1) Background: Intellectual disability is more common in low- and middle-income countries than in high-income countries. Stigma and discrimination have contributed to barriers to people with intellectual disability accessing healthcare. As part of a larger study on caregiving of children with intellectual disability in urban Cape Town, South Africa, we interviewed a sub-group of families who had never used the intellectual disability services available to them, or who had stopped using them; 2) Methods: We employed a qualitative research design and conducted semi-structured interviews to explore the views and perspectives of parents and caregivers of children with intellectual disability who are not using specialised hospital services. We developed an interview guide to help explore caregivers’ and parents’ views; 3) Results: Results revealed that caregivers and parents of children with intellectual disability did not use the service due to financial difficulties, fragile care networks and opportunity costs, community stigma and lack of safety, lack of faith in services and powerlessness at effecting changes, and self-stigmatisation; 4) Conclusion: Current findings highlight a need for increased intervention at community level and collaboration with community-based projects to facilitate access to services, and engagement with broader issues of social exclusion.

Residents’ perceptions on ecosystem services (ESs) provided by urban green spaces (UGSs) are vital for developing sustainable cities. However, there has been limited research on this issue in Malaysia. The aim of this paper is to assess Malaysians’ perceptions on ESs provided UGSs and how their perceptions are influenced by different socio-demographic factors. We used a structured online questionnaire and obtained 645 responses on 16 ESs from regulatory, cultural, and supporting ES categories. Descriptive statistics and binary logistic regressions were used for data analysis. In general, city dwellers have high positive perceptions on ESs provided by UGSs. Their perceptions for global climate regulation, noise buffering, pest regulation, spiritual, and research and education services would likely to significantly increase as they grow older. Households with moderate income have significantly greater perceptions of microclimate regulation, air filtration and aesthetic services. Having non-tertiary level education would significantly lower their perceptions of global climate and microclimate regulation, spiritual, aesthetics, and recreational services. Tertiary educated residents with non-environmental degrees also showed similar associations. Infrequent visits to UGSs would likely to significantly reduce the perception of global climate regulation, noise buffering, runoff reduction, erosion control, spiritual, and aesthetics services. People living far (>5km) from the UGSs also have significantly lower perceptions of microclimate regulation, air filtration services. Suggestions are made to incorporate ESs related content in pre-university curriculum and establishing small parks in neighborhoods to improve knowledge and uses of UGSs. These findings would assist urban planners designing environmentally sound urban policies and thereby improving human wellbeing in the cities.

Putting value to ecosystem services is something that society still refuses or simply ignores because it is not aware of the benefits that ecosystems provide us. In fact, people should be aware that a good understanding of ecosystem services can lead to win-win situations. Being aware of the importance of preserving the ecosystem and attaching value to its services will enable the development of self-sustaining strategies and appropriate policies for better ecological governance. Decades of over exploitation of natural resources, introduction and spread of alien species and, also, climate change, forest fires among other threats, have fostered biodiversity loss. The European Union Biodiversity Strategy has as one of its main goals to stop biodiversity loss and the degradation of ecosystem services; if possible, to recover the most threatened and degraded ecosystems, based on 20 Actions divided into 6 Targets. The present work falls within the scope of Action 5 of Target 2 – Improve knowledge of ecosystems and their services in the EU. The specific focus of this study is the Site of Community importance “Dunas de Mira, Gândara and Gafanhas” (Portugal) and the assessment of its ecosystem services, in accordance with the methodology proposed by the MAES (Mapping and Assessment of Ecosystems and their Services) Working Group. The work currently under way, a small segment of which is presented here, aims to identify, map and, when possible, assign value to the ecosystem services. For this purpose, modern GIS technologies will be used. This approach was implemented using a combination of data and tasks, including the photo-interpretation of Sentinel 2 (COPERNICUS Program) satellite imagery. The data geoprocessing tasks and image segmentation were developed using QGIS software and IMPACT Toolbox software (developed by the Joint Research Center – JRC, of the European Union), respectively. The analysis of Land Use and Burned Areas maps for the SCI "Dunas de Mira, Gândara and Gafanhas" led us to conclude that Forests ecosystems, the most affected by the fire of October 2017, continue to have the greatest expression in the area under study even though they have lost more than 50% of the area, and their services were also the ones most affected by the fire.

Based on multi-source remote sensing data, scenario analysis, and model simulation, the Pareto optimal solutions for water supply, water purification (N retention), and carbon storage and sequestration services under different scenarios were sought by adjusting its land use structure. The results showed that. In Scenario 1(S1), the water supply service needs to increase by 86.820 to 11.211 billion cubic metres, the water purification (N retention) service needs to decrease by 11,400 to 11,700 tons, and the carbon storage and sequestration service need to decrease by 2.070 to 2.487 billion tons. In Scenario 2(S2), the water supply service needs to increase by 8.243–10.666 billion cubic metres, the water purification (N retention) service needs to decrease by 11,300–1.10 million tons, and the carbon storage and sequestration service needs to decrease by 2.033 to 2.466 billion tons. In Scenario 3 (S3), the water supply service needs to increase by 7.832–11.437 billion cubic metres, the water purification (N retention) service needs to decrease by 1.16–10,800 tons, and the carbon storage and sequestration service needs to decrease by 19.220 to 2.380 billion tons. After land use optimisation and adjustment, the S3 ecological land structure is complete and consistent with the vision of ecological protection and urban development in the study area, which is the optimal scenario. After optimising the S3 ecosystem service supply pattern, the water supply, water purification (N retention), and carbon storage and sequestration services could connect the western and eastern ecosystem service supply areas, balance the overall ecosystem service supply pattern of the study area and meet the demand for ecosystem services. The results can guide regional land planning and ecosystem service management optimisation.

There is a growing consensus that to effectively adapt to climate change, cities need user-friendly tools and reliable high-resolution biophysical and socio-economic data for analysis, mapping, modeling, and visualization. This study examines availability of various types of information used in climate adaptation plans of 40 municipalities with population less than 300,000 people in the United and in France, probing into the choice and usage of relevant information by small municipalities. We argue that non-climatic spatial data, such as population demographic and socio-economic patterns, urban infrastructure, and environmental data must be integrated with climate tools and datasets to inform effective vulnerability assessment and equitable climate adaptation planning goals. Climate adaptation plans frequently fail to address the existing structural inequalities and environmental injustices in urban infrastructure and land use. Adaptation methodological approaches should be reassessed in the context of much needed societal transformation. Lessons learned from our studies offer valuable insights for potential development of the national and state-level climate adaptation information services for cities.

The impact of COVID-19 pandemic on the cardiovascular healthcare services in Croatia has not been systematically examined. In this study, we compared utilization and provision of cardiovascular services in Croatia during the pre-pandemic period (2017 to end of 2019) and pandemic period (2020 to end of 2021) by using large nationwide data from the Croatian Health Insurance Fund, an institution covering 95% of all insurance claims in Croatia. We report that the use of advanced heart failure treatment modalities increased while the number of coronary angiographies decreased while the number of performed percutaneous coronary interventions remained similar, even increasing in the setting of acute myocardial infarction, comparing pandemic to pre-pandemic period. Similarly, the number of transcatheter aortic valve implantations increased significantly during the pandemic era. There was a significant increase in laboratory diagnostic testing with troponin and natriuretic peptide assays during the pandemic period while the use of most cardiovascular services remained stable or only slightly decreased, compared to pre-pandemic period. These data suggest that Croatian cardiovascular healthcare services during COVID-19 pandemic showed resilience and managed to maintain or even increase the number of various diagnostic and interventional procedures despite the widespread societal and logistical challenges encountered during pandemic.

Efficient use of the operating room (OR) is crucial for any hospital. One of the major inefficiencies in the OR is surgical cases not starting or finishing on time as scheduled. When a case is delayed, it affects all subsequent cases in that OR. This study uses discrete choice analysis to determine the significant factors, including team familiarity, that influence OR case on-time start and finish. A case is considered on-time if the documented procedure start and finish times are no more than 10 minutes after the scheduled start and finish times. The analysis uses surgical case data from a large tertiary referral hospital and academic center in Greenville, South Carolina. The case data includes all surgical cases (15,091) performed during regular workdays in 2013. Two binary logit models are developed: one for case on-time start and one for case on-time finish. Results indicate that higher team familiarity between surgeon and anesthesiologist, surgeon and circulating nurse, surgeon and scrub nurse, and surgeon and CRNA improve the likelihood of an OR case on-time start and on-time finish. This finding indicates that the OR scheduling staff in the study hospital make a concerted effort to schedule the surgical teams with members who have worked well together in the past.

The purpose of this study is to bring out a scientometric analysis of the advances of digital transformation in the global banking sector. For this, a background search of the term "Digital Transformation Banking " has been brought out from the Web of Science (Wos) Database, covering records published between 2002 and 2023. A set of 312 publications was identified, which mainly includes a set of 264 academic articles, 29 articles published without cataloging a specific volume of a journal, 9 articles under review, 5 editorial material documents, 4 conference articles, and 1 document is a book chapter. Nowadays the scientific production is low but showing growing development presenting 123 publications and 7,754 citations for the year 2022. Among the scientific production, 43 publications from the Republic of China (8.8%) and 35 publications from Ukraine (7.8%) stand out. ,2%). It is also worth mentioning that the most relevant authors on this topic are Ricardo Palomo, professor and dean of San Pablo University, and Robert J Kauffman, professor at Singapore Management University in terms of influence. Main institutions in terms of scientific production, mainly: the Massachusetts Institute of Technology (MIT) of the United States and the Russian Academy of Sciences of Russia.

Modern mobile devices are replete advanced sensors that expand the array of possible methods of locating users. This is often viewed in a positive light, as a tool to gather and use spatial information, but it also brings with it the problem of “geosurveillance” in which the “Location” becomes a product in itself. In the realm of software developers, this has been reduced and discretized to a set of coordinates, devoid of human experiences and meanings. To function in such digitally augmented realities, people need to adopt specific attitudes, often accompanied with anxiety. We explored attitudes toward locational data collection practices using questionnaire surveys (n = 280) from Poznan and Edinburgh. The prevailing attitude is neutral with a strong undertone of resignation, in which surrendering personal locational information is viewed as a digital currency. A smaller number of people had stronger, emotional views, either very positive or very negative, based on uncritical technological enthusiasm or fear of privacy violation. Such a wide spectrum of attitudes is not only produced by interaction with technology but can also be viewed as a result of different perceptions and values associated with space and place itself.

Background The workload of nurses in the intensive care unit (ICU) can affect the quality of nursing services. Aim This study aimed to determine the relationship between the nursing activity score and missed care in patients hospitalized in the ICU in Zanjan, Iran. Methods This observational and prospective study was conducted from April 3 to September 18 in 2021. In this study, the tools used included a patient and nurses' profile questionnaire, Nursing Activity Score (NAS). Missed care was observed in the 301 patients for whom the NAS was calculated. Analysis of variance (ANOVA) was used to investigate the differences in mean levels of missed care. Logistic regression models were used to assess the association between factors and missed nursing care. Results Results show that the Medical ICU's mean NAS was 76.31 (95% CI: -13.06 -14.89). In 9 dimensions of care, the extent of missed care was 40.7%. In the care dimensions of assessment, hand hygiene, and infection control, the mean NAS had a statistically significant increase at higher levels of missed care (P<.5). Furthermore, work experience was identified as a protective factor for missed care (OR =.59, 95% CI: .37–.94, χ2= =4.97, p =.026). Conclusion The study revealed a high incidence of missed care. The study revealed that the mean workload was high in certain dimensions of care such as assessment, hand hygiene, and infection control. The increase in workload for nurses results in lost care. Nonetheless, the utilization of experienced nurses can help mitigate this problem. However, utilizing experienced nurses can help reduce this problem.

In this paper, possibilities for the bandwidth and wavelength utilization in future next-generation passive optical networks are presented and reasons for realizing and utilizing of extended dynamic wavelength and bandwidth algorithms for NG-PON2 networks are analyzed. Next, principles of the effective dynamic bandwidth allocation are introduced in details, focused on the importance of the decision criterion optimization. For achieving better bandwidth utilization of dedicated wavelengths, this paper is focused on the novel effective dynamic bandwidth allocation algorithm with adaptive allocation of wavelengths to ONU units and on the optimization of the decision criterion. For analyzing the novel extended DWBA algorithm utilizing for various wavelength allocation cases possible in NG-PON2 networks, a simulation program with the enhancement of the EDBA algorithm is realized. Finally, an optimization of the decision criterion defining a minimum bandwidth utilization of the actual wavelength is executed for NG-PON2 networks based on the hybrid TWDM technique.

Based on big data and artificial intelligence technology, the judicial big data intelligent service platform provides users with efficient and accurate legal consulting services. It has many functions such as intelligent question and answer, case analysis, and law inquiry. It also analyzes the application value of the intelligent legal consulting service platform in the field of judicial big data. By building an intelligent service platform, the rapid processing and analysis of massive judicial data has been realized, and the efficiency and quality of judicial work have been significantly improved. In addition, it emphasizes the importance of data management and quality control in the application of judicial big data, and puts forward specific measures to strengthen data management and quality control. With the continuous advancement of technology and the expansion of application fields, the platform is expected to achieve deep integration with other legal services, expand new application fields, and provide users with more comprehensive and efficient legal services. At the same time, it points out the problems that need to be paid attention to in the future development, such as data security, privacy protection and so on. Through in-depth analysis and research on judicial big data, the platform can provide strong support for judicial decision-making and promote the improvement of judicial justice and efficiency.

Since the 1950s sugarcane production has grown rapidly from less than 0.5 billion tonnes in the late 50s to reach over 1.9 billion tonnes in 2012 on about 27 million hectares of agricultural land. This expansion has been boosted by the high demand for bioethanol promoted as a sustainable bioenergy source which accounted in 2010 for the biggest share of the global biofuel market. Despite its benefits, the scientific debate on sugar is growing especially that counterarguments are so many, including negative impacts on different interacting ecosystems and human well-being, e.g. bigger stress on land and water resources, environmental externalities on air, a harmful impact on the biodiversity and endemic species, negative environmental externalities, health, and socio-economic aspects. This paper provides a narrative systematic review (SR) of the impacts of sugarcane production on these different ecosystems employing the ecosystem services framework for its acceptance by policy-makers. The references included for the SR were 163 and results showed that the majority of the studies are from Brazil, Australia, South Africa and the USA (≈ 75% of the literature), most of them were from peer-reviewed journals (85%), and most of the case studies adopted a quantitative research approach (93%). The literature assessed showed that sugarcane, like all agro-systems, depends on the practices and techniques to transform negative impacts into positive externalities on ecosystems and human well-being. However, the literature studied failed to include the inter-linkage in sugarcane production impacts’ and therefore to evaluate the related ecosystem services with respect to the Millennium Ecosystem Assessment (MA) framework to account for existing trade-offs. Therefore, the findings are addressed to the scientific community and decision-maker for an intensification of interdisciplinary and integrated research based on the MA framework to cover all ecosystem services, for sustainable development of the sugarcane sector.

The brief paper utilises Zimbabwe as a case study to discuss the effects of El Nino in Southern Africa. It offers potential adaptation and mitigation measures for farmers to prepare for the forecasted El Nino-influenced rainy season 2023/24 and the future. To reduce climate and weather hazards connected with El Nino, the brief report suggests anticipatory action methods be applied in southern Africa, using Zimbabwe as a case study. To protect farmers' livelihoods and enhance drought readiness for the forthcoming agricultural seasons, the paper suggests a degree of strategic, tactical, and operational decision-making that the agriculture industry should adhere to. It emphasised the significance of providing farmers with knowledge and advice regarding drought and heat stress, including cultivating crop varieties and livestock and sufficient fire safety precautions. The brief paper calls to advocate for anticipatory action to avert El Nino in Southern Africa.

A healthy park-people relation depends essentially on the fair and sustainable maintenance of rural livelihood. When protected area is designated, rural people may face restrictions of access to land and resource use for multiple ecosystem services. In Wuyishan of China, we analysed the role of traditional tea cultivation during consistent protected area management to find ways to maintain stability of this social-ecological system in the new national park era. We used an intensive social survey to investigate tea’s role, perception of ecosystem services and impacts on tea cultivation from consistent conservation policies. Results showed that tea cultivation brought major household income and associated with multiple culture services. Protected area management affected land use and conservation outcomes were more obvious to farmers than economic and social ones. From the perspective of a social-ecological system, tea cultivation in national should be conservation-compatible activities from which the potentially lost economic value is remedied by ecological and cultural valorisation. To sustain the resilience of the social-ecological system, we proposed a three-scale management framework to regulate biophysical elements at land plot scale, to link production and market at the mountain level, and to secure tenure and encourage community participation at the landscape level.

Novel strategies in coastal protection are needed to cope with climate change-induced sea level rise. They aim at the sustainable development of coastal areas in light of an intensification and land use changes. A promising approach is the design of nature-based solutions (NbS), complementing the safety levels of technical infrastructures. However, NbS lack a widespread and large-scale implementation. To address this deficit, co-design concepts are needed that combine experiences from science and practice. This work presents and discusses the approach of a coast-specific real-world laboratory (RwL) addressing the inclusive design of ecosystem-based coastal protection. Strategies of RwLs are applied for the first time in a coastal context along the North Sea coastline in Germany. We found the concept of RwLs suitable for coastal transdisciplinary research, although adaptions in the spatial reference level or flexibility in location and time of experimentation are necessary. A profound actor analysis is indispensable to specify participatory processes and interaction levels. A criteria-based cooperative selection of RwL sites helps to reveal and solve conflicting interests to achieve trust between science and practice. Addressing site-specific characteristics and practitioners’ needs, our coastal RwL provides a mutual learning space to develop and test NbS to complement technical coastal protection.

Capturing complexity is both a conceptual and a practical challenge in palliative care. The HexCom model has proved to be an instrument with strong reliability and valid for describing the needs and strengths of patients in home care. In order to explore whether it is also perceived to be helpful in enhancing coordinated and patient-centered care at a practical level, a methodological study was carried out to assess the face validity of the model. Particularly, a Delphi method involving a group of 15 experts representing the full spectrum of healthcare professionals involved in palliative care was carried out. The results show that there is a high level of agreement, with a Content Validity Index-Item greater than 0.92 both with regard to the complexity model and the HexCom-Red, HexCom-Basic and HexCom-Clin instruments, and higher than 0.85 regarding the HexCom-Figure and the HexCom-Patient instruments. This consensus confirms that the HexCom model and the different instruments that are derived from it are valued as useful tools for a broad range of healthcare professional in coordinately capturing of complexity in healthcare practice.

The complexity of urban spatial configuration, which affects human-well being and landscape functioning, needs acquisition and 3d visualisation data to inform decision-making process better. One of the main challenges in sustainability research is to conceive spatial models which are capable of adapting to changes in scale and recalibrating the related indicators depending on the degree of detail and data availability. In this perspective, the inclusion of the third dimension into Urban Ecosystem Services (UES) assessment studies highlights the details of urban structure-function relationships, improves modelling and visualisation of data and impacts, aiding decision-makers to localise, assess and manage urban development strategies. The main goal of the proposed framework concerns mapping, evaluating and planning of the UES within a 3d-virtual environment to improve the visualisation of the spatial relationships among the services allocation and the urban fabric density.

Background and objectives: Effective management for chronic diseases, hereditary and rare diseases and Thalassaemia in particular constitutes an important indicator for the quality of healthcare systems. We aimed at assessing healthcare services in different countries by using publicly available health indicators and by surveying Thalassaemia patients and their caregivers. Materials and Methods: We reviewed official worldwide databases from the WHO, World Bank, and scientific resources and also used a structured patient tailored self-completed questionnaire to survey Thalassaemia patients and their caregivers in 2023. Results: A total of 2,082 participants were surveyed (mean age 27 years, males 42%). About 1 in 4 respondents had less than high school education, while 24% had a bachelor degree. About a third of respondents were married and had either full- or part-time employment. The vast majority (~80%) had initiated transfusion therapy between 1 – 4 years of age. Only 42% reported no delays in receiving blood transfusion, while 47% reported occasional delays and 8% serious delays. About half of patients reported being very satisfied (11%) or satisfied (38%) with the quality of provided services, while 1 in 3 patients reported being unsatisfied or very unsatisfied, and their access to treatment was difficult or very difficult due to traveling expenses and high cost of treatment. Conclusion: Important improvements in the care of Thalassaemia patients have been documented during the past decades. Nevertheless, our recent survey reveals many unmet needs where additional focus is required through national healthcare systems in order to address them effectively and achieve satisfactory patient outcomes.

Certain services can help avoid environmental impact in larger contexts. However, there is no commonly agreed bottom-up methodology for calculation of the total net reduction effect of specific digital services. Life Cycle Assessment (LCA) is a common denominator for most methodologies. The most common method is the Attributional LCA (ALCA), and recently the emerging handprint ALCA estimating so-called positive environmental impacts. Moreover, Consequential LCA (CLCA) can be used to capture market effects. The third conceptual approach is Input-Output LCA. The purpose is to propose and test a new method based on some of the existing ones. The existing concepts are compared and a synthesis is made to create a practical but still useful method. The new method is applied to two illustrative cases in the Information and Communication Technology (ICT) domain; the introduction of a 5G enabled drone for pipe inspection and the 5G enabled health consultation. Compared to simplified ALCA, the difference between the absolute score for the baseline system and the target system changes up to 15% when the proposed simplified CLCA (SCLCA) method is used. The results show that SCLCA, when combined with analytical methods for expressing digital ICT services’ own impact, is a fruitful approach which is both practical and feasible.

Background and motivation: Combining Deep Reinforcement Learning (Deep RL) and Health Systems Simulations has significant potential, for both research into improving Deep RL performance and safety, and in operational practice. While individual toolkits exist for Deep RL and Health Systems Simulations, no framework to integrate the two has been established. Aim: Provide a framework for integrating Deep RL Networks with Health System Simulations, and to ensure this framework is compatible with Deep RL agents that have been developed and tested using OpenAI Gym. Methods: We developed our framework based on the OpenAI Gym framework, and demonstrate its use on a simple hospital bed capacity model. We built the Deep RL agents using PyTorch, and the Hospital Simulation using SimPy. Results: We demonstrate example models using a Double Deep Q Network or a Duelling Double Deep Q Network as the Deep RL agent. Conclusion: SimPy may be used to create Health System Simulations that are compatible with agents developed and tested on OpenAI Gym environments. GitHub repository of code: https://github.com/MichaelAllen1966/learninghospital

We aimed at developing and validating a scale on the beliefs and attitudes of mental health professionals towards services users’ rights in order to provide a valid evaluation instrument for training activities with heterogeneous mental health professional groups. Items were extracted from a review of previous instruments, as well as from several focus groups which have been conducted with different mental health stakeholders, including mental health service users. The preliminary scale consisted of 44 items and was administered to 480 mental health professionals. After eliminating non-discriminant and low weighting items, a final scale of 25 items was obtained. Exploratory and confirmatory factor analyses produced a four-factor solution consisting of the following four dimensions; system criticism/justifying beliefs, freedom/coercion, empowerment/paternalism, and tolerance/discrimination. The scale shows high concordance with our theoretical model as well as adequate parameters of explained variance, model fit, and internal reliability. Additional work is required to assess the cultural equivalence and psychometrics of this tool in other settings and populations, including health students.

Green public space immensely provides ecological soundness (ES), social resilience, social inclusiveness, mental health, self-esteem, and cultural prosperity from privileged class to lower ones. This research aims at estimating the effect of social services, safety, and infrastructural amenity in green space (parks) on mental health building self-esteem for elderly population. Data were collected from four parks out of 21 in Dhaka selected by systematic random sampling. Two-hundred and three elderly participants were picked up for survey using snowball sampling. The survey was conducted in a pre-structured questionnaire consisted of 40 close-ended questions. Data was analyzed applying ordinal logistic model, multivariate regression analysis, and Partial Least Square (PLS) -Path Modeling. The study explored several key findings-1) Infrastructural amenities impacted social services of parks; 2) Social services contributed positively to mental health boosting up self-esteem for elderly population. 3) Likewise, mental health for elderly population was affected by safety measure of green space. Dhaka requires constructing age-friendly parks to promote elderly mental health.

This paper outlines a tool developed with the purpose of creating a simple configurable emulated network environment that can be used in cyber defence exercises. Research has been conducted into the various related subject areas: cyber defence exercises, network threats, network emulation, network traffic replay, network topologies, and common network services. From this research a requirements specification was produced to encapsulate the features required to create this tool. A network, containing many of the aspects researched, was designed and implemented using Netkit-NG to act as a blueprint for the tool and to further knowledge in the construction of an emulated network. Following this the tool was developed and tested to ensure requirements were met.

Purpose –The basic purpose of this paper is to find out the librarians perceptions, skills, most effective and constrains to use social media for the marketing purposes in the University libraries and to examine how these libraries perceive the importance of social media marketing. Design/methodology/approach –A nation-wide online survey on University libraries in the Pakistan was conducted to flourish this study, and a total number of 161 responses were used to analyze collected data. Findings –This study revealed the application of social media in university Libraries is very high .The results also disclosed that University libraries observe social media as a substantial tool to increase marketing of library sources and services anticipate to increase their use. Practical implications –The findings of this study can help as a parameter for University libraries when engaging social media for marketing purposes in their libraries. Originality/value –This study calculated the present situation of social media use for marketing in the University Libraries environment, a background that has been under-study in the literature, from these perspectives: perceptions, Skills, effectiveness, practices and constrains

The ongoing expansion in volume, velocity and variety of geospatial data has stimulated the development of artificial intelligence applications and associated online cartographic visualizations. In this context, the cartographic communication through peer-reviewed media evolved to incorporate Findability, Accessibility, Interoperability and Re-usability (FAIR) principles. In this paper, we review the functionalities proposed by current international peer-reviewed media for accessing, exploring and re-using geospatial data, and situate them on a diagram conceived for peer-reviewed cartography in the artificial intelligence era. We then present an overview of the cartographic infrastructure and workflow currently available in the Terra Digitalis journal for the online publication of massive spatiotemporal data. This free and opensource based solution allows a smooth integration, from data submission to final peer reviewed publication, of dynamic, interactive 2D and 3D maps. As a proof of concept, we present two maps derived from massive spatiotemporal data, related, respectively, to a climate numerical model (raster data) and a bike sharing system’s origin-destination dataset (vector data). We argue that the combination of technologies used in the journal provides an efficient and low-cost solution, unmatched by other publication media, to boost the accessibility and FAIR principles for geospatial big data.

The study of man-land relationship in urbanization process is the current frontier and focus of international research. How to balance urban development and ecosystem conservation in the Upper Yellow River is a key issue for sustainable development in China. In this study, we evaluated the Lanzhou-Xining urban agglomeration （LXUA）by constructing a multi-dimensional assessment system for urbanization quality and ecosystem services. The efficacy function model, entropy weight method, and Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model were used to quantitatively assess the subsystems' state of development. Then, the coupling model (CD) and the coordination degree（CCD）model were used to explore the coupling coordination relationship and spatial-temporal change characteristics of the composite system. The findings indicate that: 1）In 2020, the quality of urbanization in LXUA showed the pattern of "double core". The development of urban centers in each city is insufficient, and the proportion of counties with low-level is too high. 2）Integrated ecosystem services showed an increasing distribution pattern from the northeast to the southwest. Water provision services, soil conservation services and carbon fixation services all showed growth trends. 3）Each county’s composite system was in the run-in stage or highly coupled stage. The subsystems were closely related to each other. 4）The CCD was decreased by 6% between two decades. The number of counties on the verge of disorder was the highest. About 80% of the counties are relatively lagging behind in ecosystem services.

Family support is offered to Australian parents of young children using a mix of targeted and universal child and family health services. A feature of the universal services is the ability for nurses to work in partnership with families and to offer flexibility depending on need. This model of progressive universalism relies on the voluntary engagement of families, including families with complex needs. In this study, the capacity to engage and retain families, including those at risk for child maltreatment and family violence, was examined. Child and Family Health Nurses (n=129) participated in a pragmatic, multilevel mixed-methods study using the McCurdy and Daro (2001) Integrated Theory of Parent Involvement. A questionnaire was used in the first phase of the study to collect the quantitative data. Focus groups were then held with 27 participants recruited from phase one. Both homogeneous and heterogenous practices identified from the questionnaire were the focus of the discussions. Three phases of practice were identified and described: enrolment, retention and conclusion of the nurse-parent relationship and are presented and discussed in this paper. The retention of families with complex needs relies on flexible, advanced, and multidimensional nursing practices.

Recent years have seen a proliferation of platform-based “shared mobility services” (SMS) such as car-, bike-, and e-scootersharing in many cities in Germany and around the world. At the same time, these services have become the subject of intense debates: Are they replacing private car travel, thus contributing to sustainable mobility in cities? Or are they drawing users away from public transit and cycling while obstructing public space? From the perspective of sustainable mobility politics it seems far from clear which role these new services could play in transitioning to a less car-centric mobility system. While a number of potential effects and ensuing governance issues of shared mobility services (e.g. regarding questions of equitable access, data governance, the role of public versus private actors) have already been studied this article explores the role of shared mobility services (SMS) in triggering system dynamics and feedback loops in the context of sustainability transitions. The article connects questions regarding the sustainability effects of “shared mobility services” with the role of “push” measures to reduce private car traffic in cities. Using a theoretical framework from socio-technical transitions research and from the sociology of technology it describes the recent growth of shared mobility services in Berlin as an example of the upscaling dynamics of socio-technical niche innovations. Drawing on a series of workshops with mobility service providers and representatives of public authorities it analyses the potential for conflict as well as for coalition building between service providers and public authorities. Based on the theoretical concept of the role of feedback loops and windows of opportunity for transitions it shows how the market growth of shared mobility services added momentum to an already ongoing political debate over the legitimate use of public space in Berlin. Against this backdrop the article shows how growing numbers of car-, bike-, and e-scootersharing vehicles could open up windows of opportunity for re-distributing space away from private cars. The article concludes that supporting and regulating SMS will be key to steering their growth into the direction of sustainability.

Exploring the spatio-temporal differentiation characteristics and coupling coordination relationship of the composite ecosystem of urban agglomerations is of great significance for promoting the synergistic development and integration construction of urban agglomerations. This paper is based on LUCC data, DEM, temperature, precipitation and other multi-source data, taking the central Yunnan urban agglomeration as an example. The entropy weight method is first used to determine the comprehensive weights to evaluate the regional economic and social development level. Then, the InVEST (Integrated Valuation of Ecosystem Services and Trade-offs)model was used to quantitatively calculate and analyze the spatial and temporal evolution characteristics of the four ecosystem services, including water conservation, soil conservation, carbon sequestration services, and habitat quality. The coupling coordination model was used to quantitatively analyze the evolution of the coupling coordination of the composite ecosystems in the central Yunnan urban agglomeration during the period of 2010-2020, and to reveal its development law. The results show the following: ①During the study period, the socio-economic subsystems in central Yunnan urban agglomeration demonstrated an outward radiative growth from Kunming City, marked by underdeveloped sub-centers and prevalent low-level areas. ②Trends in ecosystem services varied, with water and soil conservation showing fluctuating increases, carbon sequestration remaining stable, and habitat quality declining. The integrated ecosystem services critically important zone is mainly located in the northeastern region and southwestern edge of the study area. ③Economic, social and ecological subsystems are highly coupled, with consistent overall development trends and strong interactions. ④The increase in the degree of harmonization amounted to 7.82%, with lagging subsystems varying in different degree of harmonization subregions. The study can provide a scientific basis for urban agglomerations to formulate scientific and reasonable development policies, promoting regional sustainable development and optimizing the spatial pattern of the national territory.

Natural rivers in urban areas bear significant potential to provide ecosystem services for the surrounding inhabitants. However, surface sealing by houses and street networks, urban drainage, disposal of waste and wastewater resulting from advancing urbanization usually lead to the deterioration of urban rivers and their riparian areas. This ultimately damages their ability to provide ecosystem services. This paper presents an innovative methodology for a rapid and low-cost assessment of the ecological status of urban rivers and riparian areas in developing countries under data scarce conditions. The methodology uses a combination of field data and freely available high-resolution satellite images to assess three ecological status categories: river hydromorphology, water quality, and riparian land cover. The focus here is on the assessment of proxies for biophysical structures and processes representing ecological functioning that enable urban rivers and riparian areas to provide ecosystem services. These proxies represent a combination of remote sensing land cover- and field-based indicators. Finally, the three ecological status categories are combined to quantify the potential of different river sections to provide regulating ecosystem services. The development and application of the methodology is demonstrated and visualized for each 100 m section of the Pochote River in the City of León, Nicaragua. This spatially distributed information of the ecosystem service potential of individual sections of the urban river and riparian areas can serve as important information for decision making regarding the protection, future use, and city development of these areas, as well as the targeted and tailor-made development of nature-based solutions such as green infrastructure.

(1) Background: Applied health services research (AHSR) relies upon coordination across multiple organizational boundaries. Our aim was to understand how competing organizational and professional goals enhance or impede the conduct of high quality AHSR. (2) Methods: A qualitative study was conducted in two local health care systems in the UK, linked to a feasibility trial of a clinic-based intervention in secondary care. Data collection involved 24 semi-structured interviews with research managers, clinical research staff, health professionals, and patients. (3) Results: This study required a dynamic network of interactions between heterogeneous health and social care stakeholders, each characterized by differing ways of organizing activities which constitute their core functions; cultures of collaboration and interaction and understanding of what research involves and how it contributes to patient care. These interrelated factors compounded the occupational and organizational boundaries that hindered communication and coordination. (4) Conclusions: Despite the strategic development of multiple organizations to foster inter-professional collaboration, the competing goals of research and clinical practice can impede the conduct of high quality AHSR. To remedy this requires the alignment and streamlining of organizational goals, so that all agencies involved in AHSR develop a shared understanding and mutual respect for the progress of evidence-based medicine and the complex and often nuanced environments in which it is created and practiced.

Tourism is an important industry that promotes national economic and social progress. All-for-one tourism is a new concept of regionally coordinated development that uses the tourism industry as an engine to boost resource integration, industrial integration, and social sharing. Tourism service is the main embodiment of cultural ecosystem services for all-for-one tourism cities. Taking Liyang in China as an example, this paper used a combination of GIS spatial analysis and big data text mining to evaluate the tourism service from three aspects: the quality of tourism resources, the comprehensiveness of tourism service facilities, and the satisfaction of tourists. The results show that (1) the tourism service is better in the northwestern and eastern areas of the city, while it is lower in the northeastern and southwestern parts; (2) the hotspot areas should focus on improving the tour routes, the transport capacity, and excessive charges; the cold spot areas should work on ecological restoration and creating new tourism attractions by combining the local industries; (3) rural tourism integrating agriculture and visitation should be highlighted as a key growth point to improve the city’s tourism service function.

This paper explores decision analysis on product integration of family security services and residential fire insurance in the London and Taiwan markets by using the proposed mathematical models for counting sustainable value. This paper shows the five main different results between London and Taiwan markets with ten different parameters of the family security market, to find out the optimal number of family security integrated services for each security company in London. The improvement of the risk aversion effect based on risk and financial management will enhance the market share of the private security industries in the London and Taiwan markets. The results of this research can serve as a reference for the decision-making of private security industries on product integration under sustainable value consideration. The research findings highlight the potential benefits for both the private security industry and the insurance industry in their design and negotiation for product integration to improve both of business operation and achieve corporate social responsibility goals to match the sustainability in the future.

The issues concerning the development of the smart systems for the management of freight transport are related to many factors which are influencing by properties of such a complex processes and ICT development. We are concerned with the recognition of a wide spectrum of services and provision specifics under conditions of wireless communication networks. Also, we are investigated for the adequate provision of context data with problematic of a definition of such context data and with possibilities to apply formalized artificial intelligence methods for recognition of this context information needs for transportation. In this stage of application of the smart system, we are solving the problem of priority of provision of possible providing services, ensuring of quite optimal quality of data supply channels and restriction of flooding of wireless communication channels. The proposed methodology is based on methods of indication of con-text-aware situations and integration of such data into the situation recognition algorithms. The constructions of smart service provision system are developed for more safety management of transportation. The experimental results are demonstrated on analysis of heterogeneity of smart services, construction of schemas for service provision priorities, and extension of potential of intelligent transport with intellectual recognition possibilities of context-aware information in the transportation process.

We have estimated the level of Risk Weighted Assets among 30 countries in Europe, in 30 trimesters, using data of the European Banking Authority-EBA of 139 variables. We perform an econometric model using Pooled OLS, Panel Data with Fixed Effects, Panel Data with Random Effects, Weighted Least Squares. We found that Risk Weighted Assets is negatively associated, among others, to the level of NFC loans in mining and quarrying, in public administration and defence, and in financial and insurance activities and positively associated, among others to distribution of NFC loans in human health services and social work activities, in education and the level of net fee and commission income. Furthermore, we apply a cluster analysis with the k-Means algorithm, and we find the presence of two clusters. A comparison was then made between eight different machine learning algorithms for predicting the value of the RWAs and we found that the best predictor is the linear regression. The RWA value is predicted to increase by 1.5%.

Confidence in intermodal transport has not yet been defined. There are many different approaches to the concept of trust. However, the authors embedded them in the light of the challenges of sustainability, linking with the shift paradigm. The objective of the article is to indicate the directions and criteria for the implementation of the shift paradigm, inscribed in the idea of sustainable transport. The auxiliary objective is to predict which countries in a given year will have the TRUST status, i.e. implement the shift paradigm, and which will not implement it (DISTRESS). The article uses taxonometric techniques and built a model using General Discriminant Analysis. On their basis, the utility function was approximated, including the directions of implementation of the shift paradigm depending on the scale of the environmental load of transport. In the course of the research, an original and innovative econometric model was constructed, pointing to three variables, which had the greatest impact on trust. Thanks to the cognitive value of the model, it is possible to identify individuals who deserve the trust, i.e. it will implement the shift paradigm, with 93% probability. In the future, it is worth expanding the research by models for each country.

This short note proposes a national Geographic Information System (GIS) - based health infrastructure to deal with epidemics and pandemics. Currently, there is no pan-India health infrastructure available that can compile, update, and report the spread of epidemic diseases. It not only curtails the opportunity of finding the real-time data on the spatial distribution of a disease but prevents one to inquire into the causes of the disease through epidemiological analysis. The proposed infrastructure in this study is a pan-India one and can broadly be divided into two parts, hotspot mapping and accessibility to services. In the first part, hospitals are proposed to act as nodes of data collection, sending data to a national GIS portal. This portal shall have the capabilities of plotting the data using map rendering services such as Google and Bing Maps. This way, hotspots can be visualized in no time, benefitting the government and common citizenry alike. The second part deals with the accessibility of citizenry to a wide range of services, i.e., healthcare services, grocery outlets, emergency services, baby food, and many other essential services of the day to day life. In order to implement this, we propose that the government need to enforce a mandatory submission of locational coordinates of all Goods and Services Tax (GST) enrolled service providers. Once the coordinates are submitted, the government can effectively control the opening and closing of services and inform the citizenry at the same time. The proposed infrastructure is going to help deal with the extraordinary situations during epidemic and pandemics similar to what the world is currently facing in the form of Corona Virus Disease 2019 (COVID-19). Furthermore, the infrastructure can be scaled up or down as per the spread of a disease. The health-GIS platform proposed in this concept paper, shall help India in controlling and managing the epidemic more efficiently.

A small proportion of health care users are recognised to use a significantly higher proportion of health system resources, largely due to systemic, inequitable access and disproportionate health burdens. These high-resource health system users are routinely characterised as older, with multiple comorbidities, and reduced access to adequate health care. Geographic trends also emerge, with more rural and isolated regions demonstrating higher rates of high-resource use than others. Despite known geographical discrepancies in health care access and outcomes, health policy and research initiatives remain focused on urban population centers. To alleviate mounting health system pressure from high-resource users, their characteristics must be better understood within the context in which it arises. To examine this, a scoping review was conducted to provide an overview of characteristics of high-resource users in rural and remote communities in Canada and Australia. In total, 21 papers were included in the review. Using qualitative thematic coding, primary findings characterised rural high-resource users as those of an older age; with increased comorbid conditions and condition severity; lower socioeconomic status; and elevated risk behaviours.

Grasslands are at risk of degradation due to unsustainable management practices and climate change. Sustainable grassland soil management can promote ecosystem service delivery and improve the resilience of the entire grassland ecosystem to anthropogenic change. Here, we re-view the principal soil quality indicators (SQIs) and how they have been used to evaluate the sustainability of different grassland management practices globally. We then discuss sustainable grazing management practices, before reviewing some novel grassland species which may im-prove grassland resilience with relevance for grassland management in Europe and the UK. We also give an overview of current sustainable grassland management methods and their assessment at field scale. From this, we suggest that sustainable Grazing Management Plans (GMPs), together with the testing of drought-resistant grass species and appropriate SQIs monitoring, is key to increasing resilience of grassland ecosystems to anthropogenic change.

Introduction: As the paramedic profession continues to grow and evolve, a shift from reactive to holistic patient care models is required. As the first and often the only point of medical contact for many patients from marginalized and under-served populations, the paramedic role, and its potential future implications in caring for these patients needs to be explored. Aim: The objective of this scoping review was to explore the paramedic's role in caring for people who use illicit drugs. Methods: A scoping review of English language literature published since 2002 was conducted using CINAHL, MEDLINE, EMBASE, and Google Scholar. We used a previously published paramedic search term filter for sensitivity combined with search terms related to drug-related substance use and addiction. Studies were selected based on relevance to the research question. Results: A total of 104 peer-reviewed and 14 grey literature articles were selected for inclusion. The main finding of this scoping review is the notable lack of evidence base surrounding the contemporary paramedic role in the care provision of people who use drugs (PWUD). The results highlight high rates of mortality following a paramedic-attended drug poisoning event, presenting a unique opportunity for paramedics to intervene in meaningful ways that extend past traditional drug poisoning response. Conclusions: The interface between the community of PWUD and the paramedic may be a highly influential encounter during a patient's journey through the healthcare system. The evolving role of the paramedic in this encounter requires focused study and should be viewed as a research priority in response to the ongoing drug poisoning crisis.

Distance learning has assumed a relevant role in the Educational scenario. The use of Virtual Learning Environments contributes to obtain a substantial amount of educational data. In this sense, the analyzed data generate knowledge used by institutions to assist managers and professors in strategic planning and teaching. The discovery of students’ behaviors enables a wide variety of intelligent services for assisting in the learning process. This article presents a literature review in order to identify the intelligent services applied in distance learning. The research covers the period from January 2010 to May 2021. The initial search found 1,316 articles, among which 51 were selected for further studies. Considering the selected articles, 33% (17/51) focus on learning systems, 35% (18/51) propose recommendation systems, 26% (13/51) approach predictive systems or models, and 6% (3/51) use assessment tools. This review allowed to observe that the principal services offered are recommendation systems and learning systems. In these services, the analysis of student profiles stands out to identify patterns of behavior, detect low performance and identify probabilities of dropouts from courses.

Meta-analysis has increasingly been used to synthesize the ecosystem services literature, with some testing of the use of such analyses to transfer benefits. These are typically based on local primary studies. However, meta-analyses associated with ecosystem services are a potentially powerful tool for transferring benefits, especially for environmental assets for which no primary studies are available. In this study we use the Ecosystem Service Valuation Database (ESVD), which brings together 1350 value estimates from more than 320 studies around the world, to estimate meta-regression functions for provisioning, regulating &amp; maintenance and cultural ecosystem services across 12 biomes. We tested the reliability of these meta-regression functions and found that even using variables with high explanatory power, transfer errors could still be large. We show that meta-analytic transfer performs better than simple value transfer and, in addition, that local meta-analytical transfer (i.e. based on local explanatory variable values) provides more reliable estimates than global meta-analytical transfer (i.e. based on mean global explanatory variable values). Thus, we conclude that when taking into account the characteristics of the study area under analysis, including explanatory variables such as income, population density and protection status, we can determine the value of ecosystem services with greater accuracy.

One of the fastest growing customer service delivery platforms is online banking. However, the increasing number of attacks on online banking platforms is driving the banks to constantly review their security. This study developed an enhanced Multi-factor authentication scheme with a track and trace capability to reduce these threats. Five modalities of authentication were incorporated in the proposed scheme: The traditional username, password, personal identification number (PIN) and one-time PIN (OTP), augmented with fingerprints or facial scans, registered smart devices, and a time locked user's location. One of the scheme's most impressive accomplishments is its capacity to seamlessly detect undesired activities and send alerts in the form of secretly obtained photographs and location triangulation.

The concept of ecosystem services (ESs) provides a valuable approach to communicate societies' dependence on natural ecosystems, assisting in the evaluation of measures to protect vegetation in watersheds that promote water-related ESs. Vegetation cover and land use are important factors related to the capacity of ecosystems to provide soil loss regulation and sediment retention services, which are highly relevant for sediment management in watersheds draining into reservoirs with multiple water uses. This study aims to assess the relationship between potential changes in land use and land cover and the sediment retention service provided by riparian vegetation in a watershed draining into a hydroelectric reservoir in the Brazilian Cerrado. Sediment load was selected as a physical variable that affects different water uses in reservoirs, with these uses being dependent on the quality or quantity of stored water. Scenarios were analyzed to represent landscape reconfigurations from a baseline condition in order to account for the recovery of riparian vegetation by the agricultural sector, as foreseen in the Brazilian Forest Code. To map and quantify variations in annual sediment retention, the InVEST model was used, which allows estimating an integrated response of the drainage basin to large-scale land use changes over time and space. The results show that for the drainage basin of the Corumbá IV Hydroelectric Power Plant (HPP), the recovery of riparian areas occupied by annual crops has the potential to generate greater benefits to water use in the reservoir. In the studied catchment area, 14% of the total vegetation deficit in riparian areas is occupied by crops, while 86% is occupied by pastures. This highlights the buffering role of riparian vegetation as an effective practice for managing sediment flows originating from sheet erosion in agricultural landscapes. The methodology employed in this study allows for the quantification and mapping of the effects of soil and water conservation measures in river basins. This enables the prioritization of sectoral efforts for the restoration of native vegetation, considering the highest returns in benefits perceived by water users affected by sediment input in reservoirs. The study's results reinforce the importance of conserving vegetation in riparian areas and their surroundings for sediment retention, highlighting the role of these areas as assets in providing water-related ecosystem services.

This study assessed health inequality trends and the degree of maternal healthcare services utilization in the DRC, using two consecutive Demographic and Health Surveys, 2007 and 2013-2014. First, we assessed the changes in the magnitude of inequality in the utilization of MHCS using logistics and regressions. Second, we analyzed the distribution of inequality in each MHCS utilization variable using the Gini coefficient and the Lorenz curve. Third, we used the Wagstaff two groups concentration indices comparison method to assess health inequality trends. Finally, we fitted the concentration curves to estimate the inequality in the utilization of MHCS to the economic condition of women. Women were less likely to have their first ANC visit within the first trimester, less likely to receive checkups during ANC visits, and less likely to attend more ANC visits when living in eastern DRC compared to western DRC. Women in rural areas were less likely to have their last birth by C-section, and less likely to receive PNC than women in urban areas. Women with middle, richer, and richest wealth indexes were more likely to complete more ANC visits, more likely to deliver by C-section, most likely to receive PNC, and more likely to receive ANC than those with lower wealth indexes. Over time, inequality in the utilization of MHCS decreased for ANC and PNC but increased for the delivery by C-sections. These findings suggest that innovative strategies are still needed to improve the utilization of MHC services among poorer, rural, and underserved women in post-conflict DRC.

Equine-assisted services (EAS) are being increasingly used as complementary interventions for military veterans who have experienced trauma. However, there is limited evidence of benefit for this population and almost no literature describing desired potential outcomes and possible mechanisms of action. The aim of this article is to address these gaps by reviewing the extant literature of animal-assisted interventions in general, and equine-assisted services in particular, with the goal of providing guidance for future investigations in the field. Currently, the field is in the early stage of scientific development, but published results are promising. Interventions that enhance treatment compliance and/or outcomes could benefit this population. Preliminary results, reviewed herein, indicate that EAS interventions might benefit the military veteran population by enhancing treatment engagement and therapeutic alliance, as well as contributing to symptom reduction and resulting in various transdiagnostic benefits. It is recommended that future studies include exploration of potential beneficial outcomes discussed herein as well as investigate suggested mechanisms of action.

Modern research applies the Open Science approach that fosters the production and sharing of Open Data according to the FAIR (Findable, Accessible, Interoperable, Reusable) principles. In the geospatial context this is generally achieved through the setup of OGC Web services that implements open standards that satisfies the FAIR requirements. Nevertheless, the requirement of Findability is not fully satisfied by those services since there’s no use of persistent identifiers and no guarantee that the same dataset used for a study can be immutably accessed in a later period: a fact that hinders the replicability of research. This is particularly true in recent years where data-driven research and technological advances have boosted frequent updates of datasets. Here, we review needs and practices, supported by some real case examples, on frequent data or metadata updates in geo-datasets of different data types. Additionally we assess the currently available tools that support data versioning for databases, files and log-structured tables. Finally we discuss challenges and opportunities to enable geospatial web services that are fully FAIR: a fact that would provide, due to the massive use and increasing availability of geospatial data, a great push toward open science compliance with ultimately impacts on the science transparency and credibility.

The school food environment is a suitable place to promote healthy habits, as it is a space for learning and constant social interaction, where children spend at least a third of their day, and have one to two meals. This study aimed to analyze the sale of food in the canteens of private schools in a capital in the Northeast of Brazil and verify the influence of it on students’ eating behavior. A cross-sectional, quantitative, multicenter study was carried out, taking place simultaneously in twenty capitals in Brazil. A checklist with 87 questions was applied to those responsible for the canteens in a representative sample of schools in each city. Frequencies and associations were performed using Pearson's Chi-Square test. The analysis of the foods sold, was based on the NOVA food classification from the Dietary Guidelines for the Brazilian Population, regarding the degree and extent of processing. Latent Class Analysis was carried out to group the canteens into similar response patterns, modeled with covariates, and the association was calculated with the Kruskal-Wallis and Duun tests or Fisher's Exact test. The results showed that students were very frequently offered ultra-processed, sugar-rich foods with low nutritional value; 88.7% of such foods had been chosen by managers as part of the menu because they are “students’ food preferences”. There is an average of 2.3 fresh foods in canteens compared to 7.5 varieties of ultra-processed foods. There must be stricter control over what is sold, to minimize student’s exposure to unhealthy foods.

(1) Introduction: The unprecedented coronavirus disease 2019 (COVID-19) epidemic has caused millions of infections worldwide and represents a significant challenge facing modern health care systems. This study was conducted to investigate the impact of lockdown measures on regional neonate services, which might be used to predict the long-term effects of medical behavior. (2) Methods: Using hospital information system (HIS) Statistics data from 4 January 2019 to 27 August 2020, an interrupted time-series analysis was employed to compare changes and trends in hospital admissions and disease spectrum before and after the lockdown interventions. Furthermore, this study was designed to evaluate whether the pandemic influenced newborns' healthcare behavior. (3) Results: Overall, 13,540 infants were admitted to the NICU during the pre-COVID period (n = 12082) and COVID-impacted period (n =4558). The patients' age at admission were younger than that of the pre-COVID-19 period (median age 5d vs. 6d after birth, p＜0.001). The overall number of neonate visits consistently decreased from the first days of the lockdown measures (24 January 2020). The disease spectrum for respiratory system, infectious diseases, and gastrointestinal disease indicated no declined immediately after intervention(p =0.079, p =0.113, p =0.060, respectively). There was an immediate decline in the volume of Jaundice-related conditions (p<0.001) after lockdown measures. The percentage of patients who suffer from respiratory system and infectious diseases has decreased (p =0.005 and p =0.002). However, a relatively high percentage of patients admitted to the neonatal intensive care unit (NICU) presented with Jaundice-related conditions (p <0.001). (4) Conclusions: In summary, the COVID-19 pandemic profoundly impacted the regional neonate services. However, it is still unclear what might be the effect of long-term effects from pandemic.

The ubiquity of mobile sensors (such as GPS, accelerometer and gyroscope) together with increasing computational power have enabled an easier access to contextual information, which proved its value in next generation of the recommender applications. The importance of contextual information has been recognized by researchers in many disciplines, such as ubiquitous and mobile computing, to filter the query results and provide recommendations based on different user status. A context-aware recommendation system (CoARS) provides a personalized service to each individual user, driven by his or her particular needs and interests at any location and anytime. Therefore, a contextual recommendation system changes in real time as a user’s circumstances changes. CoARS is one of the major applications that has been refined over the years due to the evolving geospatial techniques and big data management practices. In this paper, a CoARS is designed and implemented to combine the context information from smartphones’ sensors and user preferences to improve efficiency and usability of the recommendation. The proposed approach combines user’s context information (such as location, time, and transportation mode), personalized preferences (using individuals past behavior), and item-based recommendations (such as item’s ranking and type) to personally filter the item list. The context-aware methodology is based on preprocessing and filtering of raw data, context extraction and context reasoning. This study examined the application of such a system in recommending a suitable restaurant using both web-based and android platforms. The implemented system uses CoARS techniques to provide beneficial and accurate recommendations to the users. The capabilities of the system is evaluated successfully with recommendation experiment and usability test.

The paper aims to develop and test an algorithm for classifying Russian-language text reviews of patients’ experiences with medical facilities and physicians, extracted from social media. This is motivated by the limitations of conventional methods of surveying consumers to assess their satisfaction with the quality of services, which are being replaced by automatic processing of text data from social media. This approach enables to get more objective results due to the increased representativeness and independence of the sample of service consumers. The authors have tested machine learning methods using various neural network architectures. A hybrid method was developed to classify text reviews of medical facilities posted by patients on the two most popular physician review websites in Russia. Overall, more than 60,000 reviews were analysed. The main results are as follows: 1) the classification algorithm developed by the authors has a high efficiency, the best result being achieved by the GRU-based architecture (val_accuracy = 0.9271); 2) applying the named entity search method to text messages following their partitioning improved the classification efficiency for each of the classifiers based on artificial neural networks. To further enhance the classification quality, reviews need to be semantically partitioned by target and sentiment and the resulting fragments need to be analysed separately.

Economic valuations of ecosystem services often transfer previously estimated global unit values to the geographical setting of interest. While this approach produces quick results, its reliability depends on how representative the large-scale average unit values are for the given local context. Here, we estimate the values of three ecosystem services (ES) – water filtration, nutrient cycling and carbon sequestration – in the Grand River watershed (GRW) of southern Ontario, Canada. The watershed covers nearly 7000 km2, has a humid continental climate and a population of close to one million people. Land cover is dominated by agriculture. We compare ES valuations using locally derived (i.e., GRW-specific) unit values to valuations based on unit values from a regional database and those compiled in the global Ecosystem Services Valuation Database (ESVD). The regional database includes mean unit values from three case studies within southern Ontario and one boreal watershed in British Columbia. As expected, the regional database yields average monetary values for the three ES that are close to those obtained with the local unit values but with larger associated uncertainties. Using the ESVD, however, results in significantly higher monetary values for the ES. For water filtration, the ESVD value is more than five times higher than the regional and local estimates. We further illustrate the effect of the extent of aggregation of forested and agricultural land categories on the ES values. For example, by subdividing the forest category into three sub-categories (deciduous, coniferous, and mixed forest), the estimated value of the carbon sequestration ES of forested areas within the GRW increases by 15%. Overall, our results emphasize the importance of critically assessing the origin of unit values and the land cover resolution in ES valuation, especially when the latter is used as a policy-guiding tool.

Background: Low-level physical activity (PA) among Chronic Low Back Pain (cLBP) is associated with various biopsychosocial factors. This research aimed to study the predictors of PA behavior among cLBP patients. Methods: In the present study 300 eligible patients with cLBP who referred to comprehensive health service centers in the Shahid Beheshti University of Medical Sciences (SBUMS) in Tehran, Iran were random selected.To diagnose the predictors of PA behavior, all the Theory of Reasoned Action (TRA) constructs were examined as risk factors to see if they influence on the probability of PA behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 280 cLBP patients with mean age of 57.07 ±13.09 years old participated in the study. This study showed that motivation to comply significant predictor the cLBP patients for subjective norm OR (%95CI): 2.095(0.116-2.792), p-value<0.001), intention was significant predictor for perform the PA behavior OR (%95CI): 1.431(0.138-1.538), p-value <0.001), behavior beliefs could predictor for attitude OR (%95CI): 1.276(0.106-1.355), p-value= 0.002). attitude, normative beliefs, subjective norm ,and evaluation outcome behavior could predictors the cLBP patients for intention to perform the PA behavior OR (%95CI): 1.188(0.032-1.312), p-value<0.001)., OR (%95CI): 1.158(0.076-2.208), p-value=0.003) ., OR (%95CI): 1.104(0.076-1.128), p-value<0.001) ., OR (%95CI): 0.814(0.301-1.440), p-value=0.007). Conclusions: This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm).

Research focused on understanding wider systemic factors driving behavioral change is limited with a dominant focus on the role of individual farmer and psychosocial factors for farming practice change, including reducing fertilizer application in agriculture. Adopting a wider systems perspective, the current study examines change and the role that supporting services have on fertilizer application rate change. A total of 238 sugarcane growers completed surveys reporting on changes in fertilizer application along with factors that may explain behavior change. Logistic regressions and negative binomial count-data regressions were used to examine whether farmers had changed fertilizer application rates and if they had, how long ago they made the change, and to explore the impact of individual and system factors in influencing change. Approximately one in three sugarcane growers surveyed (37%) had changed the method they used to calculate fertilizer application rates for the cane land they owned/managed at some point. Logistic regression results indicated growers were less likely to change the basis for their fertilizer calculation if they regarded maintaining good relationships with other local growers as being extremely important, they had another source of off-farm income, and if they had not attended a government-funded fertilizer management workshop in the five years preceding the survey. Similar drivers promoted early adoption of fertilizer practice change; namely, regarding family traditions and heritage as being unimportant, having sole decision-making authority on farming activities and having attended up to 5 workshops in the five years prior to completing the survey. Results demonstrated the influence of government-funded services to support practice change.

Background: Tele-emergency physicians (TEPs) take an increasingly important role in the need-oriented provision of emergency patient care. To improve emergency medicine in rural areas, we set up the project Land|Rettung (English: Rural|Rescue), which uses TEPs to restructure professional rescue services using information and communication technologies (ICTs) in order to reduce the therapy-free interval. Successful implementation of ICTs relies on user acceptance and knowledge sharing behavior. Methods and findings: We conducted a factorial design with active knowledge transfer and technology acceptance as a function of work satisfaction (high vs. low), workload (high vs. low) and point in time (prior to vs. after digitalization). Data were collected via machine readable questionnaires issued to 755 persons (411 pre, 344 post), of which 304 or 40.3% of these persons responded (194 pre, 115 post).Technology acceptance was higher after the implementation of TEP for nurses but not for other professional groups, and it was higher when the workload was high. Regarding active communication and knowledge sharing, employees with low work satisfaction are more likely to share their digital knowledge as compared to employees with high work satisfaction. Additional and more detailed analyses reveal that this is an effect of previous knowledge concerning digitalization. After implementing the new technology, work satisfaction increased for the more experienced employees, but not for the less experienced ones. Results are discussed considering the Dunning-Kruger effect. The Dunning-Kruger effect describes a cognitive bias. People with high expertise often underestimate their actual skill level. They have a more critical attitude towards their performance and feel the urgent need to fill possible knowledge gaps they notice. Conclusions: Our research illustrates that employees’ workload has an impact on the intention of using digital applications. The higher the workload, the more people are willing to use TEPs. Regarding active knowledge sharing, we see that employees with low work satisfaction are more likely to share their digital knowledge compared to employees with high work satisfaction. This might be attributed to the Dunning-Kruger effect. Highly knowledgeable employees initially feel uncertain about the change, which translates into temporarily lower work satisfaction. They feel the urge to fill even small knowledge gaps, which in return leads to higher work satisfaction. Those responsible need to acknowledge that digital change affects their employees’ workflow and work satisfaction. During such times, employees need time and support to gather information and knowledge in order to cope with digitally changed tasks.

The South African Weather Service (SAWS) manages an in-situ solar irradiance radiometric network of 13 stations and a very dense sunshine recording network; located in all six macro-climate zones of South Africa. A sparsely distributed radiometric network and over a landscape with dynamic climate and weather shifts is inadequate for solar energy studies and applications. Therefore, there is a need to develop mathematical models to estimate solar irradiation for a multitude of diverse climates. In this study, the annual regression coefficients, a and b, of the Ångström-Prescott (AP) model that can be used to estimate global horizontal irradiance from observed sunshine hours were calibrated and validated with observed station data. The AP regression coefficients were calibrated and validated for each of the six macro-climate zones of South Africa using the observation data that spans 2013 to 2019. The predictive effectiveness of the calibrated AP model coefficients was evaluated by comparing estimated and observed daily global horizontal irradiance. The maximum annual relative Mean Bias Error (rMBE) was 0.371 %, relative Mean Absolute Error (rMAE) was 0.745 %, relative Root Mean Square Error (rRMSE) was 0.910 % and the worst-case correlation coefficient (R2) was 0.910. The statistical validation metrics results show that there is a strong correlation and linear relation between observed and estimated solar radiation values. The AP model coefficients calculated in this study can be used with quantitative confidence in estimating daily GHI data at locations in South Africa where the daily observation sunshine duration data is available.

The reliance on cloud computing services and related technologies has increased due to their many benefits, including resource sharing and the need for organizations to maintain their competitive advantage in the digital market. Also, the pace of cloud growth has significantly increased because of COVID-19. Many companies and businesses have shifted their core processes to the cloud for seamless operations during the pandemic. This migration of legacy systems to the cloud creates many opportunities for businesses. However, on the other hand, it may also bring substantial challenges. Hence, a careful decision is needed to align with company goals. In this paper, we demonstrate the need and advantages of cloud computing, followed by highlighting AWS's characteristics as one of the leading cloud service providers. We also discuss the merger of AWS with SDN to improve cloud data security and performance. The outcomes of this study can provide a data migration strategy and guide decision-makers toward a secure and sustainable migration to a cloud computing environment.

Forest ecosystems provide diverse services and values that contribute to human well-being. Although high proportion of species is still undiscovered, tropical forests alone are thought to host more than 50% of the world’s biodiversity. Beyond supporting via direct use of products like timber, fiber and biomass energy, they play an important role in providing a wide range of ecosystem services such as regulating water flow and quality, water purification, improving infiltration, fresh water, erosion control, carbon sequestration and sedimentation control. They are one of the important parts of terrestrial and the largest carbon pool, occupying an integral position in the global carbon cycle. However, these days, deterioration of nature and forest biodiversity is a severe danger to the global environment. This will be accompanied by increased strains on food supply, causing increased pressure on already delicate ecological systems. Thus, better forest management strategies are necessary for managing forests sustainably. Nevertheless, little is known regarding the existing forest management approaches and their associated benefits and challenges. Multidisciplinary approaches are needed to achieve sustainable management of forests. These can be accomplished if suitable forest management innovations are put in place. Various technologies can also be adopted through applying different forest assessment tools like remote sensing using light detection and ranging technology (LiDAR) in forest management. Harnessing such technologies will definitely result in providing increased socio-economy as well as improved environmental sustainability. However, the speed of transformation depends much on level of commitment of stakeholders including policy makers. As a result, this review is intended to explore existing forest management innovations which are suitable both ecologically as well as socio-economically. This shows that while there is a lot to be improved, there are already developed forest management innovations that are already in use including PFM and MFM, which helps to achieve SFM.

This paper explores the relationships between marketing strategies, social media platforms, the adoption and diffusion of products and services, and organizational resilience to gain an understanding of the ability of organizations to cope with disruptive events (e.g., COVID-19). This can be achieved through effective marketing strategies and the efficient use of social media platforms. In fact, resilience thinking can help organizations maintain their operations by increasing the adoption and diffusion of their products and services through the use of effective marketing strategies. To achieve this article’s objectives, a literature review is conducted to help develop a conceptual framework that highlights a clear relationship between the previously discussed concepts. In addition, the novel nature of the relationship between marketing strategies and organizational resilience is dissected and its significance for organizations is demonstrated. In fact, the findings of this study suggest that effective marketing strategies that consider the "what," "who," and "how" dichotomies and the efficient use of social media to promote the adoption and diffusion of products and services can significantly enhance the resilience of organizations. These relationships can serve as a starting point for further studies examining and empirically analyzing marketing strategies and their positive effect on strengthening organizational resilience.

In the last decade, probably in response to global changes and environmental crisis, the use of the term “social-ecological system” (SES) in the scientific literature has been growing. This is certainly a sign of the recognition of the need and importance of transdisciplinary research. Here, we explore whether the use of the term is a buzzword, or it actually represents a key concept toward the integration of social and ecological research. We compiled a data base of publications (N = 1289) that mentioned SES in title, keywords and abstract. Subsequently, we analyzed: authors affiliations, type of work (conceptual, empirical, review), study site, prevailing human use, temporal and spatial scales of analysis, kind of variables analyzed (socioeconomic, biophysical), and the method/s used to integrate them. We detected four time spans in the use of the term (1975–1997, 1998–2006, 2007–2012, 2013–2016). Our results suggest that SES is a widely invoked concept to study the interface between social and ecological systems. Most works show some common elements such as the analysis of resilience, ecosystem services, sustainability, governance and adaptive management. However, the majority of studies does not study SES as a whole, integrating both social and ecological variables and their feedback loops. We consider that SES is still a concept in construction in order to build a necessary framework to integrate social and ecological sciences. For a robust evolution we recommend to focus on 1. a conscious, discussed and agreed effort of scientists to conduct transdisciplinary research needed to study SES; 2. developing methodological tools for the true integration of social and ecological data.

Given the cross-scale interactions of agricultural ecosystems, it is important to collect ecosystem service data at the multiple spatial scales they operate at. Mapping of ecosystem services helps to assess their spatial and temporal distribution and is a popular communication tool of their availability and value. For example, maps can be used to quantify distance between areas of available ecosystem services and their beneficiaries and how services fluctuate with changes in land use patterns over time, allowing identification of synergies and trade-offs. However, a lack of local context and too large a resolution can reduce the utility of these maps, whilst masking heterogeneities in access due to equity dynamics. This review identifies and summarizes eight main methods of ESS mapping found in the literature—remote sensing, biophysical modelling, agent based modelling, economic valuation, expert opinion, user preference, participatory mapping, and photo-elicitation. We consider what spatial scales these methods are utilized at and the transferability of data created by each method. The analysis concludes with a methodological framework for mapping ecosystem services, intended to help researchers identify appropriate methods for a multi-scale research design. The framework is exemplified with an overview of a research project in Ethiopia.

Payments for Ecosystem Services are a voluntary market-based instrument to remunerate provider(s) of ecosystem services by those who benefit from them. Our research aimed to create an ex-post evaluation framework to identify bottlenecks and elements hindering the success of a solution-driven PES scheme. The framework was applied to a case study to test its feasibility and concerns the provision of health and recreational services in the Medvednica Nature Park (Zagreb, Croatia). The framework was set up through three main sources: the study of PES implementation project documentation, semi-structured interviews with visitors and key stakeholders and web-scraping of TripAdvisor reviews of the park. The main findings confirmed society's interest in the park, but the lack of mapping, quantification, economic valuation and accounting of the services analysed, society's little or no demand to pay for their provision and confused knowledge of the property rights of some ecosystem service providers in the area limit the success of the PES scheme. The framework was useful to describe the chosen PES scheme and to identify bottlenecks and fragilities of the system in place, allowing to correct its application flaws and, on the other hand, to demonstrate its replicability in other contexts.

Natural capital is the wealth of nations that give them the economic status they represent. Worldwide, vulnerable people depend on natural capital for employment, salaries, wealth, and livelihoods and, in turn, determine the developmental index of the nation to which they belong. The availability of ecological services is crucial for clean water and air, food and fodder, and agricultural development. In this short commentary, we have tried to sum up the ideas and discussions over natural capital's role in ascribing economic status to countries. We have discussed how the prosperity of humans is intertwined with the services ecosystems provide and how poor natural resource management (NRM) has adversely cost human well-being. The paper concludes that to ensure the current and future human well-being, an in-depth understanding of the services ecosystems provide, is essential.

Traditional Medicine (TM) is a culturally-rooted healthcare practice, and its use, including for treating illnesses among children, has been reported in many countries. Despite the cultural significance of TM in managing children’s illnesses, evidence suggests that child mortality remains high in many settings. This indicates that the sole use of TM within families and communities might act as a barrier to using biomedical services, contributing to avoidable deaths. Globally, Indonesia is in the top 10 countries with the highest child mortality rates. In addition, Belu is a district in East Nusa Tenggara province, Indonesia that exhibits a high number of child deaths within the last three years. However, the use of TM for the treatment of illnesses among children in Indonesia has received minimal academic attention. This study aimed to understand parental beliefs, knowledge, views, and perceptions of TM and the impact on the use of TM and biomedical services in the treatment of illnesses among their children in Belu district, Indonesia. The participants (n=25) were parents with the real-life experiences of using TM for treating their children’s illnesses. They were recruited using the snowballing sampling technique. Data were collected using in-depth qualitative interviews. A thematic data analysis was performed and guided by a qualitative data analysis framework. The findings were grouped into four main themes: (i) parental beliefs, knowledge, views, and perceptions of TM, (ii) the influence of these factors on parental use of TM and biomedical services for the treatment of children’s illnesses, (iii) social and cultural influences on the use of TM and biomedical services among their children, and (iv) the impact of the sole use of TM or late medical diagnosis on the health condition and the death of children. The findings show that the use of TM is a common practice within families and communities in Belu, however evidence suggests that child mortality remains high in the setting, indicating less effectiveness of the sole use of TM. Thus, there is a need for the development of collaborative models of healthcare programs and service delivery fostering mutual respect and understanding between traditional healers and healthcare professionals, which could significantly contribute to improving parental use of biomedical services for the treatment of their children’s illnesses.

Improving HIV testing efficiency saves financial and material resources for health. We conducted a retrospective secondary data analysis of routinely collected HIV risk screening program data in Uganda, from October to November 2019, to determine the performance characteristics of the adolescent and adult HIV risk screening tool in public health facility settings. A total of 19,854 clients had been screened for HIV testing eligibility and tested for HIV. The overall positivity rate (cluster weighted prevalence of HIV) among those screened was 4.5% (95% CI: 4.1%-4.8%) versus 3.71% (95% CI: 3.06-4.50) among those not screened. The sensitivity and specificity of the risk screening tool were 90.7% (95% CI: 88.4%, 92.7%) and 75.8%, (75.2-76.4) respectively. With screening, the number needed to test to identify one PLHIV was reduced from 27 to 22. Although risk screening would have led to a 24.5% (4,825/19,704) reduction in testing volume, 9.3% (68/732) of PLHIV would have been missed, being misclassified as not eligible for testing. The cost per PLHIV identified fell by 3% from $69 without screening to $66.9 with screening. We recommend the use of scientifically validated HIV risk screening tools, and a need to explore the use of HIV self-testing as a test for tirage.

Understanding aspects of maritime/underwater cultural heritage (MUCH) and the associated cultural values and integrating them into maritime spatial planning (MSP) endeavors, is a new global challenge, alongside the rapid increase of human activities at sea and climate change impacts on the seas and the oceans. The article highlights the significance of cultural values in shaping human interactions with the marine environments, and how MSP can address the cultural dimensions of marine resources management. To this end, a systematic literature review was carried out to address the research question on how maritime/underwater cultural heritage is incorporated into MSP and map relevant academic literature. Following, a methodology that entailed an academic database search and the application of exclusion criteria, 346 articles resulted from Scopus. These articles were classified using science mapping techniques (i.e the VOSviewer Software ) and several categories (clusters) were created. The research showed a diversity of literature addressing the relationship between MUCH and MSP with a strong focus on sustainability, the significance of cultural ecosystem services (CES) and cultural values, the role of indigenous and local communities, but also of local stakeholders, the transfer of traditional knowledge to MSP and the participatory approaches and tools. The article concludes that for MSPlans to be innovative and acceptable by local communities, the “missing layer”of socio-cultural values and data is indispensable. In the MSP process, MUCH should be understood within this broader framework of socio-cultural considerations and values.

Virtual assistants (VAs) have gained widespread popularity across a wide range of applications, and the integration of Large Language Models (LLMs) such as ChatGPT has opened up new possibilities for developing even more sophisticated VAs. However, this integration poses new ethical issues and challenges that must be carefully considered, particularly as these systems are increasingly used in public services: transfer of personal data, decision-making transparency, potential biases, and privacy risks. This paper, an extension of the work presented at IberSPEECH 2022, analyzes the current regulatory framework for AI-based VAs in Europe and delves into ethical issues in depth, examining potential benefits and drawbacks of integrating LLMs with VAs. Based on the analysis, this paper argues that the development and use of VAs powered by LLMs should be guided by a set of ethical principles that prioritize transparency, fairness, and harm prevention. The paper presents specific guidelines for the ethical use and development of this technology, including recommendations for data privacy, bias mitigation, and user control. By implementing these guidelines, the potential benefits of VAs powered by LLMs can be fully realized while minimizing the risks of harm and ensuring that ethical considerations are at the forefront of the development process.

The aim of this research is forwarded for assessment of provision possibilities of the multi-componential and heterogeneous services in the fast-changing topology of cargo transportation processes. The mobile intelligent services in nowadays transport means require the development of complex infrastructure for multi-compositional service support. Our objectives are related to the investigation in data-transfer capabilities for heterogeneous service support, by offering some improvements for developing the infrastructure of transportation of vehicles by helping in the administration of transport processes. This research aims to develop an approach for assessment of infrastructure for sustainable management of cargo transportation processes by roads. Such assessment is multi-layered by including the management possibilities of cargo transportation logistic processes and electronic (smart, mobile) services by implementing of nowadays innovative software and hardware of information communication technologies (ICT). Special attention is paid for road safety, more environment cleanable, and paperless management by assessing the integration of potentials and prospects of wireless, vehicle Ad-hoc communication networks (VANET), and other communication possibilities. Some requirements are revealed for such type of infrastructure for the provision of heterogeneous services. The results of the development of infrastructure demonstrate the capacities of the potential of wireless networks for the provision of high-level of multi-component, heterogeneous services.

Background: To inform global health policies and resources planning, this paper analyzes evolving trends in physical rehabilitation needs, using data on Years Lived with Disability (YLDs) from the Global Burden of Disease Study (GBD) 2017. Methods: Secondary analysis of how YLDs from conditions amenable to physical rehabilitation have evolved from 1990 to 2017, for the world and across countries of varying income levels. Linear regression analyses were used. Results: A 66.2% growth was found in estimated YLD Counts amenable to physical rehabilitation: a significant and linear growth of more than 5.1 billion YLDs per year (99%CI: 4.8–5.4; r² = 0.99). Low-income countries more than doubled (111.5% growth) their YLD Counts amenable to physical rehabilitation since 1990. YLD Rates per 100,000 people and the percentage of YLDs amenable to physical rehabilitation also grew significantly over time, across locations (all p > 0.05). Finally, only in high-income countries Age-standardized YLD Rates significantly decreased (p < 0.01; r² = 0.86). Conclusions: Physical rehabilitation needs have been growing significantly in absolute, per-capita and in percentage of total YLDs, globally and across countries of varying income level. In absolute terms, growths were higher in lower income countries, wherein rehabilitation is under-resourced.

Achieving universal access to water and sanitation services in developing countries requires a coherent legal, political, and institutional environment, along with a clear financial strategy. Regionalizing utilities may be crucial for addressing disparities, economic inequalities, and governance challenges. Regionalization offers economies of scale, resource efficiency, knowledge sharing, and collaboration. The cornerstone will be ensuring the financial-economic viability of regional utilities, considering their social impacts in terms of affordability. The State of Santa Catarina case study is assessed. In the case of Santa Catarina, only four regional utilities currently generate sufficient revenue, without factoring in necessary investments, indicating the need to review design parameters to improve operational efficiency and increase revenues. Additional financial support may be required to ensure universal access. Tariff adjustments must strike a balance between cost-effectiveness and affordability for families.

We investigate the effect of geopolitical risk on the returns of the Information Technology, Communication Services, and Consumer Staples sector firms within the S&P 500 index. We use the event study methodology and perform more than 17,000 regressions to provide empirical evidence at the sector level that geopolitical risk leads to different responses across these 3 sectors. The response of the Information Technology sector is negative for all event windows under study, except the one spanning 10 days prior to the geopolitical event and 10 days after. The Communication Services sector has positive returns as a result of geopolitical events for all event windows, except the one from the geopolitical event date and 5 days after. The Consumer Staples sector shows a negative impact on geopolitical risk for all event windows except the one from the geopolitical event date and 5 days after, demonstrating a negative correlation to the Communication Services sector.

The construction industry, characterized by its intricate network of stakeholders and diverse workforce, grapples with the challenge of managing information effectively. This study delves into this issue, recognizing the universal importance of safeguarding data, particularly amid rising concerns of unauthorized access and breaches. Aiming to harness the potential of blockchain technology to address these challenges, this study used a hypothetical biographical and safety data of construction workers and securely stored on a Hyperledger Fabric blockchain. Developed within the Amazon Web Services (AWS) cloud platform, this blockchain infrastructure emerged as a robust solution for enhancing data security and privacy. Anchored in the core principles of data security, the model emerges as a potent defender against the vulnerabilities of traditional data management systems. Beyond its immediate implications, this study exemplifies the marriage of blockchain technology and the construction sector, potentially reshaping workforce management, especially in high-risk projects, optimizing risk assessment, resource allocation, and safety measures to mitigate work-related injuries. Practical validation through transaction testing using Hyperledger Explorer validates the model's feasibility and operational effectiveness, serving as a blueprint for the industry's data management. Ultimately, this research not only showcases the promise of blockchain technology in addressing construction data security challenges but also underscores its practical applicability through comprehensive testing, heralding a new era of data management that harmonizes security and efficiency for stakeholders' benefit.

The fusion of machine learning, biomedical, and bioengineering research offers novel ways to understand, diagnose, and treat various health conditions. However, the complexities of biomedical and bioengineering data, coupled with the intricate process of developing and deploying machine learning solutions, often pose significant challenges to researchers in these fields. We introduce a new Automatic Semantic Machine Learning Microservice Framework (AIMS) that addresses these challenges by automating key aspects of the machine learning pipeline, from data preprocessing to model evaluation. Our proposed framework emphasizes model interpretability, the integration of domain knowledge, and the efficient handling of biomedical data. Furthermore, it incorporates self-supervised knowledge learning strategies, enabling the automatic generation, optimization, and continuous adaptation of machine learning models in response to new tasks and data. We illustrate the potential of our framework through three case studies in biomedical research, showcasing its capacity to streamline research processes, improve scientific exploration quality, and provide a foundation for significant breakthroughs.

Plans are currently being drafted for the next decade of action on biodiversity – both the post-2020 Global Biodiversity Framework of the Convention on Biological Diversity (CBD) and Biodiversity Strategy of the European Union (EU). Freshwater biodiversity is disproportionately threatened and under-prioritized relative to the marine and terrestrial biota, despite supporting a richness of species and ecosystems with their own intrinsic value and providing multiple essential ecosystem services. Future policies and strategies must have a greater focus on the unique ecology of freshwater life and its multiple threats, and now is a critical time to reflect on how this may be achieved. We identify priority topics including environmental flows, water quality, invasive species, integrated water resources management, strategic conservation planning, and emerging technologies for freshwater ecosystem monitoring. We synthesize these topics with decades of first-hand experience and recent literature into 14 special recommendations for global freshwater biodiversity conservation based on the successes and setbacks of European policy, management and research. Applying and following these recommendations will inform and enhance the ability of global and European post-2020 biodiversity agreements to halt and reverse the rapid global decline of freshwater biodiversity.

Location-Based Services (LBS) have been widely deployed for the connected vehicle (CV) applications such as vehicle navigation,vehicle tracking and location-based augmented reality. The current LBS deployments have limitations in supporting time-critical CV use cases, including vehicle to vehicle (V2V), vehicle to infrastructure (V2I) and vehicle-to-people (V2P) safety applications. The paper presents the new LBS framework based on the publish-subscribe communication paradigm, to enable device-to-device (D2D) connections through use of selected application protocols in the application layer of the TCP/IP layered protocol model. Two publish-subscribe application protocols, Distributed Data Service (DDS) real-time publish and subscribe (DDS-RTPS) and Message Queue Telemetry Transport (MQTT), are introduced to support the LBS D2D applications. A number of test scenarios with Mosquitto MQTT and OpenDDS under 4G-mobile broadband (MBB) services are designed to assess the transmit/receive round-trip time (RTT) and packet-loss rate (PLR) with settings of a publisher to multiple subscribers, to simulate the connections to multiple vehicles. The transmission frequency is set for 10 Hz and the message sizes vary from 100 to 2000 Bytes. The PLRs are defined as the percentages of the delayed messages beyond a delay limit. Static test results with OpenDDS show that for the RTT delay beyond the limit of 100 ms, the total PLRs range between 5.25% and 8.76% for the message size of 50 to 2000 Bytes. Vehicle testing results with Mosquitto show that PLRs for the RTT delays between 200 ms and 1000 ms are 0.63%, 3.58% and 5.77%, for connections with 1, 4 and 10 vehicles, respectively. The results demonstrate the potential of the D2D LBS framework for medium-demanding CV safety applications such as V2P and V2I use cases, taking advantages of the 4G-MBB services and 5G extreme mobile broadband (eMBB) services and mobile devices generally available with all road users.

Agroforestry is increasingly being recognized as a holistic food production system that can have numerous significant environmental, economic, and social benefits. This growing recognition is paralleled in the U.S. by the budding interest in regenerative agriculture and motivation to certify regenerative practices. Current efforts to develop a regenerative agriculture certification offer an opportunity to consider agroforestry’s role in furthering regenerative goals. To understand this opportunity, we first examine how agroforestry practices can advance regenerative agriculture’s five core environmental concerns: soil fertility and health, water quality, biodiversity, ecosystem health, and carbon sequestration. Next, we review a subset of certification programs, standards, guidelines, and associated scientific literature to understand existing efforts to standardize agroforestry. We determine that development of an agroforestry standard alongside current efforts to certify regenerative agriculture offers an opportunity to leverage common goals and strengths of each. Additionally, we determine that there is a lack of standards with measurable criteria available for agroforestry, particularly in temperate locations. Lastly, we propose a framework and general, measurable criteria for an agroforestry standard that could potentially be implemented as a standalone standard or built into existing agriculture, forestry, or resource conservation certification programs.

The concept of sustainable management in culture has been recognised in global strategic documents on sustainable development for more than a decade. It is also increasingly reflected in the cultural polices of particular states, and – very importantly –cultural managers responsible for shaping the cultural offer in cities are becoming more interested in this concept. Despite the increasing attention being paid to this topic among both practitioners and theoreticians of management, in none of these documents or other works can we find any content directly related to the possibility of applying this concept in a town which, due to political turmoil, has been divided by a national border. Hence, this gap was the direct impulse for taking up research in this field. In the article, by using different notions of the market, our own definition of a cross-border market for cultural services was developed, and the conditions for the functioning of this market were presented based on the example town of Cieszyn (Poland) and Český Těšín (Czech Republic). In the opinion of the authors of the article, the development and functioning of a cross-border market for cultural services is essential for the application of the concept of sustainable management of the cultural offer in a town divided by a border. For the purpose of the article, a survey and individual interviews with experts shaping the cultural offer in Cieszyn and Český Těšín were conducted. The results of the research prove that despite numerous cross-border Czech-Polish projects carried out by cultural institutions, there are still many barriers in the town which make it difficult for the residents to benefit from the cultural offer available on the other side of the border. These barriers limit the full implementation and application of the concept of sustainable management of the cultural offer.

Background: In a Beveridgean decentralized healthcare system, like the Italian one, where regions are responsible for their own health planning and financing, the analysis of patients’ migration appears very interesting as it has economic and social implications. The study aims to analyze both patients’ migration for hospital rehabilitation and if the beds endowment is a driver for these flows; Methods: from 2011 to 2019, admissions data were collected from the Hospital Dis-charge Cards database of the Italian Ministry of Health, population data from Italian National Institute of Statistics and data of beds endowment from the Italian Ministry of Health website. To evaluate patients’ migration, we used Gandy’s Nomogram, while to assess if beds endowments are mobility drivers, we have created two matrices, one with attraction indexes (AI) and one with escape indexes (EI). The beds endowment, for each Italian region, were correlated with AI and EI. Spearman’s test was carried out through STATA software; Results: Gandy’s Nomogram showed that only some northern regions had good hospital planning for rehabilitation. A statistically significant correlation between beds endowment and AI was found for four regions, while with EI for eight regions. Conclusions: Only some northern regions appear able to satisfy the care needs of their residents, with an attraction minus escapes positive epidemiological balance. The beds endowment seems to be a driver of Patients’ migration, mainly for escapes. Certainly, the search for mobility drivers needs further investigation given the events in Molise and Basilicata.

Increased proliferation of IT services in all sectors has reinforced the adoption and diffusion across all levels of education and training institutions. However, lack of awareness of and knowledge about the key challenges and opportunities of elearning, seem to allude policymakers, resulting in low adoption or increased failure rate of many e-learning projects. Our study tries to address this problem through a review of relevant literature in e-learning. Our goal was to draw from the existing literature, insights into the opportunities and challenges of e-learning diffusion, and the current state-of-research in the field. To do this, we employed a systematic review of literature on some of the salient opportunities and challenges of e-learning innovation for educational institutions. These results aimed to inform policymakers and suggest some interesting issues to advance the research and adoption and diffusion of e-learning. Moreover, the bibliometric analysis shows that the field is experiencing high research attraction among scholars. However, several research areas in the field witnessed relatively low research paucity. Based on these findings, we discussed topics for possible future research.

This is a theoretical and empirical article. In the first part, an original definition of the cross-border market for cultural services has been developed, based on classic market definitions. The structure and conditions of functioning for this market have also been presented. The next part of the article discusses the supply side of the cross-border market of cultural services for the two twin towns: Cieszyn (Poland) and Český Těšín (Czech Republic). Next, based on the surveys conducted, the participation of residents of both towns in the most important cultural events organised by cultural institutions on both sides of the border was examined.

Water hyacinth (Eichhornia crassipes) is a potential accumulator of water pollutants in aquatic ecosystems, and its presence in water systems can affect water quality. This study used different field measurements and laboratory tests of Lake Water to determine the impact of water hyacinth phytoremediation capacity. A total of eight sampling stations used for the two lakes; Lake Koka and Lake Ziway. Sampling stations were selected from sites infested with water hyacinth (low, medium and high) and non-water hyacinth aquatic plants during wet and dry seasons to compare the effects of plants on water quality in the two lakes. All the sampled stations had various human interventions. The water samples were tested for the selected physico-chemical properties namely phosphate, nitrate, pH, electrical conductivity (EC), Biological oxygen demand (BOD5), temperature, and heavy metals (Chromium (Cr), Lead (Pb), Cadmium (Cd), Zinc (Zn), and Copper (Cu). These water quality variables were compared by means of ANOVA. Despite the COD of Lake Ziway, this study found no significant (p &gt; 0.05) variation in the concentrations of Cu, EC, pH and temperature between wet and dry seasons in either lake. Variations in Zn concentration and other physico-chemical parameters (EC, BOD, COD, nitrate, phosphate) between low, medium and high levels of water hyacinth were significant in both lakes (p&lt;0.05). Water hyacinth has shown significant phytoremediation nature during wet and dry seasons. The lowest average heavy metal, phosphate, and nitrate concentrations; and significant pH and temperature variations were observed in Lakes Koka and Lake Ziway, among water hyacinth and other grass-infested sites.

Spatial planners are nowadays strongly interested in the benefits of greenspace for the health of urban residents. However, concrete and context-specific guidance on effective greening strategies is still lacking. We present a novel, model-based approach to support the development of such strategies. The approach is quantitative and spatially-explicit, and accounts for multiple health benefits as well as burdens. In this study, we applied the approach to the city of Maastricht (The Netherlands), and conducted an integrated, city-scale assessment of the health benefits and burdens of four urban greenspace designs. These included: ‘No greenspace’, ‘Current greenspace’, ‘Green parking lots and squares’, and ‘Optimized greenspace locations’. For each greenspace design, indicator values were calculated for five health determinants: heat stress, air pollution, perceived unsafety, unattractive views, and tick-bite risk. To assess the health contribution of urban greenspace in a given design, these indicator values were compared with the values in the ‘No greenspace’ design. The study produced clear, quantitative conclusions about the health benefits and burdens of the urban greenspace designs for the case of Maastricht, but also generated novel, more general insights relevant to planning of urban greenspace for health. These insights concern the importance of translating health policy objectives into specific target values or thresholds, and the importance of ‘smart’ choices in greenspace type and location that can effectively reduce trade-offs between health benefits and burdens. Priorities for future research, addressing limitations of the presented approach, concern a further expansion of the range of health benefits and burdens covered by the model, and the development of a common metric for the entire range of health benefits and burdens allowing optimization of greenspace design to maximize its overall net health benefit.

Background: Misconceptions and knowledge gaps about antibiotic use contribute to inappropriate antibiotic use and antimicrobial resistance. Aim: Identifying and prioritizing misconceptions and knowledge gaps about antibiotic use from a healthcare professionals’ perspective. Methods: A modified Delphi study of two rounds with an expert meeting. A literature search was conducted to create statements about misconceptions and knowledge gaps about antibiotic use. These were rated by healthcare professionals from five EU countries representing general practice, out-of-hour services, nursing homes, and pharmacies. Consensus was achieved if ≥80% of the participants rated 4+ on a five-point Likert scale during the second Delphi round. Results. In total, 44 misconceptions were identified through the literature search within four themes: 1) antimicrobial resistance in general, 2) use of antibiotics in general, 3) use of antibiotics for respiratory tract infections, and 4) use of antibiotics for urinary tract infections. Consensus was reached for more than half of the statements within each setting. Conclusions. Experts from different settings and nationalities acknowledge that multiple misconceptions and knowledge gaps can contribute to inappropriate use of antibiotics in the community. These results provide valuable information to use in educational campaigns for patients and healthcare professionals to improve the use of antibiotics.

At the Rio Conference in 1992, the sustainable development agenda promised a new era for natural resource management, where the well-being of human society would be enhanced through the sustainable use of natural capital. Several decades on, economic growth continues unabated at the expense of natural capital, as evidenced by biodiversity loss, climate change and further environmental issues. Why is this happening and what can be done about it? In this research, we present three Agent-Based Models that explore the social, economic and governance factors driving (un)sustainability in complex social-ecological systems. Our modelling results reinforce the idea that the current economic system does not protect the natural capital on which it depends. This is due to a disjunction between the economic and environmental elements upon which the sustainable development paradigm is founded. Additionally, various factors appear to enhance social-ecological system unsustainability: the role of financial entities and monetary debt; economic speculation; technological development and efficiency; lack of long-term views and late government interventions; inefficient tipping point management; and the absence of strong top-down and bottom-up conservation forces. Interestingly, alternative scenarios showed that these same factors could be redirected to enhance sustainable development. The current economic system may, therefore, not be inherently unsustainable, but rather specific economic mechanisms, agents’ decision-making, and the kinds of links between economic and natural systems could be at the root of the problem. We argue that short- and medium-term sustainability can be enhanced by implementing mechanisms that shift capitalist forces to support environmental conservation. Long-term sustainability, however, requires further paradigm change: where the economy integrates, and fully accounts for, externalities and recognises the actual value of natural capital.

A large number of smart devices (things) are being deployed with the swift development of Inter- net of Things (IOT). These devices, owned by different organizations, have a wide variety of services to offer over the web. During a natural disaster or emergency (i.e., a situation), for example, relevant IOT services can be found and put to use. However, appropriate service matching methods are required to find the relevant services. Organizations that manage situation responses and organizations that provide IOT services are likely to be independent of each other, and therefore it is difficult for them to adopt a common ontological model to facilitate the service matching. Moreover, there exists a large conceptual gap between the domain of discourse for situations and the domain of discourse for services, which cannot be adequately bridged by existing techniques. In this paper, we address these issues and propose a new method, WikiServe, to identify IOT services that are functionally relevant to a given situation. Using concepts (terms) from situation and service descriptions, WikiServe employs Wikipedia as a knowledge source to bridge the conceptual gap between situation and service descriptions and match functionally relevant IOT services for a situation. It uses situation terms to retrieve situation related articles from Wikipedia. Then it creates a ranked list of services for the situation using the weighted occurrences of service terms in weighted situation articles. WikiServe performs better than a commonly used baseline method in terms of Precision, Recall and F measure for service matching.

The European Union green deal has proposed the “organic farming action plan” to render this farming system more sustainable for climate mitigation and adaptation and to meet the United Nations Sustainable Development Goals (UN-SDGs). While this policy instrument is fundamental to reach sustainable agriculture, there is still no agreement on what sustainable agriculture is and how to measure it. This opinion paper proposes an ecosystem-based framework on the crop life-cycle to determine the balance between economic, social and environmental pillars of sustainability to support decision-making.

This paper investigates empirically the effect of export diversification (i.e., both export product diversification and services export diversification) on financial openness, using a sample of 119 countries (including both developed and developing countries) over the period 1985-2014. Based on the Blundell and Bond's two-step system Generalized Methods of Moments, the analysis has revealed that both export product diversification and services export diversification influence positively financial openness. However, this outcome hides differentiated effects across countries in the full sample. Specially, countries with a very high real per capita income experience a positive effect of export concentration on financial openness, while for countries with a relatively lower per capita income, it is rather export diversification that drives positively financial openness. Interestingly, the effect of export diversification on financial openness depends on the size of external shocks that affect domestic economies, as well as countries' economic growth performance. Overall, these findings add to the empirical literature on the effect of international trade on financial openness by showing that both export product diversification and services export diversification matter for financial openness.

The article analyses the main aspects of upstream social marketing for implementing of mobile government (MGov). The methodology of current research is based on the systematic literature review in the fields of MGov and social marketing. According to our findings, most researchers investigated MGov from the side of citizens (consumers) and emphasised the benefits to them while changing their attitudes and behaviours in employing mobile applications. However, as there is a lack of the researches from the side of governmental bodies, in this paper, we were contrary looking for new meanings, attitudes and values from their perspective. Limitations of employment of MGov occur due knowledge gap among decision makers and public policy formers (upstream audience). Therefore, we argue that upstream social marketing for the upstream audience would bring the success in faster MGov implementation. Specific social marketing would be mostly valuable on the municipal level that is the closest substance to the society. Thus, in our paper we emphasise the benefit of the MGov for the local upstream audience and propose possible external marketers as well as the motivating theses based on these 7P of marketing mix for the successful MGov on municipal level.

Sustainable agriculture is essential to provide food security for a growing world population without further sacrificing the integrity of the environment. To make progress towards agricultural sustainability we must consider ecological and socioeconomic processes within the agricultural socio-ecosystem and involve stakeholders in the research process. We propose an innovative experimental approach for examining how natural regulation of ecosystems may provide an alternative to increasing external inputs in agriculture while improving the socio-economic welfare of farmers. These “social-ecological experiments” go further to participatory action research by not only involving stakeholders in the research process but also by manipulating simultaneously socioeconomic and ecological processes under real field conditions to give a faster route to sustainability. Social-ecological experiments are undertaken in real field conditions, explicitly involving stakeholders, and help untangle the drivers of social-ecological dynamics under various land management and farming practices. Social-ecological experiments are distinct from adaptive management and scenario-planning approaches as they highlight the interactions between ecological and social processes, manipulate the social and ecological processes shaping the system and show causal links between patterns and processes. As an example, we describe a social-ecological experiment for reducing herbicide use. Social-ecological experiments offer great opportunities for increasing stakeholders’ acceptance of environmental policies implemented through adaptive management. These experiments may help to identify management practices that optimize multiple objectives, deliver a portfolio of ecosystem services and satisfy key stakeholders.

Semantic Web technologies are being increasingly adopted by the geospatial community during last decade through the utilization of open standards for expressing and serving geospatial data. This was also dramatically assisted by an ever increasing access and usage of geographic mapping and location-based services via smart devices in people’s daily activities. In this paper we explore the developmental framework of a pure Javascript client-side GIS platform exclusively based on invocable geospatial Web services. We also extend Javascript utilization on the server side by deploying a node server acting as a bridge between open source WPS libraries and popular geoprocessing engines. The vehicle for such an exploration is a cross platform Web browser capable of interpreting Javascript commands to achieve interaction with geospatial providers. The tool is a generic Web interface providing capabilities of acquiring spatial datasets, composing layouts and applying geospatial processes. In an ideal form the end-user will have to identify those services, which satisfy a geo-related need and put them in the appropriate row. The final output may act as a potential collector of freely available geospatial web services. Its server-side components may exploit geospatial processing suppliers composing that way a light-weight fully transparent open Web GIS platform.

Rapid urbanization and climate change effects may cause dramatic change of ecosystem functions in cities, thereby inevitably affecting the growth performance of ancient trees. Few studies have explored species diversity and spatial differentiation in Benin urban area. Here, we took Cotonou city to do that. The objective of the study conducted in the city of Cotonou, was to determine the predominant level of plant diversity in the city's land-use units. The urban green frame was subdivided into six land use units, namely establishments, residences, green spaces, commercial areas, administrative areas, and roads. The forest inventories were carried out in 149 plots with surfaces evaluated at 2500 m2 each. A total of 62 tree species in 55 genera and 27 families were recorded. The results show that the flora of the city of Cotonou is characterized by a strong preponderance of exotic species. The most abundant species with high ecological importance (IVI) in the different type of land use of the city are Terminalia catappa (IVI=121.47%), Terminalia mentally (IVI=90.50%), Mangifera indica (IVI=64.06%) and Khaya senegalensis (IVI=151.16%). This study shows that a directed development of this urban vegetation could improve the resilience of urban life to climate hazards through the provision of urban ecosystem services, potential ecological infrastructure foundations and urban nature-based solutions.

The healthcare sector in Kuwait has been nurtured for many decades by the government where the Ministry of Health (MoH) controls up to 80 percent of the country’s health services. General and specialized public hospitals represent a significant proportion of health expenditures in Kuwait; amidst dwindling health resources, a declining global oil market in an oil-dependent welfare state, and a heavy reliance on a non-national clinical workforce. Although healthcare services in public sector hospitals are at highly subsidized rates, causing private sector involvement in healthcare to be considerably low, the growing demands for private delivery of care burgeoned participation of private hospitals in Kuwait, and improving hospital efficiency and productivity is more critical and timelier than ever. This paper aims to analyze public health system efficiency and hospital performance in the State of Kuwait, where we begin by evaluating the input-oriented technical efficiency (TE) of MoH hospitals in 2015-2019 and identifying potential areas for efficiency improvement by exploring influencing institutional and environmental factors. Over the five years between 2015 and 2019, TE in MoH hospitals has decreased by an average of 2.98% solely based on technical regress, where the six MoH general hospitals reported a pooled mean efficiency of 86.58%, and the nine sampled MoH specialized hospitals had a five-year pooled average of 65.47% efficiency. MoH policymakers should focus on improving allocative efficiency in the public health system, and healthcare policy reforms should focus on strengthening management structures in Kuwait’s public hospitals to improve production efficiency and financial sustainability.

Climate and land-use changes have been contributing to increase the occurrence of extreme wild-fires, shifting fire regimes and driving desertification, particularly in Mediterranean-climate regions. However, few studies have researched the effects of land-use change on fire regimes and carbon storage at the broad national scale. To address this gap, we used spatially explicit data from annual burned areas in mainland Portugal to build a typology of fire regimes based on the accumulated burned area and its temporal concentration (Gini index) between 1984 and 2019, which was combined with 2018 carbon stock data (above- and below-ground), and a landscape typology re-sulting from cluster analysis over land-use composition, diversity and configuration, to explore relationships between landscape types and the two major ecosystem services at stake: wildfire reduction and carbon stock. Cross tabulations, logistic and linear regressions were performed on these data and results revealed a strong relationship between landscapes dominated by maritime pine and eucalypt forest plantations and high-hazardous fire regime but hold the highest carbon stock. Shrubland-mixed landscapes were associated with lower carbon stocks but less hazardous fire regimes. Specialized agricultural landscapes, as well as mixed native forests and mixed agro-forestry landscapes, were the least associated with wildfires. In the case of agricultural landscapes however, this good wildfire performance is achieved at the cost of the poorest carbon stock, de-noting land degradation, whereas native forests and agroforestry landscapes strike the best trade-off between carbon stock and fire regime. Our findings support how nature-based solutions promoting wildfire mitigation and carbon stock ecosystem services may prevent and revert land degradation harming Mediterranean regions.

Although health policy resides mainly with the government, industry can play an important role in building a health ecosystem. From March to May, we administered questionnaires to 1,200 individuals from the general Korean population asking about their perception of health-friendly labels, and if they would purchase such labeled products (foods, pharmaceuticals, etc.) and services (purifying water, preventing air pollution, etc.) at extra cost. The participants placed a high value on the importance of mental, social, spiritual, and physical health factors in terms of company’s products and services with a score of about 8 out of 10 (range, 7.74-8.33). Most respondents (72.4%) said they were interested in adopting health-friendly labels. When a health-friendly label is introduced (such as one by the Business for Social Responsiveness), 65.1% of the respondents said they intended to purchase the product or service, while 6.8% said they did not, and 75.0% said they were willing to pay extra for the health-friendly product or service. Multivariate logistic regression models showed urban residence, high education level, and good social health to be significantly associated with positive attitudes toward health-friendly labels. People with high income, no religion, or normal weight were more likely to say they intend to purchase products and services with health-friendly labels. They also had a more positive attitude toward paying more for such products and services, as did people with good spiritual health. This study provides data that illustrate the importance of health-friendly products and services to the general population and companies.

Stormwater management is a key urban issue in the world, in line with the global issues of urban sprawl and climate change. It is urgent to investigate the effectiveness in managing stormwater with different strategies for maintain urban resilience. A method based on a storm water management model (SWMM) was developed for assessing the control of stormwater runoff volume and the percentage removal of suspended solids by implementing a Sponge City strategy. An interdisciplinary approach was adopted incorporating Low Impact Development (LID) with urban Green Infrastructure and Gray Infrastructure paradigms in a typical old residential community in Suzhou, China. Four types of sponge facilities for reducing stormwater runoff were bio-retention cells, permeable pavements, grassed pitches, and stormwater gardens. The simulation results indicate that the stormwater pipe system can meet the management standard for storms with a five-year recurrence interval. The volume capture ratio of annual runoff is 91% and the reduction rate of suspended solids is 56%. This study demonstrates that Sponge City strategy is an effective approach for managing stormwater, particularly in old and densely populated urban areas. Implementing spongy facilities with a LID strategy for stormwater management can significantly enhance urban water resilience and increase ecosystem services.

The owners of forests with water protection functions in Bulgaria do not receive compensation for their limited right to use wood and non-wood forest products from the forest areas they own. At the same time, the contribution derived from forests with water protection functions is received by water users and water consumers, whereas the costs of managing the forests are borne by their owners. The problem thus defined is not a forestry one, but an economic one, and the purpose of this paper ensues therefrom, namely to propose and test a methodology for valuating the produc-tion function of forest areas with water protection function in Bulgaria, allowing a fair distribu-tion of income between the forest owner and the user of forest ecosystem services. The methodol-ogy is based on the form of forest management and the analytical expression of the economic rela-tionship between a forest owner and a user of forest ecosystem services, constructed using Schen-rock’s formula. It has been tested with actual data on forest areas with water protection functions falling within the administrative and territorial scope of Velingrad municipality and based on the obtained results proposals have been made for the distribution of the contributions generated by forest ecosystems between the forest owner and the user of the forest ecosystem services.

More than 13.5 billion COVID-19 vaccine doses have so far been delivered between 2021 and 2023 through a mix of delivery platforms, with mass vaccination campaigns being the main approach. In 2022, with the most likely scenario of continued circulation of SARS-CoV-2 and the need for periodic booster doses, there was a need for countries to plan for more sustainable approaches to provide COVID-19 vaccination. In this context of uncertainty, a global tool for integrating COVID-19 vaccines into immunization programmes and primary health care was published jointly by WHO and UNICEF to respond to country needs. The guidance leveraged existing health system frameworks, proposed four steps for the COVID-19 integration journey, and identified investment areas. The development process maximized robust global stakeholder and country engagement, and the timeframe was aligned with donor funding windows to support the integration of COVID-19 vaccination. The rapid dissemination of guidance allowed its use by countries to ascertain their readiness for integrating COVID-19 vaccination and inform the development of national plans and funding applications. While progress has been made in specific areas (e.g., optimizing cold chain and logistics leveraging COVID-19 vaccination), in the context of decreasing demand for COVID-19 vaccines, reaching adult COVID-19 vaccine high-priority-use groups and engaging and coordinating with other health programmes (beyond immunization) remains a challenge. We share the learning that despite the uncertainties of a pandemic, guidance documents can be developed and used within a short timeframe. Working in partnership with stakeholders beyond immunization towards a common objective is powerful and can allow progress to be made on integrating health services and preparing better for future pandemics.

Urban Green Space (UGS) has important impacts on human health, but an integrated participatory approach to UGS design for improved residents’ health was lacking to date. The aim of our study was to develop and evaluate such a novel approach to address this gap. The approach was developed following guiding principles from the literature, and tested with groups of children and elderly as participants in two neighborhoods of Maastricht (The Netherlands) with a low score on economic and health indicators. Novel aspects of the approach are the inclusion of both positive and negative health effects, the combination of participant self-assessment and model-based assessment of the health effects of UGS designs, and the use of maps to visualize UGS designs and health effects. The participant-generated UGS designs resulted in a considerable self-assessed increase in use of the UGS for meeting, stress reduction or leisure-based physical activity, as compared to the current situation. The model-assessed positive and negative health effects of the participant-generated UGS designs were limited. The major strength of the developed approach is that it combines active participation of residents in UGS (re)design with assessment of the health effects of these UGS designs. Whereas in other participatory approaches to UGS design it often remains unclear whether the resulting designs represent an improvement in terms of health, our combination of computer model-based assessment and a participatory process produced clear outcomes regarding the health benefits and use of UGS designs.

Cultural ecosystem services has been increasingly influential in both environmental research and policy decision-making, such as for urban green spaces However, its popular definition conflates the concepts of ‘services’ and ‘benefits’ which made it challenging for planners to employ it directly for urban green space management. One the most widely used definition of this non-tangible ecosystem services are “functions of environmental spaces and cultural activities which may then result in the enjoyment of cultural ecosystem benefits”; yet the latter itself have never found its way into official laws and regulations. In this study, via a case study in Singapore, we propose new evidence to re-evaluate and re-position the two of the most important emerging concepts in managing the green spaces in urban areas. Using the transdisciplinary mixed methods of public participation GIS and social media text mining analysis, a wealth of cultural ecosystem services and their associated benefits were reported. This was especially so with regards to recreational and aesthetic services and experiential benefits. Recommendations to improve the park were also suggested, alongside sharing of methodological considerations for future research. Overall, this paper recommends the employment of the redefined cultural ecosystem services conceptual framework to generate relational, data-driven and actionable insights to better support urban green space management, which is not only useful to Singapore governments but also world-wide relevant.