Search Results (171)

Project portfolio management (PPM), as an internationally recognised discipline with well-established standards and guidelines, faces emerging challenges, particularly in public sector organisations adopting digital technologies. This article presents PPM practices in the Kingdom of Bahrain as part of the government’s efforts to achieve its economic Vision 2030. It explores Bahrain’s Public Participation Portfolio (BPPP), which includes three successful initiatives: (1) the National Suggestions and Complaints System (Tawasul), (2) the Government Innovation Competition (Fikra), and (3) the National e-Participation Platform (Sharekna). These cases highlight the benefits of digital stakeholder management in PPM and the effectiveness of a centralised portfolio management office in managing complex interdependent programmes and projects. Full article

This study explores the impact of implementing a mandatory e-government reform within Indonesia’s national ISBN service (Regulation No. 5/2022). It examines the effects of this policy shift on public service quality and the resulting administrative burden placed on stakeholders, specifically publishers. The study employs an explanatory sequential mixed-methods design (QUAN → qual). The first phase analyzes longitudinal quantitative data from annual Public Satisfaction Surveys (2021–2024). The subsequent qualitative phase analyzes thousands of archival records, including complaint logs and policy memos, to contextually explain the quantitative findings. The results indicate that the reform induced a severe digital shock, causing the Public Satisfaction Index (IKM) to plummet from Good in 2021 to Poor (75.03) in 2022. The most significant declines were observed in the Procedures (2.79/4) and Service Time (2.30/4) indicators. Qualitative analysis reveals that this collapse was driven by specific policy-induced frictions: the mandatory implementation of a Single Account system and the intentional tightening of governance and validation parameters. While limited in statistical generalizability due to its single-case archival design, this study clearly demonstrates that public managers must recognize the inherent trade-off between tightening institutional governance (control) and maintaining public service quality (satisfaction). Proactive friction management and user-centric change management are essential to mitigating such digital shocks. Ultimately, this study offers a unique longitudinal analysis that forensically links quantitative satisfaction metrics with qualitative policy frictions. Full article

Background: Primary endometrial lymphomas (PELs) are exceedingly rare and diagnostically challenging lesions. Objective: To assess the clinicopathologic features of PELs. Methods: We adhered to the PRISMA-2020 guidelines for reporting systematic reviews. A PubMed literature search (1956–2025) was conducted using keyword combinations including “endometrium” and “lymphoma,” “lymphoid proliferation,” or “lymphoproliferative lesions.” Only original articles published in the English peer-reviewed journals were considered. The inclusion criteria were: (i) studies involving human subjects, and (ii) studies published in the English language. Reviews, editorials, meeting abstracts, and non-English publications were excluded. Results: We identified 42 studies for our analysis, collectively reporting 58 cases of PELs. Abnormal uterine bleeding was the main complaint. Non-Hodgkin lymphoma (57 cases) and Hodgkin lymphoma (one case) were identified. In most cases, lymphoma was the sole lesion. In five cases, lymphoma coexisted with, preceded, or followed endometrial carcinoma. Histologically, PELs either diffusely involved the endometrium (50 cases) or were localized to endometrial polyps (eight cases). Marginal zone lymphoma (MZL) was the most frequently reported type, followed by diffuse large B-cell lymphoma (DLBCL). Other rare types included intravascular large B-cell lymphoma, NK/T-cell lymphoma, T-cell lymphoma, and low-grade B-cell lymphoma. Conclusions: Our study indicates that MZL and DLBCL were the most common types of PELs. Other extremely rare subtypes were also identified. Moreover, some PELs developed in the background of endometrial polyps and, in exceptional cases, in association with endometrial carcinoma. Radiological findings were critical for provisional diagnosis, staging, and follow-up. Key modalities included ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), and 18F-fluoro-2-deoxyglucose positron emission tomography/CT (18F-FDG PET/CT). Full article

Indoor environmental quality directly affects public health and quality of life, among which odor pollution is one of the primary drivers of indoor environmental complaints. Traditional research and management approaches, which rely predominantly on mass concentrations of individual chemical compounds, are fundamentally inadequate for addressing the inherent sensory complexity, dynamic evolution, and subjective perception of indoor odors. Through a systematic literature review, this paper for the first time establishes an integrated research framework for indoor odor pollution across the whole-life-cycle management of the built environment, structured around “source–evolution–evaluation–control”. This framework systematically analyzes emission characteristics of building-related pollution sources, revealing the profound impact of indoor dynamic chemical and biological transformation processes on odor properties. Sensory analysis, instrumental measurements, and intelligent sensing approaches are critically compared in terms of their underlying principles and application boundaries. From an engineering perspective, the effectiveness and limitations of source prevention, ventilation dilution, and terminal purification strategies are comprehensively evaluated. The analysis demonstrates that effective indoor odor management must transcend passive and fragmented mitigation practices, and that its future development depends on the deep integration of environmental chemistry, sensory science, materials science, and artificial intelligence. Finally, this review proposes that by constructing regulation systems based on real-time sensing, digital twins, and intelligent decision-making, indoor odor management can fundamentally shift from reactive complaint-driven responses to proactive health-oriented protection. This paradigm transformation provides a systematic theoretical foundation and a technological roadmap for achieving healthy, comfortable, and sustainable building environments. Full article

Food fraud represents a growing global challenge with significant implications for public health, market integrity, sustainability, and consumer trust. Beyond economic losses, fraudulent practices undermine the environmental and social sustainability of food systems by distorting markets, misusing natural resources, and weakening incentives for authentic and responsible production. Despite the establishment of harmonized frameworks of the European Union for official controls, the increasing complexity of food supply chains has exposed persistent gaps in fraud detection, particularly for high-value products such as those with PDO (Protected Designation of Origin) and PGI (Protected Geographical Ιndication) Certification. This study investigates the perceptions, attitudes, and experiences of frontline inspectors in Greece to assess current challenges and opportunities for strengthening official food fraud controls. Data were collected through a structured questionnaire, validated by experts and administered nationwide, involving 122 participants representing all major national food inspection authorities. Statistical analysis revealed significant institutional differences in perceptions of fraud prevalence, with mislabeling of origin, misleading organic claims, ingredient substitution, and documentation irregularities identified as the most common fraudulent practices. Olive oil, honey, meat, and dairy emerged as the most vulnerable product categories. Inspectors reported relying primarily on consumer complaints and institutional databases as key tools for identifying fraud risks. Food fraud was perceived to contribute strongly to losses in consumer trust in food safety and product authenticity, as well as to the erosion of sustainable production models that depend on transparency, fair competition, and responsible resource use. Overall, the findings highlight detection gaps, uneven resources across authorities, and the need for improved coordination and capacity-building to support more efficient, transparent, and sustainability-oriented food fraud control in Greece. Full article

Background: Work-related anxiety can result in prolonged work incapacity and reduce return-to-work probabilities. Despite the prevalence of work-related anxiety in somatic rehabilitation settings, there has been little research examining the experiences of affected patients from a public health perspective. This research project aims to address this gap by providing initial insights into the care provided to patients with somatic complaints and patients with additional work-related anxiety. Methods: A sequential mixed methods approach was employed, beginning with semi-structured interviews (2022, n = 18 orthopedic rehabilitation patients), followed by questionnaire distribution (2023, n = 53). Qualitative analysis distinguished between patients with higher (JA) and lower (nJA) Job Anxiety Scale scores (cut-off 2.5). Results: The findings highlight notable differences between JA and nJA patients. JA patients often report that they face unmet psychological needs, limited work-related treatment focus, financial barriers, and inadequate occupational support, relying more on self-initiative for reliable information. In contrast, nJA patients appear to benefit from stronger social networks, stable financial resources, and improved access to healthcare. Both groups report mixed experiences with workplace support. For professionals the findings underline that JA patients are specifically in need of work-related interventions, even patients themselves remind about this. Conclusions: The findings illustrate significant differences between JA and nJA patients in terms of their experiences, challenges, and support needs within healthcare, workplace, and rehabilitation contexts. While qualitatively insightful, these findings are pilot and explorative and warrant further research. Trial registration: DRKS00029004 (25 May 2022). Full article

This study examines how the explanations about school violence are constructed in Chilean online newspapers after the country—which had the longest period of school closures—returned to in-person classes. During early 2022, several complaints of school violence surged compared to the lockdown years, prompting questions about how the media shaped public interpretations of this rise. Using a content analysis of three Chilean online newspapers (“SoyChile”, “ElMostrador”, and “LUN”), this study reconstructed the Subjective Theories (STs) conveyed in their coverage. All articles (n = 50) published during three strategic periods of the 2022 school year were analyzed to identify explicit and implicit theories about the causes, intervening conditions, and strategies for addressing school violence. The most prevalent ST framed school violence as a structural problem, appearing 27 times. This narrative portrays the phenomenon as both inevitable and beyond the control of key actors, such as caregivers, teachers, school leaders, authorities, and students, ultimately reducing perceived accountability and agency in prevention or intervention efforts. Media discourse tended to legitimize explanations that locate school violence outside the sphere of individual or institutional responsibility. Full article

Social assistance is one of the primary programs organized in developing countries in a bid to reduce poverty. In Indonesia, the government has allocated IDR 152 trillion toward poverty alleviation. However, the persistent misuse of social assistance funds has unfolded to be a serious concern. According to the Ombudsman of Indonesia, approximately 81.37% of the 1004 complaints received between 29 April and 29 May 2020 were related to the misuse and misallocation of COVID-19 social assistance funds. Therefore, this study aims to comprehensively describe the legal enforcement model for preventing the misuse of social assistance funds and to identify the challenges faced by law enforcement from the perspective of legal sociology. In order to achieve the stated objectives, a qualitative approach grounded in legal sociology was adopted, utilizing empirical study methods. Data were collected through in-depth interviews with academics specializing in administrative law and public policy, as well as through an extensive review of the relevant literature. Subsequently, the gathered data were analyzed qualitatively using a descriptive approach. The obtained results showed that the key challenges in preventing the misuse of social assistance funds include weak regulatory frameworks, limited competency among law enforcement officials, and inadequate institutional infrastructure. Cultural factors were also found to play a significant role in influencing the effectiveness of law enforcement. Based on these insights, preventive measures were inferred to be essential and should focus specifically on strengthening the legal structure and utilizing technological tools to enhance transparency and monitoring. Accordingly, the substance of social assistance laws must be revised to include more detailed and specific provisions, while repressive measures should impose stricter sanctions on individuals who engage in misuse. Fostering a shift in the legal culture of society was also considered very important. These combined efforts are expected to reduce the misuse of social assistance funds, improve legal enforcement effectiveness, and essentially contribute to poverty reduction in Indonesia. Full article

Background: We examined the prevalence and correlates of energy drink (ED) consumption in Polish adults using an archival, nationally sourced dataset. Methods: Cross-sectional analysis of 120,000 adults from the archival 2024 National Health Test of Poles (computer-assisted web interview). ED consumption was assessed by frequency and dichotomized for regression (ever vs. never). Multivariable logistic regression estimated adjusted odds ratios (aOR) with 95% confidence intervals; an age cut-off was derived using ROC/Youden. Owing to the cross-sectional design, all estimates are interpreted as associations rather than causal effects. Results: In this national sample, 16.9% of adults reported ever consuming energy drinks, while regular (weekly or more frequent) consumption was rare (2.8%). After multivariable adjustment, the strongest independent correlates of ever consuming an energy drink were an age ≤53 years (aOR 3.80, 95% CI 3.61–4.01), male sex (aOR 3.17, 95% CI 3.03–3.32), frequent fast-food consumption (aOR 2.63, 95% CI 2.51–2.76), and being a current smoker (aOR 2.49, 95% CI 2.23–2.77). In contrast to the initial hypothesis, consumption was not found to be independently associated with education level. A strong, dose-dependent relationship was observed between consumption frequency and an increased prevalence of sleep disturbances, depression, and somatic complaints like headaches and chest pain. Conclusions: Energy drink consumption in Poland is concentrated within a high-risk demographic of young to middle-aged men and is deeply embedded within a cluster of adverse health behaviors. These findings underscore the need for comprehensive public health interventions that address the entire lifestyle pattern, rather than focusing solely on energy drink use. Full article

The publication analyses three criminal justice structures prominent in the scientific debate across various countries from the perspective of human rights, with particular emphasis on the principles of gender equality—the order to temporarily vacate the premises shared with the victim, the public-complaint nature of the offense of rape and the prohibition of mediation in cases of domestic violence. Their shared characteristic is their assumed support for victims of a specific type of criminal offenses, which justifies the premises and scope of these constructs (or the submitted postulates). The analysis has confirmed that all the indicated instruments unreasonably restrict the rights of victims. They are all grounded in a single model of the victim as a person—a weak, powerless woman, unable to decide about herself freely and without coercion. At the same time, it can be argued that they exemplify legal paternalism and systemic gender-based discrimination. Full article

Objectives: To identify patient-reported key disease-related challenges of macular and cone–rod dystrophies (MDs/CRDs) in a large consecutive cohort of individuals with molecularly confirmed diagnoses. Methods: Out of the 281 patients contacted, 194 (69.0%; 55.2% female) responded to an anonymized survey exploring the effects of MD/CRD on vocational training, professional careers, social participation, family life, personal well-being, and experience with ophthalmologic care. Results: While vocational training was generally less affected, professional careers were frequently disrupted, with 20.6% of patients aged ≥ 50 retiring early. A majority (54.7%) reported feeling restricted in public life. Financial constraints were noted by 20%. A negative impact on familial life (12.3%) was less frequently reported compared to anxiety (74.2%) and depression (15.8%). Diagnostic delays (≥2 years) were common (34.2%), along with a notable rate of initial misdiagnoses (22.1%). The lack of adequate psychological support was a major complaint in professional care. Conclusions: Compared to a previous study in retinitis pigmentosa, MD/CRD patients reported differing patterns of burden, especially in early retirement and family impact. Our findings underscore the need for ophthalmic and social care providers to accelerate the diagnostic process and enhance access to financial assistance and psychological support as key areas to improve patient care. Full article

Urban environmental noise represents a major public health issue contributing to chronic sleep disturbances, mainly from road, aircraft, and railway traffic. Night-time recreational noise from cafés, bars, and restaurants has emerged as a frequent source of sleep complaints but remains poorly understood, along with the influence of sociodemographic and economic factors. We addressed this gap by conducting a large-scale ecological study across the Paris Metropolitan Area (~10.5 million inhabitants) examining associations between the Average Energetic Index of night-time noise (AEI L_n) from road, aircraft, railway, and recreational sources and the prevalence of adults aged 18–79 reimbursed for hypnotic psychotropic drugs prescribed for chronic insomnia between 2017 and 2019, stratified by sex, age, and socioeconomic status. The AEI L_n represents the population-weighted average energy noise level within each territory at night (22:00–06:00 in France), calculated at the IRIS level (~2487 inhabitants per IRIS). The dispensing of hypnotic psychotropic drugs concerned 513,276 inhabitants (65.4 per 1000 inhabitants [‰]) on average per year. About 8 million inhabitants (75.7%) are exposed to night-time road traffic noise exceeding WHO health guidelines, followed by railway (~1.2 million, 11.6%), recreational (~1.2 million, 11.5%), and aircraft noise (~1.0 million, 9.8%). Each 5 dB(A) increase in AEI L_n was significantly associated (p < 0.001) with higher dispensing of hypnotic psychotropic drugs, strongest for road noise (+1.0‰), followed by recreational (+0.8‰), aircraft (+0.5‰), and railway noise (+0.3‰). Effects were significantly greater among individuals aged >50 (+8.3‰), women (+2.0‰), and those in the most socioeconomically deprived areas (+2.5‰). These results support proactive public policies aimed at reducing noise from transportation and recreational activities in densely urban areas to mitigate chronic insomnia. Full article

In recent decades, China has witnessed remarkable growth in housing construction, yet housing-related complaints have not declined significantly, highlighting the gap between housing quality and public expectations. Against this background, this study analyzes 32,277 national surveys to unpack residential satisfaction with green-livable communities in China. Entropy and standard-deviation weighting identified 16 priority indicators; artificial neural networks revealed weak direct influence of basic demographics on satisfaction, highlighting non-linear demand patterns. While 65–75% of respondents are satisfied with most attributes, significant city-level gaps persist—Beijing peaks near 90%, Chongqing falls below 50%. Dissatisfaction converges on three domains: infrastructure (parking, barrier-free access), building performance (leakage, noise, thermal defects) and smart systems (security, energy, health monitoring). Residents’ improvement priorities have shifted from basic shelter to health safety, smart technology, humanistic care and ecological amenities. A “basic-security + quality-upgrade” strategy is proposed: short-term repairs of common defects, medium-term smart-sustainable upgrades and long-term participatory governance. The findings not only enrich the theoretical framework of community satisfaction research but also provide practical guidance for enhancing community quality and meeting residents’ expectations in the context of China’s rapid urbanization and housing development. Full article

Safeguarding patient and personnel safety and improving care quality has emerged as a critical priority for healthcare systems globally. In response to persistent challenges in healthcare delivery, many countries have adopted clinical governance frameworks and organisational learning processes to strengthen accountability and promote continuous improvement. Robust clinical governance frameworks provide the processes and accountability measures necessary to foster a culture of knowledge-sharing and evidence-based decision-making, all of which are key characteristics of a learning organisation. This study seeks to investigate the role of clinical governance in improving hospital performance through three interconnected sub-studies. The first sub-study will explore how non-clinical managers in selected public sector hospitals leverage clinical governance to improve hospital performance. The second sub-study will evaluate the impact of clinical governance interventions on clinical outcomes and identify opportunities for organisational learning within these hospitals. The third sub-study will serve as an embedded experimental component, monitoring changes in complaint resolution indicators before and after interventions to assess improvements in clinical governance through both intra- and inter-hospital comparisons. Qualitative data will be analysed using NVivo version 15, with inductive thematic analysis employed to uncover emergent patterns and interpretive themes. Full article

Intimate partner violence is recognized as one of the most common forms of violence against women. However, it remains under-reported in many countries. The text aims to present key factors affecting women’s willingness to report intimate partner violence in Bulgaria. We proceed from the idea that the factors that create conditions for the existence of this type of violence in a society are also a major obstacle for women to file official complaints. Considering the complexity of the phenomenon and the numerous aspects that influence whether a victim will seek help or not, we use the three analytical levels—micro, meso and macro—to identify the main barriers to reporting intimate partner violence. The data used in the article were collected through a nationally representative adult population survey on attitudes towards violence against women in Bulgaria, in-depth interviews and focus groups with experts from various institutions related to the problem, and a survey among women victims of violence. The analysis revealed the impact on reporting willingness of macro factors such as the legal framework for preventing and regulating violence against women, as well as the existence of widely accepted cultural norms that normalize milder types of violence. At the meso level, ineffective institutional responses and a lack of support from the closest environment appear to be deterrents to reporting violence. Along with individual characteristics (such as psychological, emotional, and economic reliance) indicated by earlier studies and validated in our research, the analysis identified some poorly studied factors that positively influence the reporting of violence, such as public support expressed through social media and civil protests. Full article