Search Results (530)

Understanding the utilization patterns of nuclear medicine (NM) services is essential for optimizing resource allocation and service provision. This study aimed to address the regional evidence gap by reporting the demand for NM services by sex and age at a public hospital in Jamaica. This was a non-experimental, retrospective study of NM scans that were completed at the University Hospital of the West Indies from 1 June 2022 to 31 May 2024. While all scans were reported in the descriptive totals, for patients with multiple scans during the study period, only the data from the first visit was used in the inferential statistical analysis. This was performed with the IBM SPSS (version 29.0) software and involved the use of chi-square goodness of fit and multinomial logistic regression. A total of 1135 NM scans for 1098 patients were completed (37 patients had more than one scan); 596 (54.3%) were female and 502 (45.7%) were male, with the ages ranging from 3 days to 94 years old. Among the female patients, there was a greater demand in the ≥60 years age group for cardiac amyloid scans (χ² = 6.40, p < 0.05), while females 18–59 years had a greater demand for thyroid scans (χ² = 7.714, p < 0.05) and bone scans (χ² = 3.904, p < 0.05). On the other hand, significantly more males in the ≥60 age group presented for cardiac amyloid (χ² = 4.167; p < 0.05) and bone scans (χ² = 145.79, p < 0.01). Males were significantly less likely to undergo a thyroid scan than females (p < 0.01, OR = 0.072, 95% CI: 0.021, 0.243) while individuals aged 18–59 years were more likely to undergo this scan than patients aged 60 or older (p = 0.02, OR = 3.565, 95% CI: 1.258, 10.104). Males were more likely to do a cardiac amyloid scan (p < 0.05, OR = 2.237, 95% CI: 1.023, 4.891) but less likely to undergo a cardiac rest/stress test than females (p = 0.02, OR = 0.307, 95% CI: 0.114, 0.828). Prolonged life expectancy and an aging population have the potential to impact NM utilization, thus requiring planning for infrastructure, equipment, work force, and supplies. Cancer-related and cardiovascular indications are a top priority at this facility; hence, age- and sex-specific analysis are useful in establishing models for policy makers with regard to the allocation of economic and human resources for the sustainability of this specialized service. Full article

Willow stands (Salix spp.) are an essential part of riparian ecosystems, as they sustain biodiversity and provide bioenergy solutions. The present review synthesizes the global scientific literature about the management of willow stands. In order to achieve this goal, we used a dual approach combining bibliometric analysis with traditional literature review. As such, we consulted 416 publications published between 1978 and 2024. This allowed us to identify key species, ecosystem services, conservation strategies, and management issues. The results we have obtained show a diversity of approaches, with an increase in short-rotation coppice (SRC) systems and the multiple roles covered by willow stands (carbon sequestration, biomass production, riparian restoration, and habitat provision). The key trends we have identified show a shift toward topics such as climate resilience, ecological restoration, and precision forestry. This trend has become especially pronounced over the past decade (2014–2024), as reflected in the increasing use of these keywords in the literature. However, as willow systems expand in scale and function—from biomass production to ecological restoration—they also raise complex challenges, including invasive tendencies in non-native regions and uncertainties surrounding biodiversity impacts and soil carbon dynamics over the long term. The present review is a guide for forest policies and, more specifically, for future research, linking the need to integrate and use adaptive strategies in order to maintain the willow stands. Full article

Chronic diseases are a leading cause of death worldwide and have a significant negative impact on public health, overall well-being, national economies, and the long-term sustainability of already burdened health systems. In addressing some of the current health challenges, the contribution of pharmacists and community pharmacies is of particular significance. Pharmacists play a vital role in the medication use process, enhancing the efficacy of pharmacological interventions and facilitating the delivery of health services. Community pharmacies occupy a key position within the healthcare system, acting as a primary point of contact with the public and frequently representing the most accessible healthcare facility for patients. In recent times, community pharmacies have undergone a process of adaptation, shifting from a narrow focus on the dispensing of medications towards a more comprehensive approach that is patient-centered and incorporates a range of healthcare services, while also prioritizing the quality of the services provided. This work aims to explore the role of pharmacists in the provision of pharmaceutical services in three countries with distinct healthcare systems, examining how these services operate, the requirements for their delivery, the associated remuneration structures, and the extent of out-of-pocket costs for patients—ultimately analyzing their impact on health outcomes. Full article

Background/Objectives: Mobile healthcare units (MHUs) comprise flexible, ambulatory healthcare teams that deliver community care services, particularly in underserved or remote areas. In Greece, MHUs were pivotal in epidemiological surveillance during the COVID-19 pandemic and are now evolving into a sustainable and integrated service for much-needed community-based healthcare. To support this expanded role, targeted, competency-based training is essential; however, this can pose challenges, especially in coordinating synchronous learning across geographically dispersed teams and in ensuring engagement using an online format. Methods: A nationwide, online training program was developed to improve the knowledge of the personnel members of the Hellenic National Public Health Organization’s MHUs. This program was structured focusing on four core themes: (i) prevention–health promotion; (ii) provision of care; (iii) social welfare and solidarity initiatives; and (iv) digital health skill enhancement. The program was implemented by the University of Crete’s Center for Training and Lifelong Learning from 16 January to 24 February 2025. A multidisciplinary team of 64 experts delivered 250 h of live and on-demand educational content, including health screenings, vaccination protocols, biomarker monitoring, chronic disease management, treatment adherence, organ donation awareness, counseling on social violence, and eHealth applications. Knowledge acquisition was assessed through a pre- and post-training multiple-choice test related to the core themes. Trainees’ and trainers’ qualitative feedback was evaluated using a 0–10 numerical rating scale (Likert-type). Results: A total of 873 MHU members participated in the study, including both healthcare professionals and administrative staff. The attendance rate was consistently above 90% on a daily basis. The average assessment score increased from 52.8% (pre-training) to 69.8% (post-training), indicating 17% knowledge acquisition. The paired t-test analysis demonstrated that this improvement was statistically significant (t = −8.52, p < 0.001), confirming the program’s effectiveness in enhancing knowledge. As part of the evaluation of qualitative feedback, the program was positively evaluated, with 75–80% of trainees rating key components such as content, structure, and trainer effectiveness as “Very Good” or “Excellent.” In addition, using a 0–10 scale, trainers rated the program relative to organization (9.4/10), content (8.8), and trainee engagement (8.9), confirming the program’s strength and scalability in primary care education. Conclusions: This initiative highlights the effectiveness of a structured, online training program in enhancing MHU knowledge, ensuring standardized, high-quality education that supports current primary healthcare needs. Future studies evaluating whether the increase in knowledge acquisition may also result in an improvement in the personnel’s competencies, and clinical practice will further contribute to assessing whether additional training programs may be helpful. Full article

The UI GreenMetric World University Ranking has become a widely adopted instrument for benchmarking institutional sustainability performance; nevertheless, empirically grounded evidence from universities in diverse regional contexts remains scarce. This study undertakes a rigorous appraisal of the extent to which Mahasarakham University (MSU) has institutionalized the United Nations Sustainable Development Goals (SDGs) within its pedagogical offerings, research portfolio, community outreach, and governance arrangements during the 2021–2024 strategic cycle. Employing a mixed-methods design and guided by the 2024 UI GreenMetric Education and Research indicators, this investigation analyzed institutional datasets pertaining to curriculum provision, ring-fenced research funding, 574 peer-reviewed sustainability publications, student-led community initiatives, and supporting governance mechanisms; the analysis was interpreted through a Plan–Do–Check–Act management lens. The number of sustainability-oriented academic programs expanded from 49 to 58. Student participation in community service activities strongly recovered following the COVID-19 pandemic, and MSU’s GreenMetric score increased from 7575 to 8475, thereby elevating the institution to the 100th position globally. These gains were facilitated by strategic SDG-aligned investment, cross-sector collaboration, and the consolidation of international partnerships anchored in Thailand’s Isaan region. The MSU case provides a transferable model for universities—particularly those operating in resource-constrained contexts—endeavoring to align institutional development with the SDGs and internationally recognized quality benchmarks. The findings substantiate the capacity of transformative education and applied research to engender enduring societal and environmental benefits. Full article

This article examines the impact of everyday life infrastructure on well-being through the lens of feminist economics, with a specific focus on gender disparities within the European context. Combining the capability approach (CA) and subjective well-being (SWB) theory, this study introduces a gender-sensitive well-being budget indicator, the Well-being and Infrastructure by Gender Index, or just WIGI, to assess the differential impacts of public expenditures on women and men. Drawing on feminist critiques of infrastructure planning, it highlights how gendered patterns of access and use shape experiences of well-being. The literature review synthesizes recent contributions on well-being measurement, gendered capabilities, and the role of public infrastructure in supporting everyday life. The research utilizes the Benefits of Gender Equality through infrastructure Provision (BGGEIP) survey from the European Institute for Gender Equality (EIGE) from 28 EU member states in 2015 to evaluate the contribution of key public services—such as transport, childcare, and healthcare—to individual capabilities and subjective well-being outcomes. The findings underscore the importance of integrating gender-sensitive methodologies into infrastructure planning and public policy to promote social inclusion and equitable well-being outcomes. This article concludes by advocating for feminist economics-informed policies to enhance the responsiveness of public investments to the lived experiences of women and men across Europe. Full article

Local governments provide numerous services to their citizens. In doing so, they utilize two primary methods to deliver them: (1) producing them in-house with their own employees and equipment or (2) outsourcing them to external actors, which may take the form of other public agencies, for-profit firms, or non-profit organizations. In this entry, the authors review the logic of why local governments might choose one mechanism over another. The goal is to give readers a feel for the state of the academic literature in this regard. After reviewing basic concepts, such as the difference between the “provision” and “production” of services, the authors frame the discussion in terms of a variety of lenses used by scholars attempting to better understand the determinants of such decision-making. These include agency theory, transaction cost economics, and New Public Management. The authors also consider the role that management capacity plays in allowing cities to successfully deliver services to their constituents. Additionally, the authors offer a discussion regarding how local governments partner with non-profits in less formal ways than contracting to ensure their citizens have access to needed services. Finally, there is a review of the tradeoffs between efficiency and other values that should be accounted for when arranging service production. Full article

Urban public toilets are essential for improving urban and rural living environments. Traditional evaluations have relied on statistical indicators such as total numbers and network coverage, but have overlooked population demand, limiting their ability to reflect actual service levels and optimize spatial allocation. This study assesses the public toilet service capacity according to spatial accessibility and offers insights into layout optimization. The main urban area of Kunming was considered as the case study. First, the Gaussian two-step floating catchment area (G2SFCA) method was used to calculate public toilet accessibility. The service level of public toilets at the community scale was assessed based on the calculation results. Finally, recommendations for the optimization of the spatial layout of public toilet provision are proposed based on the evaluation findings. Results indicate that (1) 57 communities lacked access to public toilets within a 5 min walk, while only two lacked access within 20 min; all communities had access within 30 min; (2) increasing stalls in old public toilets by 50% would meet the policy requirements for most residents; (3) transportation accessibility has a significant impact on residents’ convenience in accessing public toilets. Areas with lower transportation connectivity tend to have poorer toilet accessibility. The construction of new public toilets near road networks can effectively enhance overall restroom convenience for residents in the study area. By integrating public toilet accessibility with resident restroom demand, this study proposes targeted strategies for optimizing the spatial layout of urban public toilets, offering valuable insights and feasible solutions for improving the scientific and rational allocation of urban public resources. Full article

With the increase in urban–rural disparities in China, rural public transportation systems in low-density areas face unique challenges, especially in the contexts of sparse population, complex topography, and uneven resource allocation; research on public transportation in low-density areas has had less attention compared to high-density urban areas. Therefore, how to solve the dilemma of public transportation service provision in low-density rural areas due to sparse population and long travel distances has become an urgent problem. In this paper, a dynamic optimization model based on a two-layer planning framework was constructed. The upper layer optimized the topology of multimodal transportation nodes through the Floyd shortest path algorithm to generate a composite network of trunk roads and feeder routes; the lower layer adopted an improved Logit discrete choice model, integrating the heterogeneous utility parameters, such as time cost, economic cost, and comfort, to simulate and realize the equilibrium allocation of stochastic users. It was found that the dynamic game mechanism based on the “path optimization–fairness measurement” can optimize the travel time, mode, route, and bus stop selection of rural residents. At the same time, the mechanism can realize the fair distribution of rural transportation network subjects (people–vehicles–roads). This provides a dynamic, multi-scenario macro policy reference basis for the optimization of a rural transportation network layout. Full article

Community gardens are regarded as important green spaces that promote sustainable cities. Some studies have explored the ecosystem services of community gardens in different areas. However, existing studies lack a systematic review of research on community garden ecosystem services, and there is no comparative study of English- and Chinese-language literature. This paper comprehensively reviewed key English- and Chinese-language literature on the ecosystem services of community gardens from the Web of Science and CNKI and analyzed publication years, numbers, research locations, and research topics. The results showed that the number of studies in English and Chinese has increased significantly since 2015, with a consistent upward trend. Research locations are concentrated in urban areas of Europe, America, and eastern China. Both English- and Chinese-language literature focuses on “food supply (quantity)” in the provisioning services, as well as “learning and education” and “social cohesion and integration” in cultural services. The above results are related to the governance frameworks, the management systems, the climatic conditions, and the sustainable development needs of local cities and planning strategies. Given that most of the existing research focuses on the classification and mechanisms of community garden ecosystem services, it is proposed that future research deeply explore the design factors affecting community garden ecosystem services and pay attention to the links between different ecosystem services. The main findings of this review emphasize the correlation between community garden ecosystem services and contextual factors, and point out future research directions. Full article

Ethnobotanical knowledge and biodiversity are critical components of sustainable natural resource management, especially in regions undergoing rapid environmental and socio-economic change. In Northeast Thailand, traditional plant knowledge is deeply intertwined with local cultural identity but faces increasing threats from urbanization, agricultural expansion, and generational shifts. This study presents a floristic and ethnobotanical survey of the Khanthararat Public Benefit Forest, a community-managed remnant forest in Maha Sarakham Province, documenting 110 plant species from 42 families. The Fabaceae family was the most diverse, consistent with other tropical ecosystems. Predominantly native species (85.45%) indicate minimal disturbance, while introduced (11.82%) and endemic species (2.73%) reflect ecological complexity. Ethnobotanical data revealed 34 wild edible species, 33 medicinal plants, and 19 ornamental species used by the local community, highlighting the forest’s vital role in supporting livelihoods and cultural practices. High Use Values (UVs) for species such as Spondias pinnata and Coccinia grandis underline their dual importance in food and medicine. Informant Consensus Factor (Fic) values demonstrate strong agreement on plant use for reproductive and musculoskeletal health, reflecting well-established traditional knowledge. The findings underscore the forest’s dual significance as an ecological hotspot and a repository of cultural heritage, providing essential ecosystem services including biodiversity conservation, climate regulation, and cultural provisioning. By integrating traditional knowledge with biodiversity assessment, this study offers valuable insights for community-based conservation strategies that sustain both ecological integrity and cultural resilience in Northeast Thailand. Full article

Part of the vision of the ISNS is ‘to enhance the quality of neonatal screening and medical services through dissemination of information, guidelines and best practices.’ Although newborn screening encompasses testing in the newborn period for critical congenital heart disease, hearing impairment, birth defects, and congenital biochemical disorders (usually on bloodspots), this guideline is specifically about bloodspot screening. The ISNS has provided neonatal screening guidelines for many years and here presents the renewed 2025 General Guidelines for Neonatal Bloodspot Screening. They are intended to provide a framework for screening programs to develop specific policies around all aspects of the newborn screening system, offering the basic set of items for consideration. These guidelines provide trusted anchors to build, expand, or maintain robustly organized neonatal or newborn screening (NBS) programs and a checklist to evaluate and improve the essential elements of those programs. For starting or developing programs, it is a set of elements for which provisions need to be in place and a checklist of items that the screening program should at a minimum have provisions for. The publication of these guidelines is meant as a starting point for interactive discussion, to further improve this document and expand where necessary. Full article

Urban parks are essential public resources that contribute significantly to residents’ well-being. However, disparities in the spatial distribution and social benefits of urban parks remain a pressing issue. This study focuses on the central urban area of Shanghai, a representative high-density megacity, and its findings hold significant reference value for similar cities, systematically evaluating urban park services from the perspectives of accessibility, spatial equity, and social equity. Leveraging multi-source big data and enhanced analytical methods, this study examines disparities and spatial mismatches in park services. By incorporating dynamic data, such as actual visitor attendance and residents’ travel preferences, and improving analytical models, such as an enhanced Gaussian two-step floating catchment area method and spatial lag regression models, this research significantly improves the accuracy and reliability of its findings. Key findings include (1) significant variations in accessibility exist across different types of parks, with regional and city parks offering better accessibility compared to pocket parks and community parks. (2) Park resources are unevenly distributed, with neighborhoods within the inner ring exhibiting relatively low overall accessibility. (3) A spatial mismatch is observed between park accessibility and housing prices, highlighting equity concerns. The dual spatial-social imbalance phenomenon reveals the prevalent contradiction in rapidly urbanizing areas where public service provision lags behind land development. Based on these results, this study proposes targeted recommendations for optimizing urban park layouts, including increasing the supply of small parks in inner-ring areas, enhancing the multifunctionality of parks, and strengthening policy support for disadvantaged communities. These findings contribute new theoretical insights into urban park equity and fine-grained governance while offering valuable references for urban planning and policymaking. Full article

Section 195(b) of South Africa’s Constitution calls for the efficient use of resources in public administration, while the White Paper on Local Government similarly emphasizes the efficient provision of basic services such as refuse collection and water. Despite these policy commitments, South African municipalities continue to be characterized by financial mismanagement and poor service delivery. In light of the limited empirical evidence on this issue, this study pursues two objectives. First, it estimates the levels of cost inefficiency in four local municipalities within the Frances Baard District from 2006 to 2023. Second, it determines how cost inefficiencies affect service delivery, focusing on water and refuse collection. Using a stochastic frontier analysis, several key results are confirmed. First, on average, the four municipalities are found to have spent 17.23% above the minimum cost required to deliver existing services. Second, service delivery is found to have been 23% lower than its potential. Third, operating costs and contracted services are found to have been key drivers of wasteful expenditure. Lastly, cost inefficiencies are found to have culminated in poor service delivery. Against this background, municipalities are urged to consider cutting non-essential operational spending such as entertainment and travel allowances, coupled with improved accountability on contracted services. Full article

Background: Professional knowledge and experience of healthcare organization went through continuous change and development with the progression of COVID-19 pandemic waves. However, carefully developed guidelines for cardiopulmonary resuscitation (CPR) remained largely unchanged regardless of the epidemic situation, with the largest change being a more prominent bioethical approach. It would be possible to further improve the quality of CPR by systematic data collection, the facilitation of prospective studies, and further development of the methodology based on this evidence, as well as by providing information and developing provisions on interventions with expected poor outcomes, and ultimately by refusing resuscitation. Methods: This study involved the critical collection and analysis of literary data originating from the Web of Science and PubMed databases concerning bioethical aspects and the efficacy of CPR during the COVID-19 pandemic. Results: According to the current professional recommendation of the European Resuscitation Council (ERC), CPR should be initiated immediately in case of cardiac arrest in the absence of an exclusionary circumstance. One such circumstance is explicit refusal of CPR by a well-informed patient, which in practice takes the form of a prior declaration. ERC prescribes the following conjunctive conditions for do-not-attempt CPR (DNACPR) declarations: present, real, and applicable. It is recommended to take the declaration as a part of complex end-of-life planning, with the corresponding documentation available in an electronic database. The pandemic has brought significant changes in resuscitation practice at both lay and professional levels as well. Incidence of out-of-hospital resuscitation (OHCA) did not differ compared to the previous period, while cardiac deaths in public places almost halved during the epidemic (p < 0.001) as did the use of AEDs (p = 0.037). The number of resuscitations performed by bystanders and by the emergency medical service (EMS) also showed a significant decrease (p = 0.001), and the most important interventions (defibrillation, first adrenaline time) suffered a significant delay. Secondary survival until hospital discharge thus decreased by 50% during the pandemic period. Conclusions: The COVID-19 pandemic provided a significant impetus to the revision of guidelines. While detailed methodology has changed only slightly compared to the previous procedures, the DNACPR declaration regarding self-determination is mentioned in the context of complex end-of-life planning. The issue of safe environment has come to the fore for both lay and trained resuscitators. Future Directions: Prospective evaluation of standardized methods can further improve the patient’s autonomy and quality of life. Since clinical data are controversial, further prospective controlled studies are needed to evaluate the real hazards of aerosol-generating procedures. Full article