Search Results (367)

Public Food Procurement can shape diets, markets, and territorial food systems, yet its strategic potential depends on how policy objectives are translated into tender design, contract management, and territorial food policy governance. The study draws on a predominantly international literature-based review of recommendations and selected country experiences to contextualize the analysis and identify relevant good practices. At the European Union and Portuguese levels, it systematically compares the applicable policy and legal frameworks and examines how they are translated into Portuguese procurement practice. It also situates Public Food Procurement within recent Portuguese debates on food transition, metropolitan food-system planning, and multifunctional agrifood parks. A qualitative documentary and regulatory analysis was conducted using a four-pillar framework—health, environmental, social and economic—operationalized through 28 criteria. The empirical corpus comprised 53 school food procurement procedures published in Portugal in 2023. Technical specifications or equivalent documents were unavailable for 15 procedures; the cases were retained in the fixed denominator of every criterion and pillar index, so the results shown are conservative full-corpus measures of publicly observable documentary incorporation. The reliability matrix retained all 53 procedures, but ordinal Krippendorff’s alpha was estimated from the 1064 units containing pairable ratings and was 0.625 (95% bootstrap CI: 0.576–0.667). Health achieved the highest aggregate index (37%), followed by environmental (17%), social (15%), and economic criteria (8%). Although 58% used Most Economically Advantageous Tender (MEAT) terminology, only 13% applied genuine multi-factor evaluation, while approximately four in five procedures were effectively price-only. The findings should therefore be interpreted as evidence of documentary incorporation and observability rather than supplier compliance or direct health and environmental outcomes. They indicate that a major documented weakness lies not in lack of legal authority, but in weak translation into measurable award criteria, contract clauses, monitoring mechanisms, and integrated local or regional food-policy strategies. Full article

Growing global challenges have made it imperative to evaluate economic activities not only in terms of economic growth but also from the perspectives of environmental and social well-being. Within this context, Women’s Production and Business Cooperatives have emerged as critical collective initiatives that support local development. In this study, “Women’s Production and Business Cooperatives” refer to cooperatives established and predominantly managed by women to collectively engage in the production and commercialization of goods and services, generate income and employment opportunities for their members, and promote women’s economic and social empowerment. Hereafter, these organizations are referred to as “women’s cooperatives.” However, studies that comprehensively examine the sustainability practices of women’s cooperatives through the framework of Elkington’s Triple Bottom Line (economic, social, and environmental sustainability) remain limited. From the perspective of Stakeholder Theory, cooperatives are regarded as organizations that extend beyond the pursuit of economic profit by creating value for both internal and external stakeholders, including women, local communities, the environment, consumers, and public institutions. Accordingly, this study aims to provide an in-depth examination of the sustainability practices adopted by women’s cooperatives within these three dimensions, as well as to identify the challenges they encounter. This study adopted a qualitative research design, utilizing in-depth interviews with seven presidents and managers representing women’s cooperatives. The findings suggest that zero-waste practices, the adoption of circular economy principles, and the transition toward green agriculture constitute the primary sustainability initiatives, whereas high technology and packaging costs, together with insufficient institutional collaboration, represent the major challenges to the environmental sustainability. Within the economic sustainability dimension, the findings indicate that the participating cooperatives have increasingly shifted toward industrial production standards, value-added by-products, and business-to-business (B2B) marketing strategies. Nevertheless, rising input and logistics costs, together with unfair competition, continue to pose significant challenges. As relates to social sustainability, the findings highlight intergenerational transmission of cultural heritage, psychosocial recovery, efforts to challenge social prejudice, inter-cooperative solidarity, and the allocation of resources for social benefit, including scholarship support. Overall, the findings reveal that these cooperatives make meaningful contributions to multidimensional sustainability and stakeholder well-being, thereby providing valuable empirical insights into the sustainability literature. Full article

The Post Office Horizon scandal represents one of the most severe miscarriages of justice in modern British legal history, rooted in the deployment of a defective IT system and the institutional suppression of evidence that exposed its unreliability. This paper provides a systematic analysis of the scandal through the combined lenses of cyber security, digital forensics, and IT governance, drawing directly on the Post Office Horizon Public Inquiry dataset—including witness testimony, technical documentation, audit records, and internal communications spanning more than two decades. While many of the technical and procedural failures discussed have been documented in prior scholarship, the paper’s principal contribution is the systematic mapping of those failures against recognised governance frameworks and the Legally Accountable Digital Systems (LADS) proposal this mapping motivates. We identify and analyse five interconnected failure categories: software defects and poor system design; deficient patch governance; inadequate audit logging and compromised evidence integrity; investigative failures and prosecutorial conflict of interest; and a systemic absence of technical expertise and independent oversight. Each category is mapped against nine governance framework documents, including ISO/IEC 27001, NIST SP 800-53 Rev. 5, NIST SP 800-218 (SSDF), COBIT 2019, ISO/IEC 27035, NIST SP 800-61, and ISO/IEC 27036, with ISO/IEC 27037 applied additionally to evidential handling failures and NIST SP 800-92 to log management failures. A counterfactual analysis indicates that compliance with these frameworks could plausibly have detected, exposed, or substantially reduced most of the documented failures, though this claim is necessarily inferential and conditional on good-faith implementation. The scandal was therefore not caused primarily by the absence of adequate frameworks but by their wholesale non-application and by institutional incentives, examined later in the paper, that can undermine even fully compliant controls. However, the analysis also surfaces a governance gap that no existing framework addresses: the institutional failure mode in which the organisation responsible for system integrity holds active incentives to suppress evidence of failure rather than remediate it. To address this gap, we propose the concept of Legally Accountable Digital Systems (LADS)—a governance category for systems whose outputs are used as evidence in legal proceedings—and outline three supplementary pillars: technical independence, institutional independence, and forensic admissibility governance. We draw a parallel with the Sarbanes–Oxley Act of 2002, arguing that the Horizon Inquiry dataset provides an equivalent empirical foundation for the statutory reform of digital evidence governance. Finally, we outline the substantial research opportunities the Inquiry dataset presents across IT systems analysis, cyber security, forensic accounting, social network analysis, and legal informatics—a resource comparable in significance to the Enron materials that shaped a generation of corporate governance reform. Full article

Tuberculosis (TB) and malnutrition remain major health challenges among migrant children living in low-resource urban settings. Identifying clinically relevant patterns associated with these conditions may support standardized clinical assessment and public health planning. The present study aimed to identify clinical, anthropometric and sociodemographic factors associated with TB and malnutrition among migrant children under five years of age in urban Pakistan. A community-based cross-sectional study was conducted in migrant settlements of Rachna Town, Lahore, Pakistan. Clinical, demographic and anthropometric data were collected from 300 children under five years of age. A Genetic Algorithm (GA) combined with Random Forest analysis was applied to identify the most informative variables associated with TB and malnutrition. Model performance was assessed using internal cross-validation. The analytical approach identified a concise subset of variables showing stable internal performance. Key factors associated with malnutrition included Bacillus Calmette-Guérin vaccination status, formula feeding, chest X-ray findings and gastrointestinal symptoms. The most relevant variables associated with TB were Bacillus Calmette-Guérin vaccination score, erythrocyte sedimentation rate, gastrointestinal indicators and parental occupation. The final models demonstrated good internal discrimination and substantial agreement. These findings suggest that routinely collected clinical, anthropometric, laboratory, radiological, and sociodemographic variables may support the identification of clinically relevant patterns associated with TB and malnutrition during standardized community-based assessments. The proposed data-driven approach should be interpreted as an analytical and decision-support framework for prioritizing informative variables and supporting clinical assessment, rather than as a pre-diagnostic or early risk prediction tool. Full article

Background: Disordered eating attitudes are major public health concerns associated with adverse physical, psychological, and social outcomes. Therefore, brief, psychometrically sound screening tools are needed to identify individuals at risk early. The Eating Attitudes Test-7 (EAT-7) is a shortened screening tool developed to assess disordered eating attitudes. However, its Turkish validity and reliability have not been previously examined. Therefore, this study aimed to assess the validity and reliability of the Turkish version of the EAT-7 among Turkish-speaking adults. Methods: This methodological validation study was conducted between November 2025 and January 2026. Data were collected online using a snowball sampling technique. After a pilot study with 210 participants, the main study included 1635 adults aged ≥18 years. Exploratory factor analysis was performed with 500 participants, and confirmatory factor analysis was performed with an independent sample of 1135 participants. Internal consistency and construct validity were assessed. Convergent validity was evaluated through correlations with the EAT-26, Eating Disorder Examination Questionnaire-13 (EDE-Q-13), and Depression Anxiety Stress Scale Short Form (DASS-8). Results: The Turkish version of the EAT-7 demonstrated excellent internal consistency, with a Cronbach’s alpha coefficient of 0.925. The Kaiser–Meyer–Olkin value was 0.909, and Bartlett’s test results were significant. Exploratory factor analysis supported a single-factor structure explaining 70.133% of the total variance. Confirmatory factor analysis confirmed a good model fit. The total EAT-7 score was positively correlated with the EAT-26, EDE-Q-13, and DASS-8 scores. Conclusions: The Turkish version of the EAT-7 is a valid, reliable, brief, and practical screening tool for assessing disordered eating attitudes among Turkish-speaking adults. Full article

Background: West Virginia is of particular concern regarding HPV vaccine hesitancy, currently ranking 45th among U.S. states in HPV vaccine uptake. General vaccine hesitancy and HPV- and HPV vaccine-specific misinformation, both associated with lower vaccination, have increased in recent years, complicating efforts to identify key drivers of HPV vaccine acceptance and effective intervention targets. Methods: This study used a Qualtrics survey of n = 330 parents of children aged 0–14 in West Virginia. Measures included parental HPV vaccine acceptance for their youngest child (reflecting either completed vaccination or intention to vaccinate), general vaccine hesitancy measured using the Vaccine Hesitancy Scale (VHS), and endorsement of nine common HPV- and HPV vaccine-specific misinformation statements. Misinformation items were summed and demonstrated good internal reliability (Cronbach’s α = 0.868). Results: Hierarchical logistic regression analyses indicated significant racial/ethnic differences across all model steps, with non-White parents less likely to report HPV vaccine acceptance for their child (p < 0.001). In Step 2, lower levels of general vaccine hesitancy predicted higher HPV vaccine acceptance (p < 0.001). In the final model, higher endorsement of HPV- and HPV vaccine-specific misinformation was associated with lower HPV vaccine acceptance (p = 0.035). Conclusions: These findings underscore the independent and additive influence of general vaccine hesitancy and HPV- and HPV vaccine-specific misinformation on parental HPV vaccine acceptance in West Virginia. Community-engaged public health strategies should prioritize strengthening vaccine confidence and directly addressing HPV- and HPV vaccine-specific misinformation, particularly among underserved populations. Full article

Urban centers today face unprecedented challenges in energy management, emissions, waste disposal, and public services, as nearly 70% of the global population is projected to live in cities by 2050. The complexity and rapid evolution of urban systems underscore the pressing need for stability, innovation, and adaptability, particularly regarding sustainability and digital transformation. AI-powered simulation models have emerged as transformative tools, capable of simplifying, predicting, and managing highly intricate urban systems while offering policymakers valuable insights for strategic planning. However, the integration of AI in smart and sustainable urban development presents critical legal, ethical, and regulatory concerns. This study examines these questions by evaluating existing and emerging frameworks addressing algorithmic transparency, data protection, stakeholder engagement, and sustainable development in prominent urban models including Amsterdam, Copenhagen, Singapore, Tokyo, Bangalore, and Nairobi. Comparative analysis is conducted through a doctrinal desk review, focusing on statutory provisions, international policies (EU, UN-Habitat), ISO Smart City standards, and local governance charters. Key issues addressed include the risk that AI models, if unregulated, become opaque “black boxes” that obscure both decision-making logic and accountability. Without robust standards, there is no guarantee of interoperability, revision, or representation of public interest. Equitable management, access, and inclusive participation are vital to responsible AI frameworks in urban planning. This article advances a comprehensive legal and policy framework for ensuring accountability, transparency, and stability in AI-driven city governance, bridging gaps between technological innovation, urban studies, and regulatory oversight. The proposed governance structure empowers cities to adopt multi-level, authority-driven mechanisms that safeguard the common good while leveraging AI’s potential in sustainable urban transformation. Full article

Background: The increasing prevalence of diabetes mellitus and metabolic risk factors among young adults has become a major public health concern. University students are particularly vulnerable to unhealthy lifestyle changes, including sedentary behavior, insufficient physical activity, and academic stress, all of which may be associated with an elevated risk of metabolic disorders. Objective: This study aimed to examine the associations of academic stress, physical activity, and sedentary behavior with diabetes risk among university students. Methods: A cross-sectional analytical study was conducted among 264 university students recruited through an online survey. Academic stress was assessed using a six-item Likert-scale instrument, while diabetes risk was evaluated using a composite score derived from indicators adapted from the modified Finnish Diabetes Risk Score (modified FINDRISC). Statistical analyses included descriptive statistics, Cronbach’s alpha reliability testing, exploratory factor analysis (EFA), Spearman’s correlation analysis, and multivariable logistic regression. Results: The academic stress instrument demonstrated good internal consistency (Cronbach’s alpha = 0.85). Exploratory factor analysis supported the construct validity of the instrument, with all six items loading substantially on a common academic stress factor. Correlation analysis revealed that academic stress was positively associated with sedentary behavior and diabetes risk, whereas physical activity was negatively associated with diabetes risk. Multivariable logistic regression showed that academic stress was significantly associated with an increased risk of diabetes (adjusted odds ratio [aOR] = 1.18, 95% confidence interval [CI]: 1.02–1.36; p = 0.028). Moderate-to-vigorous physical activity was associated with a lower risk of diabetes (aOR = 0.74, 95% CI: 0.60–0.92; p = 0.011), while longer sitting duration was associated with an increased risk of diabetes. Conclusions: Academic stress, sedentary behavior, and physical activity were significantly associated with diabetes risk among university students. These findings highlight the importance of developing university-based health promotion programs that integrate stress management, physical activity promotion, and sedentary behavior reduction to support the prevention of metabolic risk factors in young adults. Full article

This article examines the impact of the 1995 UNIDROIT Convention on stolen or illegally exported cultural objects thirty years after its adoption, placing the emphasis on the legitimacy of acquiring cultural goods. The Convention has reshaped the allocation of risk, responsibility, and evidentiary burden in the international art market, redefining the relationships among possessors, intermediaries, and source states under an affirmative standard of due diligence. In doing so, it departs from the traditional focus on transactional security that characterizes both civil-law and common-law systems. The article further considers the Convention’s capacity to address the traditional reluctance of courts in market-state jurisdictions to enforce foreign public law on cultural property. Despite these achievements, the Convention’s limited ratification by a substantial number of states has constrained its overall effectiveness. The article concludes by reflecting on potential strategies to enhance its reach, including broader ratification and harmonized implementation measures, underscoring the Convention’s continuing role in shaping the jurisprudence of cultural property disputes over the past three decades. Full article

Urban sustainability is tied to transport sustainability. Limitations of tools for internalization of externalities and distortions of incentives for environmentally friendly behavior of vehicle owners hinder the transition to sustainable urban development. The complexity of accurately assessing pollutants emissions by motor vehicles makes it difficult to internalize the economic damage caused by actual emissions. The purpose of the study is to develop a system for organizing the internalization of damage caused by actual emissions of pollutants by motor vehicles in the territory. For motor vehicles, the power consumption depends on operating conditions and driving style. Effective power affects the volume of exhaust gases, and the quality of the power unit and the efficiency of its management affect the content of pollutants in the exhaust gases. A system of interaction of environmental policy instruments is proposed, which allows for the internalization of economic damage from actual emissions of pollutants from vehicles. The basis of the system is dependencies of the masses of pollutant emissions with vehicle exhaust gases on the actual engine power used. The system assumes the internalization of damage from emissions, joint use of the mechanism of buying and selling rights to pollute the environment (for public and freight transport), and emission payments (for other types of vehicles). The system for accounting for actual emissions will improve the adequacy of comparing alternatives for the movement of passengers and goods, including with electric transport and unmanned systems. The system for ensuring the internalization of damage from actual emissions will reduce distortions and create adequate incentives to reduce damage from emissions. Full article

Against the coordinated advancement of building a maritime power, high-quality development of marine tourism and ecological civilization construction, realizing positive interaction between marine resource conservation and tourism industrial development has emerged as a pivotal issue for high-quality growth in coastal regions. Taking 11 coastal provincial-level administrative regions in China spanning 2008 to 2024 as the research sample, this paper first establishes an evaluation indicator system covering marine resources and the tourism industry. It further adopts an integrated empirical framework encompassing the coupling coordination degree model, spatial Markov chain model, obstacle degree model, fixed-effect model and geographically and temporally weighted regression (GTWR) model to systematically unpack the spatiotemporal differentiation characteristics, internal restrictive obstacle factors and external driving determinants of the two-system coupling coordination. On this basis, a marine resource compensation mechanism for tourist destinations is formulated. Empirical results demonstrate four core findings: (1) In terms of temporal evolution, the overall coupling coordination level keeps rising and goes through three phases: initial development, rapid improvement and post-shock recovery. After a short-term decline triggered by the pandemic, the index rebounds markedly after 2023, showing that the two systems can recover and stabilize. (2) In terms of spatial layout, a persistent stratified spatial pattern featuring “higher coordination in southern coast versus lower coordination in northern coast with three-tier hierarchical differentiation” is identified; high-level neighboring regions exert prominent positive spatial spillover effects, whereas low-level adjacent areas are prone to fall into development lock-in traps. (3) For internal constraint obstacles, the marine resource subsystem is persistently restricted by resource exploitation limits and coastal spatial scarcity, while the dominant bottleneck of the tourism industrial subsystem shifts from insufficient market scale to inadequate human capital supply. (4) Regarding external driving forces, the proportion of tertiary industry and the digital infrastructure constitute core driving contributors, whereas marketization progress and opening-up degree act as primary restrictive factors, with pronounced spatial heterogeneity existing across all driving indicators. Finally, in line with the quasi-public-good attribute and ecological externality of marine resources, this study constructs a differentiated and synergistic marine resource compensation mechanism from three dimensions: stakeholder identification, compensation implementation pathways and institutional guarantee systems. The proposed framework provides theoretical references and practical policy options to facilitate high-level coupling and coordinated development between marine resource preservation and the coastal tourism industry. The marginal contribution of this research lies in integrating coupling coordination measurement, obstacle factor diagnosis, driving mechanism identification and compensation mechanism design into an integrated analytical framework, which delivers theoretical foundations and operable policy solutions for coastal marine resource protection, tourism industrial upgrading and differentiated compensation system construction. Full article

Although the goal of “sustainable” urbanism has generated an impressive array of international frameworks and declarations, systemic progress remains elusive. A prior paper by the author identified “lock-in” as a central cause: the economic incentives, professional standards, codes, and institutional feedback structures that reinforce unsustainable patterns of urban development despite stated commitments to reform. This paper advances that diagnosis by asking what sustains the lock-in itself, and what structural intervention can address it at the root. We argue that the answer lies in recognizing a fundamental deficit in the feedback architecture governing urban development—a systematic failure to account for two categories of capital on which human welfare depends: natural and resource capital, whose depletion standard metrics render invisible, and human and value-added capital, including the built public realm and the economies of place that markets systematically undersupply. Standard welfare-economic instruments, including Pigouvian taxes, address this at the level of price signals but are unable to fully resolve it there, because multiple forms of goods—referred to as “polycapital”—are structurally interrelated and resist single scalar remedies. The paper proceeds to advance two complementary conclusions: first, that a generative modeling methodology, capable of encoding the interrelated, multi-scale character of polycapital structures, is a necessary precondition for adequate institutional response, and that pattern language methodology provides this capacity; and second, that new transactional mechanisms going substantially beyond Pigouvian instruments—which we outline—represent a necessary direction and a promising research frontier. Full article

Background: Autonomy in decision making is a critical component of respectful, person-centered maternity care. The Mother’s Autonomy in Decision Making (MADM) scale has been widely used internationally to evaluate women’s perceptions of autonomy during perinatal period. Objectives: To assess the reliability and validity of the Greek translation of the MADM questionnaire among postpartum women who have given birth in hospitals and clinics in Greece. Methods: A cross-sectional study was conducted with 450 postpartum women who gave birth in public and private maternity facilities in Greece. Participants completed the Greek MADM scale, and statistical analyses included exploratory and confirmatory factor analysis (EFA/CFA), internal consistency (Cronbach’s alpha), test–retest reliability (intraclass correlation coefficient, ICC), criterion validity (correlation with the Birth Satisfaction Scale (G-BSS), and Rasch analysis. Results: EFA revealed a one-factor structure explaining 77.6% of the variance (KMO = 0.913; Bartlett’s p < 0.001). CFA supported good model fit (CFI = 0.924, RMSEA = 0.085). The Greek MADM showed excellent internal consistency (Cronbach’s α = 0.951) and test–retest reliability (ICC = 0.995). Criterion validity was supported by moderate correlations with G-BSS subscales (r = 0.338–0.389, p < 0.005). Rasch analysis confirmed unidimensionality, high item reliability, and acceptable item fit. A cut-off score of 27.5 on the MADM scale was identified to distinguish between high and low–moderate birth satisfaction. Conclusions: The Greek version of the MADM scale demonstrates excellent psychometric properties and is a valid, reliable tool for assessing autonomy in maternity decision making. Its use can enhance quality assessment and promote respectful, autonomy-supportive perinatal care in Greek healthcare settings. Full article

In the context of the increasingly deepening concept of sustainable development, the coupling coordination between the digital economy (DE) and high-quality cultural tourism development (HQCTD) has become an important pathway for promoting the sustainable growth of Shanxi Province’s digital cultural tourism industry. Based on an in-depth analysis of the coupling relationship between the DE and HQCTD, and using panel data from 11 prefecture-level cities in Shanxi Province from 2014 to 2023, the entropy weight method and the coupling coordination degree (CCD) model were employed to investigate the relationship between the two systems, while the obstacle degree model and geographic detector were applied to identify the internal and external obstacle factors. The results indicate that both the DE and HQCTD in Shanxi Province experienced slight fluctuations under the impact of COVID-19, and significant spatial differences were observed in the comprehensive development levels of the two systems. The CCD between the DE and the HQCTD in Shanxi Province remains at a good level, with the spatial distribution having evolved from “a single-center pattern” to a “southward extension of the center”. The core obstacle factor for the DE is public budget expenditure, while the main obstacle factor for HQCTD is the number of students enrolled in higher-education institutions. The primary external driving factors at the single-factor level are industrial structure, opening up, and transportation accessibility, while the dominant interaction factors are Z2∩Z4, Z4∩Z6, Z1∩Z6, and Z1∩Z4, respectively. Based on these findings, development strategies are proposed. Full article

Background/Objectives: Falls are a significant public health issue and the second most common cause of injury and death worldwide. The risk is exceptionally high for older adults, and fall-related injuries can significantly affect their well-being and lead to pain, disability, and loss of independence, necessitating urgent redressal of this issue. This study assesses the fall risk among older patients at a referral hospital in Riyadh, Saudi Arabia. Methods: This cross-sectional study included 246 older adults aged 65 years and older from the Internal Medicine Department. Data were gathered through a survey addressing sociodemographic characteristics, fall risk assessment, prevention knowledge, behaviors, and social support. Results: A high fall risk and good knowledge of fall prevention were observed in older adults. A weak-to-moderate positive correlation was found between behavior and fall risk. Correlations were observed among age, fall prevention behavior, educational level, and fall prevention knowledge. Conclusions: While a weak-to-moderate positive association was found between fall risk and positive behaviors, no statistically significant association was observed between fall risk and fall prevention knowledge or social support. This indicates that factors other than knowledge and social support may play a critical role in influencing fall risk. Behavioral interventions alone may not reduce fall incidence sufficiently unless other underlying factors are addressed. Full article