Search Results (9,744)

Sustainable urban development depends not only on efficient design and construction but also on the long-term governance of built assets during their operational phase. However, Building Information Modeling (BIM) is still predominantly applied to design and delivery processes, with limited integration into structured maintenance and renewal planning. This study develops a BIM-enabled lifecycle governance methodology that integrates lifecycle cost modeling, service-life estimation, and time-based renewal scheduling into a unified digital asset environment. Rather than proposing a new theoretical model, the study focuses on the systematic integration and operationalization of these components into a reproducible and auditable workflow. The methodology is validated through an anonymized multi-asset industrial portfolio comprising buildings, technical infrastructure, and external works, modeled over a 30-year planning horizon using structured maintenance and renewal data. Comparative scenario analysis between reactive and planned lifecycle strategies evaluates expenditure distribution, capital concentration, and intervention synchronization. The results demonstrate that embedding structured lifecycle parameters within BIM improves the predictability of annual expenditures, reduces cost concentration in peak renewal years, and enhances transparency of long-term asset planning without significantly altering cumulative lifecycle costs. These outcomes support more structured financial planning and coordination of maintenance and renewal activities at the portfolio level. The study does not quantify environmental or social sustainability impacts; its contribution lies in providing a governance-oriented methodology that transforms BIM-based asset data into decision-support outputs for long-term lifecycle planning. Full article

Background/Objectives: This study aimed to investigate how the disparities in unmet medical needs between immigrants to South Korea and native-born populations evolved during the COVID-19 pandemic. Methods: Using nationally representative cross-sectional data from the 2018 and 2020 Surveys on Immigrants’ Living Conditions and Labor Force in South Korea, we compared unmet medical needs among immigrants at two time points (N = 12,227 in 2018; N = 18,530 in 2020). Standardized prevalence ratios (SPRs) were calculated. Analyses were stratified according to work status, gender, Korean language proficiency, education level, and duration of stay. Results: Working immigrants had lower SPRs for unmet medical needs than Korean nationals (2018: 0.879; 2020: 0.745) but non-workers had consistently higher SPRs (2018: 1.117; 2020: 1.128). The SPRs for male and female non-workers increased and decreased, respectively. The SPRs were persistently higher among individuals with poorer Korean language proficiency, lower education, and shorter duration of stay. Conclusions: Systemic disruptions, such as the COVID-19 pandemic, may exacerbate pre-existing healthcare inequalities among immigrant populations. The persistence and widening of these disparities call for targeted policies that address structural barriers and ensure equitable healthcare access during future public health crises. Full article

Cognition in older adults may be influenced by environmental factors; however, the pathways linking environmental exposures and cognition remain unclear. The aim of this narrative review is to synthesize evidence on the association between the environment and cognition in older adults, integrating biological, environmental, and behavioral elements. Systematic reviews and original studies addressing this topic were identified in Web of Science, PubMed, and Scopus. The primary neural processes associated with maintaining cognition during aging are neuronal plasticity and compensatory scaffolding. Participation in intellectually stimulating activities, physical exercise, and a healthy diet; mitigation of chronic stress; reduction in the severity of depressive symptoms; and buffering against the adverse effects of air pollution are proposed as plausible pathways that may mediate the relationship between neural processes and the environment. In this context, environmental factors that affect cognition can be classified at three levels: (i) micro-level (family and home): social interaction with family members and indoor pollution; (ii) meso-level (community and services): social interaction, land-use diversity, transportation systems, environmental design, and urban green spaces; and (iii) macro-level (society in general and public policies): social representations of old age and aging (positive aging vs. ageism) and public policies aimed at improving pathways related to cognitive maintenance. Overall, the environment may influence cognition in older adults; however, the available studies show methodological and conceptual heterogeneity, inconsistent findings, and important gaps in knowledge. Full article

Objective: This study examines whether access to basic services is associated with health-related social participation among people with disabilities, with a particular focus on participation in cultural and sports activities. Methods: Using data from the 2022 census of people with disabilities in X Province, China, we estimated Probit models to assess the association between access to three types of basic services—rehabilitation, social welfare, and social assistance—and participation in cultural and sports activities. Results: Greater access to basic services was associated with a significantly higher likelihood of participation in cultural and sports activities. Among the three service categories, rehabilitation services showed the strongest positive association. The positive association was stronger among individuals with lower disability severity. Conclusions: Access to disability-related basic services, especially rehabilitation services, may promote health-related social participation and social integration among people with disabilities. These findings highlight the importance of service access and rehabilitation support for disability healthcare, community inclusion, and quality of life. Full article

The Street Clinic (Consultório na Rua—CnR) is a strategic component of Primary Health Care in Brazil, aimed at populations experiencing homelessness, a group characterized by high levels of social and health vulnerability. This study critically analyzes the experiences of healthcare professionals working within a CnR team, identifying the meanings attributed to their work, the challenges encountered, and the strategies developed within the territory. This is an exploratory study with a qualitative approach, grounded in health narratives and the philosophical hermeneutics of Hans-Georg Gadamer. Four professionals participated, representing the totality of eligible members of a team in a medium-sized municipality in Southern Brazil, with between one and eleven years of experience in the service. Hermeneutic analysis revealed that the CnR functions as an entry point to Primary Health Care and Psychosocial Care, with the bond between team and users serving as the primary mechanism for overcoming barriers to access. Professionals report ethical suffering arising from the tension between their commitment to comprehensive care and the structural limitations of the service, including shortages of supplies, institutional instability, and precarious employment arrangements. It is concluded that strengthening the CnR requires not only investment in infrastructure and expansion of the teams, but also policies that recognize and support the complexity of street-based work, including care for the caregivers themselves. Full article

England’s population is living longer, a sign of progress and better health, but adult social care (ASC) services must adapt to support a growing number of older residents, who may need help to remain independent, safe, and well. Kent County Council (KCC), in South East England, projects a 28% and 53% increase in its residents aged 65+ and 85+, respectively, over the next decade. This study aimed to inform the development of KCC’s ASC Prevention Framework using a System Dynamics Modelling (SDM) approach to evaluate the impact of preventive interventions on ASC demand and expenditure. Using linked local health and social care data and the Johns Hopkins ACG® tool, the 1.3 million adult population was stratified into Patient Needs Groups. Analyses showed that higher ASC costs were associated with being older females, living alone, deprivation, and frailty-related indicators such as dementia, history of falls, etc. Around 28% of older adults aged 65+ accounted for 80% of ASC costs within that cohort, and related scenario testing projected a 48% rise in ASC costs over 10 years without interventions, moderated to 33% with targeted prevention. These findings demonstrate the value of integrated data and modelling to inform strategic, prevention-focused ASC planning. Full article

We systematically analyze the evolutionary characteristics of China’s public health policies, focusing on the dynamic changes in policy content, stage-specific differences, and inter-subject collaborative relationships. Based on 137 public health policy documents issued by the central government, the analysis is conducted from a dual perspective: first, the BERTopic model is employed to identify prominent policy themes and track their evolutionary paths; second, Social Network Analysis (SNA) is utilized to deconstruct the collaborative mechanisms and network structural characteristics among policy actors, goals, and tools. The findings indicate: (1) Collaboration among core policy actors is close, yet inter-departmental transparency and collaborative inclusivity remain limited for certain organizations. (2) Policy goals show a diversifying trend, with the strategic focus shifting from infectious disease prevention and control to comprehensive public health services. (3) There are significant preferences in the selection of policy tools for balancing rapid emergency response with sustainable long-term health governance. These findings reveal the evolutionary laws of the public health policy system and provide a theoretical basis for optimizing the policy framework and enhancing governance efficacy. Full article

The rapid institutional and technological transformations of the 2020–2025 period have had a significant impact on teacher professional identity. Drawing on Rosa’s social acceleration thesis and Harvey’s concept of time–space compression, this scoping review examined the dimensions of professional identity emerging in the literature published between 2020 and 2025 among in-service pre-kindergarten through 12th grade (PK-12) teachers, the educational contexts in which these dimensions were addressed, and how they interrelate. Following the PRISMA-ScR guidelines, 45 peer-reviewed articles retrieved from the Scopus and Web of Science databases were analyzed through inductive thematic coding and a dimension–context interaction matrix. Six analytically distinct yet interrelated identity dimensions were identified: Biographical and Personal, Professional and Pedagogical, Emotional and Psychological, Social and Relational, Political and Agentic, and Prospective and Imagined. These dimensions were organized within a dialogical space model distinguishing internal/individual and external/structural domains. The Emotional and Psychological dimension achieved near-universal representation, while the Prospective and Imagined dimension remained the least studied. Six convergence, five divergence, and six gap patterns were identified across seven educational contexts. The findings reveal that, in this period, teacher professional identity is not a fixed attribute carried by the individual but rather a dynamic process continuously negotiated under structural pressures. Full article

Most established street-vitality assessment tools were developed in temperate, predominantly Western urban settings and therefore do not adequately capture the climatic and socio-spatial conditions of hot–arid cities. This study develops and validates the Resident-Centered Street Vitality Framework (RCSVF) using Riyadh as a case study representative of the Arabian Desert urban context. Drawing on a cross-sectional quantitative design, the research integrates a resident survey across nineteen neighborhoods (N = 1102), physical observations of 133 street segments, a visual preference survey (N = 418), and GIS-based spatial analysis. The results reveal marked intra-urban inequality in perceived environmental quality and demonstrate that service proximity is a substantially stronger predictor of residential satisfaction than street physical quality alone. Residents consistently rated shading, green space, and pedestrian infrastructure as the weakest dimensions of their neighborhoods. These findings indicate that street vitality in hot–arid settings cannot be validly assessed through imported observer-based metrics. A resident-centered, climate-responsive framework is required to capture how thermal exposure, functional accessibility, and everyday social use interact in shaping street experience. Full article

Housing acquisition decisions play a strategic role in shaping urban habitability and long-term sustainability, as they directly influence the quality of the built environment and users’ well-being. From an architectural and urban perspective, housing selection can be understood as an assessment of urban habitat quality, in which economic, spatial, social, environmental, and risk-related dimensions interact to define the conditions of livability. This study proposes a multi-objective decision-support framework that integrates evolutionary optimization algorithms (NSGA-II and MOEA/D) with multi-criteria decision analysis (TOPSIS) to support sustainable housing decisions. The model simultaneously considers four conflicting objectives: minimizing acquisition cost, minimizing spatial accessibility and disutility from essential services, maximizing socio-spatial safety and long-term habitat value, and minimizing environmental and territorial risk. A real-world case study in the Tampico metropolitan area demonstrates how the proposed approach generates Pareto-optimal housing alternatives that explicitly reveal trade-offs between habitability dimensions. The resulting non-dominated solutions are subsequently ranked using TOPSIS to reflect user-centered preferences and facilitate transparent decision-making. The results show that the proposed framework effectively operationalizes the concept of urban habitat quality through an explainable, customizable computational tool, thereby contributing to sustainable urban development, resilience, and informed housing choices. This research supports the technological enablement of habitat assessment and aligns with the objectives of SDG 11: Sustainable Cities and Communities, offering a replicable methodology for urban and architectural decision-making contexts. Full article

Background: Mega-events like the FIFA World Cup (FWC) present unique and substantial challenges for individuals in recovery from substance use disorders (SUDs), primarily by increasing the risk of relapse. We employed a qualitative design using reflexive thematic analysis to explore the behavior of patients with SUDs during the 2022 FWC and to evaluate institutional strategies for mitigating related risks. Methods: We purposively sampled 32 participants who were present at the Naufar Center during the 2022 FWC: (i) thirteen adult patients with SUDs who were receiving treatment, and (ii) nineteen healthcare practitioners. Semi-structured patient interviews were conducted, and focus group discussions were held with a multidisciplinary team, including psychologists, nurses, and physicians. Individuals’ experiences regarding patterns in substance use behavior, environmental triggers, and the effects of institutional interventions were examined. Thematic analysis was employed to identify patterns, risks, and effective strategies. Results: Most patients maintained abstinence and only had cravings for alcohol. Triggers included public celebrations, emotional excitement, and the increased availability of addictive substances. Psychologists and physicians reported signs of behavioral destabilization; nurses observed some behavioral changes and noted logistical challenges. The participants acknowledged the supportive measures provided by Naufar, including the accessibility of clinical services, individualized therapy, social and recreational programming, and protective fan zones, which enabled them to participate in various activities during the event. Conclusions: The 2022 FWC created considerable psychological and environmental triggers for high exposure to alcohol and other substances. The supportive structured activities and tailored interventions were helpful in mitigating the risk of relapse, maintaining treatment engagement and ensuring recovery. Further research is required to explore the implications for recovery-oriented practices during culturally and socially high-risk events. Full article

Background/Objectives: Patient satisfaction and supportive care are key quality indicators in certified Head and Neck Cancer Centers (HNCC). We assessed patient-reported experiences across diagnostic staging and surgical treatment pathways, focusing on discharge management and supportive service integration. Materials and Methods: In this prospective cross-sectional study, 84 inpatients were surveyed at the time of hospital discharge after diagnostic tumor staging (n = 45) or surgical treatment (n = 39) at a German tertiary HNCC. Phase-specific standardized questionnaires with five-point Likert scales were analyzed using Pearson’s chi-square and Fisher’s exact tests. Associations of sex and treatment intensity with satisfaction and supportive care utilization were explored descriptively and in an exploratory manner. Results: Overall ratings were high across both cohorts for admission processes, inpatient organization and medical and nursing care, with no statistically significant between-group differences (p > 0.05). Information regarding diagnostic and perioperative procedures was rated very positively in both groups. Discharge-related items were generally favorable. However, patients who underwent surgery reported greater uncertainty and lower reported utilization of formal discharge management. This difference did not reach statistical significance (p = 0.0559) and should therefore be interpreted as a non-significant trend toward less positive evaluation compared with diagnostic patients. Supportive services were rated predominantly good to very good by users (>95% positive ratings). Utilization differed by treatment intensity: Speech therapy was more frequent in operative patients (p < 0.001) and social work counseling was offered and utilized more often in patients undergoing extensive surgery (p = 0.042 and p = 0.027, respectively). Overall dissatisfaction was strongly associated with perceived deficiencies in information on diagnostic procedures and tumor-related counseling (both p < 0.001), whereas waiting time for surgery was not associated with negative overall ratings. Conclusions: Patient satisfaction was consistently high across diagnostic and surgical pathways. Adequate, transparent and repeated information, particularly on diagnostics and tumor counseling, was strongly associated with higher overall satisfaction, whereas objective timing metrics were not associated with negative ratings. Discharge management may represent a sensitive transition point, particularly after extensive surgery and may therefore be a relevant target for further optimization and proactive integration of supportive care services. Sex-specific findings were limited and should be interpreted cautiously due to small subgroup sizes. Full article

Population aging has become a significant global phenomenon, particularly in developing countries where urban systems are not fully prepared to support older adults. Although the concept of age-friendly cities has been widely promoted, many municipalities still lack an integrated database that links health, social, economic, and environmental dimensions to support policymaking and built-environment improvement. This study aims to develop and validate a four-dimensional healthy aging database framework for assessing age-friendly built environments and public facilities at the municipal level. A mixed-methods approach was employed, combining quantitative surveys, built-environment assessments, and functional ability evaluation using the Barthel Activities of Daily Living Index. The study was conducted in Rangsit Municipality, Thailand, as a case study. The results demonstrate that the proposed framework can systematically integrate multidimensional aging data and identify priority areas for housing improvement, public facility modification, and community services. The framework also supports evidence-based decision-making and place-based policy implementation for age-friendly urban development. This study contributes a practical database framework and assessment tool that can assist local governments in evidence-based, inclusive, and sustainable urban development and aging societies. Full article

In the field of human–robot interaction (HRI), researchers have extensively examined the role of social robot characteristics and how these can influence human–robot relationships. In particular, the robot’s voice is one of the most studied aspects, with numerous studies focusing on specific features such as tone, frequency, pitch, and gender. The robot’s voice represents a powerful social signal, whose design can influence people’s affective evaluations and acceptance of robots. With regard to language, however, relatively few studies have investigated the role of a robot’s accent (native or foreign). This experimental study therefore explores the influence of native accent on trust in robots. The study was conducted on two different samples: 60 Italian participants and 37 Arabic participants. Participants listened to two robot presentations in their native language: one delivered with a native accent and the other with a foreign accent. After listening to both presentations, participants were asked to indicate which robot they trusted. The results showed a 77.3% preference for the robot speaking with a native accent, compared to 22.7% for the robot with foreign accent. These findings demonstrate that, regardless of the language (Italian or Arabic), accent significantly influences the choice to invest trust in the robot, supporting the similarity-attraction effect. Accent calibration thus emerges as a low-cost, high-impact parameter in socially assistive and commercial robotics. Since accent influences trust-based delegation, voice design should be strategically adapted in service, healthcare, education, and customer-facing contexts. Full article

Digital Twins (DTs) are increasingly explored in tourism and hospitality as enabling technologies for smart destinations, service optimization, and data-driven decision-making. Yet these environments are inherently human-centered. Existing DT implementations, however, are largely technology-driven and focus mostly on infrastructures and operational processes. This study presents a systematic literature review of DT applications in tourism and hospitality. It combines a comparative taxonomy with a technological and data-oriented analysis to examine how these systems are currently conceptualized, implemented, and integrated. The review analyzes 42 studies, classifying them by application level, twin focus, architectural approach, and human integration. The results show a strong dominance of destination- and facility-level DTs, limited human-centered models, and a prevalent use of varied sensing technologies. There is limited attention to interoperability and semantic integration. Governance, socio-technical aspects, and real-time synchronization mechanisms are also mostly underexplored. Based on these findings, this study identifies key research gaps and calls for a shift towards Social Digital Twins (SDTs). SDTs integrate human actors, social interactions, and governance within unified modelling frameworks. This transition will require advances in semantic and ontology-driven architectures. Greater attention to privacy, trust, and user acceptance in data-intensive service environments is also needed. Full article