Search Results (2,397)

Adaptive forest and fire management in parks and protected areas is becoming increasingly complex as climate change alters the frequency and intensity of disturbances (wildfires, pest and disease outbreaks, etc.), while park visitation and the number of people living adjacent to publicly managed lands continues to increase. Evidence-based, climate-adaptive forest and fire management practices are critical for the responsible stewardship of public resources and require the continued availability of long-term ecological monitoring data. The US National Park Service has been collecting long-term fire monitoring plot data since 1998, and has continued to add monitoring plots, but these data are housed in databases with limited access and minimal analytic capabilities. To improve the availability and decision support capabilities of this monitoring dataset, we created the Trends in Forest Fuels Dashboard (TFFD), which provides an implementation framework from data collection to web visualization. This easy-to-use and updatable tool incorporates data from multiple years, plot types, and locations. We demonstrate our approach at Rocky Mountain National Park using the ArcGIS Online (AGOL) software platform, which hosts TFFD and allows for efficient data visualizations and analyses customized for the end user. Adopting interactive, web-hosted tools such as TFFD allows the National Park Service to more readily leverage insights from long-term forest monitoring data to support decision making and resource allocation in the context of environmental change. Our approach translates to other data-to-decision workflows where customized visualizations are often the final steps in a pipeline designed to increase the utility and value of collected data and allow easier integration into reporting and decision making. This work provides a template for similar efforts by offering a roadmap for addressing data availability, cleaning, storage, and interactivity that may be adapted or scaled to meet a variety of organizational and management use cases. Full article

Background: Tobacco use remains a leading preventable cause of morbidity and mortality in the United States, with persistent disparities in cessation outcomes across socioeconomic and racial groups. While numerous interventions exist, their effectiveness is shaped by complex interrelated factors at individual, social, and healthcare system levels. Identifying and modeling these causal pathways is essential to inform equitable intervention design. Methods: This study applied the Evidence Synthesis for Constructing Directed Acyclic Graphs (ESC-DAG) protocol to integrate empirical findings from 35 quantitative studies examining barriers and facilitators of tobacco cessation intervention uptake in the United States. Using the Andersen and Aday Health Services Research Model as a guiding framework, we extracted, harmonized, and synthesized significant causal relationships into a unified DAG, distinguishing exposures, outcomes, mediators, and confounders. Results: The integrated DAG revealed that structural factors such as socioeconomic disadvantage, digital inequities, rurality, and cultural barriers exerted substantial influence on cessation outcomes. These upstream determinants operated through mediators including motivation, treatment engagement, and access barriers, while healthcare system factors such as provider engagement and proactive outreach emerged as consistent facilitators. Digital access and culturally tailored interventions were identified as underexplored yet potentially high-impact pathways. Discussion: The ESC-DAG methodology provided a structured approach to visualize and synthesize causal mechanisms beyond traditional review synthesis, highlighting points of intervention at both policy and practice levels. The findings underscore the importance of multi-level strategies, including financial support, digital equity initiatives, provider outreach, and culturally tailored cessation services. Conclusion: By applying ESC-DAG methodology, this study contributes a novel causal framework for understanding disparities in tobacco cessation intervention uptake. The resulting DAG can inform future statistical modeling, simulation studies, and equity-focused program design, supporting more effective public health strategies to reduce smoking prevalence and associated inequities. Full article

First Episode Rapid Early Intervention for Eating Disorders (FREED) is an early intervention service model and care pathway for young people aged 16–25 with a recent-onset eating disorder. This multi-site study aimed to evaluate the feasibility of a newly developed implementation fidelity tool and observe patterns of fidelity to FREED. Six eating disorder services across England took part in an assessment. Data were collected from 242 patient referrals between January and June 2025 and via semi-structured interviews with FREED staff. Total fidelity scores were calculated alongside two component scores (rapid access to the service and early intervention care package), and inter-rater agreement was assessed. The tool was feasible to use across multiple services, time efficient, aligned with existing workflows, and demonstrated high inter-rater agreement. The average fidelity score across services was 72% (‘medium fidelity’). The average component scores were 57% for rapid access targets (‘not satisfactory’) and 77% for early intervention care package (‘medium fidelity’). Rapid access target scores were highly variable across services (20–87%), whereas care package scores were more consistent (72–82%). Additional sustained resource augmentation is needed to improve model adherence and facilitate consistent access to high-quality early intervention for eating disorders, including support to meet rapid access targets. Full article

Background: The COVID-19 pandemic disrupted healthcare systems, disproportionately affecting individuals with rare diseases. This study explores the health-related quality of life and financial burden in the post-pandemic context among children with Duchenne Muscular Dystrophy and their families in Greece, providing insights into health system performance. Methods: A multicenter, cross-sectional study was conducted in two neuromuscular clinics in Greece. Fifty families (response rate 67%) completed standardized quality of life instruments (PedsQL™ 4.0 Generic Core Scale; PedsQL™ 3.0 DMD Module) and a socioeconomic questionnaire. Descriptive and correlation analyses assessed associations between functional status, financial strain, and psychosocial indicators. Results: Children with Duchenne Muscular Dystrophy reported moderate-to-severe reductions in physical and emotional well-being, and substantial out-of-pocket expenditures. Families with greater financial strain or wheelchair-dependent children had significantly lower health-related quality of life scores. Insurance coverage was positively associated with emotional and psychosocial functioning. Conclusions: Greek families living with Duchenne Muscular Dystrophy continue to face significant financial and psychosocial challenges in the post-pandemic period. While the cross-sectional design does not allow causal attribute to COVID-19 pandemic, the results underscore the need to strengthen financial protection, coordinated multidisciplinary care, and equitable access to support services for rare disease management. Full article

Healthcare discrimination is an important barrier to accessing services among Latino populations in the United States. However, few validated scales have been developed to systematically examine this issue. In this study, we evaluated the validity and reliability of a bilingual healthcare discrimination scale in a sample of churchgoing Latino adults in Los Angeles, California. The study sample included 336 participants (foreign-born: 250; US-born: 86) who attended 12 Catholic churches in Los Angeles. Psychometric testing of the 7-item healthcare discrimination (HCD) scale included internal consistency; split-half reliability; convergent, discriminant, and predictive validity; and confirmatory factor analyses. The HCD had relatively high internal consistency (full sample Cronbach’s α = 0.92; foreign-born: 0.91; US-born: 0.92) and showed good convergent and discriminant validity, as it was moderately correlated with the depression scale (full sample r = 0.28, p < 0.001) and weakly correlated with the acculturation scale (full sample r = 0.15, p = 0.008). Confirmatory factor analyses yielded further support for a one-factor solution. Our study finds that the HCD is a valid and reliable scale for use among churchgoing Latino adult populations in the United States. Future studies should examine the psychometric properties of the HCD among Latinos of diverse backgrounds, geographic locations, religious beliefs, and languages. Full article

Cities around the world are facing growing challenges related to climate change, urban sprawl, infrastructure strain, and digital transformation. In response, smart and sustainable urban development has become a global focus, aiming to integrate technology and environmental stewardship to improve the quality of life. The smart and sustainable city concept is typically applied at the city scale; however, its impact is most tangible at the neighborhood level, where residents interact directly with infrastructure, services, and community spaces. A variety of global frameworks have been developed to assess sustainability and technological integration. However, these models often fall short in addressing localized needs, particularly in regions with distinct environmental and cultural contexts. In Saudi Arabia, Vision 2030 emphasizes livability, sustainability, and digital transformation, yet there remains a lack of tailored tools to evaluate smart and sustainable progress at the neighborhood scale. This study develops HayyScore, a localized evaluation framework and prototype digital platform developed to assess neighborhood performance across five core categories: (i) Environment and Urban Resilience, (ii) Smart Infrastructure and Governance, (iii) Mobility and Accessibility, (iv) Quality of Life and Social Inclusion, and (v) Economy and Innovation. The HayyScore platform operationalizes this framework through an interactive web-based tool that allows users to input data through structured forms, calculate scores, receive category-based and overall certification levels, and view results through visual dashboards. The methodology involved a comprehensive review of global frameworks, expert input to define localized indicators, and iterative prototyping of the platform using Python 3.13.5 and Streamlit 1.45.1. To demonstrate its practical application, the prototype was tested on two Saudi neighborhoods: King Abdullah Petroleum Studies and Research Center (KAPSARC) and King Fahd University of Petroleum and Minerals (KFUPM). Key platform features include automated scoring logic, category weighting, certification generation, dynamic performance charts, and a rankings page for comparing multiple neighborhoods. The platform is designed to be scalable, with the ability to add new indicators, support multilingual access, and integrate with real-time data systems in future iterations. Full article

This study examines the multidimensional human security challenges faced by internally displaced persons (IDPs) in Adigrat City, Tigray, Ethiopia, in the context of conflict-induced displacement. Guided by the Human Security Framework, the analysis addresses threats across economic, food, health, environmental, personal, community, and political domains. Data were collected through a cross-sectional survey using structured questionnaires administered to a stratified sample of 349 IDPs, and analysed through descriptive statistics. Content analysis was conducted on interviews from 17 respondents who were selected purposefully, and secondary data was collected to understand IDPs’ experiences and institutional responses. The findings reveal severe and overlapping forms of deprivation: IDPs reside in overcrowded and inadequate shelters, face chronic food insecurity, and lack access to clean water, healthcare, and education. These conditions are compounded by psychosocial distress, including trauma, anxiety, and the erosion of social cohesion. The study finds that governmental and international responses remain limited, poorly coordinated, and insufficiently responsive to the complex needs of displaced people. While the voluntary, safe, and dignified return of displaced populations to their areas of origin should remain the ultimate objective, this outcome could be realized by fully implementing the Pretoria Cessation of Hostilities Agreement. Responses including improved shelter, essential services access, livelihood recovery, and mental health support systems are essential to address urgent needs. Full article

This study examines the evolution of the Yellow River Basin’s urban corporate network from 2003 to 2023, aiming to understand how intercity connectivity and decision-making authority have developed. Using headquarters–subsidiary linkages of listed firms, we measure connectivity and control of cities within the urban system and employ spatial error models to identify their main determinants. The results show that the network has become denser and more geographically inclusive, especially in the middle and lower reaches. However, a clear hierarchy remains, and upstream integration stays limited. Community structures are anchored by capitals, and multi-core patterns strengthen over time. Coastal hubs in Shandong handle the most significant volumes of ties, while interior capitals such as Zhengzhou, Lanzhou, Xi’an, and Taiyuan concentrate authority—a contrast that has intensified since 2013. Connectivity and control often diverge, and disparities in both have increased. Administrative rank remains the strongest predictor of a city’s position, although its influence has decreased as factors such as openness, development, producer services, and innovation have gained importance. Transportation accessibility and human capital consistently support both connectivity and control, while government intervention initially restricts network roles but becomes less influential over time. These findings suggest that intercity corporate linkages have expanded, yet decision-making authority has not dispersed and remains concentrated in a small set of capitals. Governance that coordinates across provinces is necessary to ensure that increasing linkages translate into shared economic opportunities while protecting the basin’s fragile ecological environment. Full article

This paper examines the connection between the principles of inclusive education and accessible tourism services within the larger context of inclusive tourism and universal design. Through a systematic review of current research, this study first synthesizes findings from various fields, including hospitality, disability studies, and educational research, to show how inclusive educational practices can improve accessible tourism and, conversely, how tourism experiences can serve as an effective platform for teaching inclusion. The empirical section concentrates on the challenges faced by students with disabilities in a tourism program at an international university in Japan. The research identifies significant opportunities for collaboration between different sectors but also highlights persistent barriers that require new, innovative solutions to create truly inclusive tourism experiences. However, the results of the case study reveal a large gap between theory and practice in supporting inclusive education for students of tourism in Japan. Full article

This study implemented a Lean Six Sigma (LSS) methodology to enhance the productivity of the mechanical and industrial engineering technology workshops of an international higher education institution. The efficiency and effectiveness of the engineering workshops were often compromised by poor housekeeping and operational practices, which resulted in incomplete tasks, long operational and activity times, disorganized tools, cluttered workspaces, and a lack of systematic processes for managing materials. These issues led to waste in the form of lost time, unnecessary movement, and safety risks. This eventually affected the overall productivity of the workshops. Following the combination of the Define, Measure, Analyze, Improve, and Control (DMAIC) methodology of Six Sigma with Lean manufacturing, the investigation was conducted in two parts. The first part of this research mainly consisted of measuring the existing state of the three workshops to map the process and frame issues and origins of variations. During the second part of this study, the focus shifted towards Lean thinking while applying the chosen Lean Six Sigma (LSS) tools. Implementation revealed several benefits in the workshops during each phase of DMAIC. A Plan–Do–Check–Act (PDCA) continuous improvement board was installed in the main workshop to promote continuous improvement and sustainability. The process capability increased for the main workshop and welding laboratory, which shows an increase in service and performance standards after LSS implementation. For the main workshop, the process capability ‘Cp’ increased from 0.33 to 1.24 and the process capability index (Cpk) increased from 0.26 to 0.99. The process capability index (Cpk) for the main workshop increased; however, it did not reach the value of 1.33 due to the computer workstation installation not being completed during the study. The welding laboratory showed an increased ‘Cp’ from 0.67 to 2.13, and the process capability index (Cpk) increased from 0.18 to 1.34. The layout of the workshop office was improved to support efficient workflow by providing easy access to frequently used resources while keeping movement paths clear, thereby minimizing interruptions and promoting productivity. As a result, machines and tools were used more productively and operation times decreased. The mechanical workshops can continue increasing their process capability by following the outcomes and findings of the current study, leading to sustainable quality, efficiency, and operational reliability improvements. Full article

Background/Objectives: The growing intersection between nyaope use and HIV infection constitutes a critical public health problem that undermines efforts to achieve universal access to HIV treatment in South Africa. Nyaope use is strongly associated with the increased risk of HIV of transmission. A significant amount of new HIV infections was linked to substance use through sharing of injectable needles. Despite significant progress made to increase public awareness and increase accessibility to HIV services, little is known about how addiction, stigma, and discrimination influence access to HIV treatment among homeless individuals who nyaope. This study explored the hurdles of accessing HIV treatment among people who use nyaope and are homeless in Mogale City, Gauteng Province. Methods: An exploratory descriptive qualitative research approach was employed among people who are homeless, living with HIV and using nyaope (PHHIVN) in Mogale City, between May and August 2024. Data were collected utilizing in- depth interviews in English, isiZulu and Setswana languages. Purposive sampling technique was followed to select participants, and a sample size of 25 participants was reached with a mean age of 32.28 and SD = ±5.54 years, of whom 21 (84%) were male, 3 (12%) were female and 1 (4%) identified as other. Audio recordings were transcribed, translated, and analyzed following inductive thematic analysis. Results: Social exclusion and fractured support system, prioritization of drug use, nyaope dependency, withdrawal symptoms, negative peer influence, socioeconomic factors and misconception about the interaction between nyaope and HIV treatment were reported as some of the main hurdles of accessing HIV treatment among PHHIVN in Mogale City, Gauteng Province. Conclusions: It is therefore concluded that access to HIV treatment among PHHIVN in Mogale City, Gauteng Province, remains a serious public health concern influenced by various hurdles. The development of tailored interventions to improve access and adherence to HIV treatment among this population group has potential to enhance the uptake of HIV treatment. Full article

Background: People experiencing homelessness (PEH) face significant health disparities and systemic barriers to healthcare, elevating their risk for cancer and other chronic diseases. To tackle PEHs’ challenges in accessing cancer preventive care, the CANCERLESS project implemented the Health Navigator Model (HNM)—a person-centered intervention that utilizes trained Health Navigators to provide tailored support and facilitate service access. Recognizing housing as a key determinant of health, this analysis assessed changes in housing status associated with participation in the HNM among CANCERLESS participants in Austria, Greece, Spain, and the UK. Methods: This was a secondary analysis of cross-national data collected during a single-arm interventional study. Of 652 enrolled PEH, 277 (42.5%) completed the HNM intervention follow-up and were included in the analysis. Changes in housing status from baseline to follow-up were categorized using the European Typology of Homelessness and Housing Exclusion (ETHOS) and treated as an ordered outcome. Descriptive statistics were complemented by a cumulative link mixed model with a participant random intercept to estimate the association between time (follow-up vs. baseline) and housing transitions among completers, adjusting for age, residence/legal status, and daily smoking. Results: Participants had a mean age of 47.4 (SD 13.8), primarily identified as male (64.1%), reported upper secondary education (33.9%), and were from Western European countries (39.7%), with varying housing situations. Among intervention completers, time (follow-up vs. baseline) was associated with higher odds of being in a higher ETHOS category (OR = 1.49, 95% CI = 1.02–2.20, p = 0.042), consistent with a modest improvement in housing status. Larger estimates were observed among migrants without legal documents (OR = 24.13, 95% CI = 6.41–90.89, p < 0.001), while daily smoking was associated with lower odds (OR = 0.33, 95% CI = 0.11–0.96, p = 0.041); other residence status categories were not statistically significant. Conclusions: Suggesting that tailored, navigation-based models, such as the HNM, may be linked to improved housing stability for PEH, these findings can inform piloting and context-aligned integration of the HNM within public health strategies as an alternative approach to address the complex, interconnected health and social needs of PEH. However, the lack of a comparison group and high attrition limit the results’ conclusiveness, and future evaluations should aim to include assessments of housing-associated contextual factors. Full article

Bike lending offers a service that enables individuals to borrow bicycles for short-term use (i.e., ranging from 2 hours to 36 months), typically from designated locations within cities, campuses, or communities. Unlike bikesharing systems that typically rely on automated kiosks and/or undocked and free-floating devices for public access, bike lending involves a managed program with staff, similar to a library model. These programs can be administered by community organizations, bike shops, public libraries, and other local entities. They are typically community- or membership-based, with many programs associated with non-profit organizations or publicly owned and operated. In this paper, we investigate bike lending in the United States and Canada as of Spring 2024, including a literature review, the identification and characterization of bike lending programs (n = 55), expert interviews (n = 24), a survey of bike lending operators (n = 31), and 2 focus groups with a total of 12 participants. Insights from expert interviews and operator surveys highlight the experiences of professionals involved in bike lending. The focus groups capture the experiences of bike lending users. This paper finds that North American bike lending is often tailored to the specific needs of communities, such as youth, low-income individuals, and the general population. More sustained funding could support program expansion and diversify bike offerings. Enhancing cycling infrastructure, such as adding dedicated bike lanes and paths, could improve overall cycling safety and increase participation in bike lending programs. This study’s findings could help strengthen existing bike lending programs, guide the development of new initiatives and supportive policies, and enhance safe bicycle use for participants. Full article

This study investigates how Built Environment (BE) education in Australian universities can better support student well-being and academic success. Using a mixed-methods design, survey data from 253 students across multiple institutions were analysed by integrating quantitative measures of stress, performance, and mental health with qualitative accounts of student-driven solutions. The diversity of the sample enhances the representativeness of the findings across the BE student cohort. Results confirm significant work–study pressures but, more importantly, identify novel pathways for reform, including curriculum flexibility, stronger industry–academic integration, and accessible support services. To address these gaps, the study introduces the INSPIRE Framework—a holistic, student-centred model that embeds flexibility, resilience, and institutional empathy into BE pedagogy. By filling a critical gap in the literature on student well-being in professional disciplines, the framework offers practical guidance for universities seeking to design more inclusive and sustainable learning environments. Full article

During peak hours, the large-scale and spatiotemporal imbalance of passenger flow in subway stations results in passenger crowding, queuing issues, and uneven utilization of facility capacities. These problems not only decrease the overall throughput efficiency of the station but also increase safety risks related to large passenger gatherings. This research constructed a pedestrian facility network for subway station access and egress by defining minimum capacity control units of node facilities (including station entrances/exits, fare gates, security check machines, and staircases/escalators) as network nodes and the connecting channels among these nodes were assumed as edges. With the optimization objectives of minimizing both the average walking time of passengers in the pedestrian facility network and the risk of passenger flow aggregation at nodes, an integrated optimization model for passenger flow control and service capacity configuration in the pedestrian facility network of subway stations is established. The ε-constraint method is employed to transform it into a single-objective linear integer programming model, which is then directly solved using the Gurobi optimizer version 11.0. The following conclusion were drawn form a case study on the National Convention and Exhibition Center Station of Shanghai Metro: compared with pre-optimization conditions, the optimized solution reduced the average walking time of access/egress passengers during peak hours by 11%, decreased the number of nodes with queue overflow by 76%, lowered node-level crowding risks by 45%, and reduced facility supply–demand balance standard deviation by 22.8%. Compared to single-objective optimization approaches, the proposed method only increased the average walking time by 8% while decreasing the number of overflow-prone nodes by 60% and crowding risk by 26.1%. These findings provided scientific support for the formulation of crowd management strategies and optimization of operational control in subway stations under heavy passenger flow conditions. Full article