecurity (64%), and human judgement (60%) concerns. Among pilots, 93% agreed automation improves safety, yet 80% opposed removing human pilots entirely, underscoring reliance on human adaptability in emergencies. Both groups identified regulatory assurance, demonstrable reliability, and human oversight as prerequisites for acceptance. Technologically, this paper synthesizes advances in AI-driven flight management, multi-sensor navigation, and high-integrity control systems, including Airbus’s ATTOL and NASA’s ICAROUS, demonstrating that pilotless flight is technically viable but has yet to achieve the airline-grade reliability target of 10⁻⁹ failures per flight hour. Regulatory analysis of FAA, EASA, and ICAO frameworks reveals maturing but fragmented approaches to certifying learning-enabled systems. Ethical and economic evaluations indicate unresolved accountability, job displacement, and liability issues, with potential 10–15% operational cost savings offset by certification, cybersecurity, and infrastructure expenditures. Integrated findings confirm that PPAs represent a socio-technical challenge rather than a purely engineering problem. This study recommends a phased implementation roadmap: (1) initial deployment in cargo and low-risk missions to accumulate safety data; (2) hybrid human–AI flight models combining automation with continuous human supervision; and (3) harmonized international certification standards enabling eventual passenger operations. Policy implications emphasize explainable-AI integration, workforce reskilling, and transparent public engagement to bridge the trust gap. This study concludes that pilotless aviation will not eliminate the human element but redefine it, achieving autonomy through partnership between human judgement and machine precision to sustain aviation’s uncompromising safety culture. Full article

Introduction: Vaccination has led to significant decreases in mortality over the last century but requires high levels of uptake to be successful in reducing a wide range of infectious diseases in communities. Vaccine hesitancy is on the rise in the United States with most adults not receiving all recommended vaccinations, and childhood vaccinations are declining. Living in a rural community with a lack of access to resources may further limit uptake of vaccines. Identifying strategies to enhance vaccine confidence and access may assist in increasing vaccine uptake. The purpose of this study was to describe the landscape of existing community-based vaccination efforts and assess the components of a successful community-based vaccination program in rural eastern North Carolina. To reach this purpose, we conducted qualitative interviews with those involved in running community-based vaccine education and navigation programming in rural eastern North Carolina.” Methods: Researchers conducted 25 semi-structured interviews with participants involved in vaccination efforts in three rural counties in Eastern North Carolina. Interviews were transcribed, coded in NVivo version 14, and analyzed using thematic analysis to synthesize insights from participants. Results: Study participants held manager or coordinator roles in area health agencies, clinics, and pharmacies. Reported strengths of current vaccine efforts in Eastern North Carolina included patient education, strong partnerships between organizations providing vaccines, and ability to engage community members. Successful vaccine efforts have engaged participants through social media, flyers, trusted leaders, and the provision of convenient vaccine appointments. Areas for improvement in vaccine efforts included engaging a wider audience at vaccine events, building trust in vaccines among community members, and expanding vaccine education for hard-to-reach populations. Participants supported the development of a proposed community-based education and navigation program and felt that community members would be interested. Identified challenges included low participation due to vaccine hesitancy which could be overcome through incentives and delivery from trusted individuals. Conclusions: We found that there is still a need for trust building, education, and patient engagement within the landscape of existing community-based vaccination efforts for vulnerable populations in rural eastern North Carolina. Study participants indicated support for the development of a vaccine education program and researchers determined the project to be feasible. Based on the results of this study, researchers developed and implemented an integrated vaccine education and navigation program in Eastern North Carolina. Full article

This study presents a systematic literature review to examine how the axiological values associated with cultured meat influence consumer perception, using the phenomenology of perception as an analytical framework. Fifty-four peer-reviewed qualitative and quantitative studies, identified through the Libraries Worldwide database, were analyzed using NVivo 12 software, based on predefined keywords and a rigorous selection grid. The results highlight several groups of axiological values that shape consumer attitudes, including the previously unexplored “axiological value of co-production” of cultured meat. Specifically, “dogmatic co-production” (e.g., religious or cultural co-production) appears to significantly enhance consumer perception and acceptance of cultured meat. The main limitation of this study lies in the absence of primary phenomenological field data, which may introduce researcher subjectivity inherent in qualitative paradigms. Nevertheless, the use of existing empirical studies ensures the relevance and reliability of this review. This research offers practical implications for communication strategies, suggesting that aligning messages with key axiological values and their amplifiers, particularly those related to co-production, can strengthen trust in and acceptance of cultured meat. For industry stakeholders, these findings provide guidance for value-driven positioning aimed at increasing consumer confidence. Academically, the study offers a novel perspective by integrating axiological analysis with phenomenology in the context of food technology adoption. Socially, it helps identify consumer concerns and expectations regarding the axiological values perceived as essential for the acceptance of cultured meat. The study’s originality lies in its application of phenomenological analysis to axiological frameworks and in highlighting the central role of co-production, particularly dogmatic co-production, in shaping consumer perception. Full article

Self-harm is a growing public health concern, particularly among university students facing academic anxiety. This study explored the underlying factors driving suicide planning and attempts in this population. Using a qualitative design, we conducted thematic analysis of interviews with eight counselors and eight students from five public and private universities. Analysis via NVivo Software revealed six core themes: (1) current mental health support and coping strategies, (2) triggers of suicidal ideation linked to family and psychological stressors, (3) perceptions of campus mental health services, (4) cultural and societal misconceptions surrounding suicide, (5) institutional barriers to accessing mental health care, and (6) student-driven recommendations for prevention and support. These findings highlight the complex interplay between academic pressure, emotional distress, and limited institutional support. The study emphasizes the need for universities to enhance access to mental health services, reduce stigma through open dialogue and peer support, and engage families through targeted workshops. Tailored interventions addressing academic, emotional, and familial challenges—such as flexible deadlines and improved counseling access—can significantly reduce suicidal ideation and promote student well-being. Full article

Building Information Modelling (BIM) represents a technological and organisational innovation transforming the architecture, engineering, and construction (AEC) industry by embedding data-rich collaboration into project delivery. However, the diffusion of this innovation is constrained by unresolved legal–contractual complexities, where conventional frameworks often fail to manage BIM-specific risks, such as unclear responsibilities, intellectual property, and dispute resolution. This study advances knowledge by conceptualising a novel legal–contractual analytical dimension that systematically links risk factors to tailored management strategies, enabling BIM innovation to be more effectively embedded into organisational and contractual processes. A mixed-methods design was adopted. An integrative review of Scopus- and Google Scholar-indexed studies, supported by thematic analysis in NVivo, generated a comprehensive legal–contractual Risk Breakdown Structure (RBS) that organises fragmented knowledge of legal–contractual risks. Qualitative content analysis, combined with survey and expert interview data, enabled triangulated validation and the development of the BIM-RBS Matrix and BIM-RBS–MS Nexus. These tools operationalise risk knowledge by quantifying risk severity (SPSS Version 29.0.1.0 (171)) and systematically aligning management strategies with specific risk categories. The results highlight actionable innovations, such as enhanced cybersecurity protocols (e.g., QR-based traceability) to strengthen cyber/data security and collaborative risk–reward mechanisms to address contractual design ambiguities. The study makes three primary contributions: (1) conceptualising a structured legal–contractual knowledge spectrum for BIM innovation, (2) advancing mixed-methods integration for legal–contractual risk knowledge creation and validation, and (3) providing actionable frameworks that support industry, policymakers, and researchers in embedding BIM innovation more reliably. This study frames legal–contractual risk knowledge as a critical enabler of innovation that extends theoretical understanding and offers globally relevant pathways for the knowledge-based transformation of the AEC sector. Full article

Despite vast wind energy potential, the Canadian province of Newfoundland and Labrador (NL) has historically lagged in installed capacity due to socioeconomic and technical barriers. The emergence of hydrogen as an alternative energy carrier has transformed prospects for a wind industry on the island, allowing for the possibility of exports. Since the lifting of a provincial wind energy moratorium in 2022, several companies have proposed more than 25 gigawatts (GW) of wind-to-hydrogen (W2H) capacity. Proponents and opponents differ considerably in their view on whether W2H projects will advance provincial sustainability—a debate which can be further understood through energy justice analysis. Given the current lack of empirical evidence, the study adopts a systematic review of media reports pertaining to six leading W2H projects in the province. Basic descriptive statistics (means, frequencies, etc.) are used to describe the metadata and preliminary coding process. Deductive and inductive thematic analysis are then applied to the complete dataset of online news articles (n = 112) with the support of a qualitative data management software (NVivo, Version 14). The findings build upon, challenge, and make novel contributions to several tenets of energy justice. From a distributive justice perspective, temporal variations in employment, centralization of resource revenues, and the anthropocentric nature of defined risks are highlighted. From a procedural justice perspective, social acceptance of projects, as well as the shortcomings of environmental impact assessment, are elaborated. From a recognition justice perspective, the paper demonstrates Indigenous involvement in W2H governance, yet demands an interrogation of intra- and intercommunity diversity. From a cosmopolitan justice perspective, the paper finds weak evidence of supporting vulnerable global populations through decarbonization, yet some prospects through enhancing energy security for importing countries. With respect to media reporting, the findings illustrate the outsized role of independent media in advancing evidence-based justice discourses and the central function of public media in covering rural natural resource developments. Ultimately, this study urges policymakers and private developers to ensure fair benefit distribution, deep participation, and inclusion of diverse communities during the formative stages of the W2H industry in NL and beyond. Full article

The rapid global shift toward transportation electrification has positioned e-mobility as a key part of low-carbon transition strategies. Saudi Arabia, as a major energy producer undergoing economic diversification under Vision 2030, has recently increased its policy efforts for electric mobility. This study performs a qualitative document analysis of 52 national policies, strategies, and institutional publications issued between 2010 and 2025, creating a longitudinal dataset of 1240 coded references. Using a PRISMA-aligned screening process and NVivo-based thematic coding, the analysis highlights main policy trends, institutional priorities, and implementation challenges influencing the Kingdom’s e-mobility transition. Results show a clear shift from early technology-neutral sustainability rhetoric to a more explicit policy framework focusing on industrial localization, charging infrastructure growth, renewable energy integration, and regulatory development after 2020. Despite these advances, gaps remain in governance coordination, market readiness, charging accessibility, and user adoption incentives. The paper provides a systematically mapped view of Saudi Arabia’s e-mobility policy landscape and places it within global transition trends. The findings offer practical insights for policymakers aiming to strengthen implementation, accelerate adoption, and align transport electrification with national decarbonization goals. Full article

This study examines the integration of artificial intelligence (AI)-based strategies within the framework of landscape sustainability science and urban ecology, focusing on urban sports and recreation areas in Turkey and Lithuania. In the era of sustainable urban transformation, AI technologies offer new opportunities for maintaining ecological integrity, enhancing green infrastructure connectivity, and supporting adaptive management of urban ecosystems. The research aims to comparatively analyze the role and effectiveness of AI applications—such as intelligent waste management, predictive maintenance, and spatial planning tools—in promoting clean, safe, and ecologically resilient environments. A qualitative design was employed, and data were collected through semi-structured interviews with 30 experts, including local administrators, facility managers, environmental professionals, AI specialists, and academics from both countries. Thematic analysis using NVivo revealed key themes linking AI functions to ecological outcomes, including improved resource efficiency, habitat connectivity, and data-informed governance. Results show that Lithuania’s institutionalized green infrastructure facilitates multi-scale AI adoption, while Turkey’s evolving policy framework presents significant potential for system integration. The study emphasizes the necessity of embedding AI-driven ecological indicators into landscape-scale planning and developing an interdisciplinary governance model to achieve sustainable, resilient, and inclusive urban ecosystems. Full article

This study aims to analyze how the built environment influences urban residents’ physical activity in tropical coastal regions, and to identify the relative weights of key environmental factors. Through semi-structured interviews with 31 residents in Hainan, China, and qualitative analysis using NVivo 14, five core categories influencing physical activity were identified. A conceptual model with the built environment as its central node was then developed to elucidate the interrelationships among these categories. To further weight the sub-categories, a follow-up Analytic Hierarchy Process survey was conducted with 12 experts. Integrating the two stages, it was found that the safety and site conditions are prerequisite conditions to ensure residents’ physical activity. On this basis, residents have the strongest perception of the incentive effect of site conditions and landscape. The findings provide a theoretical basis and practical reference for systematically evaluating the impact of the built environment on residents’ health and well-being, and offer guidance for planning and designing health-promoting places in tropical regions. Full article

This integrative systematic review addresses the existing gap in understanding how frugal innovation can scale sustainably in emerging economies. Through a mixed-methods analysis based on the PRISMA 2020 protocol, 142 documents published between 2019 and 2025 in Scopus and Web of Science were examined. Scientific and grey literature. The methodology combined bibliometric mapping using VOSviewer, qualitative analysis with NVivo, and a Delphi panel of 15 experts, allowing for the triangulation of theoretical, empirical, and prospective evidence. The findings reveal a transition from a phase of contextual adaptation (2019–2021) to one of systematization and governance (2022–2025), highlighting that the so-called «Frugal Scalability Paradox»—the tension between hyper-contextualization and standardization—constitutes the main obstacle to the sustainability and expansion of frugal models. This study contributes both theoretically and practically by offering a taxonomy of value mechanisms, proposing a hybrid governance framework, and outlining a research agenda focused on inclusion, technological modularity, and impact funding. Frugal innovation is redefined here as a paradigm of intelligent tension management, capable of balancing local relevance and global replicability. Full article

Contemporary medical education is shifting from traditional, teacher-centred anatomy instruction toward interactive, student-centred, and clinically integrated approaches. The Jigsaw Method aligns with this shift by fostering collective competence, which is vital for effective clinical practice. This study aimed to introduce the jigsaw model to medical students and explore its perceived effectiveness in teaching anatomy. A phenomenological qualitative design was employed to explore the experiences of second-year medical students (n = 120) at the Faculty of Health-Care Sciences, Eastern University, Sri Lanka. Open-ended questions were used to elicit students’ reflections on the effectiveness of jigsaw learning. Thematic analysis was conducted using NVivo software (ver.14). Students reported generally favourable perceptions of the jigsaw method. Four major themes emerged: two described the positive impact of the approach—enhanced understanding through peer learning and improved interpersonal and communication skills; the remaining themes addressed challenges in implementation and suggestions for refinement. Participants appreciated the structured collaboration and positive interdependence fostered by the method. Moreover, students viewed the jigsaw technique as well-aligned with student-centred learning principles. The jigsaw method was perceived as an effective cooperative learning strategy that enhanced engagement, promoted active participation, and fostered teamwork in anatomy education. These findings support the integration of structured peer-based approaches into medical curricula to enrich students’ learning experiences. Full article

Electronic cigarettes have become increasingly popular, especially among young people when compared to other demographic groups. This study explored young South African women’s experiences of using e-cigarettes. Age of initiation, patterns and reasons for using e-cigarettes, the financial impact and the experience of quitting were explored. This qualitative study used an interpretive research paradigm. Data were collected from three focus groups that were guided by a discussion guide. The total sample comprised 11 young women aged between 18 and 25 years who had used or were using e-cigarettes. Data were analysed using thematic analysis with the aid of NVivo version 12. Findings revealed five key themes: (1) age of e-cigarette initiation ranged from pre-adolescence to adolescence, and in adulthood; (2) patterns of use included occasional and daily use, concurrent use with tobacco products (dual use) and use with tobacco products and alcohol. Participants reported using e-cigarettes at social events, with other peers and alone; (3) reasons for use included emotional regulation (easing stress, boredom), peer pressure, experimentation, the appeal of e-cigarettes’ designs and flavours, ease of access and enhanced social media presence; (4) the impact of e-cigarette use weighed on financial and familial issues; (5) concerning quitting, only one participant reported successfully quitting while some participants had tried to quit but had been unsuccessful and advocated for more cessation support. Interventions to address how to better manage peer pressure, boredom and stress as well as policies to regulate the design and flavours of e-cigarettes are needed to help young women not to get initiated into a lifetime of nicotine addiction. Cessation support is also needed to assist young people (especially women) who wish to quit using e-cigarettes. Full article