Search Results (151)

Rapid urbanization and demographic shifts present significant challenges to spatial justice in green space provision. Traditional static assessments have become increasingly inadequate for guiding park planning, which now requires a dynamic, future-oriented analytical approach. To address this gap, this study incorporates population dynamics into urban park planning by developing a dynamic evaluation framework for park accessibility. Building on the Gaussian-based two-step floating catchment area (Ga2SFCA) method, we propose the human-population-projection-Ga2SFCA (HPP-Ga2SFCA) model, which integrates population forecasts to assess park service efficiency under future demographic pressures. Using neighborhood-committee-level census data from 2000 to 2020 and detailed park spatial data, we identified five types of population change and forecast demographic distributions for both short- and long-term scenarios. Our findings indicate population decline in the urban core and outer suburbs, with growth concentrated in the transitional inner-suburban zones. Long-term projections suggest that 66% of communities will experience population growth, whereas short-term forecasts indicate a decline in 52%. Static models overestimate park accessibility by approximately 40%. In contrast, our dynamic model reveals that accessibility is overestimated in 71% and underestimated in 7% of the city, highlighting a potential mismatch between future population demand and current park supply. This study offers a forward-looking planning framework that enhances the responsiveness of park systems to demographic change and supports the development of more equitable, adaptive green space strategies. Full article

Introduction: Dental caries and molar–incisor hypomineralisation (MIH) are prevalent conditions affecting children’s oral health, with functional, aesthetic, and psychosocial implications. In Spain, previous studies have highlighted geographic and sociodemographic disparities in their distribution, particularly among rural and migrant populations. Objective: To characterise oral health status, in terms of caries and MIH, among 6–7-year-old children from the towns of Palos de la Frontera, Mazagón, and San Bartolomé. Methods: A cross-sectional study was conducted involving 229 children recruited from public primary schools. Sociodemographic, anthropometric, and behavioural data were collected through clinical examination and interview. Statistical analysis included univariate and multivariate logistic regression. The study protocol was approved by the Ethics Committee of Huelva. Results: The prevalence of caries (DMFT ≥ 1) was 53.3%, with mean DMFT and dft indices of 1.78 and 0.31, respectively. MIH affected 32.8% of the cohort, with a predominance in the first permanent molars (teeth 36 and 26). Multivariate analysis identified independent predictors of caries: African (OR = 7.47; 95% CI: 2.84–23.8) and European (OR = 4.56; 95% CI: 1.26–22.3) parental origin, poor oral hygiene (OR = 3.07; 95% CI: 1.60–6.03), and the presence of MIH (OR = 3.20; 95% CI: 1.64–6.42). The municipality of San Bartolomé was associated with a higher risk of MIH (OR = 2.90; 95% CI: 1.21–7.45). Conclusions: The high prevalence of caries and MIH in the Condado-Campiña district, exceeding national averages, reflects oral health inequities linked to social determinants (migrant origin, locality) and clinical factors (MIH, oral hygiene). Targeted preventive interventions are urgently needed in high-risk populations, including culturally tailored education and policies ensuring equitable access to dental care services. Full article

This study investigates the accessibility of public healthcare services in Olsztyn County, a major urban center in the Warmia and Mazury region of Poland. The aim was to develop a methodological framework using Geographic Information System (GIS) tools and spatial data to assess the local availability of healthcare infrastructure. The analysis included key facilities such as hospitals, clinics, pharmacies, and specialized outpatient services. A spatial accessibility indicator was constructed to evaluate and compare access levels across municipalities. The results show a clear disparity between urban and rural areas, with significantly better access in cities. Several rural municipalities were found to have limited or no access to essential healthcare services. These findings highlight the uneven spatial distribution of medical infrastructure and point to the need for targeted strategies to improve service availability in underserved areas. The proposed methodological approach may support future studies and inform local and regional planning aimed at reducing healthcare inequalities and improving access for all residents, regardless of their location. This research contributes to the growing body of evidence emphasizing the role of spatial analysis in assessing public service accessibility and supports the development of more equitable healthcare systems at the local level. Full article

Background/Objectives: Breast milk donation is increasingly recognized as a vital public health resource, providing optimal nutrition for infants who cannot be breastfed by their biological mothers. Human milk banks play a crucial role in supporting infant health, particularly for preterm and medically vulnerable infants. Despite its recognized benefits, the practice of breast milk donation and utilization remains influenced by a complex interplay of individual, social, and cultural factors. Methods: This study systematically examines how demographic and sociocultural variables are associated with attitudes and behaviors related to breast milk donation. Data were collected from 1223 Israeli mothers via questionnaires distributed through WhatsApp groups between April and May 2025. By analyzing the questionnaire results, the research identified key predictors of willingness to donate and use donated milk, as well as patterns of awareness and perceived support within different population groups. Results: Higher education (χ² = 12.87, p = 0.0016) and settlement type (χ² = 83.096, p = 0.000) were significantly associated with greater willingness to donate breast milk. Income level had no effect on donation behavior, though higher-income participants were more open to its use (χ² = 86.838, p = 0.000). Lifestyle also influenced perceptions of social support (F(2, 1220) = 259.4036, p < 0.001) and cultural support (F(2, 1220) = 601.2383, p < 0.001) of milk donation and use. Significant correlation was found between perceived cultural and social support (t = 5.140, p = 0.000), emphasizing their interrelated influence on milk donation attitudes. Conclusions: The findings assist in guiding the development of public health policies, as well as targeted awareness campaigns, to promote equitable access to donor milk services across varied communities. From the public health perspective, the findings of this study can orientate campaigns that encourage both donation and use of breast milk focusing on segments of the population in which the level of awareness is relatively low. Full article

Background and Objectives: Estimating the need for palliative care for children is a crucial step in addressing the needs of children facing life-threatening conditions, while providing a powerful argument to combat unacceptably wide disparities in access to care. The need for palliative care for children in Romania remains insufficiently quantified. More accurate estimates are indispensable to assess the true extent of need and to support adequate policy responses. Materials and Methods: This retrospective cross-sectional study aimed to estimate the need for pediatric palliative care in Romania for 2022–2023. We analyzed secondary data obtained from the General Directorates of Social Assistance and Child Protection (DGASPC) in 41 counties and the six sectors of Bucharest. The analysis focused on life-limiting conditions as defined by the WHO Annex 3, Order no. 253/2018. Results: The study identified 14,499 pediatric cases with palliative care needs, showing a highly uneven national distribution, especially across diagnostic groups and age categories. We observed a higher number of cases in rural areas (7553) compared with urban areas (6946). Our own data do not include resource estimates; however, prior reports indicate only 50 palliative care beds for children in Romania. Conclusions: This study reveals a substantial and unevenly distributed need for pediatric palliative care in Romania, with notable disparities across age groups, diagnostic categories, and urban-rural areas. The identification of 14,499 eligible cases underscores the urgency of developing targeted policies and allocating adequate resources to ensure equitable access to specialized palliative services for all children in need. Full article

Promoting clean energy transition in rural areas is a key path to achieving global sustainable development, protecting public health, and promoting ecological livability. Based on data from the China Family Panel Studies (CFPS), this paper employs a multi-dimensional fixed effects model to evaluate the impact of income inequality on rural households’ clean energy transition (CET) and examines its underlying mechanisms. Research findings indicate that income inequality significantly suppresses rural households’ CET, primarily by reducing basic energy consumption and hindering the upgrading of basic energy consumption structures. Government governance quality exerts a significant negative moderating effect on the relationship between income inequality and rural households’ CET. Further analysis shows that the inhibitory effect of income inequality on CET is more significant in the regions with a low economic development level and low coal resource endowment, and in the western and northeastern regions of China. Therefore, while continuously promoting rural income growth, the government should prioritize equitable distribution, strengthen institutional capacity-building, improve the social service and security system, and facilitate rural households’ CET. Full article

Radiotherapy, a critical component of cancer treatment, faces significant challenges in Gauteng, South Africa. These disparities hinder the achievement of Sustainable Development Goal 3, primarily due to systemic issues, socioeconomic barriers, and limitations within the health system. This article presents the House framework, designed to enhance access to radiotherapy services by integrating the WHO Health Systems framework with the dimensions of access proposed by Penchansky and Thomas. The framework is visually represented as a house, with Policy & Governance as the foundation, WHO building blocks as pillars, and Equitable Cancer Care and Improved Outcomes as the roof. A mixed-methods approach was utilized, combining quantitative data from radiotherapy facilities and qualitative insights from healthcare professionals to identify barriers and potential solutions. Findings indicate significant disparities in resource distribution and accessibility between public and private institutions, compounded by socioeconomic factors like transport costs and lack of awareness. The article discusses innovative proposed framework using the 5As of access as potential solutions. The House framework serves as a valuable tool for policymakers and healthcare providers aiming to improve radiotherapy access and promote equitable cancer care in Gauteng, ultimately working towards reducing disparities in cancer outcomes. Full article

This study examines the trends, impacts, and challenges of HIV in Bangladesh from 2000 to 2024, with a focus on its epidemiology, demographic distribution, and socioeconomic determinants. Despite maintaining one of the lowest HIV prevalence rates globally (<0.1%), Bangladesh faces a concentrated epidemic among high-risk populations, including people who inject drugs (PWID), men who have sex with men (MSM), sex workers, transgender individuals, and migrant workers. Analysis reveals a steady increase in reported infections, attributed to enhanced diagnostic capacities and public awareness. The 25–49 year age group remains the most affected, accounting for over 65% of cases, underscoring the vulnerability of the economically active population. Gender disparities persist, with males representing the majority of infections but lower ART coverage among females and transgender individuals. While interventions such as PMTCT programs, ART expansion, and targeted awareness campaigns have contributed to improved outcomes, barriers such as stigma, healthcare inequities, and limited rural access hinder progress. The study also evaluates Bangladesh’s progress toward the 95-95-95 targets, highlighting significant strides in treatment and viral suppression but gaps in diagnosis. Future research must address behavioral trends, stigma reduction, and integration of HIV services for marginalized populations. This paper emphasizes the need for evidence-based strategies to ensure equitable healthcare delivery and sustainable progress in combating HIV. Full article

Culture represents the core and ultimate value of a city, serving as a foundation for its economic and social development. However, with rapid urban expansion and increasing globalization, issues related to the spatial distribution pattern, accessibility and equity of cultural resources have become more prominent. This study proposes an integrated GIS-based framework combining ANN, Kernel Density, accessibility, and LQ analyses. It evaluates cultural service coverage across walking, cycling, and driving modes under varying travel durations (5–30 min). Both area-based accessibility and residential-based accessibility are considered. Additionally, the study incorporates Location Quotient (LQ) Analysis for low-income communities across these travel modes and accessibility types to assess spatial equity. The framework is validated through a case study of red cultural resources in Shanghai (China). The results show significant mismatches between area accessibility and residential accessibility in certain administrative districts, particularly highlighting disparities in cultural service provision for disadvantaged populations. These findings suggest incorporating residential-oriented accessibility and equity-based metrics into planning practices. This method supports more accurate and equitable allocation of cultural resources and informs evidence-based decisions in facility planning, urban function optimization, and spatial management. Full article

Background/Objectives: The COVID-19 pandemic exposed critical vulnerabilities in healthcare systems, especially in ensuring continuity of care for patients with chronic diseases. Rehabilitation services, essential for recovery following SARS-CoV-2 infection, were among the most disrupted. This exploratory study aimed to assess Romanian patients’ perceptions of the accessibility and quality of post-COVID-19 rehabilitation services, focusing on individuals with chronic conditions. Methods: This exploratory cross-sectional study was conducted over a 12-month period in 2024. Data were collected from 76 adult patients diagnosed with at least one chronic condition (hypertension, diabetes mellitus, ischemic heart disease, cancer, or chronic obstructive pulmonary disease) and with confirmed prior SARS-CoV-2 infection. Most participants were recruited during outpatient specialty consultations, with a smaller number included from hospital settings, all located in Bucharest. A structured questionnaire was administered by the principal investigator after obtaining informed consent. Quantitative data were analyzed using non-parametric methods following confirmation of non-normal distribution via the Shapiro–Wilk test (p < 0.05). Satisfaction scores were reported as medians with interquartile ranges (IQR), and group comparisons were performed using the Mann–Whitney U test. A mixed-methods approach was employed, including thematic analysis of open-ended responses. Results: Patient satisfaction with rehabilitation services was consistently low. The median satisfaction scores [IQR] were accessibility 1.0 [0.0–2.0], quality of services 0.0 [0.0–4.0], staff empathy 0.0 [0.0–5.0], and perceived effectiveness 0.0 [0.0–5.0]. The median score for perceived difficulties in access was 1.0 [1.0–2.0], indicating widespread barriers. No statistically significant differences were observed between urban and rural participants or across chronic disease categories. Thematic analysis (n = 65) revealed key concerns including lack of publicly funded services, cost barriers, limited physician referral, service scarcity in rural areas, and demand for home-based rehabilitation options. Conclusions: Romanian patients with chronic illnesses and previous SARS-CoV-2 infection continue to face substantial barriers in accessing post-COVID-19 rehabilitation services. These findings highlight the need for more equitable and integrated recovery programs, especially for vulnerable populations in underserved settings. Full article

Urban parks deliver vital ecosystem services and enhance residents’ well-being globally, yet equitable access remains challenging in high-density cities. The prevailing planning paradigms predominantly rely on proximity-based metrics, overlooking critical interactions between demographic diversity, differentiated social demands, and park typology distinctions. Moreover, the existing studies frequently examine aggregate green space distributions without categorically analyzing justice implications. This study develops a geospatial–quantitative framework integrating spatial equality and social justice metrics, applied in Xuhui District, Shanghai. Key findings reveal the following: (1) spatial inequality characterized by large parks clustered in low-density peripheries, while high-density central zones lack adequate park coverage; (2) significant social justice deficits for priority groups (elderly, youth, low-income), exacerbated by insufficient consideration of socioeconomic needs; (3) pronounced disparities in justice across park types, with pocket parks exhibiting the most severe inequities. Consequently, we recommend prioritizing the social demand in park allocation and implementing community-centered pocket park development. This study not only diagnoses spatial–environmental injustices in high-density urban cores but also provides a transferable framework for equitable park planning. Full article

The strategic planning of emergency shelters is vital for enhancing urban resilience against natural disasters, ensuring timely and equitable support for vulnerable populations. However, the existing studies often overlook the effects of fixed search radii and spatial heterogeneity in supply–demand matching. This study evaluated the spatial accessibility of emergency shelters in Shenzhen, a megacity in China, using a Gaussian two-step floating catchment area (G2SFCA) method integrated with K-means clustering. The analysis incorporated three service radii (1 km, 2.5 km, and 5 km) to assess accessibility levels across spatial scales. The results indicate the following: (1) The supply–demand balance of emergency shelters in Shenzhen varies significantly across service radii. A notable mismatch exists within 1000 m; at 2500 m, the demand in high-density areas is better met with reduced regional disparities, while at 5000 m, the spatial correlation between the supply and demand weakens considerably. (2) The cluster analysis revealed the distinct spatial clustering of supply–demand imbalances, primarily driven by population density. (3) The proposed method offers empirical support for optimized shelter allocation and improving the equity and efficiency of emergency resource distribution. Full article

Postoperative pain management after hospital discharge remains one of the main clinical challenges. The use of digital and telemedicine tools offers new opportunities for the continuous monitoring of, and timely intervention in, patients discharged and followed at home. This scoping review, conducted according to the PRISMA-ScR checklist and the Joanna Briggs Institute methodology, analyzed 26 studies selected through a search of PubMed, Scopus, and Web of Science databases. Inclusion criteria comprised studies published between 2015 and 2025 that involved patients discharged home after surgery, that used digital or telemedicine tools for pain management, and that included active involvement of healthcare professionals and reported clinical outcomes. Studies show the use of a variety of digital tools, including mobile applications, web platforms, wearable sensors, automated messaging systems, and virtual reality technologies, alternating across settings for the assessment and management of pain at home, educational and therapeutic support, and to enhance communication between healthcare professionals and patients. Most reported outcomes focus on improved home-based pain control, a reduction in opioid consumption, and a high level of patient satisfaction. However, some challenges remain, particularly the low level of digital literacy among certain segments of the population. In conclusion, the implementation of telemedicine and digital technologies for managing postoperative pain at home proves to be a promising strategy. Nonetheless, it requires further scientific investigation and, from policymakers, significant investments in professional training and technological infrastructure to ensure an increasingly equitable and sustainable distribution of home healthcare services. Full article

As urban density increases and cities expand, there is a decrease in urban livability, which is closely linked to social, economic, and environmental crises. To address these negative impacts, biophilic urbanism (BU) promotes human–nature interactions and their associated benefits. However, knowledge gaps remain regarding its effectiveness across different scales. This study explores how BU contributes to improving livability in the built environment and to renewing urban landscapes. Using Amsterdam as a case study, we first identified biophilic experiences by analyzing them through quantitative, qualitative, and spatial distribution metrics. We then investigated designs that foster biophilia by applying BU tools aimed at enhancing interspecies connections and leveraging ecosystem services. Our findings, in the form of maps, provide evidence-based insights to benefit everyday life using nature in settings at different scales, along with design solutions to renew urban planning, focus on human and environmental well-being, and involve citizens in spatial transformations and maintenance processes. Finally, we advocate for BU as a holistic model that uses natural capital as a key strategy for making cities more equitable, sustainable, and resilient. Full article

This study aims to examine the current wellbeing among pharmacy students in underrepresented groups (URGs) and investigate the impact on having access to affinity groups. A survey was distributed to students in April and May 2023, at a Midwestern College of Pharmacy, centering around diversity, equity, inclusion, and accessibility (DEIA) efforts and their impact on student wellbeing and experiences with the college-supported affinity groups. Student responses were analyzed using descriptive statistics. Sixty-five (75%) of the eighty-six students who completed the survey identified with at least one URG. First-generation students (n = 36), underrepresented racial/ethnic groups (n = 24), and LGBTQ+ (n = 13) were the three most prominent groups. Twenty-seven percent (n = 23) of students belonged to multiple URGs. Among the students in URGs, three out of four experienced distress. The students in URGs experienced distress at a higher rate compared to their peers in all categories. Twenty percent (n = 16) of students did not agree that there was equitable treatment on campus. This rate was higher among students in URGs compared to their peers. Eighty-three percent (n = 52) of individuals who did not participate in an affinity group recognized there was a need. Among individuals who did not participate, nearly half identified with a URG. Pharmacy students, especially those in URGs, may benefit from additional interventions by pharmacy schools to improve the offering and visibility of supportive services. Providing URG-centered resources addresses the gap between the wellbeing and academic experience of pharmacy students in URGs compared to their peers. Full article