Search Results (5,594)

Although organizational resilience is well established, refining the systematic quantitative evaluation of health systems resilience (HSR) remains an ongoing opportunity for advancement. Research either focuses on individual HSR indicators, such as social welfare policy, public expenditure, health insurance, healthcare quality, and technology, or broadly examines socio-economic factors, highlighting the need for a more comprehensive methodological approach. This study employed the Slacks-Based Measure (SBM) within Data Envelopment Analysis (DEA) to analyze efficiency by maximizing outputs. It systematically examined key HSR factors across countries, providing insights for improved policymaking and resource allocation. Taking a five-year (2016–2020) dataset that covered 55 to 56 countries and evaluating 17 indicators across governance, health systems, and economic aspects, the paper presents that all sixteen top-ranked countries with a perfect efficiency score of 1 belonged to the high-income group, with ten in Europe, highlighting regional HSR differences. This paper concludes that adequate economic resources form the foundation of HSR and ensure stability and sustained progress. A properly supported healthcare workforce is essential for significantly enhancing health systems and delivering quality care. Last, effective governance and the equitable allocation of resources are crucial for fostering sustainable development and strengthening HSR. Full article

To solve the present housing crisis, the Support for Access to Housing Program, in the context of PRR, mainly focuses on social housing to be built or on housing of social interest to be regenerated. To approach this problem, a research question was raised: “What is the significance of the existing cooperative housing in solving the current housing crisis?” To analyze this issue, a multiple case study was adopted, comparing a collective dwelling of cooperative promotion at controlled costs in Caselas (1980s–1990s) with Expo Urbe (2000–2007) in Parque das Nações, a symbol of the new sustainable cooperative housing, which targets a population with a higher standard of living and thus is excluded from the PRR plan. These cases revealed the discrepancy created by the Cooperative Code of 1998 and its consequences for the urban regeneration of this heritage. They show that Caselas, built in a residential urban neighborhood, is strongly attached to a community, provides good social inclusion for vulnerable groups at more affordable prices, and it is eligible for urban regeneration and reuse (for renting or buying). However, the reuse of Caselcoop’s edifices cannot compromise their cultural and residential values or threaten the individual integrity. Full article

Wellington, New Zealand, is highly vulnerable to disaster-induced food security crises due to its geography and geological characteristics, which can disrupt transportation and isolate the city following disasters. Urban agriculture (UA) has been proposed as a potential alternative food source for post-disaster scenarios. This study examined the potential of urban agriculture for enhancing post-disaster food security by calculating vegetable self-sufficiency rates. Specifically, it evaluated the capacity of current Wellington’s community gardens to meet post-disaster vegetable demand in terms of both weight and nutrient content. Data collection employed mixed methods with questionnaires, on-site observations and mapping, and collecting high-resolution aerial imagery. Garden yields were estimated using self-reported data supported by literature benchmarks, while cultivated areas were quantified through on-site mapping and aerial imagery analysis. Six post-disaster food demand scenarios were used based on different target populations to develop an understanding of the range of potential produce yields. Weight-based results show that community gardens currently supply only 0.42% of the vegetable demand for residents living within a five-minute walk. This rate increased to 2.07% when specifically targeting only vulnerable populations, and up to 10.41% when focusing on gardeners’ own households. However, at the city-wide level, the current capacity of community gardens to provide enough produce to feed people remained limited. Nutrient-based self-sufficiency was lower than weight-based results; however, nutrient intake is particularly critical for vulnerable populations after disasters, underscoring the greater challenge of ensuring adequate nutrition through current urban food production. Beyond self-sufficiency, this study also addressed the role of UA in promoting food diversity and acceptability, as well as its social and psychological benefits based on the questionnaires and on-site observations. The findings indicate that community gardens contribute meaningfully to post-disaster food security for gardeners and nearby residents, particularly for vulnerable groups with elevated nutritional needs. Despite the current limited capacity of community gardens to provide enough produce to feed residents, findings suggest that Wellington could enhance post-disaster food self-reliance by diversifying UA types and optimizing land-use to increase food production during and after a disaster. Realizing this potential will require strategic interventions, including supportive policies, a conducive social environment, and diversification—such as the including private yards—all aimed at improving food access, availability, and nutritional quality during crises. The primary limitation of this study is the lack of comprehensive data on urban agriculture in Wellington and the wider New Zealand context. Addressing this data gap should be a key focus for future research to enable more robust assessments and evidence-based planning. Full article

Background/Objectives: The social importance of health literacy (HL) is widely understood, and its measurement is the subject of various studies. Due to the recent pandemic, several instruments for measuring HL about COVID-19 have been proposed in different countries, including the HLS-COVID-Q22 questionnaire. The diversity of cultures and languages necessitates the cross-cultural adaptation of this instrument. Thus, the present study translates, adapts, and validates the psychometric properties of the HLS-COVID-Q22 questionnaire to provide its cross-cultural adaptation from English to Spanish (Peru). Methods: As part of ensuring that the final questionnaire accommodates the cultural nuances and idiosyncrasies of the target language, the following activities were carried out: (a) a survey of 40 respondents; and (b) a focus group with 10 participants, followed by expert approval. In addition, the validity and reliability of the health instrument have been ascertained through a further pilot test administered to 490 people in the city of Tacna in southern Peru. Results: The resulting questionnaire helps measure HL in Peru, aiding better-informed decision-making for individual health choices. Conclusions: The presence of such a tool is advantageous in case of similar global health emergencies, when the questionnaire can be made readily available to support a promotion of strategies towards better self-care. Moreover, it encourages other Latin American stakeholders to adjust the instrument to their own cultural, language, and socio-economic contexts, thus invigorating the regional and global expansion of the HL study network. Full article

This study presents the scientific and methodological foundation of Spain’s first national framework for the ethical management of community cat populations: the Action Plan for the Management of Community Cat Colonies (PACF), launched in 2025 under the mandate of Law 7/2023. This pioneering legislation introduces a standardized, nationwide obligation for trap–neuter–return (TNR)-based management of free-roaming cats, defined as animals living freely, territorially attached, and with limited socialization toward humans. The PACF aims to support municipalities in implementing this mandate through evidence-based strategies that integrate animal welfare, biodiversity protection, and public health objectives. Using standardized data submitted by 1128 municipalities (13.9% of Spain’s total), we estimated a baseline population of 1.81 million community cats distributed across 125,000 colonies. These data were stratified by municipal population size and applied to national census figures to generate a model-ready demographic structure. We then implemented a stochastic simulation using Vortex software to project long-term population dynamics over a 25-year horizon. The model integrated eight demographic–environmental scenarios defined by a combination of urban–rural classification and ecological reproductive potential based on photoperiod and winter temperature. Parameters included reproductive output, mortality, sterilization coverage, abandonment and adoption rates, stochastic catastrophic events, and territorial carrying capacity. Under current sterilization rates (~20%), our projections indicate that Spain’s community cat population could surpass 5 million individuals by 2050, saturating ecological and social thresholds within a decade. In contrast, a differentiated sterilization strategy aligned with territorial reproductive intensity (50% in most areas, 60–70% in high-pressure zones) achieves population stabilization by 2030 at approximately 1.5 million cats, followed by a gradual long-term decline. This scenario prioritizes feasibility while substantially reducing reproductive output, particularly in rural and high-intensity contexts. The PACF combines stratified demographic modeling with spatial sensitivity, offering a flexible framework adaptable to local conditions. It incorporates One Health principles and introduces tools for adaptive management, including digital monitoring platforms and standardized welfare protocols. While ecological impacts were not directly assessed, the proposed demographic stabilization is designed to mitigate population-driven risks to biodiversity and public health without relying on lethal control. By integrating legal mandates, stratified modeling, and realistic intervention goals, this study outlines a replicable and scalable framework for coordinated action across administrative levels. It exemplifies how national policy can be operationalized through data-driven, territorially sensitive planning tools. The findings support the strategic deployment of TNR-based programs across diverse municipal contexts, providing a model for other countries seeking to align animal welfare policy with ecological planning under a multi-level governance perspective. Full article

Efficient planning of train crew rosters is a key factor in ensuring operational reliability and promoting long-term sustainability in railway transport, both economically and socially. This article presents a systematic approach to developing a crew rostering model in passenger rail transport, with a focus on the operational setting of the train crew depot in Česká Třebová, a city in the Czech Republic. The seven-step methodology includes identifying available train shifts, defining scheduling constraints, creating roster variants, and calculating personnel and time requirements for each option. The proposed roster reduced staffing needs by two employees, increased the average shift duration to 9 h and 42 min, and decreased non-productive time by 384 h annually. These improvements enhance sustainability by optimizing human resource use, lowering unnecessary energy consumption, and improving employees’ work–life balance. The model also provides a quantitative assessment of operational feasibility and economic efficiency. Compared to existing rosters, the proposed model offers clear advantages and remains applicable even in settings with limited technological support. The findings show that a well-designed rostering system can contribute not only to cost savings and personnel stabilization, but also to broader objectives in sustainable public transport, supporting resilient and resource-efficient rail operations. Full article

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

Based on a comprehensive review of the current research status of ecological compensation both domestically and internationally, combined with field survey data, this study delves into the issue of multi-stakeholder participation in the ecological compensation mechanisms of the Xin’an River Basin. This research reveals that the joint participation of multiple stakeholders is crucial to achieving the goals of ecological compensation in river basins. The government plays a significant role in macro-guidance, financial support, policy guarantees, supervision, and management. It promotes the comprehensive implementation of ecological environmental protection by formulating relevant laws and regulations, guiding the public to participate in ecological conservation, and supervising and punishing pollution behaviors. The public, serving as the main force, forms strong awareness and behavioral habits of ecological protection through active participation in environmental protection, monitoring, and feedback. As participants, enterprises contribute to industrial transformation and green development by improving resource utilization efficiency, reducing pollution emissions, promoting green industries, and participating in ecological restoration projects. Scientific research institutions, as technology enablers, have effectively enhanced governance efficiency through technological research and innovation, ecosystem value accounting to provide decision-making support, and public education. Social organizations, as facilitators, have injected vitality and innovation into watershed governance by extensively mobilizing social forces and building multi-party collaboration platforms. Communities, as supporters, have transformed ecological value into economic benefits by developing characteristic industries such as eco-agriculture and eco-tourism. Based on the above findings, further recommendations are proposed to mobilize the enthusiasm of upstream communities and encourage their participation in ecological compensation, promote the market-oriented operation of ecological compensation mechanisms, strengthen cross-regional cooperation to establish joint mechanisms, enhance supervision and evaluation, and establish a sound benefit-sharing mechanism. These recommendations provide theoretical support and practical references for ecological compensation worldwide. Full article

Art therapy serves as a crucial intervention modality for children with autism spectrum disorder (ASD), demonstrating unique value in emotional expression, sensory integration, and social communication. However, current practice presents critical challenges, including the disconnect between design expertise and clinical needs, unclear mechanisms of environmental factors’ impact on therapeutic outcomes, and insufficient evidence-based support for technology integration. Purpose: This study aimed to construct an evidence-based theoretical framework for art therapy environment design for children with autism, clarifying the relationship between environmental design elements and therapeutic effectiveness. Methodology: Based on the Web of Science database, this study employed a dual-track approach comprising bibliometric analysis and micro-qualitative content analysis to systematically examine the knowledge structure and developmental trends. Research hotspots were identified through keyword co-occurrence network analysis using CiteSpace, while 24 representative design cases were analyzed to gain insights into design concepts, emerging technologies, and implementation principles. Key Findings: Through keyword network visualization analysis, this study identified ten primary research clusters that were systematically categorized into four core design elements: sensory feedback design, behavioral guidance design, emotional resonance design, and therapeutic support design. A responsive therapeutic environment conceptual framework was proposed, encompassing four interconnected components based on the ABC model from positive psychology: emotional, sensory, environmental, and behavioral dimensions. Evidence-based design principles were established emphasizing child-centeredness, the promotion of multisensory expression, the achievement of dynamic feedback, and appropriate technology integration. Research Contribution: This research establishes theoretical connections between environmental design elements and art therapy effectiveness, providing a systematic design guidance framework for interdisciplinary teams, including environmental designers, clinical practitioners, technology developers, and healthcare administrators. The framework positions technology as a therapeutic mediator rather than a driver, ensuring technological integration supports rather than interferes with children’s natural creative impulses. This contributes to creating more effective environmental spaces for art therapy activities for children with autism while aligning with SDG3 goals for promoting mental health and reducing inequalities in therapeutic access. Full article

This study investigates the concept of landscape services (LS), which integrate environmental and sociocultural dimensions of sustainable development. Recognizing landscapes as essential to daily life and well-being, the research aims to support sustainable spatial planning by analyzing both their potential and their actual use. The study has three main objectives: (1) to assess the potential of 16 selected landscape types to provide six key LS through expert evaluation; (2) to determine actual LS usage patterns among the local community (residents); and (3) to identify agreements and discrepancies between expert assessments and resident use. The services analyzed include providing space for daily activities; regulating spatial structure through diversity and compositional richness; enhancing physical and mental health; enabling passive and active recreation; supporting personal fulfillment; and fostering social interaction. Expert-based surveys and participatory mapping with residents were used to assess the provision and use of LS. The results indicate consistent evaluations for forest and historical urban landscapes (high potential and use) and mining and transportation landscapes (low potential and use). However, significant differences emerged for mountain LS, rated highly by experts but used minimally by residents. These insights highlight the importance of aligning expert planning with community needs to promote sustainable land use policies and reduce spatial conflicts. Full article

Improving occupational health and safety (OHS) in the construction industry can contribute to the advancement of the Sustainable Development Goals (SDGs), particularly Goals 3 (Good Health and Well-being) and 8 (Decent Work and Economic Growth). Yet, workers’ risk-taking behaviors (RTBs) remain a persistent challenge. Drawing on Social Cognitive Theory and Social Information Processing Theory, this study develops and tests a social influence model to examine how foremen’s safety attitudes (SAs) shape workers’ RTBs. Drawing on survey data from 301 construction workers in China, structural equation modeling reveals that foremen’s SAs significantly and negatively predict workers’ RTBs. However, the three dimensions of SAs—cognitive, affective, and behavioral—exert their influence through different pathways. Risk perception (RP) plays a key mediating role, particularly for the cognitive and behavioral dimensions. Furthermore, interpersonal trust (IPT) functions as a significant moderator in some of these relationships. By identifying the micro-social pathways that link foremen’s attitudes to workers’ safety behaviors, this study offers a testable theoretical framework for implementing the Sustainable Development Goals (particularly Goals 3 and 8) at the frontline workplace level. The findings provide empirical support for organizations to move beyond rule-based management and instead build more resilient OHS governance systems by systematically cultivating the multidimensional attitudes of frontline leaders. Full article

Background: Schizophrenia affects patients’ organizational thinking, as well as their ability to identify problems. The main objective of this study was to explore healthcare consultants’ application of AI mind maps to educate patients with schizophrenia regarding their perceptions of family function, social support, quality of life, and loneliness, and to help these patients think more organizationally and understand problems more effectively. Methods: The study used a survey research design and purposive sampling method to recruit 66 participants with schizophrenia who attended the psychiatric outpatient clinic of a hospital in central Taiwan. They needed to be literate, able to respond to the topic, and over 18 years old (inclusive), and they attended individual and group health education using AI mind maps over a 3-month period during regular outpatient clinic visits. Results: The study results show that patients’ family function directly affects their quality of life (p < 0.05) and loneliness (p < 0.05), satisfaction with social support affects quality of life and loneliness directly (p < 0.05), and satisfaction with social support is a mediating factor between family function and quality of life (p < 0.05), as well as a mediating factor between family function and loneliness (p < 0.05). Conclusions: Therefore, this study confirms the need to provide holistic, integrated mental health social care support for patients with schizophrenia, showing that healthcare consultants can apply AI mind maps to empower patients with schizophrenia to think more effectively about how to mobilize their social supports. Full article

With the increasing application of digital interactive installations in museums, their role in enhancing audience engagement and cultural dissemination effectiveness has become prominent. However, ensuring the sustained use of these technologies remains challenging. Based on distributed cognition and perceived value theories, this study investigates key factors influencing users’ continuous usage of digital interactive installations using the Capital Museum in Beijing as a case study. A theoretical model was constructed and empirically validated through Bayesian Structural Equation Modeling (Bayesian-SEM) with 352 valid samples. The findings reveal that perceived ease of use plays a critical direct predictive role in continuous usage intention. Environmental factors and peer interaction indirectly influence user behavior through learner engagement, while user satisfaction serves as a core mediator between perceived ease of use and continuous usage intention. Notably, perceived usefulness and entertainment showed no direct effects, indicating that convenience and social experience outweigh functional benefits in this context. These findings emphasize the importance of optimizing interface design, fostering collaborative environments, and enhancing user satisfaction to promote sustained participation. This study provides practical insights for aligning digital innovation with audience needs in museums, thereby supporting the sustainable integration of technology in cultural heritage education and preservation. Full article

The swift advancements in autonomous vehicle systems have facilitated their implementation across various industries, including agriculture. However, studies primarily focus on passenger vehicles, with fewer examining autonomous trucks. Therefore, this study reviews autonomous truck systems implementation in North Dakota’s agricultural industry to develop comprehensive technology readiness frameworks and strategic deployment approaches. The review integrates systematic literature review and event history analysis of 52 studies, categorized using Social–Ecological–Technological Systems framework across six dimensions: technological, economic, social change, legal, environmental, and implementation challenges. The Technology Readiness Level (TRL) analysis reveals 39.5% of technologies achieving commercial readiness (TRL 8–9), including GPS/RTK positioning and V2V communication demonstrated through Minn-Dak Farmers Cooperative deployments, while gaps exist in TRL 4–6 technologies, particularly cold-weather operations. Nonetheless, challenges remain, including legislative fragmentation, inadequate rural infrastructure, and barriers to public acceptance. The study provides evidence-based recommendations that support a strategic three-phase deployment approach for the adoption of autonomous trucks in agriculture. 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