Applying the analysis of interconnected decision areas model to the strategic planning of the age-friendly tourist city of Isfahan

This study examined off-label and evidence-based use of second-generation antipsychotic agents among elderly nursing home residents and factors associated with off-label use. This study involved a retrospective, cross-sectional analysis of data from the 2004 National Nursing Home Survey (NNHS). The sample included nursing home residents 65 years and older who received second-generation antipsychotic agents. This study used an indication-based definition of off-label use established by the U.S. Food and Drug Administration (FDA). Evidence-based use included FDA-approved indications and indications for which the Agency of Healthcare Research and Quality found at least moderate strength of evidence of effectiveness. Descriptive statistics were used to examine the prevalence of off-label and evidence-based use. Multiple logistic regression was used to examine the patient and facility factors associated with off-label use of second-generation antipsychotics. According to the 2004 NNHS, 308,990 (23.5%) elderly nursing home residents received at least one second-generation antipsychotic agent. Of those using second-generation antipsychotics, 86.3% received them for off-label indications and 56.9% received them for an evidence-based use. Multivariate analysis found that age (> or =75 years), self-pay for nursing home care, diagnosis of dementia, and residing in a nonprofit nursing home were positively associated with off-label use, whereas receiving Medicaid benefits was negatively associated with such use. Although second-generation antipsychotics were frequently used for off-label indications, most of the usage was evidence based among elderly nursing home residents. However, the high level of non-evidence-based use combined with recent safety and efficacy data suggests an urgent need to address the evidence base for this vulnerable population.

In the recent years, substantial changes in the manner of sightseeing in cities have been becoming visible. Tourists are leaving the old city centres and are deciding to visit places that are not typical tourist attractions. In such places, alternative forms of city tourism described as off-the-beaten-track tourism are developing. In Europe, this pertains especially to historical cities, specifically capital cities and large agglomerations, such as Krakow, one of the biggest cities in Poland, commonly described as the cultural capital. The aim of this article is to analyse the management of tourism in European historical cities in the context of off-the-beaten-track tourism’s development using the case study of Krakow. To illustrate the issue, two districts, Nowa Huta and Podgórze, were chosen as the examples. In both districts one can observe changes affecting the model of city tourism that stems from the shift in motivations of visitors and from alternative ways of spending free time in the city they are visiting. This process necessitates appropriate management of tourism in the city in accordance with the rules of sustainable development and protection of cultural and historical authenticity of places and buildings.

Older cities with significant physical historic resources have become increasingly important centers for urban tourism, though contemporary attractions and events are often important in their own right. It is acknowledged that urban areas are multifaceted agglomerations where tourism complements other economic sectors and competes with them for limited resources. A limited investigation of the temporal dynamics of change of tourism in cities has been undertaken in the several countries in Europe and North America. Much less has been studied for the countries of Southeast Asia where tourism has expanded rapidly over the past several decades, a trend that is projected to continue. Urban tourism has and will continue to be important in Southeast Asia. This paper reports on the spatial modeling of the evolution of tourism in two historic cities in Southeast Asia that seeks to better understand the dynamics of temporal change of tourism within their respective urban contexts. The cases of Bangkok and Jakarta have been compared with the Ashworth and Tunbridge model to identify conformity and otherwise of Asian cases with the European theory.

Historic centers have become first-line tourist destinations. In order to achieve sustainable development, it is essential to get to know the opinions of the host community on the impact of tourism, the positives, as well as the negatives. This paper aims to understand the residents’ opinions and perceptions of destinations as the historic cities. This research looks into the residents’ opinions on the impact of tourism in the historic city of Toledo, Spain. The results of a quantitative survey among 442 residents in the city of Toledo are presented. The study is a revision of the literature and analysis and explanation of an empiric study’s results. Descriptive statistics have been used, as well as factor analysis and non-parametric tests to analyze data. The main results point out that residents have a positive vision of tourism development, rather than negative. The economic importance of tourism and its ability to create jobs stand out. However, they also think that the historic center is being turned into a museum for tourists. Analyzing their opinions according to certain demographic and socioeconomic characteristics, some major differences come up, such as that the inhabitants of residential areas have a more positive opinion than those who live in the historic center. Understanding the perspective of the residents can help the managers and planners of the tourism in the city to play down the potential negative impact of tourism and to achieve support from the host community in regards to tourism.

Special urgency for small cities in Iran represents developing problem guiding principles of transformation and development of architectural and planning structure, as well as applied technique of its evaluation in accordance with the requirements of sustainable development. This article describes leading forms of urban development settlements and identifies common principles which influence on sustainable urban development.
 The objective of this article is to assert sustainable development theories which meets city planning structure and develop a sustainability concept for Iranian small cities. This will be done through studies that were influenced by addressing a rethinking in order to emphasize adapting new trend of sustainable development which focused on city planning structure, and suitable for Iranian small cities condition. Thus, the main tasks of study could be formulated as follows: define Iranian small cities planning structure features and problems; study recent sustainability documents and related urban development forms and principles; comparative analysis; and finally suggest a creative solution for architectural and planning structure for Iranian small cities condition.
 The research used the method of analysis of latest international scientific literature and documents related to urban development sustainability in order to evaluate, compare and achieve a proper solution for Iranian small cities structures sustainability. It should be noted that such kind of analysis would be done only after analyzing and identifying the features and problems of the planning structure of Iranian small cities.
 Results of study: The article reveals recent sustainable urban development forms and its interpretations in modern urban development theories; demonstrates Iranian cities structure features; Iranian cities general plans problems; urban forms and design principles for achieving the goals of sustainable urban development for conditions of Iran.
 The scientific novelty of research is to study recent urban sustainable development forms and principles which related to urban structures; and suggest an appropriate and suitable concept for Iranian small cities development sustainability.

Chapter 4 - Modelling the tourist-historic city

Depok has a big opportunity to become an age friendly city (AFC) because it has a large number of posbindu, increased elderly population, it does not have yet the pension security for the elderly people, and it does not have yet the number of infrastructure and social facilities needed for the elderly. Before Depok City becomes an age friendly city, an assessment of the eight-dimensional indicators of AFC had been carried out by a team of UI researchers from Center of Ageing Studies in collaboration with the Institute for Survey METER in March 2013. One of the main finding was the presence of the three indicators of AFC in Depok which still lack, they are buildings and open space, housing, and civil participation and employment. The purpose of the study was to assess the public’s opinion on the three indicators of AFC that still lack in Depok. The study shows that the majority of people and government as stakeholder assess that Depok is ready to become AFC as long as supported by the government of Depok City with the good coordination with related institutions for the budget and programs prioritizing the interests of the elderly. Moreover, the existence of Komda (Comission Area) of Elderly Depok City can support the establishment of a friendly city towards the elderly. The community prefers to choose the indicators of buildings and open spaces as a top priority for elderly-friendly city rather than chooses the indicators of housing and civil participation and employment for the elderly people. Therefore, hopefully Depok City Government with related institutions can build the building which is elderly-friendly as well as AFC socialization to the government and private sectors in order to achieve rapid implementation of Depok as an AFC.

Background:Elderly population is rising due to advancement of health care, medical services, and increasing life expectancy. World Health Organization (WHO) has initiated a global project to define “age-friendly city for improving the elderly's quality of life”.Objectives:The purpose of the study was to determine the age-friendly cities characteristics from the elderly's point of view in Gorgan, Iran.Methods:This cross-sectional study was conducted in 2019 on elderly people who referred to the health centers of Gorgan, Iran. 160 eligible elderly people were recruited through multi-stage random sampling. The viewpoint of participants about the characteristics of Gorgan in the four age-friendly city indicators; urban and outdoor buildings, transport and transportation systems, information and communication services, and social support and health services was compared with the standard of WHO. Data were collected using the age-friendly city questionnaire and analyzed in SPSS-18 using Chi-square and one-sample t-tests.Results:From the elderly viewpoint, the mean score of 4 indicators; urban buildings and outdoor (58.50 ± 31.2), Transport and transportation system (43.3 ± 82.00), access to Information communication services (46.75 ± 15.1) and the level of access to social support and health services (81.43 ± 21.10). Considering age-friendly city indicators, the characteristics of Gorgan City were significantly lower than the WHO recommended standard (P < 0.001). The “Information and Communication” and “buildings and outdoor space” indicators had the highest and lowest differences from the standard, respectively.Conclusion:According to the present results it is recommended that managers and policymakers of urban planning and healthcare providers in their programs consider the elderly viewpoint to improve the urban characteristics as an age-friendly city.

Current global trends show that different regions of the globe face an increased level of urbanization, and there is a swift aging process from the Western to the Eastern European countries. Romania is a typical country expecting to triple the percentage of the older population aged 65 and over in the next 30 years. Urban policies often neglect such demographic perspectives. The World Health Organization launched the age-friendly city and communities' movement that proposes solutions for older people to age actively by improving their welfare and social participation. The concept of an age-friendly city comprised eight dimensions: (1) outdoor spaces and buildings; (2) transportation; (3) housing; (4) social participation; (5) respect and social inclusion; (6) civic participation and employment; (7) communication and information; and (8) community support and health services. It raises some important questions about how to measure and evaluate urban policies in this framework. Current work presents the process of adaptation and validation for the Romanian older population of a standardized tool - the Age-Friendly Cities and Communities Questionnaire (AFCCQ). The validation study was conducted in Bucharest (n = 424) on a representative sample of older people, who were asked to rate their life in the city, following the eight dimensions and an additional one regarding their financial situation. Four clusters were differentiated in the analysis, resulting in different views of older adults on their experience of living in the city, showing that people's socio-economic status, their living arrangements and health situation play a role in shaping their views on city life. The results highlight the importance of standardized tools to design urban policies following an age-friendly agenda.

ABSTRACTForecasting future water demands has always been of great complexity, especially in the case of tourist cities which are subject to population fluctuations. In addition to the usual uncertainties related to climate and weather variables, daily water consumption in Mashhad, a tourist city is affected by a significant different fluctuation. Mashhad is the second most populous city in Iran. The number of tourists visiting the city is subject to national and religious events, which are respectively based on the Iranian formal calendar (secular calendar) and the Arabic Hijri calendar (Islamic religious calendar). Since religious events move relative to the secular calendar, the coincidence of the two calendars results in peculiar wild fluctuations in population. Artificial neural networks (ANNs) are chosen to predict water demand under such conditions. Three types of ANNs, feedforward back-propagation, cascade-forward and radial basis functions, are developed. In order to track how population fluctuation propagates in the model and affects the outputs, two sets of inputs are considered. For the first set, based on evaluating several repetitions, a typical combination of variables is selected as inputs, whereas for the second set, new calendar-based variables are included to decrease the effect of population fluctuations; the results are then compared using some performance criteria. A large number of runs are also conducted to assess the impact of random initialization of the weights and biases of networks and also the effect of calendar-based inputs on improvement of network performance. It is shown that, from the points of view of performance measures and unchanging outputs through numerous runs, the radial basis network that is trained by patterns including calendar-based inputs can provide the best domestic water demand forecasting under population fluctuations.Editor D. Koutsoyiannis Associate editor E. Rozos

Purpose The purpose of this trends paper is to offer insights into the technological changes affecting our cities and urban tourism destinations, and to explore avenues for further research and practice in the context of smart tourism destinations. Design/methodology/approach The literature on smart cities and smart tourism destinations is analysed in view of delivering a research agenda for a new generation of “post-smart” tourism destinations, beyond existing paradigms in this field. Findings Smart tourism research to date is found to be lacking in terms of addressing emerging (“post-smart”) social issues increasingly faced by global tourism cities, such as growing inequalities between host communities and visitors, wellness (e.g. slow tourism and slow cities) and resilience and mental health (e.g. digital detox), among others. Practical implications A post-smart approach to tourism city management and marketing calls for rethinking of existing tourism and urban policies that address wider sustainability issues exemplified by the urban transitions debate as well as adopting a more holistic networked approach to smartness involving entire regions. This also calls for the development of a new research agenda in urban tourism through a new prism – the post-smart “wise” tourism destination. Originality/value A new tourism futures construct – the “wise” tourism destination – is posited. This is done within the context of a new (“post-smart”) generation of tourism cities. It is argued that “wise” tourism cities will require novel attributes and adopt a visionary strategic positioning well beyond today’s smart tourism destination paradigms. Additionally, a tentative research agenda for “wise” tourism cities is discussed.

The proportion of the elderly population to the general population is increasing day by day in our country and in the world. This situation mainly affects developing countries, but there are impacts on the developed countries as well. The global aging of the world's population increases the need for services for the elderly, thus making it necessary to address the situation in terms of urban living conditions and architectural aspects. The loss of the elderly's ability to adapt to the built environment, physical and biological constraints, and spatial inadequacies are forcing older people to change the boundaries of their habitat. Within this context, the World Health Organization (WHO) is leading the way in inspiring cities to be “age-friendly” through the Global Age-Friendly Cities Guide. It develops strategies for active aging and age-friendly cities that make the best use of health, participation, and safety opportunities to improve life quality in old age. The main purpose of this study is to propose an application based on the theoretical infrastructure about the concept and requirements of the age-friendly city, which aims to create a livable and accessible environment in which the elderly can continue their lives actively and feel integrated with the society. In the scope of the study, an age-friendly city model for active and healthy aging was developed, and its results were analyzed through the Age-friendly Bolu Karacasu sample, which was created with a project in the Urban Planning Project Studio of Abant Izzet Baysal University of Bolu in 2019-2020. Keywords : Age Friendly Cities, active aging, quality of life, accessibility, Bolu Karacasu. DOI : 10.7176/JSTR/6-10-05

ABSTRACTThis special issue bridges the existing gap in the tourism and urban literature regarding planning and tourism in European cities and investigates the interrelationship between urban planning and tourism and its evolvement and transition over time. It includes nine articles that focus on different cases of urban planning and tourism in European cities. All the cities presented in this special issue function as capital cities, therefore they were designed and planned to represent the nation to itself and to the world for incoming tourists. As a result, all those cities are endowed with monumental city planning and architecture, they have abundance of cultural institutions and monuments thus raising questions about the choice and type of the representation of heritage arise. In addition of being capitals, those cities are also places where ordinary people live and with the growing intensity and volume of tourism, questions of social and economic carrying capacity arises; some of the articles reflect on those growing concerns. The cities chosen to this special issue are: Berlin, Paris, Vienna, Barcelona, Lisbon, Prague, Budapest, Skopje (and several additional cities in Macedonia). Those cities represent a balanced geographic distribution of cities in the European continent from East to West and North to South.

Purpose This study provides the first systematic analysis of the relationship between population aging and housing demand in an Iranian intermediate city (Shahin Shahr). This study aims to quantitatively model how demographic factors influence demand and to forecast the housing shortage through 2037. The main goal is to address the important issue of how to reduce the mismatch between housing supply and demand for the elderly in high-migration cities. Ultimately, this research intends to suggest practical, localized policy solutions to promote a more equitable urban future. Design/methodology/approach This study uses a quantitative-analytical approach, using Spectrum software (version 6.1) to project the future population of Shahin Shahr until 2037. Data were gathered from official sources, including population and housing censuses, health network records and municipal statistical yearbooks. After validating the demographic model with an acceptable margin of error of 2.1%, an exponential growth model was used to convert population estimates into household projections and assess housing demand. The statistical significance of the population aging trend was confirmed through a proportions test (p &amp;lt; 0.001). Findings This study forecasts Shahin Shahr’s population will grow from 202,163 in 2022 to 311,882 in 2037, with a total fertility rate (TFR) of 1.3. The share of elderly residents (65+) increases from 9.13% to 11.63% (p &amp;lt; 0.001), driven by declining fertility (1.1 in 2023), decreasing household size (to 2.91), rising life expectancy and migration (accounting for 78% of growth). Housing demand rises sharply, creating a cumulative shortage of 81,040 units by 2037, with an annual deficit of 2,114 units, amid 666% increase in housing prices. Persistent mismatch between supply and demand favors larger units (&amp;gt;100 m²) over smaller, senior-friendly options, worsening spatial exclusion. Research limitations/implications Limitations: This study relies on secondary data, which restricts a deeper understanding of the elderly’s personal preferences and subjective needs. In addition, the predictive models used are vulnerable to unforeseen economic or political shocks. Implications: The findings highlight the structural inefficiencies of the housing market and emphasize the need for targeted interventions. A five-pillar policy framework has been proposed to encourage spatial justice and sustainable development. This research offers a model for new cities in the Global South, focusing on socioeconomic and design-oriented approaches. Practical implications This study presents an integrated analytical framework to address the elderly housing crisis by combining theories of spatial justice (Fainstein, 2010), the right to the city (Lefebvre, 1991), the age-friendly city (WHO, 2007) and the life-cycle approach (Li and Zhao, 2011). Its dual-layer model examines both structural causes – such as housing commodification and land speculation – and human impacts, including spatial discrimination. The study proposes policies like land value taxation (LVT), strategic land distribution, preferential loans for small housing units (&amp;lt;75 m²), accessibility improvements and the formation of local councils. This model offers a transferable solution for medium-sized cities in developing countries. Social implications The housing crisis in Shahin Shahr has caused spatial discrimination and excluded the elderly from adequate housing, leading to increased domestic risks such as falls and health threats. Rising intergenerational inequality has pushed younger people out of the housing market, increasing their reliance on parental support – causing delayed marriages, lower fertility rates and greater economic dependence. This trend has divided society into “insiders” and “outsiders,” deepening the social isolation of the elderly and undermining both the right to the city and spatial justice. Without action, these social inequalities are likely to continue. Originality/value By presenting an integrated analytical framework, this study offers the first systematic analysis of the relationship between population aging and housing demand in medium-sized Iranian cities. By combining Marxist, Georgist and spatial justice theories, it addresses spatial, methodological and theoretical gaps within Iranian scholarship. Focusing on Shahin Shahr as a natural laboratory, the study provides transferable insights for developing cities. Quantitative modeling using the Spectrum software, along with the proposal of a practical policy package – such as LVT – enhances its applied relevance and offers equity-focused and sustainable solutions to the elderly housing crisis.

The article is dedicated to the questions of using modern multimedia technologies for popularization of historical cities as tourist attractions from and for pre- serving cultural heritage by partially transferring the influence of mass tourist flows from the real world to the virtual reality.&#x0D; The authors formulate the main theses of the "new normality", reflecting the specifics of the current stage of economic development and characterizing the environment in which managerial decisions are currently being taken. The au- thors also highlight the main trends and challenges of this "new normality" influencing the development of tourism industry and, particularly, tourism in historical cities.&#x0D; The article notes that technical capabilities and marketing needs of the target audience of travelers should be taken into account. The authors classify modern, technically accessible technologies of augmented and virtual reality and their possibilities in the organization of tourism in historic cities. The article shows the role of storytelling technologies in the forming the audiences of potential tourists and the loyalty of attendees, who visit the historic city more than once. The results of online surveys conducted on a sufficiently wide sample substantiate the relevance of the approaches proposed by the authors. The material also shows the ways of using the augmented reality tools in historical cities. The authors raise the issues of the safe organization of virtual space in the historic cities and propose options for approbation of the developed approach in St. Petersburg.