Search Results (5,285)

Objectives: Cardiovascular diseases (CVDs) represent the main global burden of morbidity and mortality, with an accelerated epidemiological transition in regions such as Latin America. The university environment constitutes a period of critical vulnerability due to increased sedentary lifestyles and cardiometabolic risk factors. The objective of this study was to evaluate the cardiovascular risk profile in a university community in the central Andean region of Colombia using anthropometric, haemodynamic and biochemical indicators. Methods: A cross-sectional, observational, and analytical study was conducted on a sample of n = 143 participants (students, teachers, and administrators) aged between 18 and 80 years. Haemodynamic parameters (SBP, DBP, MAP), anthropometric parameters (BMI, % body fat, waist-to-height ratio [WC/W]) and lipid profile were evaluated. Statistical analysis included multiple linear regression models to determine predictors of systolic blood pressure (SBP). Results: Significantly higher levels of SBP were found in the older age groups compared with the younger age groups, reaching stage 1 hypertension levels in the sixth decade. The biochemical profile revealed metabolic deterioration with an atherogenic index (TC/HDL) consistently above the clinical threshold (>4.5) in all groups. The regression model BMI was identified as the statistical predictor with the strongest association with SBP variability in the sample (β = 1.18), followed by age (β = 0.28). A marked sexual dimorphism was observed, with men presenting early haemodynamic risk, while women experienced an accelerated post-menopausal tension and metabolic crisis. Conclusions: The university community presents latent cardiometabolic vulnerability closely linked to modifiable anthropometric factors. These findings underscore the urgency of implementing institutional preventive health policies and weight control intervention programmes to mitigate the future burden of chronic diseases on campus. Full article

Gender-based and sexual violence are major public health concerns, and norms about consent are central to their prevention. This study examines how attitudes toward sexual consent relate to digital sexual consent and to the occasional feeling of distrust in public consent campaigns and institutions. We conducted a cross-sectional online survey embedded in the evaluation of a municipal consent campaign in Zaragoza (Spain). Adults (N = 404; 56.7% women) completed a 14-item short version of the Sexual Consent Scale–Revised, two items on digital sexual consent, and three items on institutional reluctance (perceived “sermonizing” tone, distrust in effectiveness, and lack of personal identification with the message). Correlation and multiple regression models with robust standard errors were estimated, controlling for gender, age, education, income, relationship status, and social media use. Attitudes toward sexual consent were strongly and positively associated with digital sexual consent. Gender was the most consistent sociodemographic correlate: men showed less egalitarian attitudes than women across all consent measurements. Institutional reluctance was systematically related to less supportive consent attitudes: perceiving institutional messages as exaggerated or personally irrelevant predicted lower support for sexual and digital consent norms, whereas trust in the campaign’s effectiveness was associated with more egalitarian attitudes. The findings support the continuity between sexual and digital consent and highlight gender and institutional trust as key determinants for the prevention of gender-based and sexual violence. Public health and social policies should integrate digital consent into consent education and co-design campaigns that minimize defensive reactions and rebuild trust in institutions. Full article

Air pollution is one of the major environmental challenges threatening global sustainable development and human health. The World Health Organization identifies it as a critical factor contributing to non-communicable diseases and inequality, especially in vulnerable populations such as children. The findings highlight the negative effects of environmental degradation on physical health and underline the urgent need to incorporate health metrics, such as children’s fitness, into sustainability monitoring frameworks and public policies aiming at cleaner and healthier urban environments. The aim of this study was to examine the association between ambient particulate pollution and cardiorespiratory fitness in school-aged children from two rural villages in southern Spain characterised by relatively higher and lower levels of particulate matter. A total of 938 children (primary and secondary school levels) participated in a naturalistic pre–post study design. Cardiorespiratory fitness was assessed using the 6 min walk test, where maximal oxygen uptake (VO₂max) was estimated. Assessments were conducted before and after a period characterised by unfavourable air-quality conditions in the higher-pollution village. The students were assigned by convenience into an experimental [n = 476 (EG)] and a control group [n = 462 (CG)]. The t-test, repeated measures analysis and MANOVA test were used in order to report differences within and between groups, as well as time-points and academic levels. The significance level was set at p < 0.05. Significant differences between groups were reported within the pre-test period, showing elevated pre-test values in the CG compared to the EG. The EG showed a higher pre–post difference in estimated VO₂max compared to the CG for primary education level (16.19%, ES(d) = 0.91 vs. 3.07%, ES(d) = 0.26; p < 0.001, respectively); secondary education (EG: 12.29%, ES = 0.91 vs. CG: 1.69, ES(d) = 0.16); and the whole population (EG: 14.72%, ES = 0.91 vs. CG: 2.84, ES = 0.25). It seems that the environmental context, and specifically the air pollution in the area of residence, may be an important factor to consider in relation to the assessment of physical fitness in the school-aged youth population. Full article

Background: Healthcare policy in the United Kingdom recognizes that teenagers and young adults (TYAs: 16–24 years at diagnosis) require specialist care. In England, Principal Treatment Centers (PTCs) exist, delivering enhanced care exclusively within the PTC or as ‘joint care’ with designated hospitals (DHs). Central to this is the TYA multidisciplinary team (MDT) and an outreach model coordinating care between hospitals. We previously reported similar outcomes regardless of care location. Aims: To compare TYA experiences of care with healthcare professionals’ perspectives of the service they deliver. Methods: Mixed methods across England and Wales were used. The TYA-MDT identified TYAs who then received a postal invite to a cross-sectional survey capturing experiences of places of care, treatment, healthcare professional support (HCP), mental health, sexuality/fertility, clinical trials and care coordination. Comparisons were made based on exposure to care in a specialist TYA environment within 6 months of diagnosis: all-TYA-PTC (all care in the TYA-PTC, n = 70, 28%), no-TYA-PTC (no care in the TYA-PTC (n = 87, 35%): care delivered in a children/adult unit only), and joint care (care in a TYA-PTC and in a children’s/adult unit, n = 91, 36%). HCP perspectives were captured by rapid ethnography. Results: A total of 250/1056 (24%) TYAs participated. Overall, 200 (80%) rated their teams as excellent/good for helping them prepare for treatment. No evidence of significant differences existed between categories of care for proportions receiving support from key TYA-related professionals: TYA cancer nurse specialists (all-TYA-PTC n = 58, 91%; joint care n = 71, 88%; no-TYA-PTC n = 64, 82%) and social workers (all-TYA-PTC n = 30, 55%; joint care n = 36, 48%; no-TYA-PTC n = 28, 38%). A trend of diminishing support from youth support co-coordinators existed (all-TYA-PTC 63%; joint care 49%; no-TYA-PTC 40%, p = 0.069). This may explain why few differences in patient experiences existed across categories of care. Forty-nine HCPs participated. They were more critical in their interpretation of care, highlighting inequity in resources and challenges in some pathways and coordination. Conclusions: Similar access to age-appropriate support across care settings is likely to reflect recruitment methods. When TYAs are known to the MDT, age-appropriate care can be mobilized beyond TYA units, which could explain the equitable outcomes observed across different care locations in young people who responded to the survey. Nevertheless, gaps persist in communication and coordination, particularly within joint care models, and in the involvement of allied health professionals such as dieticians and physiotherapists, whose input is essential for rehabilitation and return to normal life. Strengthening these areas will require continued investment in workforce capacity and digital infrastructure to support genuinely coordinated, developmentally appropriate TYA cancer care. Full article

Population aging in middle-income economies produces macroeconomic and distributional consequences that aggregate frameworks cannot detect. This paper develops a multi-household CGE model calibrated to a 26-sector Social Accounting Matrix for Thailand (2024) and traces the labor, saving, and fiscal channels of aging across eleven counterfactual scenarios. Three findings emerge. First, aging’s primary macroeconomic cost operates through capital accumulation, not output contraction: investment falls seven times faster than the GDP under a savings-driven closure, because middle-aged households—the economy’s dominant net savers—compress lifecycle saving in response to aging. The saving channel alone amplifies the labor supply shock four-fold (range: 3.5–4.5). Second, aging can raise elderly welfare. When elderly households retain labor market attachment, wage gains from tighter factor markets outweigh declining capital returns—a welfare reversal invisible to representative agent and OLG frameworks by construction. The critical labor income threshold is ${\alpha }_L^{\ast }=35.5\%$ (range: 34.8–36.2%), confirmed across all participation increments tested (elderly welfare gain: THB 341–521 million). Third, no single instrument satisfies efficiency and equity simultaneously. Pension transfers crowd out investment nonlinearly above 12 percent of tax revenue (range: 10–14%); health demand expansion is the decisive complement that converts redistribution into a near-Pareto improvement. Policy complementarity is an empirical necessity, not a theoretical refinement. Collectively, these results reframe demographic aging as a factor price redistribution mechanism whose welfare incidence is determined by the cohort-level income composition—with direct implications for aging policy in middle-income economies facing rapid demographic transitions under tighter fiscal constraints than for advanced economies encountered at equivalent demographic stages. Full article

This study examines how socio-economic and demographic factors influence electric vehicle (EV) adoption in New South Wales (NSW), Australia. Using 2021 Australian Bureau of Statistics (ABS) census data and EV registration records, a cross-sectional analysis was conducted at the postcode level. Ordinary Least Squares (OLS) regression was applied to identify key determinants of EV uptake. The final model demonstrates strong explanatory power (R² = 0.819%). Results indicate that economic status, captured through a combined income and mortgage indicator, is the strongest predictor, associated with an approximately 101.7% increase in EV registrations for each standard deviation increase. Vehicle ownership density also shows a strong positive effect (an 80.9% increase). In contrast, areas with higher reliance on active transport exhibit a statistically significant negative association with EV adoption. Additional factors, including age, education, and occupational composition (managers and professionals), show moderate positive effects. These findings highlight persistent socio-economic disparities in EV uptake and suggest that targeted policy interventions are required to support a more equitable transition to sustainable transport. Full article

As rural residents face the dual challenges of transforming dietary structures and addressing nutritional health burdens, establishing a resilient food consumption system for rural households has become an urgent priority. Drawing on micro-level data from the China Land Economic Survey (CLES) for the period 2020–2022, this study employs two-way fixed effects models, an instrumental variable (IV) approach, and seemingly unrelated regression (SUR) techniques to examine the impact of agricultural production diversity on household food expenditure and dietary diversity, as well as the underlying mechanisms. The results reveal that agricultural production diversity yields a significant and robust dual-dividend effect within household food consumption systems: it not only reduces per capital food expenditure but also enhances dietary diversity. Mechanism analysis indicates that diversified production increases food self-sufficiency, thereby reducing cash outflows for essential food items, while simultaneously improving dietary diversity through increased agricultural income and greater agricultural commercialization. Heterogeneity analysis further shows that these effects are more pronounced in villages lacking rural industrial support and among non-ageing households. These findings suggest that, in contexts where market mechanisms remain underdeveloped, the uncritical pursuit of absolute agricultural specialization may not align with the livelihood and nutritional needs of rural residents. From the perspective of fostering a healthy and resilient food system, China should adopt differentiated agricultural support policies, encourage rural households to maintain an appropriate degree of production diversity, and strengthen local agricultural market infrastructure. Full article

Against the backdrop of intensifying global population aging, ensuring the sustainable provision of age-friendly spaces has become an important domain of urban policy intervention. A close examination of the supply–demand matching of age-friendly spaces is therefore essential for policymakers seeking to achieve social and environmental sustainability in an aging society. However, existing approaches to assessing this alignment primarily rely on quantitative analyses of geographical spatial distribution, lacking methods to evaluate the structural alignment of spatial functional types. To address this gap, this study proposes and validates a type-based quantitative approach to examining the alignment between policy supply and everyday demands for age-friendly spaces. By integrating policy text analysis, questionnaire surveys, activity logs, and behavior snapshots, the study identifies the types of age-friendly spaces mentioned by policies and those demanded in daily life, and quantitatively evaluates their alignment using a matching model. The results show that the older adults’ spatial demands shift progressively from life-oriented spaces to survival-oriented spaces as age increases and health declines. More importantly, a significant structural imbalance is evident: survival-oriented spaces are oversupplied, while life-oriented spaces remain in short supply. This study provides a diagnostic method for assessing the provision of age-friendly spaces and provides practical implications for local governments in formulating more balanced, responsive, and sustainable supply strategies. Full article

Artificial intelligence (AI) is increasingly used to support tuberculosis (TB) screening and diagnosis, particularly through computer-aided detection (CAD) applied to chest radiography (CXR). However, the programmatic value of AI depends not only on diagnostic accuracy but also on implementation context, threshold calibration, and integration into diagnostic pathways. We conducted a narrative, state-of-the-art review of AI applications across the TB diagnosis pathway. Evidence was synthesized from World Health Organization policy documents, independent validation initiatives, and peer-reviewed studies published between 2010 and 2026, with a structured selection process aligned with PRISMA principles. CAD for CXR is the most mature AI application and is recommended by WHO for TB screening and triage among individuals aged ≥15 years in specific contexts. Across studies, CAD-CXR demonstrates sensitivity comparable to human readers, although performance varies by product, population, and imaging conditions, necessitating local threshold calibration. Evidence from implementation studies suggests improvements in screening efficiency and potential cost-effectiveness in high-burden settings. Other AI modalities, including computed tomography (CT)-based imaging analysis, point-of-care ultrasound interpretation, cough or stethoscope sound analysis, clinical risk models, and genomic resistance prediction show promising but heterogeneous results, with most requiring further independent validation and prospective evaluation. AI has the potential to strengthen TB screening and diagnostic pathways, but its impact depends on integration into health systems and evaluated using patient- and program-level outcomes rather than accuracy alone. A differentiated approach is needed, with responsible scale-up of policy-endorsed tools alongside rigorous evaluation of emerging technologies to support effective and equitable TB care. Full article

Background: Hepatitis E virus (HEV) is an increasingly recognized cause of acute viral hepatitis in Thailand as the burden of hepatitis A, B, and C has declined. HEV is a positive-sense RNA virus in the family Hepeviridae with three major open reading frames encoding replication proteins (ORF1), the capsid protein (ORF2), and an accessory protein involved in viral egress (ORF3). Unlike highly endemic regions where genotypes 1 and 2 are linked to waterborne outbreaks, infections in Thailand are reported mainly as sporadic cases associated with zoonotic transmission, most commonly genotype 3. Objectives: This review summarizes the epidemiology, transmission routes, and public health implications of HEV infection in Thailand. Methods: Peer-reviewed studies on HEV seroprevalence, molecular epidemiology, and transmission in Thailand were identified through PubMed using combinations of the keywords “HEV” and “Thailand”. Two investigators independently screened titles, abstracts, and full texts. Eligible studies were synthesized qualitatively. Results: Earlier studies suggested low population exposure, but more recent evidence indicates substantial cumulative risk. A nationwide survey among blood donors reported anti-HEV IgG seroprevalence of about 30%, with geographic variation and increasing prevalence with age. Detection of HEV RNA in pigs, slaughterhouse environments, and retail pork products, together with links to raw or undercooked pork consumption, supports pigs as the principal reservoir and foodborne exposure as an important route. Transfusion-associated infection has also been documented. Conclusions: In Thailand, HEV infection is linked mainly to zoonotic and foodborne transmission involving genotype 3. Stronger surveillance, food safety measures, and risk-based blood safety policies are needed. Full article

Background: As Taiwan transitions into a super-aging society, the government has launched “Long-term Care (LTC) 3.0,” a policy initiative that marks a strategic shift from service expansion to integrated quality verification, digital oversight, and social resilience. This transition demands a robust quality verification mechanism. Ensuring perceptual consistency between service providers and external evaluators is critical for systemic fairness and sustainable service quality. Objective: This study utilized a two-dimensional gap analysis to examine the discrepancy in service quality benchmarks between home-based LTC center managers and assessment committee members, identifying critical divergence zones for institutional improvement. Methods: A cross-sectional evaluative study was conducted, involving center managers (evaluatees, n = 50) and external experts (evaluators, n = 28). The data were collected via a structured instrument covering 20 consensus benchmarks. Results: Significant perceptual gaps were identified across all dimensions (p < 0.001), with “Professional Care Quality” exhibiting the largest effect size (Cohen’s d > 1.5). Benchmarks with low external scores but high internal ratings were categorized into the “Overestimation (Management Blind Spot)” quadrant, signaling a systemic overestimation bias in administrative and clinical risk management. Conclusions: This study provides empirical evidence for the refinement of LTC 3.0 assessment systems. The results offer a strategic roadmap for policymakers to enhance organizational resilience by transitioning from subjective self-perception to objective, data-driven quality management through the two-dimensional gap model. Full article

This study quantifies the spatiotemporal evolution of non-communicable disease (NCD) mortality risk associated with temperature extremes in the Metropolitan Area of the Valley of Mexico (MAVM) from 2000 to 2019. Using a Bayesian risk assessment framework, we analyzed 747,131 deaths to evaluate the impact of extreme temperature indices (Tn90p, Tn10p, TNn, Tx90p, Tx10p, TXx, DTR) across demographic and geographic dimensions. Results reveal a significant intensification of mortality risk, particularly for circulatory and metabolic diseases after 2005 and 2014. Risk expansion analysis identified 16 cases of robust relative risk (RR) intensification, predominantly among elderly populations. Females and males aged 65+ with metabolic diseases exhibited the highest thermal vulnerability. Our analysis further indicates a systematic shift in mortality risk toward higher nocturnal temperatures and reduced diurnal variability, suggesting a transition from cold-related stress to persistent nighttime heat exposure. Spatial Bayesian modeling shows a progressive homogenization of environmental risk across the metropolitan area, with high-risk thermal profiles expanding from the urban core toward peripheral municipalities, reducing the extent of previously lower-risk zones. Notably, the number of municipalities in the highest risk category for females aged 65+ with metabolic diseases increased by 550%, while for males of the same age, the expansion reached 163%. These findings indicate that vulnerability in megacities is a dynamic process driven by nocturnal warming and thermal instability. They highlight the urgent need to integrate climate-sensitive planning strategies—such as the identification and preservation of climatic refuge zones—into urban development policies, alongside continuous monitoring of temperature-related health risks. Full article

This study investigates European citizens’ perspectives on farmers’ roles, highlighting gender, age, education, political orientation, community size, social class, and attitudes towards the EU. This study was developed using 21,002 interviews with European Citizens from all 27 EU countries. A quantitative data analysis methodology was used from the European Eurobarometer 97.1 survey. Seven models were formulated and tested. It is shown that men prioritise economic growth and food stability, while women emphasise environmental protection and animal welfare. Younger individuals focus on rural job creation, whereas older citizens value food security. Higher education levels correlate with environmental and animal welfare concerns. Right-leaning citizens favour economic development, whereas left-leaning individuals prioritise ecological issues. Larger communities emphasise economic growth, while smaller ones focus on environmental preservation. Social class influences priorities, with higher classes concerned about sustainability and lower classes about job creation. Pessimistic views about the EU correlate with food safety concerns, while optimistic views align with environmental and animal welfare priorities. These findings suggest that aligning agricultural and food policies with citizens’ diverse needs can foster a more sustainable and resilient European food system. Full article

Heavy metal contamination in drinking water remains a pervasive global challenge with significant consequences for environmental quality and human health. This review synthesizes findings from recent studies examining heavy metal concentrations in different sources of drinking water, including municipal tap water, groundwater, surface water, and bottled/sachet water across various geographical regions. The study used a systematic review of studies published from 2015 to 2024. The result showed a variation in the concentrations of heavy metals from all the sources, with tap water generally exhibiting lower heavy metal levels. Pb, Fe, Mn, and other metals persist in different sources and from many regions with levels above the permissible limits recommended by the World Health Organization (WHO) in some instances, which were sometimes linked to aging distribution systems and other pollution sources. Bottled and sachet water, commonly regarded as safer alternatives, also showed some levels of heavy metals such as Pb, Cd, and Cr, reflecting inconsistent packaging or production oversight. Surface waters display variability with heavy metals pollution, driven by industrial discharge, mining activities, agricultural runoff, and urban wastewater inputs. Groundwater sources, although naturally shielded, frequently contained elevated concentrations of As, Hg, and Ni due to both geological and anthropogenic factors. Pb concentrations were below detection limit in some of the published papers; however, the values reported in this study ranged from ND to 260.0 µg/L (tap water), ND to 0.259 mg/L (surface water), ND to 0.791 mg/L (groundwater), and ND to 123.15 µg/L (bottled water). Arsenic (As) concentrations ranged from ND to 692 µg/L from different sources, with the highest concentration from groundwater. Collectively, these patterns underscore the need for strengthened monitoring frameworks, improved water treatment technologies, and integrated pollution-prevention strategies. Addressing heavy metal contamination in drinking water requires coordinated policy approach and continuous monitoring to reduce human exposure and safeguard global public health. Full article

Against the backdrop of rapid population aging, investigating the intersection and impacts among lifestyle, cognitive health, and retirement holds significant academic value and great practical significance for advancing the achievement of the sustainable development goal (SDG) of “Good Health and Well-being”. This study employs data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) and adopts a Fuzzy Regression Discontinuity Design (FRDD) to examine the impact of lifestyle on cognitive health, identify lifestyle changes induced by retirement, and explore the underlying mechanisms and heterogeneous effects across population subgroups. The empirical results indicate that social engagement and physical exercise exert positive effects on cognitive health, while smoking and drinking significantly impair cognitive health. Retirement leads to reduced social participation and physical activity, as well as increased smoking and drinking, which in turn significantly lower cognitive health through the mediating role of lifestyle. Furthermore, the negative impact of retirement on cognitive health is heterogeneous: it is statistically significant among males, individuals with higher educational attainment, and those employed outside the government departments, but insignificant among females, individuals with lower educational attainment, and those working in the government sector. This study clarifies the functional logic linking retirement, lifestyle, and cognitive health, providing theoretical references and practical implications for formulating policies to safeguard cognitive health among middle-aged and older adults. Full article