Search Results (2,578)

Water-related ecosystem services provide a broad range of benefits, including the mitigation of extreme hydrometeorological events, the provision of water for various uses, the support of tourism, and the provision of cultural services. This study assesses the perceptions and accessibility of these services among communities located near the Alafiarou and Okpara dams in Benin and the Bagré dam in Burkina Faso. The methodology involved designing and implementing a questionnaire in KoboCollect, with trained agents deployed to conduct data collection at each of the three sites. Data analysis indicates that respondents identified biodiversity conservation and the provision of drinking water as the most crucial ecosystem services. Over two-thirds of participants reported observing both positive and negative changes in the services provided by rivers and in socio-economic activities since the construction of the dams. While the majority noted improvements in agriculture, irrigation, water quality, fisheries, and flow rates, other changes included biodiversity loss, a decrease in vegetation cover (notably trees and shrubs), an increase in the population of mosquitoes and other insects, and a decline in fishery resources downstream. Despite these challenges, local communities were strongly willing to participate in initiatives aimed at protecting and restoring river ecosystems and their related services. Full article

Despite extensive research on early childhood education (ECE) quality at the preschool level, toddler settings remain comparatively understudied, particularly in Chile and Latin America. Research suggests that quality ECE strengthens child development, while low-quality services can be harmful. ECE quality comprises structural features like ratios and classroom resources, and process features related to interactions within classrooms. This study examines how process and structural quality indicators are related in nurseries serving disadvantaged backgrounds. Data were collected from 51 Chilean urban classrooms serving children aged 12–24 months. Classrooms were evaluated using the Classroom Assessment Scoring System (CLASS) for toddlers, questionnaires, and checklists. Latent Profile Analysis identified process quality patterns, while multinomial regression examined associations with structural quality indicators. The results revealed low-to-moderate process quality across classrooms (M = 4.78 for Emotional and Behavioral Support; M = 2.35 for Engaged Support for Learning), with three distinct quality clusters emerging. Marginally significant differences were found between high- and low-performing clusters regarding classroom space (p = 0.06), number of toys (p = 0.08), and staff educational credentials (p = 0.01–0.07). No significant differences emerged for group sizes or adult-to-child ratios, which are heavily regulated in Chile. These findings underscore the need to strengthen quality assurance mechanisms ensuring all children access quality ECE. Full article

Background/Objectives: Pressure injuries are a significant concern among older adults, particularly in community-based long-term care settings where prolonged immobility is prevalent. This study aimed to identify factors influencing sacral interface pressure in community-dwelling older adults, with an emphasis on support surface usage and clinical risk indicators. Methods: A total of 210 participants aged 65 years and older, all receiving long-term care services in South Korea, were enrolled in this study. Sacral interface pressure was measured in the supine position using a portable pressure mapping device (Palm Q7). General characteristics, Braden Scale scores, Huhn Scale scores, and mattress usage were assessed. Data were analyzed using descriptive statistics, t-tests, chi-square tests, and logistic regression. Results: Mattress non-use was identified as the strongest predictor of elevated sacral interface pressure (OR = 6.71, p < 0.001), followed by Braden Scale scores indicating moderate risk (OR = 4.8, p = 0.006). Huhn Scale scores were not significantly associated with interface pressure. These results suggest that support surface quality and skin condition have a stronger impact on interface pressure than mobility-related risk factors. Conclusions: The findings highlight the importance of providing high-quality pressure-relieving mattresses and implementing standardized nursing assessments to reduce the risk of pressure injuries. Integrating smart technologies and expanding access to advanced support surfaces may aid in developing tailored preventive strategies for vulnerable older adults. Full article

Background: Access to safe and reliable water and sanitation remains a critical public health and development challenge, with rural and low-income communities being disproportionately affected by inadequate services and heightened exposure to waterborne diseases. Despite global efforts and infrastructure-based progress indicators, significant disparities persist, and these often overlook users’ perceptions of water quality, reliability, and safety. This study explores the determinants of household satisfaction with drinking water in rural areas, comparing subjective user feedback with official access data to reveal gaps in current monitoring approaches and support more equitable, user-centered water governance. Methods: This study was conducted in Kazakhstan’s Atyrau Region, where 1361 residents from 86 rural villages participated in a structured survey assessing household access to drinking water and perceptions of its quality. Data were analyzed using descriptive statistics and multinomial logistic regression to identify key predictors of user satisfaction, with results compared against official records to evaluate discrepancies between reported experiences and administrative data. Results: The field survey results revealed substantial discrepancies between official statistics and residents’ reports, with only 58.1% of respondents having in-house tap water access despite claims of universal coverage. Multinomial logistic regression analysis identified key predictors of user satisfaction, showing that uninterrupted supply and the absence of complaints about turbidity, odor, or taste significantly increased the likelihood of higher satisfaction levels with drinking water quality. Conclusions: This study underscores the critical need to align official water access statistics with household-level experiences, revealing that user satisfaction—strongly influenced by supply reliability and sensory water quality—is essential for achieving equitable and effective rural water governance. Full article

Objective: This study aimed to investigate the impact of depression and anxiety disorders on mortality in women diagnosed with gynecologic cancers, utilizing nationwide retrospective cohort data. Methods: Data from the Korean National Health Insurance Service (NHIS) database, covering women diagnosed with cervical, endometrial, or ovarian cancers between 2007 and 2014, were analyzed. Women diagnosed with depression or anxiety disorders within one year after cancer diagnosis were identified and compared with a control group comprising patients with gynecologic cancers who did not develop either disorder during the same post-diagnosis period. Mortality was evaluated as the primary outcome. Results: Of 85,327 women analyzed, 784 (0.9%) were diagnosed with depression or anxiety disorders. Patients with depression or anxiety exhibited significantly higher mortality (38.4% vs. 29.9%; p < 0.001). Multivariate analysis indicated that depression significantly increased mortality risk (OR 1.46, 95% CI 1.27–1.66), whereas anxiety alone showed no significant effect (OR 0.97, 95% CI 0.74–1.27). Combined depression and anxiety showed the highest mortality risk (OR 1.47, 95% CI 1.31–1.65). Conclusions: Depression and anxiety disorders are significant predictors of increased mortality in women with gynecologic cancers, emphasizing the necessity for integrated mental health assessment and interventions in oncologic care to improve both survival and quality of life. Full article

With the arrival of an aging society and the continuous extension of the human lifespan, the quality of life has not improved in a corresponding manner. People’s demand for happiness and health is increasing. As a result, a model emerged that integrates tourism and medical services, which is health tourism. This growing demand has prompted many service providers to see it as a business opportunity and enter the market. Tourism can help travelers release work stress and restore physical and mental balance; meanwhile, health check-ups and disease treatment can help them regain health. Consumers have long favored health and medical tourism because it helps relieve stress and promotes overall well-being. As people age, some consumers experience a gradual decline in physical functions, making it difficult for them to participate in regular travel services provided by traditional travel agencies. Therefore, this study aims to explore the service needs of health and medical tourism customers (tourists/patients) and the interrelationships among these service needs, so that health and medical tourism service providers can develop more customized and diversified services. This study identifies four key drivers of medical tourism services: medical services, medical facilities, tour planning, and hospitality facilities. This study uses the APA (attention and performance analysis) method to assess each dimension and criterion and utilizes the DEMATEL method with the NRM (network relationship map) to identify network relationships. By combining APA and NRM techniques, this study develops the APA-NRM technique to evaluate adoption strategies and identify suitable paths for health tourism services, providing tailored development strategies and recommendations for service providers to enhance the service experience. Full article

With the rapid development of video streaming services, adaptive bitrate (ABR) algorithms have become a core technology for ensuring optimal viewing experiences. Traditional ABR strategies, predominantly rule-based or reinforcement learning-driven, typically employ uniform quality assessment metrics that overlook users’ subjective preference differences regarding factors such as video quality and stalling. To address this limitation, this paper proposes an adaptive video bitrate selection system that integrates preference modeling with reinforcement learning. By incorporating a preference learning module, the system models and scores user viewing trajectories, using these scores to replace conventional rewards and guide the training of the Proximal Policy Optimization (PPO) algorithm, thereby achieving policy optimization that better aligns with users’ perceived experiences. Simulation results on DASH network bandwidth traces demonstrate that the proposed optimization method improves overall Quality of Experience (QoE) by over 9% compared to other mainstream algorithms. Full article

(1) The beach areas of Galveston, Texas, USA are heavily used for recreational activities and often experience elevated fecal indicator bacteria levels, representing a potential threat to ecosystem services, human health, and tourism-based economies that rely on suitable water quality. (2) During the span of 15 months (March 2022–May 2023), water samples that exceeded the U.S. Environmental Protection Agency-accepted alternative Beach Action Value (BAV) for enterococci of 104 MPN/100 mL were analyzed via microbial source tracking (MST) through quantitative polymerase chain reaction (qPCR) assays. The Bacteroides HF183 and DogBact as well as the Catellicoccus LeeSeaGull markers were used to detect human, dog, and gull fecal sources, respectively. The qPCR MST data were then utilized in a quantitative microbial risk assessment (QMRA) to assess human health risks. Additionally, samples collected in July and August 2022 were sequenced for 16S rRNA and matched with fecal sources through the Bayesian SourceTracker2 program. (3) Overall, 26% of the 110 samples with enterococci exceedances were positive for at least one of the MST markers. Gull was revealed to be the primary source of identified fecal contamination through qPCR and SourceTracker2. Human contamination was detected at very low levels (<1%), whereas dog contamination was found to co-occur with human contamination through qPCR. QMRA identified Campylobacter from canine sources as being the primary driver for human health risks for contact recreation for both adults and children. (4) These MST results coupled with QMRA provide important insight into water quality in Galveston that can inform future water quality and beach management decisions that prioritize public health risks. Full article

Smart cities are technologically advanced urban environments where interconnected systems and data-driven technologies enhance public service delivery and quality of life. These cities rely on information and communication technologies, the Internet of Things, big data, cloud computing, and other Industry 4.0 tools to support efficient city management and foster citizen engagement. Often referred to as digital cities, they integrate intelligent infrastructures and real-time data analytics to improve mobility, security, and sustainability. Ubiquitous sensors, paired with Artificial Intelligence, enable cities to monitor infrastructure, respond to residents’ needs, and optimize urban conditions dynamically. Given the increasing significance of Industry 4.0 in urban development, this study adopts a bibliometric approach to systematically review the application of these technologies within smart cities. Utilizing major academic databases such as Scopus and Web of Science the research aims to identify the primary Industry 4.0 technologies implemented in smart cities, assess their impact on infrastructure, economic systems, and urban communities, and explore the challenges and benefits associated with their integration. The bibliometric analysis included publications from 2016 to 2023, since the emergence of urban researchers’ interest in the technologies of the new industrial revolution. The task is to contribute to a deeper understanding of how smart cities evolve through the adoption of advanced technological frameworks. Research indicates that IoT and AI are the most commonly used tools in urban spaces, particularly in smart mobility and smart environments. Full article

The quality of water in households can be affected by plumbing design and materials, water usage patterns, and source water quality characteristics. These factors influence stagnation duration, disinfection residuals, metal release, and microbial activity. In particular, stagnation can degrade water quality and increase lead release from lead service lines. This study employs numerical modeling to assess how combined corrosion control and flushing strategies affect lead levels in household taps with lead service lines under reduced water use. To estimate potential health risks, the U.S. EPA model is used to predict the percentage of children likely to exceed safe blood lead levels. Lead exceedances are assessed based on various regulatory requirements. Results show that exceedances at the kitchen tap range from 3 to 74% of usage time for the 5 µg/L standard, and from 0 to 49% for the 10 µg/L threshold, across different scenarios. Implementing corrosion control treatment in combination with periodic flushing proves effective in lowering lead levels under the studied low-consumption scenarios. Under these conditions, the combined strategy limits lead exceedances above 5 µg/L to only 3% of usage time, with none above 10 µg/L. This demonstrates its value as a practical short-term strategy for households awaiting full pipe replacement. Targeted flushing before peak water use reduces the median time that water remains stagnant in household pipes from 8 to 3 h at the kitchen tap under low-demand conditions. Finally, the risk model indicates that the combined approach can reduce the predicted percentage of children with blood lead levels exceeding 5 μg/dL from 61 to 6% under low water demand. Full article

Rural roads are critical for connecting isolated communities to essential services such as education and health and administrative services, as well as production and market opportunities in low-income countries. More than 70% of movements of people and goods in Sub-Saharan Africa are heavily reliant on rural transport systems, using both motorised but mainly alternative means of transport. However, rural roads often suffer from poor construction due to the use of low-strength, in situ soils and limited financial resources, leading to premature failures and subsequent traffic disruptions with significant economic losses. This study investigates the use of rice husk ash (RHA), a waste byproduct from rice production, as a sustainable supplement to Ordinary Portland Cement (OPC) for soil stabilisation in order to increase durability and sustainability of rural roads, hence limit recurrent maintenance needs and associated transport costs and challenges. To conduct this study, soil samples collected from Mulungushi, Zambia, were treated with combinations of 6–10% OPC and 10–15% RHA by weight. Laboratory tests measured maximum dry density (MDD), optimum moisture content (OMC), and California Bearing Ratio (CBR) values; the main parameters assessed to ensure the quality of road construction soils. Results showed that while the MDD did not change significantly and varied between 1505 kg/m³ and 1519 kg/m³, the OMC increased hugely from 19.6% to as high as 26.2% after treatment with RHA. The CBR value improved significantly, with the 8% OPC + 10% RHA mixture achieving the highest resistance to deformation. These results suggest that RHA can enhance the durability and sustainability of rural roads and hence improve transport systems and subsequently improve socioeconomic factors in rural areas. Full article

Situated in the southern hilly-mountain belt of China’s “Three Zones and Four Belts Strategy”, Gannan region is a critical ecological shelter belt for the Ganjiang River. Decades of intensive mineral extraction and irrational agricultural development have rendered it into an ecologically fragile area. Consequently, multiple restoration initiatives have been implemented in the region over recent decades. However, it remains unclear how relationships among ecosystem services have evolved under these interventions and how future ecosystem management should be optimized based on these changes. Thus, in this study, we simulated and assessed the spatiotemporal dynamics of five key ESs in Gannan region from 1990 to 2020. Through integrated correlation, clustering, and redundancy analyses, we quantified ES interactions, tracked the evolution of ecosystem service bundles (ESBs), and identified their socio-ecological drivers. Despite a 31% decline in water yield, ecological restoration initiatives drove substantial improvements in key regulating services: carbon storage increased by 6.9 × 10¹² gC while soil conservation rose by 4.8 × 10⁸ t. Concurrently, regional habitat quality surged by 45% in mean scores, and food production increased by 2.1 × 10⁵ t. Critically, synergistic relationships between habitat quality, soil retention, and carbon storage were progressively strengthened, whereas trade-offs between food production and habitat quality intensified. Further analysis revealed that four distinct ESBs—the Agricultural Production Bundle (APB), Urban Development Bundle (UDB), Eco-Agriculture Transition Bundle (ETB), and Ecological Protection Bundle (EPB)—were shaped by slope, forest cover ratio, population density, and GDP. Notably, 38% of the ETB transformed into the EPB, with frequent spatial interactions observed between the APB and UDB. These findings underscore that future ecological restoration and conservation efforts should implement coordinated, multi-service management mechanisms. Full article

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by inattention, hyperactivity, and impulsivity, frequently observed in juvenile offenders. This systematic review explores the interplay between ADHD and juvenile delinquency, focusing on behavioural, psychological, and social dimensions. Following the PRISMA guidelines, a systematic literature review was conducted using EBSCO Discovery Service, Science Direct, PubMed, and snowballing techniques. Studies meeting specific inclusion criteria, including juvenile offenders diagnosed with ADHD and comparisons to non-offender or non-ADHD control groups, were analysed. The methodological quality of studies was assessed using the Joanna Briggs Institute appraisal tools. A total of 21 studies were included, highlighting significant associations between ADHD and juvenile delinquency. ADHD symptoms, especially impulsivity and emotional dysregulation, were linked to an earlier onset of offending and higher rates of property crimes. Comorbidities such as conduct disorder, substance use disorder, and depression exacerbated these behaviours. Sociodemographic factors like low education levels and adverse family environments were also critical modifiers. Early intervention and tailored treatment approaches were emphasised to address these challenges. The findings underscore the need for early diagnosis, individualised treatment, and integrative rehabilitation programmes within the juvenile justice system to mitigate long-term risks and promote social inclusion. Full article

In today’s dynamic and highly uncertain environment, organizations, particularly in the aviation sector, face increasing challenges that demand resilient, flexible, and data-driven change management decisions. Responding to the growing need for structured approaches to managing complex uncertainties—geopolitical tensions, economic volatility, social shifts, rapid technological advancements, environmental pressures and regulatory changes—this research proposes a theoretical change management model for aviation service providers, such as airports. Integrating three analytical approaches, the model offers a robust, multi-method approach for supporting sustainable transformation under uncertainty. Normative analysis using Bayesian decision theory identifies influential external environmental factors, capturing probabilistic relationships, and revealing causal links under uncertainty. Prescriptive planning through scenario theory explores alternative future pathways and helps to identify possible predictions, offer descriptive evaluation employing fuzzy comprehensive evaluation, and assess decision quality under vagueness and complexity. The proposed four-stage model—observation, analysis, evaluation, and response—offers a methodology for continuous external environment monitoring, scenario development, and data-driven, proactive change management decision-making, including the impact assessment of change and development. The proposed model contributes to the theoretical advancement of the change management research area under uncertainty and offers practical guidance for aviation organizations (airports) facing a volatile external environment. This framework strengthens aviation organizations’ ability to anticipate, evaluate, and adapt to multifaceted external changes, supporting operational flexibility and adaptability and contributing to the sustainable development of aviation services. Supporting aviation organizations with tools to proactively manage systemic uncertainty, this research directly supports the integration of sustainability principles, such as resilience and adaptability, for long-term value creation through change management decision-making. Full article

Background/Objective: The most effective strategy for addressing users’ prosthetic needs is a comprehensive clinical assessment that provides a holistic understanding of the individual’s symptoms, health, function, and environmental barriers and facilitators. A standardized evaluation form would provide guidance for a structured approach to comprehensive clinical assessments of people with LLA. The objective of this study was to determine a list of relevant elements to be included in prosthetic evaluation for adults with lower limb amputation. Methods: Three independent focus group discussions were conducted with prosthetists (n = 15), prosthesis users (n = 11), and decision makers (n = 4) to identify all relevant elements that should be included in the clinical assessment of prosthetic services. The final content was then determined using the Delphi technique, with 35 panelists (18 prosthetists and decision makers, and 17 prosthesis users) voting in each round. Results: A total of 91 elements were identified through the focus group, of which 78 were included through the Delphi process. The identified elements are mostly related to the physical health of the prosthesis user (e.g., mobility, pain, and medical information), while others address personal or psychosocial aspects (e.g., activities of daily living, goals, and motivation) or technical aspects (prosthesis-related). Conclusions: Through a Delphi consensus, a list of relevant elements to be included in a prosthetic evaluation was generated. These results will inform the development of a standardized clinical prosthetic assessment form. This form has the potential to improve the quality of clinical evaluations, guide interventions, and enhance the well-being of prosthetic users. Full article