Search Results (797)

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

Introduction and Objectives: Risk-sharing agreements (RSAs) have emerged as a key strategy for financing high-cost medical technologies while ensuring financial sustainability. These payment mechanisms mitigate clinical and financial uncertainties, optimizing pricing and reimbursement decisions. Despite their widespread adoption globally, Latin America has reported limited implementation, particularly for high-cost medical devices. This study aims to share insights from designing RSAs in the form of Outcome Protection Programs (OPPs) for medical devices in Latin America from the perspective of a medical devices company. Methods: The report follows a structured approach, defining key OPP dimensions: payment base, access criteria, pricing schemes, risk assessment, and performance incentives. Risks were categorized as financial, clinical, and operational. The framework applied principles from prior models, emphasizing negotiation, program design, implementation, and evaluation. A multidisciplinary task force analyzed patient needs, provider motivations, and payer constraints to ensure alignment with health system priorities. Results: Over two semesters, a panel of seven experts from the manufacturer designed n = 105 innovative payment programs implemented in Argentina (n = 7), Brazil (n = 7), Colombia (n = 75), Mexico (n = 9), Panama (n = 4), and Puerto Rico (n = 3). The programs targeted eight high-burden conditions, including Coronary Artery Disease, atrial fibrillation, Heart Failure, and post-implantation arrhythmias, among others. Private providers accounted for 80% of experiences. Challenges include clinical inertia and operational complexities, necessitating structured training and monitoring mechanisms. Conclusions: Outcome Protection Programs offer a viable and practical risk-sharing approach to financing high-cost medical devices in Latin America. Their implementation requires careful stakeholder alignment, clear eligibility criteria and endpoints, and robust monitoring frameworks. These findings contribute to the ongoing dialogue on sustainable healthcare financing, emphasizing the need for tailored approaches in resource-constrained settings. Full article

The integration of artificial intelligence (AI), big data analytics, and blockchain technologies within the digital economy presents transformative opportunities for promoting low-carbon urban development. However, a systematic understanding of how these digital innovations influence urban carbon mitigation remains limited. This study addresses this gap by proposing two research questions (RQs): (1) What are the key success factors for artificial intelligence, big data, and blockchain in urban carbon emission reduction? (2) How do these technologies interact and support the transition to low-carbon cities? To answer these questions, the study employs a hybrid methodological framework combining the decision-making trial and evaluation laboratory (DEMATEL) and interpretive structural modeling (ISM) techniques. The data were collected through structured expert questionnaires, enabling the identification and hierarchical analysis of twelve critical success factors (CSFs). Grounded in sustainability transitions theory and institutional theory, the CSFs are categorized into three dimensions: (1) digital infrastructure and technological applications; (2) digital transformation of industry and economy; (3) sustainable urban governance. The results reveal that e-commerce and sustainable logistics, the adoption of the circular economy, and cross-sector collaboration are the most influential drivers of digital-enabled decarbonization, while foundational elements such as smart energy systems and digital infrastructure act as key enablers. The DEMATEL-ISM approach facilitates a system-level understanding of the causal relationships and strategic priorities among the CSFs, offering actionable insights for urban planners, policymakers, and stakeholders committed to sustainable digital transformation and carbon neutrality. 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

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

Background/Objectives: BRIGHTLIGHT was the national evaluation of adolescent and young adult (AYA) cancer services in England. BRIGHTLIGHT results were not available when the most recent healthcare policy (NHSE service specifications for AYA Cancer) for AYA was drafted and therefore did not consider BRIGHTLIGHT findings and recommendations. We describe the co-development and delivery of a Policy Lab to expedite the implementation of the new service specification in the context of BRIGHTLIGHT results, examining the roles of multi-stakeholders to ensure service delivery is optimised to benefit AYA patients. We address the key question, “What is the roadmap for empowering different stakeholders to shape how the AYA service specifications are implemented?”. Methods: A 1-day face-to-face policy lab was facilitated, utilising a unique, user-centric engagement approach by bringing diverse AYA stakeholders together to co-design strategies to translate BRIGHTLIGHT evidence into policy and impact. This was accompanied by an online workshop and prioritisation survey, individual interviews, and an AYA patient workshop. Workshop outputs were analysed thematically and survey data quantitatively. Results: Eighteen professionals and five AYAs attended the face-to-face Policy Lab, 16 surveys were completed, 13 attended the online workshop, three professionals were interviewed, and three AYAs attended the patient workshop. The Policy Lab generated eight national and six local recommendations, which were prioritised into three national priorities: 1. Launching the service specification supported by compelling communication; 2. Harnessing the ideas of young people; and 3. Evaluation of AYA patient outcomes/experiences and establishing a national dashboard of AYA cancer network performance. An animation was created by AYAs to inform local hospitals what matters to them most in the service specification. Conclusions: Policy and research evidence are not always aligned, so when emerging evidence does not support current guidance, further exploration is required. We have shown through multi-stakeholder involvement including young people that it was possible to gain a different interpretation based on current knowledge and context. This additional insight enabled practical recommendations to be identified to support the implementation of the service specification. Full article

Ensuring sustainable food systems is an urgent global priority as populations grow and environmental pressures mount. Technological innovations such as genetic engineering (GE) and nanotechnology (nano) have been promoted as promising pathways for achieving greater sustainability in agriculture and food production. Yet, the sustainability of these technologies is not defined by technical performance alone; it hinges on how they are perceived by key stakeholders and how well they align with broader societal values. This study addresses the critical question of how expert stakeholders evaluate the sustainability of GE and nano-based food and agriculture (agrifood) products. Using a multi-method online platform, we engaged 42 experts across academia, government, industry, and NGOs in the United States to assess six real-world case studies—three using GE and three using nano—across ten different dimensions of sustainability. We show that nano-based products were consistently rated more favorably than their GE counterparts in terms of environmental, economic, and social sustainability, as well as across ethical and societal dimensions. Like prior studies, our results reveal that stakeholders see meaningful distinctions between nanotechnology and biotechnology, likely due to underlying value-based concerns about animal welfare, perceived naturalness, or corporate control of agrifood systems. The fruit coating and flu vaccine—both nano-enabled—received the most positive ratings, while GE mustard greens and salmon were the most polarizing. These results underscore the importance of incorporating stakeholder perspectives in technology assessment and innovation governance. These results also suggest that responsible innovation efforts in agrifood systems should prioritize communication, addressing meaningful societal needs, and the contextual understanding of societal values to build trust and legitimacy. Full article

Background: Selecting enterprise resource planning (ERP) systems for complex port environments is a significant challenge. This study addresses a key research gap by identifying and prioritizing the critical factors for ERP selection within the strategic context of United Arab Emirates (UAE) ports, which function as vital hubs in global trade. Methods: A hybrid methodology was employed, first using the Fuzzy Delphi Method (FDM) to validate thirteen challenges with five industry experts. Subsequently, the Relative Importance Index (RII) was used to rank these challenges based on survey data from 48 UAE port professionals. Results: The analysis revealed “Cybersecurity concerns” as the highest-ranked challenge (RII = 0.896), followed by “Engagement with external stakeholders” (RII = 0.842), and both “Process optimization” and “Technical capabilities” (RII = 0.808). Notably, factors traditionally seen as critical in other sectors, such as “Organizational readiness” (RII = 0.746), were ranked significantly lower. Conclusions: The findings indicate a strategic shift in ERP selection priorities toward digital resilience and external integration rather than internal organizational factors. This research provides a sector-specific decision-support framework and offers actionable insights for port authorities, vendors, and policymakers to enhance ERP implementation in the maritime industry. Full article

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

Background/Objectives: Telehealth enhances access to specialty care, but stakeholder perspectives are often overlooked. The objective was to evaluate participant and provider satisfaction with a novel telehealth-enabled home safety program. Methods: This is a sub-investigation of a non-randomized pilot study of a novel telehealth-enabled home safety program that enrolled 23 persons with Parkinson’s Disease (PwPs) at risk for falls and their respective care partners (CPs). Dyads participated in four to six televisits over three months, where they performed “virtual home tours” using a mobile platform (tablet mounted on a rolling stand) with a physical therapist to identify and mitigate environmental fall hazards. Satisfaction was assessed using PI-developed surveys and open feedback. Mobile platform usability was assessed with the System Usability Scale (SUS). Results: A total of 95.65% of dyads were very to extremely satisfied with the entire program overall, and the therapist indicated the same for 73.91% of the dyads. Additionally, 95.65% of dyads reported gaining new awareness of home fall hazards. Difficulties maneuvering the mobile platform, using a tablet, and connectivity issues were common challenges noted. The mean score on SUS for the mobile platform was 65, indicating poor perceived usability, and most dyads indicated they would have preferred using a smartphone for the program. Other priorities, including competing health and personal obligations, along with resistance to change, were the primary barriers to implementing program recommendations. Conclusions: Our novel telehealth-enabled home safety program was well-received by patients and the study therapist. Using a smartphone and troubleshooting connectivity issues might help further improve the usability and accessibility of this program. Full article

Hazards stemming from extreme natural events have exhibited heightened prominence in recent years. The natural hazard management process adopts a comprehensive approach that encompasses all stakeholders involved in the disaster management cycle. “Actions for Resilience” (A4R) represents a standardised concept derived from ISO/TR 22370:2020 that integrates principles from various scientific disciplines to enhance resilience in systems, whether they are socio-ecological systems, communities, or organisations. A4R emphasises proactive measures and interventions aimed at fostering resilience rather than merely reacting to crises or disruptions. It recognises that resilience is a multifaceted concept influenced by various factors, including social, economic, environmental, and institutional dimensions. Central to A4R is the understanding of complex system dynamics. Also, A4R involves rigorous risk assessment to identify potential threats and vulnerabilities within a system, as well as to build adaptive capacity within systems. A4R advocates for the development of resilience metrics and monitoring systems to assess the effectiveness of interventions and track changes in resilience over time. These metrics may include indicators related to social cohesion, ecosystem health, economic stability, and public infrastructure resilience. In this context, the study aims to apply the proposed hierarchy of factors and group decision-making using fuzzy numbers to identify strategic priorities for improving the urban resilience of the pilot area. The identified priority factors are then analysed across different scenarios, and corresponding actions are described in detail. Full article

Higher-education institutions are increasingly embracing digital transformation to meet the evolving expectations of students, academics, and administrators. The smart campus paradigm offers a strategic framework for this shift, yet most existing assessment models originate from high-income contexts and remain largely untested in the Global South, where infrastructural and technological conditions differ substantially. This study addresses this gap by evaluating the contextual relevance of a comprehensive smart campus assessment framework at the Papua New Guinea University of Technology (PNGUoT). A questionnaire survey of 278 participants—students and staff—was conducted using a 5-point Likert scale to assess the perceived importance of performance indicators across four key dimensions: Smart Economy, Smart Society, Smart Environment, and Smart Governance. A hybrid methodology combining the Best–Worst Method (BWM) and Public Opinion (PO) data was used to prioritise framework components. The research hypothesises that contextual factors predominantly influence the framework’s relevance in developing countries and asks: To what extent is the smart campus assessment framework relevant and adaptable in the Global South? The study aims to measure the framework’s relevance and identify contextual influences shaping its application. The findings confirm its overall applicability while revealing significant variations in stakeholder priorities, emphasising the need for context-sensitive and adaptable assessment tools. This research contributes to the refinement of smart campus frameworks and supports more inclusive and responsive digital transformation strategies in developing country higher education institutions. Full article

With the continuous improvement of reservoir projects and the advancement of digital twin basin initiatives in China, rapidly and accurately generating long-term practical reservoir operation schedules has become a key priority for stakeholders. This study proposes a Theory-guided Long Short-Term Memory (TgLSTM) model to extract optimal reservoir operation rules accurately and reliably. Concretely, TgLSTM integrates data-fitting accuracy with the physical constraints of an operation, e.g., water level constraints and minimal discharge constraints, to address the low credibility often observed in conventional LSTM networks. Using the Three Gorges Reservoir during the dry season as a case study, a multi-year hydrological series optimized by particle swarm optimization (PSO) was used to train the TgLSTM network and derive optimized operation rules. Results show that TgLSTM efficiently generates operation schemes close to the theoretical optimum, achieving power generations of 4.27 × 10¹⁰ kW·h and 4.19 × 10¹⁰ kW·h in two test years, with deviations of only 4.20% and 2.33%, respectively. Compared to traditional LSTM models, TgLSTM is more reliable as it captures key operational characteristics such as terminal water levels and water level fluctuations, maintaining an average ten-day drawdown depth below 1.5 m—significantly lower than the 7 m fluctuations observed with conventional LSTM. Furthermore, comparative analyses against SwR, BP–ANN, and SVM confirm that TgLSTM offers a moderate performance in absolute metrics but is the best to simulate the constrained reservoir operation. Full article

Climate change, the consequences of which have been more intense than ever in the last few decades, makes the need for sustainable transportation even more imperative. The promotion of public transportation and the discouragement of private car use are among the main priorities of sustainable transport planning in modern urban areas. However, the selection of the most appropriate transport project, apart from significant opportunities, is also accompanied by significant challenges, especially under the demand of compromising—often conflicting—social, environmental, and economic criteria, as well as different stakeholders’ interests. The aim of the present paper is to provide decision analysts and policy-makers with a decision-support tool for the prioritization and optimum selection of public transport projects for an urban area within the framework of sustainability. For this purpose, a comprehensive inventory of criteria for the evaluation of urban public transport systems (alternatives), along with a standardized table with the relevant performance of the most common alternatives (i.e., metro, tram, monorail, and BRT) are provided based on international literature review. A multi-criteria decision-aiding methodology based on TOPSIS (Technique for Order Preference by Similarity to Ideal Solution), allowing for the direct exclusion of an alternative not meeting certain “binding” criteria from further evaluation, thus saving time, effort and cost, taking into account different stakeholders’ interests and preferences, as well as the particularities and special characteristics of the study area, is then proposed and tested through a theoretical case study. Full article

The transition to the circular economy (CE) is one of the EU’s current strategic policies to improve its competitiveness and sustainability. While the EU has developed a framework for monitoring overall progress toward the CE, there are gaps in monitoring specific priority sectors, such as the bioeconomy. In order to support industry and policymakers in this sector, this paper presents the application of the BIORADAR’s product circularity monitoring framework to five bio-based fertilizers. The framework is composed of two publicly available indicators: the circular index and the circularity indicator of nutrient; and two new indicator proposals: the biodegradable content and the nutrient slow-release index. Making use of life cycle inventories and supplementary data from the scientific literature, these four indicators were calculated for algae biomass, compost, feather meal, spent mushroom substrate, and wood vinegar. The framework proved to be useful for measuring the circularity at the product level for bio-based fertilizers, especially shedding light on the virgin non-renewable materials consumption, waste generation, biodegradability, nutrient recovery process efficiency, and nutrient release speed. It constitutes the first approach to measuring circularity tailored to bio-based fertilizer. By incorporating it into eco-design, innovation, and managerial decision-making processes, key stakeholders can rely on guiding metrics to support their transition toward higher circularity levels. Full article