Search Results (897)

Background: Family caregivers are a vital yet often under-recognized part of the healthcare system. They provide essential emotional, physical, and logistical support to individuals with illness, disability, or frailty, and their contributions improve continuity of care and reduce system strain. However, many healthcare and social service providers are not equipped to meaningfully engage caregivers as partners. In Alberta, stakeholders validated the Caregiver-Centered Care Competency Framework and identified the need for a three-tiered education model—Foundational, Advanced, and Champion—to help providers recognize, include, and support family caregivers across care settings. This paper focuses on the development and early evaluation of the Advanced Caregiver-Centered Care Education modules, designed to enhance the knowledge and skills of providers with more experience working with family caregivers. The modules emphasize how partnering with caregivers benefits not only the person receiving care but also improves provider effectiveness and supports better system outcomes. Methods: The modules were co-designed with a 154-member interdisciplinary team and grounded in the competency framework. Evaluation used the first three levels of the Kirkpatrick–Barr health workforce education model. We analyzed pre- and post-surveys from the first 50 learners in each module using paired t-tests and examined qualitative feedback and SMART goals through inductive content analysis. Results: Learners reported a high level of satisfaction with the education delivery and the knowledge and skill acquisition. Statistically significant improvements were observed in 53 of 54 pre-post items. SMART goals reflected intended practice changes across all six competency domains, indicating learners saw value in engaging caregivers as partners. Conclusions: The Advanced Caregiver-Centered Care education improved providers’ confidence, knowledge, and skills to work in partnership with family caregivers. Future research will explore whether these improvements translate into real-world practice changes and better caregiver experiences in care planning, communication, and navigation. Full article

The ongoing degradation of global forests has severely weakened ecosystem service functions, and traditional judicial remedies have struggled to quantify intangible ecological losses. China has become an important testing ground for restorative justice through the establishment of specialized environmental courts and the practice of environmental public interest litigation. Since 2015, China has actively explored and institutionalized the application of the concept of restorative justice in its environmental justice reform. This concept emphasizes compensating environmental damages through actual ecological restoration acts rather than relying solely on financial compensation. This shift reflects a deep understanding of the limitations of traditional environmental justice and an institutional response to China’s ecological civilization construction, providing critical support for forest ecosystem restoration and enabling ecological restoration activities, such as replanting and re-greening, habitat reconstruction, etc., to be enforced through judicial decisions. This study conducts a qualitative analysis of judicial rulings in forest restoration cases to systematically evaluate the effectiveness of restorative justice in compensating for losses in forest ecosystem service functions. The findings reveal the following: (1) restoration measures in judicial practice are disconnected from the types of ecosystem services available; (2) non-market values and long-term cumulative damages are systematically underestimated, with monitoring mechanisms exhibiting fragmented implementation and insufficient effectiveness; (3) management cycles are set in violation of ecological restoration principles, and acceptance standards lack function-oriented indicators; (4) participation of key stakeholders is severely lacking, and local knowledge and professional expertise have not been integrated. In response, this study proposes a restorative judicial framework oriented toward forest ecosystem services, utilizing four mechanisms: independent recognition of legal interests, function-matched restoration, application of scientific assessment tools, and multi-stakeholder collaboration. This framework aims to drive a paradigm shift from formal restoration to substantive functional recovery, providing theoretical support and practical pathways for environmental judicial reform and global forest governance. Full article

Transportation is often cited as a significant barrier to healthcare access by Veterans, particularly those from minority groups, who have disabilities, or live in rural areas. Autonomous shuttles (AS) offer a potential solution, yet limited research has explored Veterans’ experiences with this technology. This study qualitatively investigated Veterans’ lived experiences with AS through focus groups, enrolling participants aged 18+ from Gainesville, The Villages, and Lake Nona, Florida. Via a directed content analysis, six key themes were identified: Perceived Benefits, Safety, Experience with Autonomous Vehicles (AV), AS Experience, AV Adoption, and Perception Change. Among 26 participants (aged 30–85; 77% men; 88% urban residents), prominent themes included Safety (n = 161), Perceived Benefits (n = 153), and AS Experience (n = 118), with predominantly positive counts in all themes except AS Experience. Participants acknowledged safety advantages and multitasking potential of AS over human-operated vehicles while recommending improvements to the shuttle’s slow speed, availability and convenience. While the AS ride was positively received overall, some participants noted issues with comfort and braking, emphasizing the need for further technological enhancements. Real-world exposure to AS appeared to influence acceptance positively, offering insights for policymakers and industry stakeholders aiming to optimize AS deployment for mobility-vulnerable Veterans. Full article

Introduction: Low medication adherence and low hypertension control are a public health challenge, particularly in low- and middle-income countries (LMICs). Healthcare system- and patient-related barriers hinder the successful management of hypertension. This study aimed to identify the perceptions of barriers and facilitators to hypertension management among health system stakeholders in Santander, Colombia. Materials and Methods: We conducted a qualitative, phenomenological, and interpretative study, comprising five focus groups, to explore the barriers and facilitators to managing people with hypertension. Each focus group was formed by stakeholders from territorial entities, healthcare insurers, or healthcare providers. Meetings were held between December 2022 and February 2023. The sessions were recorded and transcribed using NVivo Transcription and analyzed using NVivo version 1.6.1. Results: Seven categories of barriers and facilitators were identified: strategies, resources, access, risk assessment, cross-sector collaboration, articulation, and stewardship. Of these categories, articulation and stewardship emerged as the main barriers, as revealed through axial coding and cluster analysis, which highlighted deficiencies in stewardship practices, a lack of clear objectives, and misalignment with public policy frameworks. Conclusions: Multisectoral actions extending beyond healthcare providers and aimed at improving coordination and intersectoral collaboration are essential for enhancing hypertension control in LMICs, such as Colombia. Addressing social determinants and strengthening primary healthcare through community-based strategies are critical, making stewardship and improved access key priorities. Full article

Artificial Intelligence (AI) and Generative AI are transformative yet double-edged technologies with evolving risks. While research emphasises trustworthy, fair, and responsible AI by focusing on its “what” and “why,” it overlooks practical “how.” To bridge this gap in financial services, an industry at the forefront of AI adoption, this study employs a qualitative approach grounded in existing Responsible AI and Corporate Digital Responsibility (CDR) frameworks. Through thematic analysis of 15 semi-structured interviews conducted with professionals working in finance, we illuminate nine non-technical barriers that practitioners face, such as sustainability challenges, trade-off balancing, stakeholder management, and human interaction, noting that GenAI concerns now eclipse general AI issues. CDR practitioners adopt a more human-centric stance, emphasising consensus-building and “no margin for error.” Our findings offer actionable guidance for more responsible AI strategies and enrich academic debates on Responsible AI and AI-CDR symbiosis. Full article

As sustainability becomes a strategic priority across global financial services, its implementation in emerging insurance markets remains insufficiently understood. This study explores the integration of environmental, social, and governance (ESG) principles within Saudi Arabia’s insurance sector, combining content analysis of corporate disclosures with qualitative insights from industry stakeholders. The research investigates how insurers embed ESG principles into their operations, the development of sustainable insurance products, and their perceived financial and regulatory implications. The findings reveal gradual progress in ESG integration, primarily driven by governance reforms aligned with national development agendas, while social and environmental dimensions remain comparatively underdeveloped. Stakeholders identify regulatory ambiguity, data limitations, and technical capacity as persistent barriers, but also point to increasing investor and consumer interest in sustainability-aligned offerings. This study offers policy and managerial recommendations to advance ESG principle adoption, emphasizing standardized disclosures, capacity-building, and product innovation. It contributes to the limited empirical literature on ESG principles in Middle Eastern insurance markets and highlights the sector’s potential role in promoting inclusive and sustainable finance. Full article

What elements of nature do people involved in conservation projects seek to protect, and why? How do they identify and relate to nature? Answers to such fundamental questions are shaped by normative assumptions that can result in distinct conservation strategies and practices. Despite their importance, normative assumptions are rarely explicitly stated in conservation sciences, possibly because an epistemology of modern science suggests that normative backgrounds are not relevant to the production of objective knowledge, or because researchers and practitioners are unaware of the diversity of positions that exist. Using a combination of qualitative and quantitative methods, we created a catalogue of existing normative positions in conservation literature and described their key characteristics. We described 72 distinctive normative positions about human–nature relationships. Each position was characterized by unique combinations of value-states belonging to one or more of the following five dimensions: ontology (the positionality of human with respect to nature), axiology (value systems and ethical frameworks), pragmatism (extent of human interventions), epistemology (knowledge sources), and agency (agents of change). We then scored each position in terms of its alignment (support, opposition, or neutrality) with respect to all value-states within each dimension. A fuzzy correspondence analysis revealed that the field of conservation is heterogeneous beyond the conventional gradient of intrinsic–instrumental–relational values. The frequency and circumstances under which stakeholders adopt different normative positions are unknown, but the list of dimensions and associated values provided in this study may serve as a checklist for scoping this diversity. Consideration of values stemming from alternative normative positions may help broaden support for conservation actions. Full article

Caring for the lives and welfare of animals is central to veterinary and animal sanctuary work, yet the meaning remains a subject of complex debates. Different stakeholders negotiate what constitutes appropriate care, leading to conflicting demands and expectations from internal and external sources. This article is based on two qualitative studies: Study I explores the multifaceted aspects of death work in farm animal medicine, emphasising the practical, emotional and ethical challenges involved. Study II examines human–animal interaction in sanctuaries, which reveal tensions between instrumental and relational care in animal-centred work. Relational care represents a subjectifying approach with individual attention to animals, while instrumental care is a more objectifying perspective based on species representation. These demands can often be contradictory, complicating day-to-day decision making under pressure. To analyse these complexities, this study employs Clarke’s situational analysis (social worlds/arenas mapping), providing a means of comparing care work across different fields. This approach highlights how actor constellations, institutional settings, and structural constraints influence the negotiation of care. Addressing these issues provides a more nuanced understanding of the professional challenges of animal-centred care and the necessary skills to navigate its inherent contradictions. Full article

As climate change intensified water scarcity in Southern Europe, tourism-dependent regions such as Portugal’s Algarve faced growing pressure to adapt their water management systems. This study investigated how hotel groups in the Algarve have adopted and communicated water reuse technologies—specifically desalination and greywater recycling—under environmental, institutional, and reputational constraints. A comparative qualitative case study was conducted involving three hotel groups—Vila Vita Parc, Pestana Group, and Vila Galé—selected through purposive sampling based on organizational capacity and technology adoption stage. The analysis was supported by a supplementary mini-case from Mallorca, Spain. Publicly accessible documents, including sustainability reports, media coverage, and policy frameworks, were thematically coded using organizational environmental behavior theory and the OECD Principles on Water Governance. The results demonstrated that (1) higher organizational capacity was associated with greater maturity in water reuse implementation; (2) communication transparency increased alongside technological advancement; and (3) early-stage adopters encountered stronger financial, regulatory, and operational barriers. These findings culminated in the development of the Maturity–Communication–Governance (MCG) Framework, which elucidates how internal resources, stakeholder signaling, and institutional alignment influence sustainable infrastructure uptake. This research offered policy recommendations to scale water reuse in tourism through financial incentives, regulatory simplification, and public–private partnerships. The study contributed to the literature on sustainable tourism and decentralized climate adaptation, aligning with UN Sustainable Development Goals 6.4, 12.6, and 13. Full article

The implementation of Building Information Modelling (BIM) in public design processes enhances efficiency, transparency, and sustainability. However, public agencies often encounter significant barriers, particularly regarding organisational and managerial readiness. This study develops a BIM implementation framework tailored to the specific needs of an Italian public agency. The research adopts a qualitative approach, combining 15 semi-structured interviews with process mapping Using (Business Process Modeling Notation) BPMN. The current as-is workflows were analysed and validated by internal stakeholders. Based on this analysis, strategic objectives were defined, relevant (Building Information Modelling) BIM uses were selected, and revised to-be processes were proposed, integrating new roles and responsibilities according to the standards. The framework addresses both technical and organisational dimensions of BIM adoption, highlighting the need for training, coordination, and stakeholder engagement. The main outcomes include a structured process model, a priority-based selection of BIM uses, and a role matrix supporting organisational transformation. The added value for researchers lies in the replicable methodology that combines empirical process mapping with implementation planning. For practitioners, especially consultants in sustainable design, the study offers a practical roadmap for aligning BIM adoption with project goals, regulatory compliance, and environmental performance targets in complex public sector contexts. Full article

Governance challenges, success factors, and stakeholder dynamics are central to the implementation of Positive Energy District (PED) Labs, which aim to develop energy-positive and sustainable urban areas. In this paper, a qualitative analysis combining expert surveys, participatory workshops with practitioners from the COST Action PED-EU-NET network, and comparative case studies across Europe identifies key barriers, drivers, and stakeholder roles throughout the implementation process. Findings reveal that fragmented regulations, social inertia, and limited financial mechanisms are the main barriers to PED Lab development, while climate change mitigation goals, strong local networks, and supportive policy frameworks are critical drivers. The analysis maps stakeholder engagement across six development phases, showing how leadership shifts between governments, industry, planners, and local communities. PED Labs require intangible assets such as inclusive governance frameworks, education, and trust-building in the early phases, while tangible infrastructures become more relevant in later stages. The conclusions emphasize that robust, inclusive governance is not merely supportive but a key driver of PED Lab success. Adaptive planning, participatory decision-making, and digital coordination tools are essential for overcoming systemic barriers. Scaling PED Labs effectively requires regulatory harmonization and the integration of social and technological innovation to accelerate the transition toward energy-positive, climate-resilient cities. Full article

This study examines the role of public–private partnerships in promoting the sustainable development of travel destinations through a comparative analysis of two emblematic heritage-based hospitality projects: Dar Tantora in Al Ula, Saudi Arabia, and Sextantio Le Grotte della Civita in Matera, Italy. These case studies were analysed through both architectural–urban and economic–legal perspectives to highlight how public–private partnership models can support heritage conservation, community engagement, and responsible tourism development. A mixed-methods approach was employed, combining quantitative indicators—such as projected profitability, tourist volume, and employment—with qualitative insights from interviews with key stakeholders. The analysis reveals that while both models prioritise cultural authenticity and adaptive reuse, they differ significantly in funding structures, legal frameworks, and governance dynamics. Dar Tantora exemplifies a top-down, publicly funded model integrated into Saudi Arabia’s Vision 2030 strategy, whereas Sextantio reflects a bottom-up, private initiative rooted in social enterprise. The findings offer insights into how different public–private partnership configurations can foster sustainable tourism development, depending on local context, institutional frameworks, and strategic goals. The study contributes to the broader discourse on regenerative tourism, architectural conservation, and policy-driven heritage reuse. Full article

Workforce transformation is one of the most pressing challenges in the AI-driven construction industry, as traditional skilled labour roles are rapidly evolving into more interdisciplinary, digitally enabled positions. This study aims to investigate how AI is fundamentally reshaping skill requirements within the construction sector, to analyse stakeholder perceptions and adaptive responses to workforce transformation, and to explore strategies for optimizing construction workforce development to facilitate the critical transition from traditional “skilled workers” to contemporary “smart talent.” It employs phenomenological qualitative research methodology to conduct in-depth interviews with 20 stakeholders in Chongqing, and uses NVivo 14 to conduct thematic analysis of the data. The findings indicate that AI has penetrated all areas of the construction process and is transforming jobs to more likely be digitalized, collaborative, and multi-faceted. However, significant cognitive disparities and varying adaptive capacities among different stakeholder groups have created structural imbalances within the workforce development ecosystem. Based on these key findings, a four-pillar talent development strategy is proposed, encompassing institutional support, educational reform, enterprise engagement, and group development, while stressing the necessity for systemic-orchestrated coordination to reimagine a smart talent ecosystem. This study advances theoretical understanding of digital transformation within construction labour markets, while offering real pathways and institutional contexts for developing regions that desire to pursue workforce transformation and sustainable industrial development in the AI era. Full article

Cultural heritage in insular regions faces increasing challenges due to overtourism, seasonal economies, and insufficient protection frameworks. This study investigates the adaptive reuse of Sarakina Mansion, a deteriorated 18th-century estate on the island of Zakynthos, as a model for integrating cultural heritage preservation with sustainable tourism. The research addresses the gap in localized strategies for heritage-led development in the context of islands with overtourism. Through a qualitative case study methodology—including site analysis, archival research, and stakeholder interviews—this paper explores how abandoned cultural assets can be reactivated to foster community engagement and diversify tourism models. Two distinct SWOT analyses were conducted as follows: one at the territorial level (Zakynthos Island) and another focused on the island’s cultural heritage. The findings highlight key obstacles such as environmental degradation and policy fragmentation, but they also reveal opportunities for adaptive reuse grounded in local identity and sustainable practices. The proposed reuse scenario for Sarakina promotes partial structural stabilization and community-driven cultural programming, aiming to create a hybrid open-air cultural hub. This study contributes a replicable framework for reimagining neglected heritage assets in overtourism-affected areas, aligned with the UN Sustainable Development Goals (SDGs). Full article

There is a growing global interest in making existing buildings more energy-efficient. However, stakeholders seem to have differing views on the matter, especially in developing countries, thus raising the issue of awareness amongst key stakeholders at the operational stage of existing buildings. This study aimed to examine stakeholders’ awareness of the benefits of passive retrofit in residential buildings using a convergent mixed-methods approach. Quantitative data were collected from 118 property managers and 163 owners of residential buildings, and qualitative data were collected from six government officials in Lagos State, Nigeria. The quantitative data collected were analysed using fuzzy synthetic evaluation, which addresses the fuzziness in judgement-making on multi-criteria phenomena. The results revealed that property managers and owners had a moderately high level of awareness of the environmental, economic, and social benefits of the passive retrofitting of residential buildings. However, while property managers generally had a higher level of awareness than owners, a significant gap was found in their awareness of environmental benefits. Conversely, the qualitative analysis results showed that government officials demonstrated a strong awareness of environmental benefits (energy reduction, air quality, and natural lighting) and economic advantages (cost savings and lower implementation costs). In contrast, their awareness of social benefits was limited to health improvements. The findings have practical implications for policy development and awareness campaigns. Building agencies need to further reinforce their targeted awareness programmes for owners, who demonstrated fair awareness of environmental benefits while leveraging the intermediary role of property managers in promoting home retrofit practices. Economic benefits should also be an integral part of policy frameworks to drive wider adoption across all stakeholder groups. Full article