Search Results (2,148)

In October 2021 the Swedish government committee of inquiry, the Adoption Commission, was appointed, which presented its final report in June 2025. The Adoption Commission investigated irregular and unethical adoptions to Sweden from the 1950s until today, and it was a part of an ongoing global process of coming to terms with past concerning transnational adoptions. This qualitative media text study examines how the Adoption Commission was perceived by the Swedish adoption world’s three stakeholders, the adoptive parents, the adoption organizations, and the adoptees, between 2021 and 2024 and in relation to transitional justice theories, with a focus on the issues of retributive and restorative justice. Full article

In the context of the GCC, the adoption of integrated reporting (IR) remains limited, due in part to weak regulatory enforcement, a lack of awareness of the strategic benefits of IR, and a strong focus on short-term financial results. This limited reporting context presents a significant challenge for firms to credibly demonstrate their value to the market and attract potential investors, thus communicating long-term value. Given these limitations, this study considers how IR contributes to firm value, but also examines the mediating role that firm image (FI) plays in this relationship as a reputational construct representing stakeholder perspectives of a firm’s transparency and accountability. The research employs a quantitative methodology, analysing secondary data from corporate governance and integrated reports spanning 2017–2018 to 2022–2023. Findings indicate a positive and robust relationship between integrated reporting and the firm’s value, which was assessed using Tobin’s Q. The findings highlight the significant mediating role of firm image, illustrating how IR practices, via increased transparency, accountability, and sustainability, enhance firm value. This study provides significant insights for researchers, policymakers, and corporate managers, highlighting the strategic relevance of IR in the GCC region. The findings demonstrate that integrated reporting improves transparency, accountability, and sustainability, thereby assisting corporate managers in utilising IR to enhance firm image and facilitate value creation. Policymakers can utilise these insights to develop regulatory frameworks that promote integrated reporting practices, thereby enhancing transparency and sustainable growth within the corporate sector. Full article

Background/Objectives: Military Service Members (SMs) require optimal nutrition to support health, readiness, and job performance. However, they often fall short of meeting nutrition guidelines. This study aimed to determine the impact and feasibility of implementing the U.S. Marine Corps (USMC) “Fueled to Fight^®” (F2F) nutrition program in non-appropriated fund (NAF) food venues. Objectives included evaluating changes in Military Nutrition Environment Assessment Tool (mNEAT) scores, feasibility of implementing and maintaining F2F strategies, and influence on customer purchasing patterns. Methods: Researchers conducted a pre-post interventional study from January to December 2024 at three NAF food venues across two USMC bases. F2F strategies, including identifying items using a stoplight color coding system (Green = healthy, Yellow = less healthy, Red = least healthy), menu revisions, food placement, promotion, and marketing, were implemented. Data included mNEAT assessments, sales reports, and stakeholder focus groups. Generalized Estimating Equations models were used to analyze sales data. Results: mNEAT scores increased across all venues post-intervention. Availability and sales of Green items increased, while sales of Red items decreased in some venues. Profit increased at all three food venues. Focus groups revealed feasibility and provided insights for future interventions. Conclusions: F2F interventions in NAF food venues are feasible and can positively impact the food environment and customer purchasing patterns without negatively affecting profit. This study highlights the importance of integrating nutrition programs into all military food venues, not just government-funded dining facilities, to support the nutritional fitness and readiness of SMs. 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 research aims to identify and prioritize key planning elements for the redevelopment of such housing complexes by incorporating perspectives from both experts (supply-side) and residents (demand-side). To achieve this, a hybrid multi-criteria decision-making framework was developed by integrating the Analytic Hierarchy Process (AHP) and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). A total of 25 planning elements were identified through Focus Group Interviews and organized into five domains: legal and institutional reforms, project feasibility, residential conditions, social integration, and complex design. The AHP was used to assess the relative importance of each element based on responses from 30 experts and 130 residents. The analysis revealed a clear divergence in priorities: experts emphasized feasibility and regulatory considerations, while residents prioritized livability and spatial quality. Subsequently, the TOPSIS method was applied to evaluate four real-world redevelopment cases. From the supply-side perspective, Seoul A District received the highest score (0.58), whereas from the demand-side perspective, Gyeonggi D District ranked highest (0.69), illustrating the differing priorities of stakeholders. Overall, Gyeonggi D District emerged as the most favorable option in the combined evaluation. This research contributes a structured and inclusive decision-making framework for the regeneration of public housing. By explicitly comparing and quantifying the contrasting preferences of key stakeholders, it underscores the critical need to balance technical feasibility with resident-centered values in future redevelopment initiatives. Full article

The modified Rankin Scale (mRS) is a widely used outcome measure for assessing disability in stroke care; however, its administration is often affected by subjectivity and variability, leading to poor inter-rater reliability and inconsistent scoring. Originally designed for hospital discharge evaluations, the mRS has evolved into an outcome tool for disability assessment and clinical decision-making. Inconsistencies persist due to a lack of standardization and cognitive biases during its use. This paper presents design principles for creating a standardized clinical assessment tool (CAT) for the mRS, grounded in human–computer interaction (HCI) and cognitive engineering principles. Design principles were informed in part by an anonymous online survey conducted with clinicians across Canada to gain insights into current administration practices, opinions, and challenges of the mRS. The proposed design principles aim to reduce cognitive load, improve inter-rater reliability, and streamline the administration process of the mRS. By focusing on usability and standardization, the design principles seek to enhance scoring consistency and improve the overall reliability of clinical outcomes in stroke care and research. Developing a standardized CAT for the mRS represents a significant step toward improving the accuracy and consistency of stroke disability assessments. Future work will focus on real-world validation with healthcare stakeholders and exploring self-completed mRS assessments to further refine the tool. Full article

Having in view the current global disruptive social and economic landscape, sustainability becomes more important than ever. As producers become more concerned about adopting more sustainable practices, customer awareness towards sustainable behavior must be the focus of all stakeholders. Within this context, the SHIFT framework (proposed in 2019) highlights the manner in which consumers’ traits and attitudes influence their propensity towards sustainable consumption. It consists of five factors considered to be relevant to consumer behavior: Social influence, Habit formation, Individual self, Feelings and cognition, and Tangibility. Different from previous studies, this research focuses on applying the SHIFT framework to the automotive industry, taking into consideration the contribution of digital technologies to fostering sustainable consumer behavior throughout the entire product lifecycle. Using a qualitative research approach, the most relevant digital technologies in the automotive industry were identified and mapped in relation to the three phases of consumption (choice, usage, and disposal). The research aimed to develop and test an original conceptual framework, starting from the SHIFT. The results of the study highlight the fact that the digital technologies, in their diversity, are integrated in different ways into each of the three phases, facilitating the adoption of sustainable consumption. To achieve sustainability, the two key stakeholders, consumers and producers, should share a common ground on capitalizing the opportunities offered by digital technologies. Full article

Demand Side Management (DSM) plays a crucial role in modern energy systems, enabling more efficient use of energy resources and contributing to the sustainability of the power grid. This study examines DSM strategies within a multi-environment context encompassing residential, commercial, and industrial sectors, with a focus on diverse appliance types that exhibit distinct operational characteristics and user preferences. Initially, a single-objective optimization approach using Genetic Algorithms (GAs) is employed to minimize the total energy cost under a real Time-of-Use (ToU) pricing scheme. This heuristic method allows for the effective scheduling of appliance operations while factoring in their unique characteristics such as power consumption, usage duration, and user-defined operational flexibility. This study extends the optimization problem to a multi-objective framework that incorporates the minimization of CO₂ emissions under a real annual energy mix while also accounting for user discomfort. The Non-dominated Sorting Genetic Algorithm II (NSGA-II) is utilized for this purpose, providing a Pareto-optimal set of solutions that balances these competing objectives. The inclusion of multiple objectives ensures a comprehensive assessment of DSM strategies, aiming to reduce environmental impact and enhance user satisfaction. Additionally, this study monitors the Peak-to-Average Ratio (PAR) to evaluate the impact of DSM strategies on load balancing and grid stability. It also analyzes the impact of considering different periods of the year with the associated ToU hourly schedule and CO₂ emissions hourly profile. A key innovation of this research is the integration of detailed, category-specific metrics that enable the disaggregation of costs, emissions, and user discomfort across residential, commercial, and industrial appliances. This granularity enables stakeholders to implement tailored strategies that align with specific operational goals and regulatory compliance. Also, the emphasis on a user discomfort indicator allows us to explore the flexibility available in such DSM mechanisms. The results demonstrate the effectiveness of the proposed multi-objective optimization approach in achieving significant cost savings that may reach 20% for industrial applications, while the order of magnitude of the trade-offs involved in terms of emissions reduction, improvement in discomfort, and PAR reduction is quantified for different frameworks. The outcomes not only underscore the efficacy of applying advanced optimization frameworks to real-world problems but also point to pathways for future research in smart energy management. This comprehensive analysis highlights the potential of advanced DSM techniques to enhance the sustainability and resilience of energy systems while also offering valuable policy implications. Full article

Background and Objectives: Depression is a leading cause of disability globally, with treatment challenges including limited access, stigma, and poor adherence. Gamification, which applies game elements such as points, levels, and storytelling into non-game contexts, offers a promising strategy to enhance engagement and augment traditional treatments. Our research is the first study designed to explore the implementation of gamification within the Malaysian context. The objective was to explore the feasibility of implementation of gamification as an adjunctive treatment for adults with depression. Materials and Methods: Focus group discussions were held with five mental health professionals and ten patients diagnosed with moderate depression. The qualitative component assessed perceptions of gamified interventions, while quantitative measures evaluated participants’ depressive and anxiety symptomatology. Results: Three key themes were identified: (1) understanding of gamification as a treatment option, (2) factors influencing its acceptance, and (3) characteristics of a practical and feasible intervention. Clinicians saw potential in gamification to boost motivation, support psychoeducation, and encourage self-paced learning, but they expressed concerns about possible addiction, stigma, and the complexity of gameplay for some patients. Patients spoke of gaming as a source of comfort, escapism, and social connection. Acceptance was shaped by engaging storylines, intuitive design, balanced difficulty, therapist guidance, and clear safety measures. Both groups agreed that gamification should be used in conjunction with standard treatments, be culturally sensitive, and be presented as a meaningful therapeutic approach rather than merely as entertainment. Conclusions: Gamification emerges as an acceptable and feasible supplementary approach for managing depression in Malaysia. Its success depends on culturally sensitive design, robust clinical oversight, and seamless integration with existing care pathways. Future studies should investigate long-term outcomes and establish guidelines for the safe and effective implementation of this approach. We recommend targeted investment into culturally adapted gamified tools, including training, policy development, and collaboration with key stakeholders to realistically implement gamification as a mental health intervention in Malaysia. Full article

Tunisia faces significant challenges related to climate change, which deeply affect its natural and agricultural resources. This reality threatens not only food security but also the economic stability of rural communities and mainly rural women. This research aims to assess the impact of climate change on rural women in the agricultural development group in Sidi Bouzid, focusing on the strategies adopted and the support provided by various stakeholders to mitigate this impact. To achieve this, we developed a rigorous methodology that includes structured questionnaires, focus group discussions, and topological analysis through Multiple Correspondence Analysis (MCA). The results revealed that rural women were categorized into three groups based on their vulnerability to climate change: severely vulnerable, vulnerable, and adaptive. The findings highlighted the significant impact of climate change on water resources, which has increased family tensions and reduced agricultural incomes, making daily life more challenging for rural women. Furthermore, a deeper analysis of interactions with external stakeholders emphasized the important role of civil society, public organizations, and research institutions in strengthening the climate resilience of rural women. Given these findings, strategic recommendations aim to enhance stakeholder coordination, expand partnerships, and improve access to essential technologies and resources for women in agricultural development groups. Full article

Urban transport is a key driver of greenhouse gas emissions in Europe, making its decarbonization essential to achieving EU climate neutrality targets. This study examines how European strategies, such as the Green Deal, the Sustainable and Smart Mobility Strategy, and the Fit for 55 package, are reflected in Romania’s transport policies, with a focus on implementation challenges and urban outcomes in Bucharest. By combining policy analysis, stakeholder mapping, and comparative mobility indicators, the paper critically assesses Bucharest’s current reliance on private vehicles, underperforming public transport satisfaction, and limited progress on active mobility. The study develops a context-sensitive reform framework for the Romanian capital, grounded in transferable lessons from Western and Central European cities. It emphasizes coordinated metropolitan governance, public trust-building, phased car-restraint measures, and investment alignment as key levers. Rather than merely cataloguing policy intentions, the paper offers practical recommendations informed by systemic governance barriers and public attitudes. The findings will contribute to academic debates on urban mobility transitions in post-socialist cities and provide actionable insights for policymakers seeking to operationalize EU decarbonization goals at the metropolitan scale. Full article

The right to development, an inherent human right for all, emphasizes that all individuals and communities have the right to participate in, contribute to, and benefit from development that ensures the full realization of human rights. In Kenya, where a significant portion of the population faces poverty and vulnerability to climate change, access to rights-based needs such as clean water, healthcare, and education still remains a critical challenge. This study explored the implementation of a Human Rights-Based approach to community development through a Public–Private Development Partnership model (PPDP), with a focus on alleviating poverty and improving access to rights-based services at the community level in Narok and Nakuru counties. The research aimed to identify critical success factors for scaling the PPDP model and explore its effects on socio-economic empowerment. The study employed a mixed-methods approach for data collection, using questionnaires to obtain quantitative data, focus group discussions, and key informant interviews with community members, local leaders, and stakeholders to gather qualitative data. We cleaned and analyzed all our data in R (version 4.4.3) and used the chi-square to establish the significance of differences between areas where the PPDP model was implemented and control areas where it was not. Results reveal that communities with the PPDP model experienced statistically significant improvements in employment, income levels, and access to rights-based services compared to control areas. The outcomes underscore the potential of the PPDP model to address inclusive and sustainable development. This study therefore proposes a scalable pathway beginning with access to rights-based needs, followed by improved service delivery, and culminating in economic empowerment. These findings offer valuable insights for governments, development practitioners, investment agencies, and researchers seeking community-driven developments in similar socio-economic contexts across Africa. For the first time, it can be adopted in the design and implementation of development projects in rural and local communities across Africa bringing into focus the need to integrate rights-based needs at the core of the project. 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

Securing thermal comfort while minimizing energy consumption in educational buildings is vital for achieving sustainable development goals. Drawing on the Environmental, Social, and Governance (ESG) framework, this systematic review synthesizes findings from 84 peer-reviewed studies published over the past decade, with a focus on how thermal comfort and energy use are assessed in educational contexts. The review identifies three primary research themes: climate resilience, multidimensional human-centric design, and energy decarbonization. However, it also reveals that existing studies have placed disproportionate emphasis on the environmental dimension, with insufficient exploration of issues related to social equity and governance structures. To address this gap, this study introduces an ESG-driven theoretical framework encompassing seven dimensions: thermal environment stability, multimodal thermal comfort assessment integration, sustainable energy use, heterogeneous thermal demand equality, passive–active design synergy, participatory thermal data governance, and educational thermal well-being inclusivity. By fostering interdisciplinary convergence and emphasizing inclusive stakeholder engagement, the proposed framework provides a resilient and adaptive foundation for enhancing indoor environmental quality in educational buildings while advancing equitable climate and energy strategies. Full article