Search Results (540)

(1) Background: This article aims to understand the forms and elements through which the inhabitants of the city of Medellin have configured their subjectivity in the context of the application of neoliberal policies in the last two decades. In this way, we can approach the frameworks of understanding that constitute a fundamental part of the individuation processes in which the incorporation of their subjectivities is evidenced in neoliberal contexts that, in the historical process, have been converging with authoritarian, antidemocratic and neoconservative elements. (2) Method: A qualitative approach with a hermeneutic-interpretative paradigm was used. In-depth semi-structured interviews were conducted with 41 inhabitants of Medellín who were politically identified with right-wing or center-right positions. Data analysis included thematic coding to identify patterns of thought and points of view. (3) Results: Participants associate success with individual effort and see state intervention as an obstacle to development. They reject redistributive policies, arguing that they generate dependency. In addition, they justify authoritarian models of government in the name of security and progress, from a moral superiority, which is related to a negative and stigmatizing perception of progressive sectors and a negative view of the social rule of law and public policies with social sense. (4) Conclusions: The naturalization of merit as a guiding principle, the perception of themselves as morally superior based on religious values that grant a subjective place of certainty and goodness; the criminalization of expressions of political leftism, mobilizations and redistributive reforms and support for policies that establish authoritarianism and perpetuate exclusion and structural inequalities, closes roads to a participatory democracy that enables social and economic transformations. Full article

Introduction: Obesity is a rapidly increasing condition that leads to serious health issues. The sense of smell, one of the oldest senses related to energy metabolism, has been increasingly studied in relation to obesity. Objective: This study investigates the impact of childhood obesity on the volumes of the olfactory bulb and pituitary gland, exploring the relationship between body mass index and these brain structures. Method: This study included 146 participants aged 6–18 years with different body mass indices between 2021 and 2024 at Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey. Participants were classified into normal weight, obese, and morbidly obese groups, and olfactory bulb and pituitary gland volumes were retrospectively analyzed. MRI scans were performed to exclude intracranial pathologies due to headache complaints, and patients with cranial pathologies were excluded from the study. Results: This study examined the olfactory bulb and pituitary gland volumes among normal weight, obese, and morbidly obese groups aged 6–18 years. In the morbidly obese group, right olfactory bulb area and right olfactory bulb volume were significantly higher compared to the other groups, while left olfactory bulb area was higher in both the obese and morbidly obese groups. Additionally, in the morbidly obese group, pituitary height was significantly lower than the other groups, and pituitary volume was also found to be reduced in morbid obesity. Conclusions: This study demonstrated that childhood obesity is linked to significant changes in the volumes of the olfactory bulb and pituitary gland. In morbidly obese children, an increase in pituitary volume and alterations in olfactory bulb volume suggest possible neuroanatomical adaptations. Full article

This article examines the accessibility of public space for individuals with disabilities in the Netherlands, as well as the relevant legal frameworks intended to promote accessibility. It discusses the Convention on the Rights of Persons with Disabilities (UN CRPD) and efforts to implement its provisions at the local level. The article first provides an overview of Dutch legislation and regulations concerning accessibility in public spaces. It then presents an analysis of the experiences of individuals with disabilities in navigating streets and pavements in two Dutch cities, Utrecht and Almere. The central question is to what extent equal participation in public space has been realised. The findings indicate that national legislation remains inadequate in addressing the accessibility of streets and pavements. Despite the constitutional amendment in January 2023, which prohibits discrimination on the grounds of disability, substantive equality is largely dependent on the individual policies and bylaws of the 342 municipalities. The involvement of individuals with disabilities in shaping the inclusive use of public space is therefore crucial at the local level. This article highlights local initiatives that have successfully drawn the attention of municipal policymakers and civil servants to the importance of accessible streets. Full article

Henri Lefebvre’s “right to the city” has rarely been examined through an intersectional feminist lens, leaving unnoticed the uneven burdens that urban design and policy place on women. This article bridges that gap by combining constitutional analysis, survey data (n = 736), in-depth interviews, and participatory observation to assess how Quito’s public spaces affect women’s safety and mobility. Quantitative results show that 81% of respondents endured sexual or offensive remarks, 69.8% endured obscene gestures, and 38% endured severe harassment in the month before the survey; 43% of these incidents occurred only days or weeks beforehand, underscoring their routine nature. Qualitative narratives reveal behavioral adaptations—altered routes, self-policing dress codes, and distrust of authorities—and identify poorly lit corridors and weak institutional presence as spatial amplifiers of violence. Analysis of Quito’s “Safe City” program exposes a gulf between its ambitious rhetoric and its narrow, transport-centered implementation. We conclude that constitutional guarantees of participation, appropriation, and urban life will remain aspirational until urban planning mainstreams gender-sensitive design, secures intersectoral resources, and embeds women’s substantive participation throughout policy cycles. A feminist reimagining of Quito’s public realm is therefore indispensable to transform the right to the city from legal principle into lived reality. Full article

The construction of child-friendly cities is important for social and economic development. Based on the two-dimensional analysis framework of “Policy Tools–Policy Elements”, this study uses NVIVO 15 qualitative analysis software to code and quantitatively analyze China’s current child-friendly city construction policies. This study examines the formulation strategies and operational characteristics of policy texts on building child-friendly cities in China. The research shows that there are structural imbalances in current policies on child-friendly city construction in China, with too many supply-oriented policy tools and insufficient application of environmental policy and demand-oriented policy tools. The mix of policy instruments is poorly structured, with insufficient attention to children’s rights and social policies and a lack of monitoring and evaluation of policy performance. In the future, China’s children’s urban construction policy should strengthen the balance between the design of policy structures, optimize the structure of policy tools, strengthen the design and protection of laws and policies of children’s rights, and establish a monitoring and evaluation system of policy performance. Full article

(1) Background: Previous studies indicate that individuals who engage in regular physical activity have a higher pain threshold than those who do not exercise. However, it remains unclear how this phenomenon behaves in individuals exposed to chronic hypoxia. This study evaluates pain perception at high altitude between high-altitude natives who exercised regularly and those who did not practice physical activity. (2) Methods: Eighty-four healthy volunteers aged 20 to 30 years old with a body mass index (BMI) within the normal range (18.5–24.9) residing in the city of Puno (3825 m) were recruited. The unilateral ischemia pain provocation test was used, applying pressure with a manual sphygmomanometer to generate transient ischemia in the arm while the patient opens and closes their hand. Onset, peak, and resolution times of pain, heart rate, and oxygen saturation were recorded. (3) Results: The average time to pain onset in the right arm was 30.2 s ± 14.1 during light physical activity, whereas, during moderate physical activity, it increased to 32.5 s ± 15.4. In the left arm, the average time until pain sensation was 27.9 s ± 16.8 during light physical activity and increased to 34.6 s ± 18.5 with moderate physical activity. Regarding the progression of pain intensity, the average time to reach unbearable pain in the right arm was 54.1 s ± 16.4 during light physical activity and 53.8 s ± 19.6 during moderate physical activity; in the left arm, it was 53.0 s ± 19.6 during light physical activity, increasing to 59.3 s ± 24.5 during moderate physical activity. (4) Conclusions: A more stable and slightly higher pain tolerance in the dominant arm was observed. Full article

Security in public spaces has long been the subject of debate and extensive experimentation. With the exponential growth in risks (both expected and unexpected) that public spaces are exposed to, further exacerbated by the pandemic crisis, urban security management increasingly conflicts with the right to social interaction in space. To avoid creating overly controlled spaces that are unsuitable for generating sociality and spontaneous interactions, and which often reproduce discriminatory social dynamics, while at the same time ensuring users’ awareness of being in a safe environment, it is necessary for all three dimensions of public space security—policy, design, and governance—to converge. This study focuses on governance, exploring how security management shapes public life and how it can align with planning that supports vibrant, spontaneous interaction. Using a multi-method qualitative approach, including a critical literature review, EU policy analysis, and empirical research from the Horizon Europe SAFE CITIES project, the study introduces two tools: the Security and Vulnerability Assessment (SVA) framework and the Atlas for Safe Public Spaces Design. These were tested in pilot sites, including the Gorizia-Nova Gorica cross-border square. Results support a governance model integrating “security by design,” which aligns with Foucault’s view of governance as adaptable to uncertainty and flow. This mixed-method approach allowed for a comprehensive examination of the governance dynamics shaping urban security, ensuring that the study’s conclusions are grounded in theoretical insights and practical implementation, though necessarily limited in generalizability. By framing security as a process of negotiated governance rather than a set of technical constraints, the study offers a conceptual contribution to urban security discourse and practical guidance for planning secure, inclusive public spaces. Full article

Background: Cardiac contractility modulation (CCM) is an established therapy for patients with heart failure with a reduced ejection fraction (HFrEF) who are still symptomatic despite guideline-directed medical therapy. It has been described previously that CCM leads to both an improvement of heart failure symptoms as well as of the parameters of left ventricular (LV) function, including LVEF and global longitudinal strain (GLS). However, so far there are no reports describing the effects of CCM on right ventricular (RV) or left atrial (LA) function, respectively. This might be of particular interest as RV global strain (RV GS) and LA strain are important prognostic parameters in heart failure. Methods: Adult patients with heart failure with reduced left ventricular function (LVEF <45%) and a QRS complex <130 ms despite guideline-directed medical therapy and with an indication for CCM were eligible for inclusion into this study. Patients receive a follow-up examination every 3 months, including a standardized echocardiographic examination with a special focus on strain analysis. While the effects of CCM on LV global longitudinal strain have been described before, this analysis reports the findings on the RV and LA strain. Results: Between 30.12.2021 and 10.09.2024, 22 patients were prospectively included in the study. CCM implantation was performed in 19 patients. Under active CCM therapy, there was an improvement in right ventricular global strain (CCM: −13.7 ± 4.5 vs. no CCM: −10.1 ± 5.0; p < 0.05), free wall strain (CCM: −14.6 ± 7.3 vs. no CCM: −10.3 ± 10.2; p < 0.05), left atrium strain rate (CCM: 19.7 ± 1.0 vs. no CCM: 15.3 ± 10.2; p < 0.05), and left atrium strain contraction (CCM: −11.5 ± 7.0 vs. no CCM: −7.1 ± 8.5; p < 0.05), whereas there was no difference in left atrium strain conduit (CCM: −9.0 ± 5.0 vs. no CCM: −8.1 ± 5.4; n.s.). To determine which of these parameters are linked to an improvement of quality of life, as seen in the Kansas City Heart Failure Questionnaire (KCCQ), a regression analysis was performed. It turned out that only the parameters of left atrial (LA) strain (LAS_R and LAS_CT) were significantly associated with improved quality of life, while other echocardiographic parameters, such as LV-EF, LV-GLS, and RV-GS, showed no clear association. Conclusions: CCM therapy is not only associated with improvements of left ventricular function but also restores right ventricular and left atrial strain in patients with HFrEF. Regarding the improvement in quality of life, the increase of LA strain seems to be of special importance. Full article

This study examines the transformative impact of the Special Zones of Social Interest (AEIS-1) implemented in Diadema, São Paulo, in 1994, as an innovative urban policy tool in Brazil. Rooted in the principle of the social function of property established in the 1988 Federal Constitution, the research analyzes the development of social interest housing projects (HISs) led by housing movement associations. The study adopts a mixed-methods approach, combining primary data from local housing associations and the municipal government with geospatial analysis. The results reveal that between 1996 and 2013, over 20 LHISs were successfully established, directly benefiting approximately 2000 low-income families. These projects utilized a self-construction model financed entirely by families, overcoming the lack of public investment. The findings highlight the critical role of housing associations in organizing, planning, and implementing urban housing initiatives. This model not only addressed housing deficits but also fostered community resilience and inclusivity. By demonstrating how grassroots organizations can drive urban transformation, this research underscores the potential of participatory practices in advancing spatial justice and the right to the city. The Diadema case offers valuable insights for cities facing similar challenges, advocating for equitable and democratic urban development strategies. Full article

Designing physical environments that are safe, functional, and equitable for all users is crucial to understanding the needs and requirements of the local community from a gender perspective, to achieve gender equality and women’s safety in the public realm. In the Saudi context, international assessments of women’s rights still acknowledge the country as one of the most prominent examples of structural gender inequality, both in the world and relative to regional peers within the Middle East and North Africa. This research aims to illuminate women’s mobility behavior as a tool for women’s inclusion in the built environment, supporting policymakers to design projects that build more inclusive cities for women. This research examines the dynamic relationship between women’s mobility and the built environment in Riyadh, Saudi Arabia, within the context of Vision 2030. By employing a mixed-method approach, including literature reviews and a comprehensive survey, the research highlights critical indicators such as safety, cultural norms, and infrastructure. The research concludes that safety, cultural and social norms, and the availability of public facilities significantly impact women’s ease of mobility. The paper reaches an actionable recommendation for policymakers to create more inclusive urban environments that support women’s aspirations and needs, ultimately contributing to a more equitable society that supports the expectations and needs of all women in Riyadh. Full article

Background: Sleep-disordered breathing (SDB), particularly Cheyne–Stokes respiration (CSR), is highly prevalent among patients hospitalized with acute decompensated heart failure (ADHF) and is associated with worse clinical outcomes. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated cardiorenal benefits in heart failure, but their effects on nocturnal respiratory parameters remain underexplored. Objectives: This study aims to evaluate the impact of SGLT2i therapy on key respiratory and cardiac indices including CSR burden, oxygenation, and right heart function in patients with ADHF and reduced left ventricular ejection fraction. Methods: In this single-center prospective cohort study, 60 patients with ADHF, LVEF < 40%, and a baseline apnea–hypopnea index (AHI) > 5 were assessed before and three months after the initiation of SGLT2i therapy. Sleep respiratory parameters were measured using home polygraphy (ApneaLink^TM), while cardiac and renal indices were evaluated by echocardiography, NT-proBNP, and the estimated glomerular filtration rate (eGFR). Structural and functional echocardiographic changes were analyzed both at baseline and following the 3-month treatment period. Patient-reported outcomes were assessed using the Epworth Sleepiness Scale (ESS) and Kansas City Cardiomyopathy Questionnaire (KCCQ). Results: After 3 months of SGLT2i therapy, significant improvements were observed in daytime sleepiness (ESS: −2.68 points; p < 0.001), CSR index (−5.63 events/h; p < 0.001), AHI (−3.07 events/h; p < 0.001), ODI (−6.11 events/h; p < 0.001), and mean nocturnal SpO₂ (+1.95%; p < 0.001). KCCQ scores increased by 9.16 points (p < 0.001), indicating improved quality of life. Cardiac assessments revealed reductions in NT-proBNP (−329.6 pg/mL; p < 0.001) and E/e′ ratio (−1.08; p < 0.001), with no significant change in LVEF or chamber dimensions. Right ventricular function improved, as evidenced by the increased TAPSE/sPAP ratio (+0.018; p < 0.001). Renal function remained stable, with a non-significant upward trend in eGFR. Conclusions: This exploratory study suggests that SGLT2 inhibitors may be associated with the attenuation of Cheyne–Stokes respiration and an improvement in right heart function in patients with ADHF, warranting further investigation in controlled trials. These findings highlight the potential of SGLT2is to address overlapping cardio-respiratory dysfunction in this high-risk population. Full article

Background and Objectives: Globally, there is a demographic transition toward an increase in the number of older adults, and with it, the comorbidities associated with aging. This requires healthcare providers to understand which variables can affect functional independence for performing activities of daily living. The general objective of this study was to determine the predictive effect of left and right handgrip strength, depression, mild to moderate dementia, and cognitive function on functional independence in older adults. Materials and Methods: This study featured a predictive cross-sectional design with n = 84 older adults with some level of physical independence; older adults with completely limited physical independence and those with severe dementia were excluded. To assess depression, the Geriatric Depression Scale was used; for dementia, the Hachinski Ischemic Scale was used; for cognitive impairment, the Folstein version of the MMSE was used; for functional independence, the Barthel Index was used; for handgrip, a 90-kg Dynatron^® professional hydraulic dynamometer (UT 84121) Number Series. 11010141, from the Dynatronics Corporation located in Salt Lake City, Utah USA, was used. Results: In total, 58.8% of the participants were female, with a mean age of 84.89 ± 7.095, with ranges from 68 to 102 years. Multiple regression analysis showed that the level of cognition, left-hand grip strength, and a low level of depression are strong predictors of independence in activities of daily living in the elderly, with an explained variance of R² = 0.34. Conclusions: Cognitive function, left-hand grip strength, and depression significantly predict the independence of older adults. Studies with larger sample sizes are recommended to confirm the veracity of the results and to design methodologically rigorous interventions that include psychological aspects such as cognitive stimulation, promoting physical activity, and addressing depressive problems to improve the functional independence of older adults. Full article

This study investigates the transfer of rural land contracting rights in Shandong Province, China, employing a mixed methods approach that integrates qualitative policy analysis and quantitative multiple linear regression models based on panel data from 16 prefecture-level cities (collected in 2010–2022). The findings demonstrate that land transfer optimizes resource allocation, enhances agricultural output efficiency, and serves as a critical mechanism for advancing agricultural modernization and rural revitalization. Key drivers, such as agricultural modernization and industrial development, significantly promote land transfer, particularly in coastal areas, while challenges like non-standardized contracts and inadequate farmer protections persist. The study proposes targeted strategies, including strengthening agricultural modernization, enhancing farmer income through non-agricultural industries, and improving institutional frameworks to stabilize the land transfer market. Additionally, it highlights the potential role of rural social workers in addressing contentious issues such as women’s rights, displacement, and access to resources, ensuring equitable and sustainable rural development. These measures aim to accelerate agricultural modernization, promote rural economic growth, and enhance the competitiveness and social well-being of rural areas, providing a robust foundation for policy formulation. Full article

Under China’s dual land ownership system, the use rights of urban land (state-owned) and rural land (collective-owned) are not equal. Understanding the roles of ownership type and government decision-making behaviors in the formation of land prices is crucial for further reform to promote “equal rights and equal prices” for urban and rural land. This paper analyzed the impact of ownership type on construction land prices using micro-level land transaction data from Wujin District, Changzhou City, from 2015 to 2021 and investigated the role of government decision-making behaviors such as spatial planning and supply plan in this relationship. The results show that collective ownership has a negative impact on land prices, and the development of collective-owned construction land has a positive impact on the prices of adjacent land. In addition, the boundary of downtown areas determined by spatial planning enhances the negative impact of collective ownership on land prices, thus widening the price gap between state and collective-owned land within the downtown areas. Furthermore, the proportion of collective-owned construction land in the annual land supply determined by the land supply plan strengthens the negative impact of collective ownership on land prices, meaning that an increase in the supply of collective-owned construction land leads to further downward pressure on land prices. This study can provide insights for policy making aiming to achieve “equal rights and equal prices” for land with different ownership type in China and in other countries with a dual land ownership system. Full article

The Lower Silesian Voivodeship is one of 16 Polish voivodeships—it covers the Lower Silesia region. The area was chosen for this study due to its location at the crossroads of three countries (Poland, the Czech Republic, and Germany), centuries-old traditions in terms of the tourist function, wealth of nature, and the specificity of its demographic potential (almost total replacement of the regional community after World War II). The article identifies the main components of the settlement network and refers to the 11th Sustainable Development Goal. The purpose of this article is to analyze demographic changes and the evolution of the tourist function in Lower Silesia, with particular focus on their correlations and spatial diversification. The conducted analyses were based on the statistical data provided by the Local Data Bank of the Statistics Poland (LDB SP). Synthetic measures of development were used to analyze the tourist function. The research period varies depending on the particular stage and results from the availability of statistical data. The core of the research covers the years 1946–2023. It was established that Lower Silesia is characterized by a developed tourist function but, simultaneously, has been experiencing an increasingly pronounced demographic crisis. The research findings point to divergent choices made by the users–residents and users–tourists. The leaders in terms of the tourist function include, i.e., the Karkonosze County and Jelenia Góra city with county rights and, at the same time, the rapidly depopulating areas. The leading cities of Lower Silesia are not developing in an even manner; in this respect, the region is moving away from the 11th Sustainable Development Goal. Full article