Search Results (381)

The siphon effect between airports has amplified the polarization in passenger throughput, undermining the balanced development and sustainability of airport clusters. The airport siphon effect occurs when one airport attracts a disproportionate share of passengers, concentrating traffic at the expense of others, which affects the overall resilience of the entire airport cluster. To address this issue, this study proposes a siphon index, expands the range of ground transportation options for passengers, and establishes a zero-siphon model to assess the impact of siphoning on the resiliency of airport clusters. Using this framework, four major airport clusters in China were selected as research subjects, with regional aviation accessibility serving as a measure of resilience. The results showed that among the four airport clusters, the siphon effect is most pronounced in the Guangzhou region. To explore the implications of this effect further, three airport disruption scenarios were simulated to assess the resilience of the Pearl River Delta airport cluster. The results indicated that the intensity and timing of disruptive events significantly affect airport cluster resilience, with hub airports being particularly sensitive. This study analyzes the risks associated with excessive route concentration, providing policymakers with critical insights to enhance the sustainability, equity, and resilience of airport clusters. The proposed strategies facilitate coordinated infrastructure development, optimized air–ground intermodal connectivity, and risk mitigation. These measures contribute to building more sustainable and adaptive aviation networks in rapidly urbanizing regions. Full article

Background: Youth tobacco use remains a significant public health concern, particularly in urban communities disproportionately burdened by health disparities. In Baltimore City, where tobacco-related harms are elevated, understanding the relationship between tobacco use—including e-cigarettes—and mental health among high school students is essential for guiding equitable prevention and cessation strategies. The CEASE (Communities Engaged and Advocating for a Smoke-free Environment) program, in collaboration with the American Lung Association’s Not On Tobacco (N-O-T) initiative, developed an online school-based survey to inform community-responsive interventions. Aims: This study aimed to examine the associations between cigarette use, including conventional cigarette use, and self-rated mental health among high school students in Baltimore City. Methods: High school students in Baltimore City completed an anonymous online survey that assessed demographic characteristics, tobacco knowledge and use, mental health, and related behaviors. Self-rated mental health was dichotomized as poor versus fair/good. Tobacco use categories included current use of e-cigarettes and conventional cigarettes. Logistic regression models were used to examine associations between tobacco use and self-rated mental health, adjusting for age, gender, race, and parental education. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. Results: No statistically significant associations were found between self-rated mental health and e-cigarette use and conventional tobacco use after adjusting for covariates. Conclusions: The absence of a significant association may reflect unique aspects of the social context in Baltimore City, where youth may not use tobacco products as a coping mechanism for mental health challenges. Alternatively, it may be due to limitations in measurement, particularly the use of a single-item mental health assessment. These findings should be considered preliminary. Future research using more comprehensive mental health measures and larger samples is warranted to further explore these complex relationships. Full article

The COVID-19 pandemic significantly disrupted higher education worldwide, imposing strict isolation measures, transitioning learning online, and exacerbating existing social and economic inequalities. This literature review examines the pandemic’s impact on the mental health of college students, with a focus on those belonging to minority groups, including racial, ethnic, migrant, gender, sexuality-based, and low-income populations. While elevated levels of anxiety, depression, and loneliness were observed across all students, findings indicate that LGBTQ+ and low-income students faced the highest levels of psychological distress, due to compounded stressors such as family rejection, unsafe home environments, and financial insecurity. Racial and ethnic minority students reported increased experiences of discrimination and reduced access to culturally competent mental healthcare. International and migrant students were disproportionately affected by travel restrictions, legal uncertainties, and social disconnection. These disparities underscore the need for higher education institutions to implement targeted, inclusive mental health policies that account for the unique needs of at-risk student populations during health crises. Full article

Chronic obstructive pulmonary disease (COPD) is an escalating global health burden, with a disproportionate impact on low- and middle-income countries (LMICs). Although tobacco smoking is a well-established risk factor, emerging evidence highlights the significant role of non-smoking exposure in driving the prevalence of COPD in these regions. This narrative review synthesizes current data on key non-smoking contributors, including household air pollution, ambient urban pollution, occupational exposure, early-life respiratory insults, chronic infections, and socioeconomic adversity. These risk factors are associated with distinct COPD phenotypes, often marked by increased airway inflammation, reduced emphysema, and variable airflow limitation. Such presentations are particularly common among women and younger populations in LMICs. However, diagnostic and therapeutic challenges persist, owing to limited disease awareness, under-resourced health systems, restricted access to essential medications, and financial constraints impacting adherence. Despite the proven effectiveness of non-pharmacological measures and public health interventions, their implementation remains inadequate because of infrastructural and funding limitations. Bridging these gaps requires region-specific clinical guidelines, improved diagnostic infrastructure, expanded access to affordable treatment, and culturally sensitive interventions. Future priorities include identifying robust biomarkers, refining disease definitions to accommodate non-smoking phenotypes, and advancing implementation science to improve interventions. A coordinated, context-aware global response is essential to reduce the growing burden of COPD in LMICs and to ensure equitable respiratory health outcomes. Full article

This study investigates the gendered nexus between climate change, food insecurity, and conflict in Plateau State, Nigeria. This region in north-central Nigeria is marked by recurring farmer–herder clashes and climate-induced environmental degradation. Drawing on qualitative methods, including interviews, gender-disaggregated focus groups, and key informant discussions, the research explores how climate variability and violent conflict interact to exacerbate household food insecurity. The methodology allows the capture of nuanced perspectives and lived experiences, particularly emphasizing the differentiated impacts on women and men. The findings reveal that irregular rainfall patterns, declining agricultural yields, and escalating violence have disrupted traditional farming systems and undermined rural livelihoods. The study also shows that women, though they are responsible for household food management, face disproportionate burdens due to restricted mobility, limited access to resources, and a heightened exposure to gender-based violence. Grounded in Conflict Theory, Frustration–Aggression Theory, and Feminist Political Ecology, the analysis shows how intersecting vulnerabilities, such as gender, age, and socioeconomic status, shape experiences of food insecurity and adaptation strategies. Women often find creative and local ways to cope with challenges, including seed preservation, rationing, and informal trade. However, systemic barriers continue to hinder sustainable progress. This study emphasized the need for integrating gender-sensitive interventions into policy frameworks, such as land tenure reforms, targeted agricultural support for women, and improved security measures, to effectively mitigate food insecurity and promote sustainable livelihoods, especially in conflict-affected regions. Full article

Cervical cancer (CC) remains a critical global health issue which disproportionately affects low- and middle-income countries. In Chile, the Arica and Parinacota region experiences high CC mortality and low Papanicolaou (Pap) test coverage, with indigenous Aymara women facing significant screening barriers. Understanding health beliefs surrounding CC prevention is essential for improving adherence, particularly in under-represented populations. This study assesses the psychometric properties of the CPC-28, an instrument measuring beliefs about CC and Pap testing, among Aymara women in Chile. A cross-sectional survey of 299 Aymara women (25–64) was conducted using stratified probabilistic sampling. Confirmatory factor analysis (CFA) confirmed the CPC-28’s six-factor latent structure, demonstrating strong model fit (CFI = 0.969, TLI = 0.965, RMSEA = 0.058). Reliability indices ranged from acceptable to excellent (α = 0.585–0.921; ω = 0.660–0.923). Moderate correlations emerged between severity, susceptibility, and perceived benefits of Pap testing, although CPC-28 results did not predict adherence. These findings support CPC-28’s validity evidence for Aymara women but highlight cultural influences on screening behaviors. Structural barriers, including language and healthcare inaccessibility, are likely to affect perceived susceptibility. Future research should explore indigenous perspectives and socio-cultural determinants of Pap testing, incorporating mixed-method approaches to identify culturally relevant interventions and improve screening adherence. Full article

Background: Cardiovascular disease remains a leading cause of preventable mortality in the United States, with rural counties in the Deep South experiencing disproportionately high burdens. Grounded in the Andersen healthcare utilization model, this study examined how enabling resources, predisposing characteristics, and access-related barriers relate to coronary heart disease (CHD) prevalence and mortality. Methods: This ecological analysis included 418 counties across Alabama, Georgia, Louisiana, Mississippi, and South Carolina. Using Local Indicators of Spatial Association (LISA) and multivariable linear regression, we tested three theory-based hypotheses and assessed the spatial clustering of CHD outcomes, while identifying key structural and sociodemographic predictors. Results: Counties with greater rurality and fewer healthcare providers exhibited significantly higher rates of CHD prevalence and mortality. Primary care provider availability and higher household income were protective factors. Digital exclusion, measured by lack of access to computers or mobile devices, was significantly associated with higher CHD prevalence and mortality. Spatial analysis identified the counties with better-than-expected cardiovascular outcomes despite structural disadvantages, suggesting the potential role of localized resilience factors and unmeasured community-level interventions. Conclusions: The findings affirm the relevance of the Andersen model for understanding rural health disparities and highlight the importance of investing in both digital infrastructure and healthcare capacity. Expanding telehealth without addressing provider shortages and social determinants may be insufficient. Local policy innovations and community resilience mechanisms may offer scalable models for improving cardiovascular health in disadvantaged areas. Full article

Background: Clostridioides difficile infection (CDI) poses substantial clinical and economic challenges worldwide. This study aimed to evaluate the global burden, trends, and inequalities of CDI from 1990 to 2021, with projections extending to 2040. Methods: We conducted a systematic analysis of the Global Burden of Disease Study 2021 data for 204 countries and territories. CDI-related mortality and disability-adjusted life years (DALYs) were analyzed from 1990 to 2021. Joinpoint regression assessed the trends, a decomposition analysis identified the contributing factors, and cross-country inequalities were measured with slope and concentration indices. A log-linear age–period–cohort model projected future burden to 2040. Results: Global CDI-related deaths increased from 3047 (95% uncertainty interval [UI], 2550–3609) in 1990 to 15,598 (95% UI, 13,418–18,222) in 2021. The age-standardized mortality rate rose from 0.10 to 0.19/100,000 population (average annual percent change [AAPC], 2.26%; 95% confidence interval [CI], 1.77–2.76%), and the age-standardized DALY rate increased from 1.83 to 3.46/100,000 (AAPC, 1.94%; 95% CI, 1.43–2.45%). Epidemiological changes were the primary driver of this burden, contributing 45.46%. Inequalities were intensified, particularly in high sociodemographic index countries, evidenced by increases in the slope index from 2.00 to 4.17 and concentration index from 0.52 to 0.69. The projections suggest that mortality and DALY rates among populations aged ≥80 years will continue to rise through 2040. Conclusions: The global CDI burden has increased significantly over three decades, disproportionately affecting high sociodemographic index countries. The projected rise in CDI burden among older adults through 2040 underscores the urgent need for targeted interventions and strategic planning. Full article

In 2020, the Chinese government announced the “Dual Carbon” goals, making carbon responsibility the most prominent focus within the Environmental, Social, and Governance (ESG) practices of Chinese firms. This shift creates a new type of ESG-washing, a practice involving the selective disclosure of information that portrays the firm in a favorable light, thereby leading stakeholders to overestimate its ESG performance. In this study, we define a novel type of ESG-washing behavior called “ESG carbonwashing”, in which firms disproportionately highlight their carbon responsibility initiatives while overlooking other dimensions of ESG. By adopting a strategy of excessively emphasizing their carbon-related efforts in ESG activities, these firms mislead stakeholders about their overall ESG performance. Using a sample of 59 high-carbon-emitting firms listed on the Shanghai and Shenzhen A-share markets from 2018 to 2022, we construct a systematic framework to measure the extent of ESG carbonwashing and further analyze its temporal and industry-level variations. Our key findings indicate that: (1) ESG carbonwashing has significantly increased alongside the rollout of the “Dual Carbon” policy; (2) there are significant inter-industry differences, with the steel and aviation sectors exhibiting the highest levels of ESG carbonwashing, while the building materials industry shows the lowest. This study offers valuable guidance for ESG information users in detecting and mitigating carbonwashing practices, while also providing robust empirical support for refining relevant regulatory frameworks. Full article

Background/Objectives: Preschool children from low-income, ethnically diverse communities face disproportionate rates of behavioral challenges and early expulsion from early care and education (ECE) programs. This study evaluated the efficacy, feasibility, and utility of Jump Start on the Go (JS Go), a bilingual, AI-enabled mobile application. JS Go is designed to deliver a 14-week early childhood mental health consultation model in under-resourced ECE settings. Methods: This mixed-methods study compared JS Go to the standard in-person Jump Start (JS) program. Participants included 28 teachers and 114 children from six centers (three JS Go, three JS). Quantitative measures assessed teacher classroom practices and child psychosocial outcomes at baseline and post-intervention. App usability and acceptability were only evaluated post-intervention. Seven semi-structured interviews were conducted post-intervention with JS Go directors/teachers to assess the app’s feasibility for implementing the four program pillars: safety, behavior support, self-care, and communication. Results: JS Go was more effective than JS in promoting teacher classroom practices related to behavior support and resiliency. Both programs were similar in improving children’s protective factors and reducing internalizing behaviors, with consistent effects across English and Spanish-speaking children. Teachers rated the JS Go app with high acceptability, though predicted future usage showed greater variability. Rapid qualitative analysis showed that participants found the app easy to use, frequently accessed its resources, and considered it helpful for reinforcing key strategies across the four program pillars. Conclusions: JS Go is a novel approach to providing mental health consultation. It represents a promising mobile adaptation of the established JS consultation model, with important implications for future practice and research. Full article

Background: Adverse childhood experiences (ACEs) such as abuse (defined as emotional, physical, or sexual abuse without distinguishing type or severity) have long been linked to mental health challenges in adulthood. However, less is known about how these effects differ by sex/gender in global samples, particularly using large-scale, multi-country panel data. Objectives: To examine whether the long-term association between childhood abuse and changes in depressive symptoms during adulthood differ between men and women, after adjusting for demographic and socioeconomic factors. Methods: We conducted a secondary analysis of Waves 1 and 2 of the Global Flourishing Study (GFS), a longitudinal panel study covering 22 diverse countries. The sample included adult participants with complete data on childhood abuse (yes/no); depression at baseline and follow-up; sex/gender; and relevant covariates (age; education; marital status; immigration status; smoking status; and employment). Depression was measured using a two-item scale. Multi-group structural equation models were used to test the effect of ACE on changes in depression over time where groups were defined based on sex/gender. Results: Overall, childhood abuse was associated with a statistically significant increase in depression scores between Wave 1 and Wave 2. This association was significant among women but not among men. Conclusions: Our findings suggest that the mental health consequences of childhood abuse extend into adulthood and disproportionately affect women. These sex/gender differences may reflect variations in stress processing; coping; and social roles. Interventions addressing early adversity may need to be tailored to recognize and respond to such sex/gender-specific vulnerabilities. Full article

Sustainable agricultural development in China in the face of growing environmental concerns relies critically on how well regulatory policies strengthen agricultural resilience. This study aims to systematically investigate the impact of air pollution on agricultural economic resilience and its mechanisms of action and to explicitly assess the moderating role of environmental regulation. This study develops a thorough index system that evaluates agricultural economic resilience in three areas: risk resistance and recovery, adaptive adjustment capacity, and restructuring innovation. Panel data from 30 Chinese provinces from 2000 to 2023 is used to achieve this. The implications of air pollution and its diverse consequences on agricultural economic resilience are systematically assessed using a two-way fixed-effects and moderating-effects model. The following are the primary conclusions: First, air pollution has a significant negative impact on the economic resilience of agriculture. This conclusion holds after considering the endogeneity problem and a series of robustness tests, such as the exclusion of samples, random sampling, and quantile regression. Second, different dimensions of agricultural economic resilience, intensity levels, and economic growth phases influence how much air pollution reduces agricultural economic resilience. Notably, at various stages of economic growth, air pollution steadily weakens the economic resilience of agriculture. In particular, the impact is more pronounced in the post-financial-crisis phase of domestic demand expansion and the phase of financial clearing and high-quality development. According to a dimensional perspective, air pollution significantly reduces the farm sector’s capacity to endure and recover from dangers while also making adaptive modifications easier, and the impact on transformational innovation is not significant. In terms of intensity, in contrast to places with higher resilience, those with lower resilience are disproportionately more adversely affected by air pollution. Third, environmental control mitigates some of the detrimental effects of air pollution on agricultural economic resilience. Based on these results, this study calls for stricter air pollution control measures, strengthens environmental regulatory support for agricultural resilience, and demonstrates region-specific governance solutions to guarantee the stability and sustainability of the agricultural economic framework. Full article

Textile dye production requires significant amounts of water and chemicals, generating substantial wastewater, which places significant burdens on local environments and water resources. Bangladesh is a global textile dye hub, exporting primarily to the EU and the USA. This research explores Water Unequal Exchange (WUE), which arises when high-income countries (HIC) externalize water use and pollution from consumption and production to low-income countries (LIC), driving environmental degradation beyond their borders. To determine WUE, this paper measures wastewater, groundwater, and chemicals embedded in Bangladesh’s textile trade to the EU and USA between 2000 and 2023. This is based on the net weight of the top 18 textile imports from Bangladesh, provided by the UN Comtrade Database. This paper finds that 3,942,091 million liters of groundwater, 10,792,675 million grams of chemicals, and 2,860,420 million liters of wastewater are embedded in these textile imports. The prices per kg of textiles differ depending on product type, and the highest volume of textile product categories have the lowest price per kg. In conclusion, the textile trade from Bangladesh to the EU and the USA represents a case of WUE, where Bangladesh disproportionately internalizes resource over-extraction and environmental impacts from dye production for low economic gain. Full article

Background: Anemia is a chronic condition that disproportionately affects women and children. Anemia shows detrimental long-term impacts on maternal and child health and development, with the highest burden observed in low- and middle-income countries. In the Lao People’s Democratic Republic (PDR), anemia is prevalent in 39% of women of reproductive age, 47% of pregnant women, and 43% of children under five. Objective: Our study evaluates associations between maternal anemia at pregnancy and postpartum and infant hemoglobin (Hb) levels in early infancy. We further investigate the influence of breastfeeding practices on this association. Methods: Data from the Social Transfers for Exclusive Breastfeeding ongoing randomized control trial (RCT) (n = 298) in Vientiane, Lao PDR, was used. Maternal and infant Hb levels were assessed during pregnancy and at one, six, and twelve months postpartum. We used generalized estimating equations (GEE) for repeated measures analysis. Results: Anemic mothers at pregnancy and postpartum saw a 1.89 g/L (adjusted 95% CI: −4.48 to 0.70, p = 0.15) and 3.25 g/L (adjusted 95% CI: −7.86 to 1.36, p = 0.17) decrease in infant Hb levels compared to non-anemic mothers. Among postpartum anemic mothers who followed the World Health Organization (WHO) breastfeeding recommendations, an increase of 7.87 g/L in infant Hb levels (adjusted 95% CI: −2.21 to 17.94, p = 0.13) was observed. Conclusions: A weak negative association was found between maternal anemia during pregnancy and the first year postpartum and infant Hb levels. However, among anemic mothers at postpartum, adhering to WHO breastfeeding recommendations may help to mitigate this impact. Full article

Background/Objectives: Epidemics have historically shaped societies, influencing demographic structures, social organization, and economic stability. The 1742–1743 epidemic had a profound impact on populations along the Royal Road (Camino Real), the main colonial corridor between Buenos Aires and Lima. However, its specific demographic and socio-economic effects remain underexplored. This study aims to examine these impacts of the 1742–1743 epidemic through a comparative analysis of urban centers and Indigenous communities. Methods: A historical–comparative approach was employed, analyzing secondary sources including parish records and colonial administrative documents. This study assessed excess mortality and socio-economic consequences across different population groups and settlement types. Results: Mortality rates increased dramatically—up to twelve times the pre-epidemic average in Cordova (Córdoba) and by 45% in Santa Fe—disproportionately affecting Indigenous and enslaved populations. Urban centers experienced severe economic disruption and slow recovery, whereas Indigenous communities and Jesuit missions demonstrated greater resilience. Their communal strategies and early isolation measures contributed to a faster demographic stabilization. Additionally, the epidemic weakened colonial governance in some areas, altering local power structures. Conclusions: The epidemic of 1742–1743 revealed divergent patterns of vulnerability and resilience. Comparative analysis underscores recurring themes in the epidemic response and recovery, drawing relevant parallels with contemporary crises such as COVID-19. Recognizing these historical patterns of adaptation can inform present and future public health strategies. The terminology “plague” is used based on contemporary sources and not confirmed clinically. Full article