Introduction: In Central Europe, in Hungary, the state guarantees access to health care and basic health services partly through the Semmelweis Plan adopted in 2011. The primary objectives of the Semmelweis Plan include the optimisation and transformation of the health care system, starting with the integration of hospitals and the state control of previously municipally owned hospitals. The transformation of the health care system can have an impact on health services and thus on meeting the needs of the population. In addition to reducing health inequalities and costs, the relevant benefits include improving patients’ chances of recovery and increasing patient safety. The speciality under study is decubitus care. Our hypothesis is that integration will improve the chances of recovery for decubitus patients through access to smart dressings to promote patient safety. Objective: to investigate and demonstrate the effectiveness of integration in improving the chances of recovery for decubitus ulcer patients. Material and methods: The research compared two time periods in the municipality of Kalocsa, Bács-Kiskun County, Southern Hungary. We collected the number of decubitus patients arriving and leaving the hospital from the nursing records and compared the pre-integration period when decubitus patients were provided with conventional dressings (01.01.2006–2012.12.31) and the post-integration period, which entailed the introduction of smart dressings in decubitus care (01.01.2013–2012.12.31). The target population of the study was men and women aged 0–99 years who had developed some degree of decubitus. The sample size of the study was 4456. Independent samples t-test, Chow test and linear trend statistics were used to evaluate the results. Based on the empirical evidence, a SWOT analysis was conducted to further examine the effectiveness of integration. Results: The independent samples t-test model used was significant (for Phase I: t (166) = −16.872, p < 0.001; for Phase II: t (166) = −19.928, p < 0.001; for Phase III: t (166) = −19.928, p < 0.001; for Phase III: t (166) = −16.872, p < 0.001). For stage III: t (166) = −10.078, p < 0.001; for stage IV: t (166) = −10.078, p < 0.001; for stage III: t (166) = −10.078, p < 0.001). for stage III: t (166) = −14.066, p < 0.001). For the Chow test, the p-values were highly significant, indicating a structural break. Although the explanatory power of the regression models was variable (R-squared values ranged from 0.007 to 0.617), they generally supported the change in patient dynamics after integration. Both statistical analyses and SWOT analysis supported our hypothesis and showed that integration through access to smart dressings improves patients’ chances of recovery. Conclusions: Although only one segment of the evidence on the effectiveness of hospital integration was examined in this study, integration in the study area had a positive impact on the effective care of patients with decubitus ulcers, reduced inequalities in care and supported patient safety. In the context of the results obtained, these trends may reflect different systemic changes in patient management strategies in addition to efficient allocation of resources and quality of care.

This article analyses the complex factors contributing to rising medical expenses, focusing on the senior citizen demographic in Malaysia. With the global aging population, notably in lower and middle-income countries, the study highlights the escalating medical and health insurance costs, driven by age, income source, modern healthcare, and geographical residence. The research draws on an extensive literature review, demographic analysis, and quantitative methods to examine these determinants. It critically analyzes Malaysia’s healthcare system, which operates on a dual-tier model, and the financial burden placed on senior citizens. The findings indicate that age, source of income, and geographical residence significantly influence medical expenses, whereas modern healthcare’s impact is not statistically significant. The study calls for government intervention, insurance industry adjustments, and private sector support to mitigate the financial strain on senior citizens. Recommendations include tax relief adjustments, National Health Insurance Scheme implementation, and employment sustainability for seniors. This research provides some recommendations to policymaking, the insurance industry, and academia by providing insights into managing the healthcare needs of an aging population sustainably.

The purpose of this study is to analyze issues related to the use of green technology and to provide a theoretical basis for how the application of green technology in agriculture can reduce inequality. Additionally, the study aims to explore policy alternatives based on the analysis of inequality reduction issues through farmer surveys. For this purpose, this study used survey data to analyze farmers’ perceptions, acceptance status, willingness to accept green technology, and perceptions of inequality. The quantitative analysis was performed to analyze the relationship between the acceptance of green technology and perceptions of inequality. The results confirmed that access to information, perception of climate change, and awareness of the need to reduce greenhouse gas emissions are major factors. In particular, the higher the satisfaction with policies regarding the introduction of green technology, the lower the perception of inequality. Specifically, the acceptance of green technology showed a significant positive correlation with access to information, perception of climate change, and awareness of the need to reduce greenhouse gas emissions, while perceptions of inequality showed a significant negative correlation with policy satisfaction. In conclusion, green technology in agriculture is vital for reducing climate change damage and inequality. However, targeted policy support for small-scale farmers is essential for successful adoption. This study provides policy implications related to the application of green technology in the agricultural sector, which can promote sustainable agricultural development.

This study investigated the changing land use patterns and their impacts on ecosystem in the Teesta River Basin of northwestern Bangladesh. Although anthropocentric land use patterns, including agricultural land use, settlements, built areas, and waterbody loss, have been increasing in the Nilphamari district, by negatively affecting local ecosystems, they have not been identified by prior research. Limitations of contemporary literature motivated me to work on this crucial ground in the Teesta River Basin in Northwestern Bangladesh. This study applied a mixed research approach to identify the study objectives. Firstly, the land use and land cover (LULC) changes which occurred between 2000 and 2020 were detected using satellite imagery and supervised classification method. In addition to the detection of LULC changes, the study explored the people’s perceptions and experiences about the ecosystem changes resulted from the LULC changes over the last 20 years, conducting stakeholders’ consultations and household surveys utilizing a semi-structured questionnaire. The findings indicated that waterbodies in Nilphamari district have significantly decreased from 378 km² in 2000 to 181 km² in 2020. In the same way, the vegetation coverage has reduced 187 km² between the years 2000 and 2020. On the contrary, agricultural lands (croplands) have increased from 595 km² to 905 km² and settlements have increased from 81 km² to 206 km² between the years 2000 and 2020. From the chi-square test, it was found a significant association between ecosystem change and biodiversity loss. It was further identified that waterbody decreases have significant impacts on aquatic ecosystems. The results of this study also indicated that due to the introduction of foreign tree species, local and native species have been significantly decreasing over the time. This study emphasizes the non-anthropocentric and inclusive land use policy implications for protecting life on land and preserving the aquatic ecosystem in Bangladesh.

The urgency of adapting urban areas to the increasing impacts of climate change has prompted the scientific community to seek new approaches in partnership with public entities and civil society organizations. In Malaysia, Penang Island has developed a nature-based urban climate adaptation program (PNBCAP) seeking to increase urban resilience, reduce urban heat and flooding, strengthening social resilience, and build institutional capacity. The project includes a strong knowledge transfer component focused on encouraging other cities in the country to develop and implement adaptation policies, projects, and initiatives. This research develops a model adopting the most efficient processes to accelerate the transfer of knowledge to promote urban adaptation based on the PNBCAP. The methodology is developed based on a review of literature focused on innovation systems and change theories. The integration of success strategies in adaptation contributes to informing the creation of solutions around the alliance of local, state, and national government agencies, scientific institutions, and civil society organizations, in a new framework designated the Malaysian Adaptation Sharing Hub (MASH). MASH is structured in 3-steps and will function as an accelerator for the implementation of urban climate adaptation policies, with the target of creating 2 new adaptation-related policies to be adopted annually by each city member, based on knowledge gathered in the PNBCAP. It is concluded that, to speed up urban adaptation, it is necessary to reinforce and promote the sharing of knowledge resulting from or associated with pilot projects.

Dredging and reclamation operations are pivotal aspects of coastal engineering and land development. Within these tasks lie potential hazards for personnel operating dredging machinery and working within reclamation zones. Due to the specialized nature of the work environment, which deviates from conventional workplace settings, the risk of workplace accidents is significantly heightened. The aim of this study is to conduct a comprehensive risk analysis of the safety aspects related to dredging and reclamation activities, with the goal of enhancing safety and minimizing the frequency and severity of potential dangers. This research comprises a thorough risk analysis, integrating meticulous hazard identification from sample projects and literature reviews. It involves risk assessment by gathering insights from experts with direct working experience and aims to assess potential risks. The study focuses on defining effective risk management strategies, exemplified through a case study of a nearshore construction project in Thailand. The study identified numerous high and very high-risk factors in the assessment and analysis of occupational safety in dredging and reclamation work. Consequently, a targeted response was implemented to control and mitigate these risks to an acceptable level. The outcome of this study will provide a significant contribution to the advancement of guidelines and best practices for improving the safety of dredging and reclamation operations.