Search Results (73)

This community-engaged qualitative study co-defined digital health and artificial intelligence (AI) priorities with First Nations communities in Manitoba, Canada, including those with disabilities. Grounded in Indigenous research methodologies and community-based participatory research, the project responded to persistent inequities in rehabilitation and health service access shaped by geography, colonial legacies, and jurisdictional fragmentation. These inequities are especially important in the context of aging, as older adults and Elders may experience compounded barriers related to disability, chronic conditions, mobility limitations, and digital exclusion. Over approximately 12 months, an interdisciplinary team consisting of First Nations scholars and partners, disability organizations, clinicians, and researchers conducted relationship-building visits and meetings with First Nations leadership, Elders/Knowledge Keepers, health providers, and community members to inform the design of a Gathering focused on disability, digital health, and AI. A one-day community-engaged Gathering was held on Treaty 1 and 2 Territory in Winnipeg and convened approximately 70 participants from multiple First Nations communities and disability/health organizations. Five facilitated roundtables explored: (1) health and research priorities for First Nations persons with disabilities; (2) primary care and disabilities; (3) digital access and cultural safety; (4) culturally safe and ethical AI use; and (5) health system challenges, disability, and digital health. Data consisted of facilitator-produced, de-identified table summaries, facilitator reflection forms, and participant-validated plenary notes; no recordings or individual sociodemographic data were collected. Using qualitative description and team-based content analysis, three interrelated domains emerged: (1) relationships, identity, trust, and cultural safety; (2) system, infrastructure, and equity conditions required for accessible care and digital inclusion (e.g., connectivity “dead zones,” device access, transport, and culturally safe services); and (3) opportunities, risks, and governance principles for AI and data use (e.g., AI literacy, privacy, bias, Indigenous data sovereignty, and Nation-specific governance). Findings emphasize that equitable digital health and AI must be relational, disability-informed, culturally safe, and led under First Nations authority, with AI positioned to support, rather than replace, human care relationships. The findings also highlight the importance of designing digital health and AI initiatives that remain accessible and trustworthy for older adults and Elders, particularly where aging, disability, and rural or remote living intersect. Full article

Aquatic recreation significantly enhances well-being; however, individuals experiencing functional limitations remain frequently marginalized from this form of tourism due to infrastructural and environmental barriers. This study investigates the perceived operational risks and apprehensions encountered by users with specific accessibility needs during yacht sailing, aiming to inform inclusive vessel design aligned with the social dimension of sustainable development. A survey of 277 participants with diverse, officially certified functional limitations was conducted to evaluate their maritime experiences and safety concerns. Participants identified a mean of 11 pre-voyage apprehensions out of 19 distinct risk categories. The most prevalent concerns included stumbling, slipping, or falling on board (79%), the risk of falling overboard (73%), and seasickness (70%), with an overall moderate severity ($\overline{X}$ = 2.2 on a 4-point scale). Crucially, severe safety concerns (e.g., vessel sinking or falling overboard) were significantly mitigated following practical sailing experience. Conversely, everyday functional and ergonomic challenges—such as moving between the deck and crew quarters ($\overline{X}$ = 2.6), operating rigging ($\overline{X}$ = 2.7), embarkation ($\overline{X}$ = 2.6), and utilizing sanitary facilities ($\overline{X}$ = 2.1)—persisted irrespective of experience level. Statistical analysis revealed that gender and age had negligible effects on concern levels. Extensive maritime experience reduced apprehensions regarding balance and swimming competencies, while concurrently increasing awareness of communication and comfort-related operational challenges. This study highlights a distinct divergence between initial psychological anxiety—which is largely mitigated by experience—and persistent architectural barriers inherent in standard yacht design. The results underscore that achieving meaningful inclusivity in water tourism requires prioritizing interior spatial layouts, accessible sanitary facilities, and barrier-free vertical circulation in naval architecture, rather than focusing exclusively on emergency safety systems. These insights directly support the advancement of Sustainable Development Goal 10 and the integration of universal and human-centered design principles within the maritime recreation sector. Full article

Artificial intelligence systems increasingly mediate high-stakes human activities, yet urban navigation remains highly challenging for blind and visually impaired individuals. Although digital navigation technologies have significantly improved route planning and accessibility, many existing systems still rely on generic interaction paradigms that insufficiently account for cognitive load, contextual uncertainty, and the adaptive needs of vulnerable users. This challenge highlights the importance of Human-Centred AI approaches capable of supporting not only functional accessibility, but also cognitively sustainable and trustworthy interaction. This paper introduces LAZAR, a human-centred adaptive AI framework for accessible urban mobility grounded in a user-centred design methodology and formalised through a structured Software Requirements Specification. Rather than focusing exclusively on route optimisation, LAZAR approaches assistive navigation as an adaptive human–AI interaction problem in which instructional granularity, interaction frequency, and feedback mechanisms are designed to support user autonomy and situational awareness whilst limiting unnecessary cognitive burden. The proposed framework integrates high-fidelity prototyping, accessibility-oriented interaction modelling, and a modular multi-agent architecture intended to support adaptive and personalised guidance. Central to the approach is a cognitive load-aware interaction layer designed to regulate the presentation and timing of navigational assistance according to user needs and contextual conditions. The proposed multi-agent architecture is presented as a modular design framework whose interaction principles and interface logic were partially operationalised in the evaluated prototype. The complete integration of all adaptive coordination mechanisms, together with large-scale real-world validation, remains part of ongoing and future development work. This work contributes a structured methodology for the design of adaptive assistive AI systems that integrates accessibility requirements, human-centred interaction principles, and cognitively informed guidance strategies. A formative usability evaluation involving eleven visually impaired participants provides preliminary empirical evidence regarding usability, accessibility, and perceived usefulness of the proposed interaction model. The framework establishes a foundation for future research on inclusive and adaptive AI-based navigation systems in urban environments. Full article

The transition toward a sustainable bioeconomy and the integration of environmental, social, and governance (ESG) principles into finance have increased the demand for green skills in the financial sector. However, the literature remains fragmented, as green skills are often discussed through related constructs such as ESG competencies, sustainability knowledge, green human capital, green training, or green HRM outcomes. This study systematizes existing research and develops a finance-specific framework explaining what green skills in finance are, how they are formed, and how they support sustainable practice and bioeconomy-oriented capital allocation. A systematic literature review was conducted in accordance with PRISMA 2020 guidelines through searches in Scopus, Web of Science, and Google Scholar. After applying predefined inclusion and exclusion criteria, 47 articles were included. The findings show that green skills in finance are multidimensional and include environmental and sustainability knowledge, digital and analytical skills, behavioral and value-oriented skills, and managerial, strategic, and creative capabilities. Their formation is shaped by education and professional training, green HRM practices, and institutional and regulatory mechanisms. Overall, green skills function as human, organizational, and institutional capacities that support ESG credibility, climate-risk assessment, sustainability disclosure, responsible capital allocation, and anti-greenwashing practices in the transition toward a sustainable bioeconomy. Full article

This study analyzes the transition of the Artificial Intelligence of Things (AIoT) toward a Human-Centered Artificial Intelligence (HCAI) approach. Following PRISMA 2020 guidelines, a Systematic Literature Review was conducted on 1 April 2026, retrieving literature from Scopus, Web of Science, SciELO, and Springer Nature Link. The inclusion criteria prioritized open-access, peer-reviewed English articles published between 2020 and 2025 that addressed AIoT architectures and explainability mechanisms. The screening procedure involved a dual independent review process, followed by a rigorous methodological quality assessment to minimize the risk of bias, culminating in a final sample of 40 studies from an initial pool of 971 records. The findings reveal a structural paradox: while intelligent systems achieve greater operational autonomy, legal and moral accountability remains inexorably bound to the human operator. Furthermore, 77.5% of the evaluated implementations employ superficial explainability, functioning merely as a psychological buffer to manage automation anxiety rather than providing a genuine interactive control mechanism. It is concluded that programming based on HCAI principles must shift from a post hoc feature to an inherent architectural requirement. Establishing explainability by design is imperative to guarantee an interactive audit capability that comprehensively safeguards operational integrity and preserves human agency, although the exclusive reliance on open-access literature limits visibility into proprietary commercial models. Full article

This paper addresses a persistent divide in water governance: critical frameworks reveal power dynamics and ontological diversity but lack operational guidance, while operational frameworks prioritize technical management at the expense of ontological plurality and social legitimacy. We introduce Water-Important Socioecological Systems (WISe) as a prescriptive framework that integrates political ontology with hydrosocial territory analysis to inform more reflexive and inclusive water governance. WISe designates specific zones where ecological functions for water sustainability are concentrated and where social practices, productive livelihoods, and symbolic meanings coexist inseparably with biophysical processes. Unlike Integrated Water Resources Management (IWRM), which treats social and ecological dimensions as separate pillars, and the Ostrom Social-Ecological Systems framework, which undertheorizes ontological plurality, WISe explicitly centers the coexistence of multiple ways of understanding and relating to water as a governance principle. The framework was developed through a five-phase mixed-methods conceptual inquiry combining a systematic literature review (202 documents), an exploratory stakeholder survey of 223 participants across six Colombian hydrographic basins, and an analysis of designated water-strategic ecosystems. The findings reveal that ontological diversity is distributed across all stakeholder groups: hydrological supply framings predominate (36.4–45.8%), yet territorial-integrated perspectives appear in all groups, with government actors (22.9%) showing the highest proportion. The majority (56.1%) perceive WISe as exclusively state-managed, revealing a dominant ontological position that reduces socioecological territories to objects of administrative control. This article presents WISe as a conceptual and prescriptive framework informed by exploratory empirical evidence. Rather than offering a definitive empirical validation of the model, this study provides initial analytical grounding for its development and identifies indicative patterns that warrant further testing across other geographical and institutional contexts. WISe offers a framework comprising six defining characteristics and five operational dimensions that bridge theoretical understandings with governance-oriented analysis, treating ontological difference not as an obstacle but as essential knowledge for more reflexive and equitable water governance. Full article

Background: Osteoinduction and bone regeneration are fundamental biological mechanisms enabling osseointegration and long-term durability of endosseous dental implants. In clinical practice, poor bone conditions, aesthetic demands, and peri-implant soft tissue problems commonly need the utilization of regenerative techniques targeted at optimizing both hard and soft tissue results. The purpose of this narrative review was to examine osteo-inductive and regenerative strategies currently employed in implant dentistry, with particular emphasis on the mechanobiological integration of hard–soft tissue regeneration and its implications for peri-implant tissue stability, osseointegration, and clinical predictability. Methods: A narrative literature review was done using PubMed and Scopus databases. Based on predetermined inclusion and exclusion criteria, studies published in English during the previous five years were reviewed. The core narrative analysis comprised a selection of physiologically relevant research that addressed osteo-inductive techniques, bone regeneration, osseointegration, and peri-implant soft tissue outcomes, as well as clinical studies, randomized controlled trials, systematic reviews, and narrative reviews. A narrative synthesis was carried out because of methodological variability. Special emphasis was placed on evidence addressing the biological and clinical interaction between hard- and soft-tissue regenerative strategies, reflecting the specific conceptual focus of the review. Results: The evidence presented suggests that implant surface biofunctionalization, biologically active grafting materials, guided bone regeneration, and supplementary biological treatments may have a favorable impact on implant stability and peri-implant bone healing. Several investigations also underlined the biological dependency between peri-implant bone regeneration and soft tissue architecture, stressing the significance of soft tissue thickness, keratinized mucosa, and emergence profile stability. Even in inflammatory environments, bioactive titanium surface changes showed osteogenic potential, indicating a supporting function in early osseointegration. Conclusions: By promoting osseointegration and improving peri-implant tissue outcomes, osteo-inductive and regenerative techniques are essential to modern implant dentistry; however, their greatest potential may lie in integrated hard–soft tissue regenerative approaches aimed at improving long-term clinical predictability. To further understand the clinical efficacy of combination hard–soft tissue regeneration methods, future well-designed clinical trials with standardized outcome measures are needed. Future research should further clarify the mechanobiological principles underlying these integrated regenerative approaches. Full article

The inclusion of vulnerable groups in cultural life is a central issue of social justice, equality, and sustainable development. While equality ensures formal access to cultural participation, equity requires differentiated, needs-responsive measures that address structural barriers to meaningful engagement. Vulnerable groups—those at increased risk of social exclusion and inequality—often face such barriers despite the recognized role of the arts in promoting well-being, empowerment, and social cohesion. This study examines how Slovenia’s main cultural institutions conceptualize and implement inclusion, focusing on target groups, accessibility measures, and structural challenges and assessing whether their practices reflect principles of equality or equity. A mixed-methods approach combined an online survey of 26 institutions with semi-structured interviews with six representatives. Data were analyzed using descriptive statistics and thematic coding. The findings indicate that inclusion is present but fragmented and largely unsystematic. Institutions predominantly adopt equality-based approaches through general programming and standard adaptations, while equity-oriented, structurally embedded measures remain limited. Groups requiring sensory, communicative, or content-related adaptations are less frequently included. Overall, inclusion remains capacity-driven rather than equity-oriented, highlighting the need for coherent, equity-based frameworks to ensure sustainable and meaningful cultural participation. Full article

This study critically engages the ongoing national conversation and policy discourse on land expropriation without compensation in South Africa, offering both analytical insight and a principled position. It presents a qualitative, normative-analytical inquiry grounded primarily in critical documentary analysis of legislation, jurisprudence, and land reform scholarship. The study situates the contemporary debate within South Africa’s broader historical and structural context, where patterns of land dispossession continue to shape persistent spatial inequality and exclusion. The analysis proceeds from the premise that meaningful urban spatial transformation cannot be realised without addressing the structural constraints embedded within existing land governance and spatial planning systems. In this regard, debates around land expropriation are not simply questions of property law or economic policy but are fundamentally connected to broader concerns of spatial justice, economic inclusion, and social equity. These concerns are particularly salient when considering emerging imaginaries of African urban futures, including the notion of the Pan-African City—an urban formation envisioned as spatially integrated, socially inclusive, and reflective of shared continental aspirations for equitable development. The central argument advanced in this study is that unless South Africa gives serious and programmatic attention to land expropriation—moving beyond token or partial policy measures—the structural conditions necessary for such inclusive urban futures will remain unattainable. In this sense, any vision of a Pan-African City within South Africa’s borders risks remaining short-lived, if not altogether specious. To fully engage this debate, the paper unpacks and interrelates the concepts of land expropriation, compensation, expropriation without compensation, economic inclusivity, social equity, spatial justice, and the Pan-African City. These concepts cannot be adequately understood independent of the distinctly South African context—a context shaped by a history of racialised dispossession, deeply entrenched spatial inequalities, and the limitations of both first-generation (restitution, redistribution, tenure reform) and second-generation (e.g., the Spatial Planning and Land Use Management Act) land reform initiatives. The point advanced is unequivocal: without resolving the land question, sustainable housing and human settlement solutions in South Africa will not materialise. Anything less risks entrenching a democratic façade atop an unresolved colonial, segregationist, and apartheid foundation. Full article

Background: Limitations in timely and equitable access to essential medicines among older adults not only constitute a clinical barrier to the effective management of chronic conditions, but also represent a violation of the fundamental right to life, health and the principles of dignity, equality and non-discrimination that safeguard this population within the framework of human rights. Objective: To examine access to essential medicines for older adults with high-cost chronic conditions as a constitutive dimension of the fundamental rights to health, life and human dignity, in accordance with international human rights standards. Design: A literature review was conducted of articles published between 2020 and March 2025 in five databases, using the search terms: “pharmacological treatment,” “access to health,” “chronic diseases,” and “barriers to access.” After evaluating the inclusion criteria (language and year) and exclusion criteria (case studies), 12 articles were selected. A narrative synthesis was performed on the following aspects: application of the principles of the right to health, barriers to access, and rights violated or at risk. Results: The expansion of health coverage faces several barriers that violate fundamental principles of the right to health: equity, accessibility to medical advances, and long-term, quality, and specialized services, thus limiting autonomy. In conclusion, guaranteeing access to pharmacological treatments in old age will contribute to building more just and humane societies through public policies on coverage and pharmaceutical education, the simplification of treatment regimens, and the implementation of programs that allow people to age with dignity, considering health a human right based on equality and non-discrimination, participation and transparency. Full article

Background/Objectives: Necrotizing enterocolitis (NEC) is an inflammatory disease with an incidence of about one in 1000 live births, much higher in premature and low birth weight newborns. Intestinal dysbiosis is an important element in the pathogenesis of NEC, and for this reason, experimental models have been used to administer fecal microbiota transplants (FMTs) for prophylaxis and treatment of NEC with very satisfactory results. The primary endpoint of the study is safety, defined as the incidence of adverse events (AEs) and serious adverse events (SAEs) occurring from the time of intervention until hospital discharge, classified according to severity and assessed for relatedness to the intervention. Methods: This prospective, single-arm, open-label clinical study will include 20 infants born between 24 0/7 and 36 6/7 weeks of gestation. FMTs will be administered twice as a deep rectal infusion via a Foley catheter. The donors of the material from which the FMT will be prepared will be women in the third trimester of pregnancy. The safety of the therapy will be assessed by comparison with a control group, i.e., 20 patients who will meet the same inclusion criteria and will not meet any of the exclusion criteria, subject to the same hospital observation but without undergoing any medical/therapeutic intervention other than the collection of biological material. Discussion: The study will provide data on the safety and initial efficacy of FMT in this group of patients, which will allow for further research into the use of this method in the prevention of infections and NEC. Ethics: The study protocol was approved by the Bioethics Committee of the Medical University of Warsaw, Warsaw, Poland (KB/52/2025). All procedures will follow the principles of the Declaration of Helsinki. The results of the study will be submitted for knowledge translation in peer-reviewed journals and presented at national and international pediatric society conferences. Clinical Trial Registration: The study is registered at ClinicalTrials.gov: ID: NCT06333405. Full article

Smart devices and multimodal biosignal systems, including electroencephalography (EEG/MEG), ECG-derived heart rate variability (HRV), and electromyography (EMG), increasingly supported by artificial intelligence (AI), are being explored to improve the assessment and longitudinal monitoring of mental health conditions. Despite rapid growth, the available evidence remains heterogeneous, and clinical translation is limited by variability in acquisition protocols, analytical pipelines, and validation quality. This systematic review synthesizes current applications, signal-processing approaches, and methodological limitations of biosignal-based smart systems for mental health monitoring. Methods: A PRISMA 2020-guided systematic review was conducted across PubMed/MEDLINE, Scopus, the Web of Science Core Collection, IEEE Xplore, and the ACM Digital Library for studies published between 2013 and 2026. Eligible records reported human applications of wearable/smart devices or multimodal biosignals (e.g., EEG/MEG, ECG/HRV, EMG, EDA/GSR, and sleep/activity) for the detection, monitoring, or management of mental health outcomes. The reviewed literature after predefined inclusion/exclusion criteria clustered into six themes: depression detection and monitoring (37%), stress/anxiety management (18%), post-traumatic stress disorder (PTSD)/trauma (5%), technological innovations for monitoring (25%), brain-state-dependent stimulation/interventions (3%), and socioeconomic context (7%). Across modalities, common analytical pipelines included artifact suppression, feature extraction (time/frequency/nonlinear indices such as entropy and complexity), and machine learning/deep learning models (e.g., SVM, random forests, CNNs, and transformers) for classification or prediction. However, 67% of studies involved sample sizes below 100 participants, limited ecological validity, and lacked external validation; heterogeneity in protocols and outcomes constrained comparability. Conclusions: Overall, multimodal systems demonstrate strong potential to augment conventional mental health assessment, particularly via wearable cardiac metrics and passive sensing approaches, but current evidence is dominated by proof-of-concept studies. Future work should prioritize standardized reporting, rigorous validation in diverse real-world cohorts, transparent model evaluations, and ethics-by-design principles (privacy, fairness, and clinical governance) to support translation into practice. Full article

As genomic technologies continue to evolve, understanding the scope and limitations of available prenatal testing methods is essential for accurate diagnosis and counseling. Chromosomal microarray analysis (CMA) and exome sequencing (ES) have emerged as key complementary tools in this setting. This review aims to outline the technical principles underlying CMA and ES and to compare their diagnostic capabilities and limitations in the prenatal context. This narrative review includes a literature search, with additional relevant articles identified through manual screening of reference lists from key publications and review articles. Due to the narrative nature of this review, no formal inclusion or exclusion criteria or quantitative synthesis were applied. Special focus was placed on clinical indications, variant interpretation challenges—particularly uncertain and incidental findings—gene selection strategies, and implications for prenatal counseling. Indications for both tests have increased over time but differ substantially. CMA is becoming the standard prenatal genetic test, particularly in the evaluation of fetal structural anomalies, whereas ES remains restricted to selected fetal structural anomalies. Interpretation of molecular results remains a major challenge, especially for variants of uncertain significance and incidental findings with unclear or unexpected implications for pregnancy management. For ES, agnostic gene selection strategies showed superior diagnostic yield compared with phenotype-driven approaches, likely reflecting the limited characterization of prenatal phenotypes. Continuous refinement of clinical indications, bioinformatic pipelines, variant classification criteria, and gene curation strategies is critical to ensure that prenatal results are accurate and clinically meaningful. Together, ongoing improvements in technology, interpretation, and clinical integration have the potential to transform prenatal genomics into a more precise, informed, and ethically responsible field. Full article

Contemporary cities constitute both the primary site where the climate crisis manifests its most evident impacts and the privileged laboratory for testing strategies of adaptation and resilience. However, the growing emphasis on “climate neutrality” policies risks obscuring the social dimension of urban regeneration processes, thus generating new imbalances and forms of exclusion. This paper offers a critical reflection on the role of urban planning beyond climate neutrality, reorienting it towards a perspective of climate justice capable of integrating ecological transition goals with those of social and territorial cohesion. The research adopts a mixed-method approach, combining theoretical and documentary analysis with empirical case comparison, to investigate the relationship among urban regeneration, urban welfare, and spatial inequalities. The study aims to identify strategies for preventing climate gentrification, a phenomenon in which adaptation and mitigation measures—if not accompanied by adequate redistributive mechanisms—produce socio-spatial displacement effects that exclude the most vulnerable communities from the environmental benefits generated. The comparative analysis of two international case studies—Little Haiti (Miami) and the Green Corridors of Medellín (Colombia)—reveals two contrasting trajectories of the ecological transition: a regressive one, driven by market logics and real-estate valorization, and a progressive one, grounded in principles of equity, participation, and inclusive distribution of environmental benefits. Full article

This article compares the roles of allotments and community gardens in democratising London’s urban food system. Drawing from ethnographic and participatory action research (PAR), it reveals a recent policy shift favouring community gardens compared to allotments, which has resulted in a net reduction in long-term urban agriculture space in London. The study contrasts these two trajectories of urban agriculture across five democratic processes: (1) fostering food security, (2) expanding health benefits, (3) reclaiming the commons, (4) building spaces of interaction and representation, and (5) decoupling from dominant regimes. While community gardens tend to perform well in terms of social inclusion and environmental education of local communities and marginalised populations, allotments tend to be more successful in terms of productive capacity and developing autonomy due to their relatively more secure tenure. However, both trajectories are increasingly challenged by the dynamics of neoliberal urban development and the withdrawal of the state from its welfare responsibilities. This article argues that both trajectories do not have to be mutually exclusive and that their coexistence is in fact necessary to develop a more resilient urban food system, one that realises the principles of food sovereignty, social justice, and agroecological urbanisms at the local level. Full article