Search Results (614)

Based on the concept of integrated communities, this study focuses on improving public service facilities and perfecting convenient service facilities within integrated communities. Taking the central area of Nanchang’s old city as the research subject, the paper analyzes the configuration of public service facilities in 186 communities within this area and examines the correlation of configuration indicators. On the basis of data analysis, five communities with different allocation levels were selected for verification. The verification results show that field research and data analysis mutually confirm each other, and there is a positive correlation between the allocation level and the overall community environment. Combining data analysis and community verification, this study proposes two paths for integrated community construction oriented toward facility optimization and allocation level improvement, providing more operable theoretical support and practical guidance for the construction of integrated communities. Full article

Based on multi-source data including mobile signaling data and remote sensing imagery, this research constructed human activity indicators and applied spatial analysis methods to identify gender-specific patterns in green space usage across different types of days. A Standardized Gender Difference Index (SDI) was developed to quantify gender-based disparities in both temporal and spatial dimensions. Correlation analysis was employed to examine spatial influencing factors and their interrelationships. The results indicate that on holidays, a stable male-dominant usage pattern was observed across all parks, with males showing a preference for cultural parks. On weekdays, although male users remain predominant overall, considerable variations exist among parks. On a daily scale, males exhibit earlier and more flexible activity patterns, whereas females demonstrate significantly lower presence during evening hours, indicating a “nocturnal poverty” phenomenon. Spatially, community parks display the greatest gender disparity, whereas comprehensive parks show relative gender balance. Although both genders value barrier-free facilities, females place additional emphasis on service facilities, while males are more influenced by mixed land-use functions surrounding the parks. This study demonstrates that high-precision, large-coverage multi-source data can accurately and dynamically identify gender-based differences in green space usage and their influencing factors, providing valuable insights for inclusive urban planning. Full article

The danwei community emerged as a basic socio-spatial unit in China’s urban landscape, primarily constructed in the mid-20th century. Today, amid population aging and the deterioration of service facilities supporting health environment, the mental and physical conditions of danwei residents are increasingly challenged. Through an investigation of the built environment history and physical activity patterns in Community Hua, a typical case of former danwei community in Chengdu, China, this paper indicates that danwei communities have accumulated health-promoting legacies rooted in their historical spatial planning and collective lifestyle. The tangible legacy includes an open space system centered around green facilities, while the intangible legacy encompasses a diverse range of well-organized sports and cultural events. Following the reform of unit society in China in the late 1990s, these health-promoting legacies continue to exist within the danwei communities. Consequently, this study suggests that future renewal of open spaces within danwei neighborhood should be based on community history, thus the spatial legacy benefiting residents’ health can be preserved and utilized. Full article

Aquaculture lagoons must reconcile visitor access with biodiversity protection. This study integrates results of a large survey of the attitudes of tour operators with field observations of fish populations to test whether operator choices can align tourism and conservation. Using data from 801 guided-tour participants in Taiwan’s Cigu Lagoon, a sequential experience hierarchy was validated whereby environmental knowledge enhanced attitudes, strengthened perceived guide professionalism, induced flow, and ultimately increased conservation intention (R² = 0.523). Experiential service quality exerted stronger effects than functional quality (β = 0.287 vs. 0.156; both p < 0.001). Parallel underwater monitoring indicated that electric, low-vibration motors were associated with richer fish assemblages and larger fish body sizes; fish abundance is 61% higher and mean body length 38% greater, with community composition differing significantly by motor type (PERMANOVA, p < 0.001). Together, these results link training and technology adoption to measurable ecological gains and pro-conservation motivation, indicating that electrified propulsion and interpretive practice are mutually reinforcing levers for biodiversity-positive tourism. The framework offers directly actionable criteria—motor choice, guide development, and safety/facility context—for transitioning small-scale fisheries and recreation toward low-impact marine experiences. Full article

Background: Cervical cancer (CC) is the most common cancer among Ugandan women and the leading cause of cancer mortality. Screening has proven to be a cost-effective method in reducing its burden, yet uptake among women of reproductive age remains alarmingly low, with national adherence rates under 10%. Objective: This study explored healthcare workers’ (HWs) perspectives on barriers and facilitators to screening and attitudes toward implementing human papillomavirus (HPV) DNA testing with self-collection. Methods: A qualitative research design was employed. Twenty semi-structured interviews were conducted with purposively sampled healthcare providers and administrators across different cadres at a referral hospital and three peripheral health centres in Northern Uganda. Interviews were analysed thematically using the Social Ecological Model. Data collection and analysis proceeded iteratively until thematic saturation. Reporting follows the Consolidated Criteria for Reporting Qualitative Research (COREQ). Results: Participants described individual and interpersonal barriers such as limited awareness, poor preventive health-seeking, fear of results, stigma, and limited male involvement. Organisational barriers included staff shortages, weak referral practices, and stock-outs of supplies, while policy constraints included limited governmental support and competing priorities. Facilitators included targeted health education, routine referrals from all service entry points, outreach screening, and donor support. Most respondents favoured scaling up of self-collected HPV testing, citing higher acceptability and feasibility for outreach, contingent on sustained supplies, laboratory capacity, and training. Conclusions: Multi-level interventions are needed to strengthen facility workflows, staff capability, community engagement, and reliable supply chains. Expanding access to self-collected HPV testing may overcome major barriers and represents a promising strategy to increase screening uptake in Uganda and similar low resource settings. Full article

Urban park green spaces (UPGSs) play a critical role in enhancing residents’ quality of life, particularly for older adults. However, inequities in accessibility and resource distribution remain persistent challenges in aging urban areas. To address this issue, this study takes Gulou District, Nanjing City, as an example and proposes a comprehensive framework to evaluate the overall quality of UPGSs. Furthermore, an enhanced Gaussian two-step floating catchment area (2SFCA) method is introduced that incorporates (1) a multidimensional park quality score derived from an objective evaluation system encompassing ecological conditions, service quality, age-friendly facilities, and basic infrastructure; and (2) a Gaussian distance decay function calibrated to reflect the walking and public transit mobility patterns of the older adults in the study area. The improved method calculates the accessibility values of UPGSs for older adults living in residential communities under the walking and public transportation scenarios. Finally, factors influencing the social equity of UPGSs are analyzed using Pearson correlation coefficients. The experimental results demonstrate that (1) high-accessibility service areas exhibit clustered distributions, with significant differences in accessibility levels across the transportation modes and clear spatial gradient disparities. Specifically, traditional residential neighborhoods often present accessibility blind spots under the walking scenario, accounting for 50.8%, which leads to insufficient accessibility to public green spaces. (2) Structural imbalance and inequities in public service provision have resulted in barriers to UPGS utilization for older adults in certain communities. On this basis, targeted improvement strategies based on accessibility characteristics under different transportation modes are proposed, including the establishment of multi-tiered networked UPGSs and the upgrading of slow-moving transportation infrastructure. The research findings can enhance service efficiency through evidence-based spatial resource reallocation, offering actionable insights for optimizing the spatial layout of UPGSs and advancing the equitable distribution of public services in urban core areas. Full article

Rapid population aging calls for a shift from static facility configuration toward understanding how spatial structures coordinate with everyday behavior. This study develops a structure–behavior coordination framework to examine how the spatial embedding of community service centers and surrounding facilities aligns with older adults’ mobility and activity chains. Using Guangzhou as a case, three representative facility aggregation forms—clustered, linear, and patchy—were identified through POI-based spatial analysis. Behavioral mapping supported by Public Participation GIS (PPGIS) and social network analysis captured facility co-use and path continuity, while rank-based measures (Rank-QAP and Rank-Biased Overlap) evaluated correspondence between structural and behavioral centralities. Findings show form-sensitive rather than typological coordination: the clustered case (FY) exhibits compact, mixed-use integration; the linear case (DJ) requires ground-level access along main pedestrian corridors; and the patchy case (LG) relies on a few highly accessible dual-core nodes where improved connectivity strengthens cohesion. Everyday facilities such as markets, parks, and plazas act as behavioral anchors linking routine routes. The framework offers a transferable tool and comparable metrics for diagnosing alignment between built structure and everyday behavior, guiding adaptive, evidence-based planning for age-friendly community systems. Full article

Addressing earthquake risk remains a significant global challenge, requiring rapid assessment of evacuation shelters for effective disaster response. Existing frameworks, such as FEMA’s Hazus, Copernicus EMS, and UNOSAT, offer valuable insights but are typically regional, static, and event-focused, lacking mechanisms for continuous shelter-level updates. This study introduces the Shelter Hazard Impact and Lifeline Outage Estimation (SHILOE) framework. SHILOE is a stepwise estimation approach integrating multisensor datasets for time-scaled assessments of shelter functionality and operability. These datasets include seismic intensity, liquefaction probability, tsunami inundation, IoT-derived power outage data, communication network disruptions, and social media. Application to the 2024 Noto Peninsula earthquake showed that ≥93.6% of designated and activated shelters were impacted by at least one hazard, with all experiencing at least one lifeline outage. The framework delivers estimates through three phases: immediate (within tens of minutes, e.g., simulation-based hazard models and lifeline data), intermediate (days, e.g., observation-based datasets), and refinement (ongoing, e.g., Social Networking Service and detailed field surveys). By progressively incorporating new data across these phases, SHILOE generates dynamic, facility-level insights that capture evolving hazard exposure and lifeline status. These outputs provide actionable information for emergency managers to prioritize resources, reinforce shelters, and sustain critical services, thereby advancing disaster resilience. Full article

Background: Cervical cancer remains a significant public health concern in Kenya, with male partner involvement increasingly recognized as a key factor in effective prevention and control. However, limited research has explored the specific barriers and enablers to such involvement in the Kenyan context. This study aimed to examine the challenges and opportunities associated with male partner involvement in cervical cancer prevention in Central Kenya. Methods: A qualitative descriptive design was employed. Purposive sampling was used to select 73 participants, including 20 couples (40 individuals), 20 nurses, 2 clinical officers, 2 gynecologists, 6 community health workers, and 3 county health directors. Data were collected through interviews and focus group discussions and analyzed thematically to identify key patterns and insights. Results: The mean age of male partners was 36.9 years, and 30.5 years for female partners. Most couples (70%, n = 28) had attained secondary education. The average duration of professional experience for nurses and clinical officers was 13 years. Key challenges included knowledge gaps, financial and logistical barriers, limited moral support, time constraints, sociocultural beliefs, stigma, and inadequate facility infrastructure. Identified opportunities included community education, shifting norms, improved couple communication, practical support from men, and integration of services. Conclusions: This study identifies key challenges and practical opportunities for increasing male involvement in cervical cancer prevention. Clarifying and promoting specific male roles such as support for screening and vaccination can enhance the effectiveness of cervical cancer prevention strategies in Central Kenya. Full article

Globally, women continue to die from pregnancy-related conditions that could be prevented through ensuring timely access to emergency obstetric care and facility-based deliveries supervised by skilled birth attendants. However, many women are reluctant to deliver in maternity healthcare facilities due to the widespread disrespect and abuse that patients have reportedly received. Respectful maternity care has been identified amongst the possible solutions. This study explored perceptions of respectful maternity care and the enabling conditions of a multidisciplinary group of maternity healthcare providers working at a busy, specialised public mother and child regional hospital in Gauteng, South Africa. An explorative, descriptive, and contextual study design with a phenomenological perspective was adopted. Semi-structured interviews were conducted with each of the 30 purposefully selected study participants. The interviews were digitally recorded, professionally transcribed, and analysed using Tesch’s Constant Comparison method. Two main categories, namely (1) healthcare providers’ perceptions of respectful maternity care and (2) enabling conditions for its practice emerged, encompassing seven themes: women-centred care, provision of high-quality care, preservation and promotion of women’s rights, creating an enabling environment for the practice of RMC, in-service training, accountability of healthcare providers for their actions, and community involvement. The perceptions of the study participants regarding respectful maternity care align with global standards; however, successful implementation requires the establishment of enabling conditions. Full article

Background/Objectives: Living with a disabled family member has extensive implications for the whole family involved in their care, and there is dependency on healthcare support for maintaining quality of life. This qualitative study, conducted in Northern Ireland, investigated the support needs of different family members living with a severely impaired individual across the lifespan. A key objective was to identify support needs for intervention. Methods: In-depth semi-structured interviews were conducted to obtain data from eight mothers, fathers, sisters and brothers of a profoundly disabled child or sibling. Data was analyzed using Interpretive Phenomenological Analysis, allowing for the application of double hermeneutic in which the researchers derived meaning from the lived experiences of participants. Results: The analysis yielded five themes in total. Three themes were related to gaps in healthcare systems: Support Needs in Childhood, Support in Transition into Adult Services, and Worry for the Future; and two themes were linked with support needs: Associative Disability in Family Members; and Stigma. All family members had caregiving roles, and these had similarities and differences according to the relationship with the care-receiver. Participants recognized their families were survivors, however maintained a family tragedy rather than positive change outlook. Conclusions: Recommendations derived from the findings to alleviate the stressors of the situation for family members include increasing community support and age-related respite facilities. Additionally, improving and enhancing education of disabilities in schools, and immersing and further integrating individuals with disability into society, will alleviate the alienation, isolation and loneliness experienced by family members. Full article

To counter the high unmet need for family planning in urban areas of Sindh province, Pakistan, Greenstar Social Marketing began implementation of The Challenge Initiative (TCI) in collaboration with the government departments of Population Welfare and Health in eight urban districts of Sindh province. This study aimed to assess the effectiveness of TCI’s Community Health Volunteers (CHVs) on public sector service provision of family planning services in eight urban districts of Sindh province, Pakistan. The Contraceptive Logistics Management Information System (cLMIS) and District Health Information System 2 (DHIS2) were used to obtain monthly contraceptive data from June 2022 to December 2024. CHVs began implementation at different time points in each district, starting from January 2023 to October 2023, when CHVs became operational in all eight districts. Descriptive statistics and two-sample t-tests were used for data analysis. CHVs significantly improved family planning service provision, particularly for short- and long-acting methods at the facility level, with greater change observed in Department of Health facilities. This study provides preliminary evidence of the effectiveness of CHVs in increasing public sector service provision of contraceptives, particularly for Department of Health facilities. CHVs bridge the gap between the community and the facility, particularly in areas uncovered by the government’s existing mobilization staff. Full article

Introduction: Tuberculosis (TB) remains a public health concern, and people at risk for TB are hesitant to seek care. The first South African National TB prevalence survey, conducted in 2017–2019, found that most participants with TB symptoms did not seek care for TB. In 2022, an estimated 23% of people with TB in South Africa were undiagnosed, contributing to the country’s burden of “missing” TB cases. This study explores health-seeking behaviour among people with TB (PwTB) in South Africa, focussing on barriers and facilitators to care-seeking and the quantification of TB-related stigma from a patient and community perspective. Methods: We conducted a mixed-method study in the City of Johannesburg (COJ) Metropolitan Municipality from February to March 2022. PwTB aged 18 and older initiating TB treatment for microbiologically confirmed pulmonary TB were recruited from three primary healthcare facilities in the COJ. After providing written informed consent, they participated in a one-time, in-depth, face-to-face interview. The interviews were digitally recorded and conducted by trained facilitators. We used thematic analysis with deductive approaches to develop themes. We used the Van Rie TB stigma assessment scale to quantify perceived stigma. Results: We interviewed 23 PwTB with an overall median age of 39 years and 14 (61%) males. Patient-level barriers to accessing TB care included visiting traditional healers and pharmacists before their TB diagnosis; wrong or missed diagnosis by private doctors; work commitments; scarcity of resources to attend the clinic or walk long distances; perceived and experienced stigma; and a lack of TB knowledge. Facility-level barriers included long clinic queues and uncertainty about where to receive TB care in the clinic. Facilitators for TB care-seeking included being in contact with someone who had TB, receiving encouragement from family, or having knowledge about TB transmission and early diagnosis. The overall median total stigma score among 21 PwTB was 53 (IQR: 46–63), with median community and patient stigma scores of 25 (IQR: 22–30) and 31 (IQR: 21–36), respectively. Conclusions: We found important considerations for the TB programme to improve the uptake of services. Since PwTB consult elsewhere before visiting a facility for TB care, TB programmes could establish private–public partnerships. TB programmes could also increase TB awareness in the community, especially among males, and mobile clinics could be considered to assist with TB case detection and treatment provision. Applying behavioural design techniques and co-designing interventions with patients and providers could improve TB health-seeking behaviours. Full article

Background/Objectives: Leisure participation is vital for children’s development and family inclusion, yet families of children with developmental delays and disabilities face significant barriers. Guided by a health literacy framework, this study examined how personal and organizational health literacy shape access to inclusive leisure opportunities. Methods: Semi-structured interviews were conducted with 14 caregivers of young children (aged 2 to 6 years) with developmental delays and disabilities. A qualitative content analysis was applied to identify family and environmental factors shaping leisure participation. Results: Families with stronger personal health literacy engaged in diverse leisure activities, prioritizing children’s development through park visits and structured home routines. In contrast, weak organizational health literacy—reflected in limited inclusive facilities and support systems—restricted opportunities, increased caregiver stress, and forced adaptations such as traveling farther or rescheduling activities. These barriers underscored families’ vulnerability to exclusion while also highlighting their resilience in navigating daily life. Conclusions: This study demonstrates that health literacy functions at both personal and organizational levels to shape leisure participation. Beyond identifying barriers, it shows that leisure is intertwined with developmental needs and school readiness. By applying a health literacy lens, the study contributes to understanding family dynamics in inclusive leisure and underscores the need for responsive community services and inclusive policies. Full article

Existing building management systems face critical limitations in real-time data integration, primarily relying on static models that lack dynamic updates from IoT sensors. To address this gap, this study proposes a novel system integrating MQTT over WebSocket with Three.js visualization, enabling real-time sensor-data binding to Building Information Models (BIM). The architecture leverages MQTT’s lightweight publish-subscribe protocol for efficient communication and employs a TCP-based retransmission mechanism to ensure 99.5% data reliability in unstable networks. A dynamic topic-matching algorithm is introduced to automate sensor-BIM associations, reducing manual configuration time by 60%. The system’s frontend, powered by Three.js, achieves browser-based 3D visualization with sub-second updates (280–550 ms latency), while the backend utilizes SpringBoot for scalable service orchestration. Experimental evaluations across diverse environments—including high-rise offices, industrial plants, and residential complexes—demonstrate the system’s robustness: Real-time monitoring: Fire alarms triggered within 2.1 s (22% faster than legacy systems). Network resilience: 98.2% availability under 30% packet loss. User efficiency: 4.6/5 satisfaction score from facility managers. This work advances intelligent building management by bridging IoT data with interactive 3D models, offering a scalable solution for emergency response, energy optimization, and predictive maintenance in smart cities. Full article