Search Results (6,702)

Despite the economic relevance of climate-transition risk, firm-level carbon exposure often fails to appear as a robustly priced factor when ESG measures and sustainability shocks are conflated. This study examines whether carbon exposure is conditionally priced in European equity returns using a strongly balanced quarterly panel of 238 firms from the MSCI Europe ESG Leaders universe (2018–2024). Total greenhouse gas emissions act as a proxy for carbon exposure, mapped to within-year percentiles and standardized by sector-year. Regressions control for ESG scores and controversies and include firm and quarter fixed effects with firm-clustered, dependence-robust standard errors. The linear carbon coefficient is small and statistically indistinguishable from zero, indicating no stable return premium from within-firm changes in carbon exposure. Functional-form tests reject linearity: quadratic and quintile specifications reveal curvature and a non-monotonic pattern, with return differences concentrated in the middle of the carbon distribution. Conditioning on macro-financial stress, measured by the ECB Composite Indicator of Systemic Stress, yields limited evidence of a uniform carbon penalty. However, high-controversy states are associated with lower returns, while ESG scores show negative associations under dependence-robust inference. Overall, carbon-related pricing appears to be nonlinear and state-dependent, whereas controversy risk is the most robust sustainability predictor of returns. Full article

For historically marginalized groups and residents of low-resource rural communities, contact tracing is a critical tool for controlling the spread of communicable diseases. To improve its effectiveness, more research on identifying factors that influence an individual’s willingness to comply with contact tracers is needed. Therefore, we examined the association of race/ethnicity, contextual factors, and willingness to engage in contact tracing during the COVID-19 pandemic. The sample included 337 adults (56% Black/African American and 66% female). Approximately 80% of the participants indicated they would disclose the names of contacts. The results from the multivariate logistic regression analyses indicated lack of access to COVID-19 testing sites (aOR = 2.20; 95% CI = 1.08–4.48) and trust in health care providers (aOR = 7.57; 95% CI = 3.82–14.88) were significantly associated with willingness to share information with contact tracers. Race did not moderate the relationship between trust and engaging with contact tracers. The results suggest contact tracing is a viable strategy for mitigating disease transmission in rural communities, particularly when trust in health care providers is high and access to testing is limited, regardless of race. Public health officials should invest in maintaining contact tracing teams that include medical providers and prioritize building trusting relationships with all community members. Full article

Given the lack of integrated, cross-cutting approaches in urban Quality of Life measures, a new framework is proposed here that draws upon a city-level index co-created under the Quality of Life Initiative implemented by UN-Habitat. Using a conceptual narrative review with a systematic structure, themes relevant to the urban context were clustered into three areas or ‘lenses’ through which decision-making in development and policy might be viewed, namely: Structural (i.e., adequacy, affordability, objective safety), Fairness (i.e., equity, inclusion, opportunity), and Perception (i.e., belonging, perceived safety, meaning and purpose). In support of creating sustainable communities, structural foundations and needs, such as housing, transport, food, and infrastructure, typically need to be addressed first. These structural realities are then filtered through a fairness lens—who benefits, who participates, and who is left behind? Finally, the filtered urban experience culminates in perception-level outcomes in terms of how people feel, connect, and find meaning in their urban experience. While presented sequentially in the framework, this is not prescriptive. Cities may start with any one lens dependent upon the context of the sustainable development challenge they are seeking to address while still recognizing the dynamic tensions among the lenses. The power of the framework lies in moving beyond siloed thinking to examine interconnections and intersectionality. To explore the potential practical application of the framework it was applied to three key urban Quality of Life challenges, namely, informality, migration, and sustainability. The framework is offered as an adaptable tool for policymakers and practitioners to support the design of more equitable, inclusive, and meaningful urban development interventions that support delivery of the Sustainable Development Goals and the global agenda to leave no one behind. Full article

This study investigates inter-city disparities in the distribution of social amenities for four demographic groups across mainland China, moving beyond the conventional focus on knowledge-economy amenities to include relatively disadvantaged populations. It further explores the relationship between amenity distribution and China’s urban hierarchy at multiple geographical scales. Results show that amenities are disproportionately concentrated in cities with larger populations, stronger economies, and higher administrative status, reflecting the influence of demographic, economic, and political structures. Consequently, substantial geographical disparities align with regional economic imbalances. However, inequality levels vary by amenity type and social group: commercially oriented amenities, such as those targeting high-skilled professionals and women, exhibit greater inequality, whereas publicly supported amenities for older adults and children exhibit comparatively lower disparities. The study further reveals that in many smaller cities, the provision of high-skilled labor amenities tends to outstrip local demand, indicating that the role of such amenities in shaping location choices may be overestimated in less central regions. These findings highlight the need for context-sensitive urban amenity policies and greater governmental attention to mitigating inequalities in essential public amenities to promote urban equity and competitiveness. Full article

Traditional financial models often fail construction firms by ignoring industry-specific volatility. This study proposes an Explainable AI (XAI) framework to predict Return on Assets (ROA) and Debt-to-Equity (D/E) ratios using KOSPI and KOSDAQ data (2015–2024). It compares a baseline financial dataset (Dataset 1) with an industry-augmented version (Dataset 2) that incorporates the Producer Price Index (PPI) and labor wages. Using ANN, LSTM, and RF, the study found that the RF model achieved the highest predictive power (${\mathrm{R}}^2=0.7978$). Notably, Dataset 2 improved accuracy significantly, reducing the Mean Absolute Error (MAE) for ROA by approximately 56%. SHAP analysis revealed that rising rebar and steel prices (PPI_RB) negatively impact both profitability and stability. In contrast, the concrete price index (PPI_CO) showed a positive influence, reflecting firms’ ability to manage costs or adjust prices. Crucially, material costs proved far more influential than labor costs. These findings indicate that supply-chain and raw-material-price indicators are salient predictors, suggesting that management may prioritize monitoring and mitigating supply-chain volatility, while causal validation remains beyond the scope of this study. Ultimately, by leveraging an XAI-based interpretation, this study provides a decision-making basis for formulating procurement and hedging strategies using raw material price indices, while also proposing an analytical framework that explains financial performance in the construction industry from a volatility-oriented perspective. Full article

Understanding how patients engage with digital health technologies is critical for improving the reach and equity of telehealth services. While prior research has largely focused on demographic predictors of telehealth use, this study applies a hybrid data mining approach to uncover behavioral engagement patterns and evaluate their predictive power. Using data from the 2022 U.S. Health Information Trends Survey (HINTS; N = 3525), we identified four distinct eHealth engagement typologies through Latent Class Analysis (LCA): (1) Highly Digital Engagers, (2) Moderate Digital Users, (3) Social Media and App Enthusiasts, and (4) Wearable and Health App Enthusiasts. We then modeled telehealth utilization as the outcome using multivariable logistic regression and eXtreme Gradient Boosting (XGBoost) with Shapley Additive Explanations (SHAP). Compared to Highly Digital Engagers, Moderate Digital Users had significantly lower odds of telehealth use (OR = 0.52), while the other two classes had higher odds. SHAP analyses confirmed that depression status and geographic region interacted with engagement profiles to shape telehealth access, with a notably negative effect of depression within Class 2. These findings demonstrate the value of integrating behavioral segmentation with interpretable machine learning to characterize heterogeneity in digital health engagement and its association with telehealth utilization. Our study offers a scalable, population-level analytic framework that can inform targeted telehealth planning and outreach strategies aligned with real-world patterns of digital engagement. Full article

This study examines the determinants of profitability for 21 Bulgarian commercial banks over the period from the first quarter of 2007 to the first quarter of 2025, using financial statement data. Bank profitability is measured by return on assets (ROA) and return on equity (ROE) and modeled within a panel autoregressive distributed lag (PMG-ARDL) framework. The empirical specification combines bank-specific and macroeconomic variables, allowing for the identification of both long-run equilibrium relationships and short-run bank-level dynamics. The long-term results indicate that the net interest margin (NIM), net fee and commission margin (NFM), government bond yields, the growth of the gross domestic product (GDP), and the loan-to-deposit ratio (LDR) positively affect profitability. On the other hand, higher unemployment, rising housing prices, increased loan loss impairments, and the ratio of cash holdings to total assets reduce profitability. The findings provide policy-relevant insights for bank management, regulators, and macroprudential authorities regarding efficiency, income diversification, and credit risk management. The findings facilitate a more comprehensive assessment of banking sector resilience and provide a foundation for the development and refinement of macroprudential and supervisory policy measures. Full article

Background/Objectives: Mental health issues pose a growing public health burden in aging societies, a challenge particularly accentuated in rural China. This study investigated whether the establishment of rural community organizations—specifically volunteer groups, agricultural cooperatives, cultural and sports clubs, senior dance troupes, and senior associations—influences depressive symptoms and life satisfaction among rural older adults. Methods: Data were obtained from the Well-being of Elderly Survey in Anhui Province (WESAP) across three waves (2015, 2018, and 2021). The final sample comprised a balanced panel of 511 older adults, providing 1533 observations. A two-way fixed-effects model was employed to analyze the data. Results: Empirical results show that the establishment of agricultural cooperatives was associated with lower depressive symptoms. Cultural and sports clubs were associated with reduced depressive symptoms and positively correlated with life satisfaction. Mechanism analysis revealed associations consistent with a dual “economic–social” pathway: establishing agricultural cooperatives was associated with greater economic resilience and stronger social bonds. The establishment of cultural and sports clubs correlated with higher mental well-being, accompanied by increased time spent in social interaction. Notably, volunteer groups and senior associations showed no significant association with mental health outcomes. Conclusions: Rural community organizations are critical drivers of mental health equity. Policymakers should prioritize support for organizations that are deeply embedded in rural daily life and integrate economic functions with social interaction to maximize mental health benefits for older adults. Full article

Against the backdrop of global climate governance and evolving ESG (Environmental, Social, and Governance) infrastructure, this study examines how market-based ESG ratings drive corporate carbon performance. Employing a staggered difference-in-differences (DID) approach based on a quasi-natural experiment with the initial release of SynTao Green Finance’s ESG ratings as an exogenous shock, we analyze Chinese A-share listed firms (2014–2022) from an internal and external interaction perspective. The results show ESG ratings significantly enhance carbon performance by improving internal control quality and analyst attention. Equity balance degree and public environmental concern strengthen these effects internally and externally, respectively. The positive impact is more pronounced in non-polluting industries, firms with low customer concentration, and those undergoing digital transformation. This study reveals the dual transmission mechanisms and boundary conditions of ESG ratings, offering theoretical and policy insights for achieving “dual carbon” goals. Full article

This bibliometric study provides a comprehensive mapping of the scientific landscape on education financing in Europe, highlighting its main trends, conceptual foundations, and influential contributions. Based on 168 publications indexed in the Web of Science and analyzed using VOSviewer, the research traces the chronological evolution of the field, explores keyword co-occurrence networks, and identifies the most impactful studies. Findings indicate a steady growth of academic interest after 2005, with a notable peak from 2014 to 2019, stimulated by major European policy frameworks such as Europe 2020 and Horizon 2020. Keyword analysis reveals dominant themes—including higher education, performance-based funding, human capital, digitalization, and governance—while areas such as pre-university education, digital equity, and large-scale comparative assessments remain insufficiently explored. Highly cited publications focus on the diversification of funding sources, the tensions generated by neoliberal approaches in higher education, and the persistent challenges of financing inclusive education. In addition, country-level analysis highlights an uneven geographic distribution of research output, with scientific production concentrated in a limited number of European countries, alongside contributions from non-European partners reflecting international collaboration patterns. Overall, results show that European research on education financing is fragmented and often shaped by political and institutional priorities. By identifying major research directions and uncovering existing gaps, this study offers a valuable foundation for future investigations aimed at strengthening equity, sustainability, and innovation in the financing of education systems. Full article

Background/Objectives: We aim to codesign and test a nurse-led, large language model-empowered agent to increase hepatitis B screening and vaccination for inclusion health populations. Methods: This study employs a double diamond model-guided codesign methodology. It includes four phases: (i) Discover: To identify intervention targets, a systematic review was undertaken that synthesized 51 factors influencing hepatitis B screening and vaccination among inclusion health populations. A qualitative study will later be conducted to further elucidate specific cultural barriers in the Chinese context. (ii) Define: To delineate effective intervention designs, two systematic reviews were performed, informing the integration of nurse-led intervention components (e.g., counseling, case management, and care coordination) and adaptation of a large language model to address identified intervention targets. (iii) Develop: To codesign an agent, hepatitis B prevention datasets will be constructed with subsequent model adaptations through fine-tuning and retrieval-augmented generation, as well as collaborations among diverse stakeholders. It will facilitate human–agent interactive consultation, intelligent case management, and care coordination, as well as collaborate with a nurse-led multidisciplinary team to manage hepatitis B screening, vaccination, and care linkage. (iv) Deliver: To evaluate and refine the agent, a mixed-methodology will be adopted, encompassing quantitative evaluation of model response, as well as qualitative evaluation of user experience, technical barriers, and potential benefits. Discussion: This intervention is expected to improve hepatitis B screening and vaccination rates among inclusion health populations, thereby enhancing diagnosis, immunity, and care linkage. It will establish a codesign framework for nursing-specific large language models, broadening the impact of nurses on preventive health equity. Full article

Form ADV regulatory disclosures made by mutual fund management firms indicate that nearly one-third of investment advisers to mutual funds offer pension consulting services to defined contribution plans, creating inherent conflicts of interest that allow advisers to recommend their own affiliated funds to plan sponsors. Using the complete universe of Form ADV filings merged with CRSP mutual fund data, I examine how these retirement plan conflicts affect mutual fund portfolio management and performance over the period 2003 to 2014. In contrast to prior studies that relied on hand-collected plan-level data and focused on participant outcomes, this study provides fund-level evidence using comprehensive regulatory disclosures to assess how such conflicts affect managerial incentives. I found that equity mutual funds managed by conflicted advisers exhibited widespread underperformance and were managed to a significantly lesser extent, consistent with weakened incentives arising from sticky defined contribution assets. The effects were economically larger for target date mutual funds, which played a central role as default investment options in retirement plans. The results have important policy implications, suggesting that disclosure alone may be insufficient to mitigate conflicts of interest and highlighting the need for stronger fiduciary oversight and governance of plan menus, particularly for default investment options. Full article

Background: Motivational text messages can encourage increased physical activity. This study aimed to validate motivational text messages among older adults and care partners and to assess differences in perceived motivational value between the two groups. Methods: We designed nine motivational text messages to capture nine distinct physical activity scenarios. For this cross-sectional observational study, we enrolled 14 content experts, 310 older adults, and 305 care partners. Content experts assessed the relevance, while the older adults and care partners assessed the perceived motivational value of each text message on a 5-point Likert scale. We computed the item content validity index and assessed differences in perceived motivational value among older adults and care partners using quantile regression while adjusting for sociodemographic and health characteristics. Results: The item content validity index ranged from 0.86 to 1.00. The median (interquartile range) perceived motivational value for each text message was 4.0 (3.0–5.0), and there were no statistically significant differences in reported motivational values between older adults and care partners. Conclusion: We present nine content-validated text messages with high motivational value for older adults and care partners that can be integrated into technology-based intervention studies and may improve physical activity behavior in both groups. Full article

Identity-based communities that share common characteristics, beliefs, and experiences (e.g., Black LGBTQ+ communities) have historically been conceptualized as protective bubbles that buffer Black LGBTQ+ individuals against the deleterious effects of systemic racism and cisheterosexism. However, this monolithic narrative often masks the internal power dynamics that divide belonging. This study explores the exclusionary dynamics embedded within these safe spaces, examining how internal hierarchies of skin tone, socioeconomic status, and gender performance function as proximal stressors. Guided by a critical constructivist paradigm, this study utilized Reflexive Thematic Analysis to analyze open-ended survey responses from 74 Black LGBTQ+ adults. Data were drawn from a larger mixed-methods study and analyzed using a six-phase recursive process to identify latent patterns of intragroup gatekeeping. The analysis revealed that the sanctuary of the community is restricted. Three primary themes emerged: (1) Phenotypic Capital and the Politics of Authenticity, where lighter skin tone triggered authenticity scrutiny and darker skin tone faced rejection based on physical appearance; (2) Socioeconomic Gatekeeping, where belonging was stratified by the cost of participation and protective insularity within working-class spaces; and (3) Policing the Binary, where rigid adherence to gender archetypes created a landscape of performance surveillance. Access to community resilience is not a universal right but a negotiated status contingent upon the payment of a resilience tax. To promote genuine health equity, researchers and practitioners working with this population must move beyond the uncritical referral to “community” and actively dismantle the internalized systems of oppression that fracture collective survival. Full article

Civil registration of births and deaths underpins people’s legal identity, access to essential services, and evidence-based policy. Over the last two decades, the expansion of the National Health Mission (NHM) and the dramatic increase in institutional deliveries have created new opportunities to link maternal healthcare with critical event documentation. Primary health centres (PHCs) and community health centres (CHCs), which are frequently the initial point of contact for rural households, are emerging as important places for birthing and registration. Despite their expanding importance, the particular role of these grassroots facilities in birth registration results has not been thoroughly investigated. This study addresses that gap by assessing their role in increasing registration coverage among children under the age of five. We analyzed nationally representative data from the National Family Health Survey rounds 4 (2015–2016) and 5 (2019–2021). This study focused on children under five, examining the association between place of delivery and registration status. Descriptive analysis and multivariable logistic regression estimated the odds of registration across delivery settings. Pooled data from both survey rounds captured temporal shifts, and predicted probabilities were calculated for institutional deliveries, adjusting for socio-demographic covariates. The proportion of institutional births occurring in PHCs and CHCs rose from 30.5% to 34.7% between the two survey rounds. Registration among children delivered in these facilities increased from 80.8% to 90.2%, the highest gain among all delivery settings. Regression analysis showed that births in PHCs/CHCs were associated with 38% higher odds of being registered compared to private facilities. States designating PHCs and CHCs as official registrars, such as Delhi, Rajasthan, and Uttar Pradesh, reported the greatest improvements. Lower-level government health facilities are not only advancing safe delivery but also acting as pivotal nodes for civil registration. Their dual function creates a scalable model for integrating healthcare with legal identity creation, supporting equity and accelerating progress toward Sustainable Development Goal 16.9. Full article