Search Results (664)

Background/Objectives: Access to health services is often limited due to socio-economic and organizational determinants of health systems, which lead to increased unmet healthcare needs. This study aimed to identify access barriers for the general population in Greece, including those that may have emerged following the COVID-19 pandemic. Methods: This was a cross-sectional survey of 1002 Greek citizens. A questionnaire regarding socio-demographics, healthcare utilization, and access to health services was used. Interviews took place between October and November 2022. Results: Of 837 participants who used health services in 2022, 82.6% had a medical consultation, 80.6% took diagnostic tests, and 63.6% visited a pharmacy for pharmaceuticals. Of those having a medical consultation, 33.1% did so at an NHS health unit, while 75% of the participants taking diagnostic tests visited a contracted private laboratory. Out of the 135 participants requiring hospitalization, 62% were hospitalized in a public hospital, while 85% of the participants requiring pharmaceuticals visited a private pharmacy. Access barriers in the past year were reported by 48% of the participants requiring a medical consultation, 34% of the participants requiring diagnostic tests, and 40% of the participants requiring hospitalization. The most common barriers were long waiting times and financial constraints. The main barrier to accessing pharmaceuticals was the availability and administration of the product. Conclusions: The identified healthcare access barriers highlight the vulnerabilities of the current health system in Greece, which were further exposed during the COVID-19 pandemic crisis. Addressing socioeconomic factors that are considered key access indicators should be the focus of future health policy initiatives. Full article

Background/Objectives: The demand for accessible and reliable digital health services has increased significantly in recent years, particularly in regions facing physician shortages. HomeDOCtor, a conversational AI platform developed in Slovenia, addresses this need with a nationally adapted architecture that combines retrieval-augmented generation (RAG) and a Redis-based vector database of curated medical guidelines. The objective of this study was to assess the performance and impact of HomeDOCtor in providing AI-powered healthcare assistance. Methods: HomeDOCtor is designed for human-centered communication and clinical relevance, supporting multilingual and multimedia citizen inputs while being available 24/7. It was tested using a set of 100 international clinical vignettes and 150 internal medicine exam questions from the University of Ljubljana to validate its clinical performance. Results: During its six-month nationwide deployment, HomeDOCtor received overwhelmingly positive user feedback with minimal criticism, and exceeded initial expectations, especially in light of widespread media narratives warning about the risks of AI. HomeDOCtor autonomously delivered localized, evidence-based guidance, including self-care instructions and referral suggestions, with average response times under three seconds. On international benchmarks, the system achieved ≥95% Top-1 diagnostic accuracy, comparable to leading medical AI platforms, and significantly outperformed stand-alone ChatGPT-4o in the national context (90.7% vs. 80.7%, p = 0.0135). Conclusions: Practically, HomeDOCtor eases the burden on healthcare professionals by providing citizens with 24/7 autonomous, personalized triage and self-care guidance for less complex medical issues, ensuring that these cases are self-managed efficiently. The system also identifies more serious cases that might otherwise be neglected, directing them to professionals for appropriate care. Theoretically, HomeDOCtor demonstrates that domain-specific, nationally adapted large language models can outperform general-purpose models. Methodologically, it offers a framework for integrating GDPR-compliant AI solutions in healthcare. These findings emphasize the value of localization in conversational AI and telemedicine solutions across diverse national contexts. Full article

The proliferation of digital public service platforms and the expansion of e-government initiatives have significantly increased the volume and diversity of citizen-generated feedback. This trend emphasizes the need for classification systems that are not only tailored to specific administrative domains but also robust to the linguistic, contextual, and structural variability inherent in user-submitted content. This study investigates the comparative effectiveness of large language models (LLMs) alongside instruction-tuned embedding models in the task of categorizing public transportation complaints. LLMs were tested using a few-shot inference, where classification is guided by a small set of in-context examples. Embedding models were assessed under three paradigms: label-only zero-shot classification, instruction-based classification, and supervised fine-tuning. Results indicate that fine-tuned embeddings can achieve or exceed the accuracy of LLMs, reaching up to 90 percent, while offering significant reductions in inference latency and computational overhead. E5 embeddings showed consistent generalization across unseen categories and input shifts, whereas BGE-M3 demonstrated measurable gains when adapted to task-specific distributions. Instruction-based classification produced lower accuracy for both models, highlighting the limitations of prompt conditioning in isolation. These findings position multilingual embedding models as a viable alternative to LLMs for classification at scale in data-intensive public sector environments. Full article

Urban areas are at the forefront in addressing global challenges such as climate change and biodiversity loss. Among the key responses are nature-based solutions, which are increasingly being integrated into policy frameworks but which require strong community engagement for their effective implementation. This paper presents the findings of surveys conducted within the Place Lab in Katowice, Poland, an initiative developed as part of an international project and used as a participatory tool for co-creating and implementing green infrastructure. The project applies both place-based and people-centred approaches to support European cities in their transition towards regenerative urbanism. Place Lab activities encourage collaboration between local authorities and residents, enhancing awareness and fostering participation in environmental initiatives. The survey data collected during the project allowed for the evaluation of changes in public attitudes and levels of engagement and for the identification of broader societal phenomena that may influence the implementation of nature-based solutions. The findings revealed, for instance, that more women were interested in supporting the project, that residents tended to be sceptical of governmental actions on climate change, and that views were divided on the trade-off between urban infrastructure such as parking and roads and the presence of green areas. Furthermore, questions of responsibility, awareness, and long-term commitment were frequently raised. Building on the survey results and the existing literature, the study proposes a set of indicators to assess the contribution of citizen participation to the adoption of nature-based solutions. While the effectiveness of nature-based solutions in mitigating climate change impacts can be assessed relatively directly, evaluating civic engagement is more complex. Nevertheless, when conducted transparently and interpreted by experts, indicator-based assessment can offer valuable insights. This study introduces a novel perspective by considering not only drivers of engagement but also the obstacles. The proposed indicators provide a foundation for evaluating community readiness and commitment to nature-based approaches and may be adapted for application in other urban settings and in future research on climate resilience strategies. Full article

Renewable Energy Communities (RECs) are voluntary coalitions of citizens, small and medium-sized enterprises and local authorities, which cooperate to share locally produced renewable energy, providing environmental, economic, and social benefits rather than profits. Despite a favorable European and Italian regulatory framework, their development is still limited in the Member States. To this end, this paper proposes a methodology to identify optimal spatial configurations of RECs, based on proximity criteria and maximization of energy self-sufficiency. This result is achieved through the mapping of the demand, expressive of the energy consumption of residential buildings; the suitable areas for installing photovoltaic panels on the roofs of existing buildings; the supply; the supply–demand balance, from which it is possible to identify Positive Energy Districts (PEDs) and Negative Energy Districts (NEDs). Through an iterative process, the optimal configuration is then sought, aggregating only PEDs and NEDs that meet the chosen criteria. This method is applied to the case study of the Avellino Province in the Campania Region (Italy). The maps obtained allow local authorities to inform citizens about the areas where it is convenient to aggregate with their neighbors in a REC to have benefits in terms of energy self-sufficiency, savings on bills or incentives at the local level, including those deriving from urban plans. The latter can encourage private initiative in order to speed up the RECs’ deployment. The presented model is being implemented in the framework of an ongoing research and development project, titled Renewable Energy Communities Monitoring, Optimization, and Planning (RECMOP). Full article

This research explores the concept of open building (OB) in the context of low-cost housing, focusing on its historical applications in Egypt during the 1980s. By evaluating past experiences, the study aims to extract key lessons that can inform the design and implementation of contemporary social housing projects. The goal is to foster resilience and diversity in housing typologies to ensure they align with the evolving needs of residents. To achieve these objectives, the research employed a multi-dimensional strategy, beginning with a comprehensive literature review of the open building movement (OB); then, the study traced the evolution of the OB movement in Egypt using a qualitative analysis approach, which involved analyzing its implementation in low-cost housing projects over the past four decades. Through this historical lens, the study identifies design principles and strategies that can enhance social housing projects by applying OB. Considering the life cycle cost, OB enables an incremental process that would align with users’ financial capacities. The research revealed the substantial capacity of open building (OB) to address Egypt’s social housing challenges, primarily by fostering user-driven flexibility in housing unit design and area selection. This empowers occupants to choose spaces perfectly suited to their family’s evolving needs. Moreover, the findings provide a roadmap for revitalizing the OB movement by analyzing and overcoming past implementation difficulties, consequently balancing the initial cost and long-term economics for citizens and significantly reducing the governmental sector’s expenditure. Full article

Urban environments are increasingly challenged by rapid urbanisation and climate change, demanding strategic responses that are both adaptable and sensitive to local context. Typological classification offers a structured approach to understanding diverse urban contexts, enabling targeted interventions that support climate neutrality and livability. While global pressures are shared, their impacts differ widely across cities, highlighting the need for context-aware urban analytics to guide effective transformation. This paper presents a methodological perspective on a computational framework and workflow based on open source data, designed to support the classification and optimisation of urban environments across different urban contexts; it explores the framework’s potential and limitations, grounded in a review of relevant literature and available datasets. We propose a workflow encompassing four main steps: (1) classifying urban environments based on quantifiable characteristics, (2) identifying key performance indicators (KPIs) differentiated by urban typology, (3) proposing interventions to optimise urban environments according to underlying typological classification, and (4) validating the proposed solutions in simulated environments. The framework prioritises open data sources provided by public authorities as well as open science and citizen science initiatives. A more streamlined integration of data is proposed, facilitating both the classification and assessment of urban environments aligned with their primary typological designation. Full article

The city of Al Ain is a fast-developing area. With building typology varying from low-rise to mid-rise, sustainable design in buildings is needed. As the majority of the city’s population is Emirati Citizens, the percentage of expats is increasing. The expats tend to live in mid-rise buildings. One of the central midrise areas is AL Ain Square. This study aims to investigate how an optimized mashrabiya pattern can impact the energy and the Predicted Mean Vote (PMV) in a 3-bedroom apartment, fully oriented to the south, of an expat family. The methodology is as follows: case study selection, Weather analysis, Modeling/Validation of the base case scenario, Optimization of the mashrabiya pattern, Simulation of various scenarios, and Results. Analyzing the selected case study is the initial step of the methodology. This analysis begins with the district, building typology, and the chosen apartment. The weather analysis is relevant for using the mashrabiya (screen device) and the need to improve energy consumption and thermal comfort. The modeling of the base case shall be performed in Rhino Grasshopper. The validation is based on a one-year electricity bill provided by the owner. The optimization of mashrabiya patterns is an innovative process, where various designs are compared and then optimized to select the most efficient pattern. The solutions to the selected scenarios will then yield the results of the optimal scenario. This study is relevant to industry, academia, and local authorities as an innovative approach to retrofitting buildings. Additionally, the research presents a creative vision that suggests optimized mashrabiya patterns can significantly enhance energy savings, with the hexagonal grid configuration demonstrating the highest efficiency. This finding highlights the potential for geometry-driven shading optimization tailored to specific climatic and building conditions. Contrasting earlier mashrabiya studies that assess one static pattern, we couple a geometry-agnostic evolutionary solver with a utility-calibrated EnergyPlus model to test thousands of square, hexagonal, and triangular permutations. This workflow uncovers a previously undocumented non-linear depth perforation interaction. It validates a hexagonal screen that reduces annual cooling energy by 12.3%, establishing a replicable, grid-specific retrofit method for hot-arid apartments. Full article

This study analyzes how Vietnam’s Ministry of Culture, Sports and Tourism (MoCST) communicates policy implementation in tourism governance through 35 official responses to citizen petitions, using Heidbreder’s Multilevel Policy Implementation Strategies Framework (centralization, agencification, convergence, networking). Content coding, frequency analysis, co-occurrence network, and sentiment analysis reveal a dominant centralization pattern, with MoCST maintaining strong top-down control in decision-making and resource allocation. Convergence reflects increased inter-ministerial coordination, while agencification is limited, and networking with private or civil sectors remains weak. This weak networking limits participatory decision-making and hinders the development of adaptive, community-based tourism initiatives, which are crucial for sustainable tourism governance. Positive sentiment is more associated with centralized and convergent actions, indicating institutional trust. The study extends Heidbreder’s framework to a non-Western, centralized context and calls for stronger local agency roles and inclusive networks to enhance resilience and community ownership in policy implementation. Full article

In 2022, the United Nations Global Biodiversity Framework set forth an ambitious target for “biodiversity-inclusive cities”, recognising the imperative to address biodiversity decline across all sectors, including the built environment. However, the application of this emerging concept remains limited, with few projects directly aligned with the framework’s objectives or timelines necessary for meaningful biodiversity outcomes. To address this limitation this research presents The Paddock, a 27-home regenerative development in southeastern Australia, designed to empower residents in ecological restoration and regeneration efforts. Engagement was initiated through citizen science surveys and a co-design workshop during 2015–2016. As a result, The Paddock seeks to support five focal species’ return via ecosystem-centred design principles. Utilising a mixed-methods approach, the paper documents the design process, ecological decision-making, and the evolving people–nature relationships within the community. Preliminary results indicate the anecdotal return of four targeted species alongside other local fauna. Feedback gathered from residents, combined with insights from the landowner and architect, illustrates that residing in a regenerative environment enhances ecological connections and stewardship tendencies. Ongoing long-term species monitoring will further evaluate the project’s ecological impact. This case study underscores the potential of biodiversity inclusive design (BID) in fostering biodiversity-positive and socially responsive housing developments. Full article

The increasing urgency of the energy transition, particularly in ecologically sensitive regions, demands spatially informed planning tools to guide renewable energy development. This study presents a Multi-Criteria Decision-Making (MCDM) approach to assess the suitability of the Gargano district in southern Italy for the implementation of Renewable Energy Communities. The analysis combines expert-based weighting and the Weighted Linear Combination method to evaluate seven key criteria grouped into environmental, socioeconomic, and technical dimensions. The resulting suitability scores, calculated at the municipal scale, highlight spatial disparities across the district, revealing that areas with the highest potential for Renewable Energy Community (REC) deployment are largely situated at the boundaries of the Gargano National Park. These zones benefit from stronger infrastructure, higher energy demand, and fewer environmental constraints, particularly with regard to wind energy initiatives. Conversely, municipalities within the park exhibit lower suitability, constrained by strict landscape regulations and lower population density. The findings provide valuable insights for regional planners and policymakers, supporting the adoption of targeted, environmentally compatible strategies for the advancement of citizen-led renewable energy initiatives in complex territorial contexts. Full article

Through the testimony of a Tangier female citizen who grew up in the “prolific multilingual Spanish-French-Darija context of international Tangier”, this article analyzes the web of beliefs projected onto both the inherited and local languages within her linguistic repertoire. Starting from the daily realities in which she was immersed and the social networks that she formed, we focus on the representations of communication and her affective relationship with the host societies. The analysis starts from the most immediate domestic context in which Spanish, in its variant Jaquetía (a dialect of Judeo-Spanish language spoken by the Sephardic Jews of northern Morocco) was displaced by French as the language of instruction. After an initial episode of reversible attrition, we witnessed various phenomena of translanguaging within the host society. Following the binomial “emotion-interrelational space”, we seek to discern the affective contexts associated with the languages of a multilingual childhood, and which emotional links are vital for maintaining inherited ones. This shift towards the valuation of the affective culture implies a reorientation of the gaze towards everyday experiences as a means of research in contexts of language contact. Full article

The social and civic participation of older adults has proven to be an asset that positively influences the dynamics of social inclusion that affect them, and expert opinion from international organisations calls for its inclusion in the development of public policies in response to the increasing longevity worldwide. However, the characteristics of this participation have not been sufficiently analysed. The main objective of this study was to test the explanatory capacity of an operational proposal relating to the participation of older people based on a multidimensional participation structure. Four dimensions were established: two relating to social participation (associations and volunteering and public sociability) and two linked to citizen participation (political and electoral participation, as well as active citizenship and civic engagement). Based on the proposal, a technical expert panel (TEP) was asked to identify the main participation challenges faced by older people across the four dimensions identified. Consensus was sought using prioritisation matrices. The results showed, among other issues, the key role of the dimensions of citizen participation in identifying participation challenges that have an impact on social inclusion. The political and electoral participation dimension had a specific weight regarding the challenges linked to current problems and characteristics. On the other hand, the active citizenship and civic engagement dimension was oriented towards the challenges linked to desirable conditions and recommended initiatives in the future to improve the impact of older people’s participation. The expert panel’s statements coincide with the recommendations of international organisations on the need to involve older persons in policymaking from a perspective of comprehensive and person-centred care. This provides a concrete response to people’s demands and fosters bottom-up planning policies that contribute to social cohesion. Full article

Introduction: Lung cancer (LC) is the leading cause of cancer mortality and is responsible for 1.8 million deaths annually. The early identification of risk factors, particularly smoking, is essential in improving outcomes. Public health campaigns play a crucial role in raising awareness, but misinformation and resource limitations hinder their effectiveness. This study evaluates the impact of a public awareness campaign on Saudi citizens’ understanding of lung cancer (LC) risks and screening. Methods: An interventional study was conducted in Riyadh, Saudi Arabia, using pre- and post-campaign self-administered surveys. A total of 1,426 participants aged 18 or older were surveyed either before or after the campaign. A matching approach was used to control for confounding variables. Each participant may receive a maximum total score of 14 for their knowledge of lung cancer and a maximum total score of 10 for their awareness of lung cancer screening. Results: A total of 713 participants were surveyed pre-campaign, and 859 post-campaign). After matching, 308 participants remained for the analysis, with no significant demographic differences between those who were surveyed before and after the campaign. Post-campaign, awareness was significantly improved, which is reflected in an increase in accurate responses to key statements. The median knowledge scores increased from 11.0 to 23.0, indicating a substantial increase in understanding. Conclusions: The campaign effectively enhanced the awareness of LC risk factors and screening. However, new misconceptions regarding universal screening emerged, emphasizing the need for clear messaging. Future initiatives should address socioeconomic and gender disparities, promote collaborative decision-making, and implement long-term educational strategies. These findings align with previous research and highlight areas for improvement in public health outreach. Full article

Cantabrian mixed forests, located in areas of Spain, Portugal, and France, serve as an essential biogeographic transition region, noted for its extraordinary plant diversity and ecological intricacy. To aid conservation and research initiatives, a uniform checklist of vascular plants was created, incorporating information from citizen science platforms, scientific databases, herbarium records, and local floras. The outcome is a carefully selected collection of more than 8000 taxa, with over 76% recognized as native, highlighting the area’s importance as a reservoir of biodiversity and a climate refuge. Taxonomic discrepancies were resolved via expert verification and adherence to international naming standards, establishing a dependable basis for ecological research. The checklist demonstrates notable variations in organisms, ecological approaches, and evolutionary lineages, influenced by geographical diversity, climate variations, and past land use patterns. Importantly, the study emphasizes the drawbacks of unchecked biodiversity data and shows the benefits of expert-driven synthesis for addressing gaps and biases in species documentation. The floristic information presented here can act as a basis for transboundary conservation planning, ongoing biodiversity tracking, and the development of adaptive management approaches in response to climate change and ecological decline. This initiative represents an important move towards safeguarding the distinct natural heritage of this distinctive biogeographic region. Full article