Search Results (3,021)

Housing stock is observed to be associated with high carbon emissions, high fuel poverty and low comfort levels in the UK. Retrofitting the housing stock is one of the best solutions to address these problems. This paper directly corresponds with human and planetary health in terms of climate change, human health and mental health by addressing the challenges of housing retrofit at scale. Retrofitting houses can also contribute to social equity, reduced use of planetary resources and better financial and physical comfort. Despite the availability of the right technology, government grants and the potential to acquire supply chain and skilled labour, the progress of retrofit is extremely poor. Importantly, the UK is off track to achieve net zero by 2050, and the housing stock contributes 18.72% of the total emissions. The problem is further exacerbated by the 30.4 million units of housing stock. Robust strategies are required to retrofit the housing stock at scale. The study uses a qualitative modelling method under the diffusion of innovations theory to formulate a retrofit-at-scale strategy for the UK. Findings recommend focusing on skill development, show homes, research and innovation, supply chain development, business models, government grants and regulatory tools in a trajectory from 2025 to 2050. The proposed strategy is aligned with the segments of the diffusion of innovation theory. Although the analysis was performed with reference to the UK, the findings are transferable, considering the broader and urgent concerns related to human and planetary health. Full article

The growing economic pressures on healthcare systems have heightened the need for effective and sustainable cost management strategies. This study presents a PRISMA-based systematic review of 210 peer-reviewed articles published between 1974 and 2024, retrieved from the Scopus and Web of Science databases. Following a structured selection and screening process, the articles were analysed to identify dominant cost control tools, contextual applications, and methodological trends across diverse health systems. The findings highlight a strong prevalence of Activity-Based Costing (ABC), Diagnosis-Related Groups (DRG), and benchmarking practices, predominantly in public hospital settings. However, significant thematic gaps remain, particularly concerning low-income countries, interdisciplinary integration, and the evaluation of digital technologies for financial optimisation. This review provides a comprehensive thematic synthesis of international research, consolidating knowledge in healthcare cost management and offering evidence-based recommendations to guide future empirical research, policy design, and strategic planning in health finance. Full article

The main purpose of this research is to examine the significance of green bonds and green banking loans as financing tools for ecologically sustainable projects in the face of increasing worldwide environmental issues. This research seeks to uncover the determinants of both instruments’ issuance and the obstacles to their acceptance. A thorough systematic literature review will be conducted to assess the efficacy of these tools in improving company financial performance and cost of debt, advancing environmental sustainability, and influencing investor behavior. This methodology guarantees a comprehensive and impartial examination of peer-reviewed publications from reputable sources such as Web of Science and Scopus. Although issues such as greenwashing, market liquidity, and regulatory discrepancies still exist, both tools are growing steadily in the sustainable financing spectrum. The results also suggest that both instruments are influenced by several factors, often overlapping due to their common focus on financing sustainable projects. The credit rating, financial health, and overall environmental performance of the issuing entity significantly influence the attractiveness and pricing of green bonds, as do the market conditions, regulatory frameworks, and certification. The environmental profile and creditworthiness of the borrower are key determinants for green banking loans. The review enhances the current body of knowledge by presenting a theoretical structure for comprehending the dynamics of green debt markets and proposing practical recommendations for policymakers and financial institutions. Furthermore, it emphasizes the deficiencies in existing research, including the need for further longitudinal investigations into green bank loans and a more thorough examination of the notion of ‘greenium’. We searched Web of Science and Scopus up to 26 April 2024. Eligibility criteria included peer-reviewed English-language studies on green bonds or green banking loans. After screening, 128 studies were found to have met the inclusion criteria. Full article

Carbon farming represents a strategic approach to enhancing agricultural sustainability while reducing greenhouse gas (GHG) emissions. In Türkiye, agriculture accounted for approximately 14.9% of national GHG emissions in 2023, dominated by methane (CH₄) and nitrous oxide (N₂O). By increasing carbon storage in soils and vegetation, carbon farming can improve soil health, water retention, and climate resilience, thereby contributing to mitigation efforts and sustainable rural development. This study reviews and synthesizes international and national evidence on carbon farming mechanisms, practices, payment models, and adoption enablers and barriers, situating these insights within Türkiye’s agroecological and institutional context. The analysis draws on a systematic review of peer-reviewed literature, institutional reports, and policy documents published between 2015 and 2025. The findings indicate substantial mitigation potential from soil-based practices and livestock- and manure-related measures, yet limited uptake due to low awareness, capacity constraints, financial and administrative barriers, and regulatory gaps, highlighting the need for region-specific approaches. To support implementation and scaling, the study proposes a policy-oriented, regionally differentiated and digitally enabled MRV framework and an associated implementation pathway designed to reduce transaction costs, enhance farmer participation, and enable integration with emerging carbon market mechanisms. Full article

Municipal solid waste management (MSWM) remains a critical environmental governance challenge in rural and peri-urban regions of the Global South, where service delivery gaps exacerbate illegal dumping and public health risks. Geographic Information Systems (GIS) are increasingly promoted as decision-support tools to improve waste collection efficiency and environmental monitoring; however, their adoption in resource-constrained municipalities remains limited. This study investigates the institutional and policy barriers shaping GIS readiness in four rural municipalities within South Africa’s Vhembe District. Using a qualitative case-study design, semi-structured interviews were conducted with 29 municipal officials across managerial and operational levels, complemented by 399 community responses to an open-ended survey question. Thematic analysis, guided by Institutional Theory and the Technology Acceptance Model (TAM), identified five interrelated themes: waste production and disposal behaviours, collection and infrastructure constraints, institutional and operational challenges, policy and standardisation gaps, and technology readiness. The findings reveal that weak service reliability, fragmented governance structures, limited human and financial capacity, and inconsistent policy enforcement collectively undermine GIS adoption, despite its high perceived usefulness among officials. The study demonstrates that the effectiveness of GIS as an environmental management tool is contingent on institutional readiness rather than technological availability alone and highlights the need for integrated reforms in service delivery, institutional capacity, and policy implementation to enable GIS-supported sustainable waste management. Full article

Background/Objectives: Socioeconomic stressors, such as financial strain, rising living costs, and perceived price burden, have gained relevance in the post-pandemic period and may adversely affect adolescent mental health. This study examined the association between subjective financial stress and symptoms of depression, anxiety, and emotional/behavioral difficulties among adolescents in Northern Italy. Methods: Data were obtained from the 2025 Corona and Psyche South Tyrol (COP-S) population survey. A total of 2554 adolescents aged 11–19 years and their parents participated; 1598 adolescents provided complete data for analyses of socioeconomic stressors (parent-reported Family Affluence Scale III, adolescent self-reported and parent proxy and self-reported burden due to price increases). Mental health outcomes included depressive symptoms (PHQ-2), generalized anxiety (SCARED-GAD), and emotional/behavioral difficulties (SDQ). Associations were assessed using chi-square tests, Kendall’s tau correlations, and two-factor ANOVA models. Results: Elevated depressive symptoms were present in 10.7% of adolescents, emotional/behavioral difficulties in 13.9%, and anxiety symptoms in 27.9% of adolescents. Female adolescents consistently showed higher symptom levels in all domains. Self-reported financial burden was the strongest and most consistent correlate of mental health problems, demonstrating small-to-moderate positive correlations with depressive symptoms (τ = 0.20, p < 0.001), emotional/behavioral difficulties (τ = 0.14, p < 0.001), and anxiety (τ = 0.25, p < 0.001). Parent-reported burden showed weaker and less consistent associations, and the Family Affluence Scale III was not significantly related to any of the mental health outcomes. ANOVA models indicated that adolescents’ own perception of financial burden significantly predicted anxiety levels in both age groups (11–14 and 15–19 years), whereas discrepancies between adolescent and parent burden perceptions were particularly relevant among younger adolescents. Conclusions: In this affluent European region, subjective financial strain, especially adolescents’ perception of burden due to rising prices, is a stronger determinant of depressive symptoms, anxiety, and psychosocial difficulties than parental burden reports or structural affluence indicators. Adolescents, especially females, appear to be particularly vulnerable. These findings underscore the importance of addressing subjective financial stress in adolescent mental health and public health strategies. Full article

The emergence and dissemination of antimicrobial resistance (AMR) are driven by complex, interconnected mechanisms involving microbial communities, environmental factors, and human activities, with climate change playing a pivotal and accelerating role. Rising temperatures, altered precipitation patterns, and other environmental disruptions caused by climate change create favorable conditions for bacterial growth and enhance the horizontal gene transfer (HGT) of antibiotic resistance genes (ARGs). Thermal stress and environmental pressures induce genetic mutations that promote resistance, while ecosystem disturbances facilitate the stabilization and spread of resistant pathogens. Moreover, climate change exacerbates public and animal health risks by expanding the range of infectious disease vectors and driving population displacement due to extreme weather events, further amplifying the transmission and evolution of resistant microbes. Livestock agriculture represents a critical nexus where excessive antibiotic use, environmental stressors, and climate-related challenges converge, fueling AMR escalation with profound public health and economic consequences. Environmental reservoirs, including soil and water sources, accumulate ARGs from agricultural runoff, wastewater, and pollution, enabling resistance spread. This review aims to demonstrate how the Mediterranean’s strategic position makes it an ideal living laboratory for the development of integrated “One Health” frameworks that address the mechanistic links between climate change and AMR. By highlighting these interconnections, the review underscores the need for a unified approach that incorporates sustainable agricultural practices, climate mitigation and adaptation within healthcare systems, and enhanced surveillance of zoonotic and resistant pathogens—ultimately offering a roadmap for tackling this multifaceted global health crisis. Full article

Background/Objective: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have received widespread attention as effective obesity treatments. However, limited research has examined the perspectives of patients contemplating GLP-1RAs. This study explored perceptions, motivations, and barriers among individuals considering GLP-1RA therapy for obesity treatment, with the goal of informing patient-centered care and enhancing clinician engagement. Methods: Adults completed surveys and interviews between June and November 2025. In this pragmatic mixed-methods study, both survey and interview questions explored perceived benefits, barriers, and decision-making processes. Qualitative data, describing themes based on the Health Belief Model, were analyzed using Dedoose (version 9.0.107), and quantitative data were analyzed using SAS (version 9.4). Participant characteristics included marital status, income, educational attainment, employment status, insurance status, age, race/ethnicity, and sex. Anticipated length on GLP-1RA medication and selected self-reported health conditions (depression, anxiety, hypertension, heart disease, back pain, joint pain), reported physical activity level, and perceived weight loss competency were also recorded. Results: Among the 31 non-diabetic participants who were considering GLP-1RA medication for weight loss, cost emerged as the most significant barrier. Life course events, particularly (peri)menopause among women over 44, were commonly cited as contributors to weight gain. Participants expressed uncertainty about eligibility, long-term safety, and treatment expectations. Communication gaps were evident, as few participants initiated discussions and clinician outreach was rare, reflecting limited awareness and discomfort around the topic. Conclusions: Findings highlight that individuals considering GLP-1RA therapy face multifaceted emotional, financial, and informational barriers. Proactive, empathetic clinician engagement, through validation of prior efforts, clear communication of risks and benefits, and correction of misconceptions, can support informed decision-making and align treatment with patient goals. Full article

Background: Hypertensive disorders of pregnancy (HDP) have significant implications for women’s long-term health, including at least a twofold increased lifetime risk of cardiovascular disease (CVD). The Blood Pressure Postpartum (BP²) Study was a three-arm randomised trial evaluating follow-up and lifestyle behaviour change strategies during the first year after HDP. Methods: This qualitative sub-study, embedded within the BP² Study, explored women’s experiences of life in the first year following HDP. Semi-structured telephone interviews were conducted with 34 women, approximately 10–12 months postpartum. Interviews were transcribed verbatim and a thematic analysis was undertaken. Results: Participants reflected on their experiences post-HDP; three major themes were identified: Navigating life with a newborn, The value of support, and Processing and Moving forward. Some women felt informed and empowered to make positive lifestyle changes; others were still processing their HDP experience and/or feeling overwhelmed by the demands of early motherhood. Responses were influenced by their HDP experience, available support, prior experience with healthy behaviours, and financial stability. Conclusions: The findings highlight that postpartum women who experienced HDP face unique challenges, including physical recovery, emotional processing, and intensive infant care. It often takes time for these women to begin prioritising their own health, as they navigate these challenges. The insights generated from women’s experiences suggest that flexible, accessible, and individually tailored support may facilitate postpartum health, promote lifestyle change, and help reduce long-term CVD risk. Full article

Health equity and financial inclusion (FI) are at the core of the Sustainable Development Goals, yet their intersection remains critically under-studied. This bibliometric study maps this emergent and fragmented field by analyzing 24,140 publications from Scopus, PubMed, Web of Science, and Lens.org over five decades. Employing co-citation and co-word analysis via VOSviewer, chart research trends, governance frameworks, and policy linkages were systematically presented. The analysis reveals that less than 0.3% of the identified literature explicitly bridges financial inclusion with health outcomes, and direct investigations into health equity are virtually absent. Despite recent growth, fundamental gaps persist, including a lack of empirical studies on digital financial tools in low- and middle-income countries (LMIC) health contexts and insufficient focus on disadvantaged populations. As the first comprehensive empirical mapping of this nexus, this study underscores the urgency for scholarly and policy action to strategically leverage financial instruments for equitable healthcare access. The findings provide a foundational map and a structured agenda to consolidate this nascent field. Full article

Background/Objectives: The extent to which patients with cancer discontinue dental treatment for financial reasons remains unclear. This study compared the prevalence of financially driven dental treatment discontinuation between patients with cancer and without cancer (controls) and identified factors associated with discontinuation among patients with cancer. Methods: This cross-sectional, questionnaire-based survey conducted in November 2024 comprised 500 patients who had one of five common cancers in Japan and 500 non-cancer participants allocated to reflect the cancer group age distributions, sex, and household income. Only patients who received cancer treatment within the past 5 years and had a family dental clinic were included. Discontinuation was assessed from self-reported dental treatment cessation for economic reasons. Univariate analyses were employed for group comparisons (p < 0.05). Results: Dental treatment discontinuation for financial reasons occurred in 3.4% (95% CI 2.1–5.4%) of patients with cancer and 5.8% (95% CI 4.1–8.2%) of controls (p = 0.096). Among the patients with cancer, those who discontinued were younger (58.8 vs. 66.1 years, p = 0.010) and frequently reported physical or psychological barriers to dental care and discontinuation being financially driven (all p < 0.001). They also had poor oral health-related quality of life (Oral Health Impact Profile-14: 17.4 vs. 7.8, p < 0.001) and greater financial toxicity (Comprehensive Score for Financial Toxicity: 24.6 vs. 29.3, p = 0.001). Conclusions: Oral health-related quality of life was lower among participants reporting dental treatment discontinuation. Early identification of financial barriers and support may warrant further study. Full article

Background/Objectives: Pain and pain-related conditions are considered a global health and financial burden. In order to improve pain management, pain intensity assessment, and pain diagnosis, various biomarkers have been proposed. Since their clinical utility is not proven yet, the aim of this umbrella review is to synthesize existing evidence of all types of pain biomarkers available. Methods: Systematic searches were conducted in PubMed, Scopus, and the Cochrane Library from inception to 2 June 2025. Eligible studies were systematic reviews and meta-analyses examining any clinical, biochemical, genetic, neurophysiological, or imaging biomarker related to pain. The screening of studies, data extraction, and assessment of methodological quality using the AMSTAR-2 tool were conducted by two independent reviewers. Findings were summarized narratively. Results: A total of 49 systematic reviews and meta-analyses were included. Most reviews were rated as low or critically low quality. Inflammatory biomarkers (CRP, IL-6, TNF-α) reported the most consistent associations with chronic musculoskeletal pain, while neuroimaging and EEG measures reflected central nervous system alterations. Proteomic multi-protein panels demonstrated exploratory diagnostic potential, particularly for fibromyalgia, but lacked clinical validation. Evidence for genetic, hormonal, metabolic, neurochemical, and tissue-specific biomarkers was inconsistent and methodologically limited, supporting mechanistic rather than clinical inference. Conclusions: No single biomarker has achieved clinical validation for chronic pain, but several biomarker classes show promise. Future implications include high-quality longitudinal studies, standardized protocols, and multidimensional biomarker panels. Full article

Background: Zoonotic spillover events with pandemic potential are increasingly associated with environmental change, ecosystem disruption, and intensified human–animal interactions. Although the specific origin and timing of future pandemics remain uncertain, there is a clear need to complement traditional preparedness strategies with approaches that support earlier anticipation and prevention. Objectives: This study aims to propose a conceptual approach to reframe pandemic preparedness toward proactive surveillance and spillover prevention. Methods: We introduce a tachyon-inspired conceptual approach, using a thought experiment based on hypothetical faster-than-light particles to illustrate anticipatory observation of pandemic emergence. The framework is informed by interdisciplinary literature on emerging infectious diseases, One Health surveillance, predictive epidemiology, and public-health preparedness. Results: The proposed approach highlights the importance of proactive, integrated surveillance systems that combine human, animal, and environmental data. Key elements include the use of advanced analytical tools such as neural networks, early characterization of population risk profiles, strengthened public-health infrastructure, coordinated governance, adaptable financial resources, and a resilient healthcare workforce. The integration of animal welfare considerations, translational research, and planetary health principles is emphasized as central to reducing spillover risk. Conclusions: Tachyon-inspired thinking offers a conceptual tool to support a shift from reactive pandemic response toward proactive anticipation and prevention. Embedding integrated surveillance and One Health principles into public-health systems may enhance early detection capacity and contribute to mitigating the impact of future pandemics. Full article

This study investigates the barriers in adopting the Circular Economy (CE) in Saudi Banking under Vision 2030 and using the Resource-Based View and stakeholder theory. This study examined how customer engagement, process innovation, and dynamic capabilities limit the implementation of CE. A quantitative, cross-sectional survey collected 418 responses from bank employees in Riyadh and was collected from January to March 2024. A 29-item Likert scale was analyzed with SmartPLS 4; measurement quality was strong, and confirmatory factor analysis confirmed construct validity. Results highlight the main barriers as customer resistance regulatory constraints and lack of adequate employee training. The construct is highly interconnected (r = 0.758), showing that improvements in customer engagement and process innovation strengthen dynamic capabilities. The study provides practical guidance for banks and policymakers on designing circular finance products, targeted training, and supportive regulations to accelerate the CE transition and achieve measurable sustainability outcomes in financial sectors, aligning with SDG 3, good health and well-being, and SDG 7, affordable and clean energy. Full article

Background/Objectives: Family members are the principal providers of home-based care for migrant older adults. Linguistic, cultural, and structural barriers within health systems exacerbate the caregiver burden across emotional, physical and financial domains. Although home healthcare services may alleviate this burden, variability in access, cultural safety, and care coordination can also intensify it. This scoping review maps the evidence on the burden experienced by family caregivers who deliver home-based healthcare to migrant older adults and examines how these arrangements affect caregivers’ health and well-being. It synthesizes the literature on facilitators and barriers—including access, cultural-linguistic fit, coordination with formal services, and legal/immigration constraints—and distills implications for policy and practice to strengthen equitable, culturally responsive home care. Method: The Joanna Briggs Institute (JBI) scoping review framework was used to conduct the review. A comprehensive search was performed across six databases (CINAHL, Scopus, Web of Science, PsycINFO, MEDLINE and Sociological Abstracts) for articles published between 2000 and 2025. Studies were selected based on predefined inclusion criteria focusing on the family caregiver burden in providing home healthcare for migrant older adults. Data extraction and thematic analysis were conducted to identify key themes. Results: The review identified 20 studies across various geographical regions, highlighting four key themes: (1) Multidimensional Caregiver Burden, (2) The Influence of Gender, Family Hierarchy, and Migratory Trajectories on Caregiving, (3) Limited Access to Formal and Culturally Appropriate Support, and (4) Health Outcomes, Coping, and the Need for Community-Based Solutions. Conclusions: System-level reforms are required to advance equity in home healthcare for aging migrants. Priorities include establishing accountable cultural-safety training for providers; expanding multilingual access across intake, assessment, and follow-up; and formally recognizing and resourcing family caregivers (e.g., navigation support, respite, training, and financial relief). Investment in community-driven programs, frameworks and targeted outreach—co-designed with migrant communities—can mitigate isolation and improve uptake. While home healthcare is pivotal, structural inequities and cultural barriers continue to constrain equitable access. Addressing these gaps demands coordinated policy action, enhanced provider preparation, and culturally responsive care models. Future research should evaluate innovative frameworks that integrate community partnerships and culturally responsive practices to reduce the caregiver burden and improve outcomes for migrant families. Full article