Search Results (212)

Tuberculosis (TB) remains a leading cause of death in Bangladesh, disproportionately affecting low socio-economic status (SES) populations. This review, guided by the WHO Social Determinants of Health framework and Rockefeller-Lancet Planetary Health Report, examined how social, economic, and ecological factors link SES to TB burden. The first literature search identified 28 articles focused on SES-TB relationships in Bangladesh. A second search through snowballing and conceptual mapping yielded 55 more papers of diverse source types and disciplines. Low-SES groups face elevated TB risk due to smoking, biomass fuel use, malnutrition, limited education, stigma, financial barriers, and hazardous housing or workplaces. These factors delay care-seeking, worsen outcomes, and fuel transmission, especially among women. High-SES groups more often face comorbidities like diabetes, which increase TB risk. Broader contextual drivers include urbanisation, weak labour protections, cultural norms, and poor governance. Recommendations include housing and labour reform, gender parity in education, and integrating private providers into TB programmes. These align with the WHO End TB Strategy, UN SDGs and Planetary Health Quadruple Aims, which expand the traditional Triple Aim for health system design by integrating environmental sustainability alongside improved patient outcomes, population health, and cost efficiency. Future research should explore trust in frontline workers, reasons for consulting informal carers, links between makeshift housing and TB, and integrating ecological determinants into existing frameworks. Full article

People living with HIV (PLHIV) in under-resourced rural regions face intersecting social and structural barriers that intensify their vulnerability. This pilot study explored how overlapping marginalized identities and socioeconomic hardship shape experiences of discrimination among PLHIV in Southern Illinois. Twenty-two participants completed a community-informed survey that captured racial, sexual, and gender identities alongside indicators of stigma across healthcare, housing, employment, and community settings. The findings reveal that most participants experienced at least one form of discrimination, with the highest burden concentrated among those identifying as Black, Nonbinary, Gay/Lesbian, or low-income. Discrimination was particularly prevalent in healthcare and housing environments. Importantly, poverty and housing instability were not just common but appeared to amplify the experience of stigma, compounding the effects of identity-based marginalization. These results highlight the urgent need for integrated, affirming, and structurally responsive interventions tailored to the realities of multiply marginalized PLHIV in rural areas. Future research and services must consider the interplay of identity and economic precarity in order to promote equitable care and support. Full article

Residents in low-income multifamily housing often struggle to afford energy for essential needs such as heating, cooking, and electronics. Climate change may increase these energy demands, and high energy bills can reflect inefficiencies in a home’s systems or envelope. Improving the energy efficiency in low-income housing benefits both social justice and sustainability. However, there is limited information on the impact of energy upgrades in multifamily settings. This study examined the energy-related experiences of low-income families in public housing in Detroit, Michigan, who received energy-conserving measures (ECMs) such as efficient light bulbs, faucets, thermostats, and refrigerators in 2022. Thirty-nine residents completed surveys and provided energy usage data before and after the upgrades; twelve residents provided their hourly energy usage. Over 90% of residents reporting income information had an energy burden exceeding 6%, with higher energy expenses during colder months. While many residents appreciated the upgrades, quantitative evidence of reduced energy burdens was insufficient. Existing utility programs for multifamily residents typically offer minor upgrades but do not include larger appliance replacements or improvements to home insulation. To maximize energy efficiency for low-income families, thus promoting sustainability, more comprehensive programs and retrofits are necessary. Full article

In Sweden, persons with intellectual disability have a legal right to support in everyday life, including housing with support and participation in daily activities, but government reports show that many do not receive the support they need or would prefer. The aim of this study was to explore how persons with intellectual disability experience and reflect upon support in everyday life. Thirteen adults with mild intellectual disability participated in one to three interviews each. Content analysis yielded an overarching theme “Persons with intellectual disability request two different forms of support” and three themes: “Support requested to achieve independence”, “Challenges in requesting support”, and “Mutual support in a safe environment”. The study shows that persons with intellectual disability can be hindered in requesting and obtaining support due to both internal factors and support persons’ inability to provide support in a way that is acceptable to the person with intellectual disability. Persons with intellectual disability adapt to the support person to receive support without burdening them. Persons with intellectual disability also strive to become more independent in everyday life. Being situated in a context where mutual support is a natural part of the social life is found to be optimal. Full article

Driven by many factors, the housing affordability landscape in the United States (U.S.) is in crisis. This research examines the potential role of inclusionary zoning (IZ) policies as a tool to alleviate housing cost burdens and deliver affordable housing in the rapidly growing southeastern region of the U.S., with a specific focus on Greenville County, South Carolina. Utilizing data from LawAtlas, this study first conducts a policy scan on the state of IZ policies across seven comparable jurisdictions. This study further employs qualitative semi-structured interviews with stakeholders to assess the current challenges to affordable housing in the county. Our findings suggest that growing regions such as Greenville County face unique challenges as they strive to meet the growing demand for affordable housing that serves a wide range of community members. A major finding from interviewees includes a need for more localized and nuanced metrics of housing affordability, greater density, and mixed-use development. However, the county faces challenges for such developments due to NIMBYism and preference for a more traditional rural and suburban typology of housing in the county. Finally, our study finds that zoning policies that enhance the supply of affordable housing by design can promote equity, trust, economic growth, and quality of life. Full article

Managing risk, matching resources efficiently, and ensuring fair allocation are fundamental challenges in both finance and decision-making processes. In many scenarios, participants contribute unequally to collective outcomes, raising the question of how to distribute costs, benefits, or opportunities in a justifiable and optimal manner. This paper applies the Shapley value—a solution concept from cooperative game theory—as a principled tool in the following two specific financial settings: first, in tax cooperation games; and second, in assignment markets. In tax cooperation games, we use the Shapley value to determine the equitable tax burden distribution among three firms, A, B, and C, which operate in two countries, Italy and Poland. Our model ensures that countries participating in coalitions face a lower degree of tax evasion compared to non-members, and that cooperating firms benefit from discounted tax liabilities. This structure incentivizes coalition formation and reveals the economic advantage of joint participation. In assignment markets, we use the Shapley value to find the optimal pairing in a four-buyers and four-sellers housing market. Our findings show that the Shapley value provides a rigorous framework for capturing the relative importance of participants in the coalition, leading to more balanced tax allocations and fairer market transactions. Our theoretical insights with computational techniques highlights the Shapley value’s effectiveness in addressing complex allocation challenges across financial management domains. Full article

This study examines the impact of housing price increases on income inequality using the dynamic system GMM for OECD countries (2010–2021). We test the hypothesis that housing price appreciation affects income distribution differently based on economic development levels and homeownership patterns. The analysis is conducted both for the entire sample and by dividing countries into two groups based on per capita income, Group 1 (16 countries) with below-median per capita GDP and Group 2 (17 countries) with above-median per capita GDP, to account to account for structural differences in housing markets, financial systems, and wealth accumulation mechanisms. The findings show that rising housing prices help reduce income inequality, especially in countries that are relatively low-income and where more low-income households own their homes. Specifically, our estimates indicate that a one-point increase in the housing price index leads to a statistically significant (p < 0.05) 0.21 percentage point reduction in the Gini change rate in lower-income countries. However, in higher-income countries, the effect of housing prices on inequality is statistically insignificant, suggesting that the relationship between housing markets and income inequality varies across different economic contexts. This insignificance likely stems from countervailing forces: while housing appreciation increases wealth for homeowners, higher housing costs may disproportionately burden lower-income households through rental markets in these economies. The findings highlight the importance of country-specific housing programs that consider homeownership patterns and financial market access in tackling inequality, along with comprehensive public social policies. Our study has implications for policymakers seeking to address inequality through housing market interventions, particularly during the post-2008 recovery period and into the early pandemic phase. Full article

Over the past two decades, research on residential segregation and environmental justice has evolved from spatial assimilation models to include class theory and social stratification. This study leverages recent advances in machine learning to examine how environmental, economic, and demographic factors contribute to ethnic segregation, using Las Vegas as a case study with broader urban relevance. By integrating traditional econometric techniques with machine learning and deep learning models, the study investigates (1) the correlation between housing prices, environmental quality, and segregation; (2) the differentiated impacts on various ethnic groups; and (3) the comparative effectiveness of predictive models. Among the tested algorithms, LGBM (Light Gradient Boosting) delivered the highest predictive accuracy and robustness. To improve model transparency, the SHAP (SHapley Additive exPlanations) method was employed, identifying key variables influencing segregation outcomes. This interpretability framework helps clarify variable importance and interaction effects. The findings reveal that housing prices and poor environmental quality disproportionately affect minority populations, with distinct patterns across different ethnic groups, which may reinforce these groups’ spatial and economic marginalization. These effects contribute to persistent urban inequalities that manifest themselves in racial segregation and unequal environmental burdens. The methodology of this study is generalizable, offering a reproducible framework for future segregation studies in other cities and informing equitable urban planning and environmental policy. Full article

Inequitable access to parks persists in cities where race, income, and geography shape residents’ proximity to public green space. This study analyzes 20 parks in Salt Lake City—10 in the Eastside and 10 in the Westside—using demographic, housing, and transportation data drawn from GIS tools and spatial platforms. By assessing indicators such as household income, racial composition, rent burden, walkability, and transit access, the findings confirm that Westside parks—located in lower-income and more racially diverse neighborhoods—are significantly less accessible. Eastside parks, by contrast, tend to serve higher-income, majority-white areas with better infrastructure. This paper illustrates how spatial inequality in surrounding conditions limits park accessibility, and it proposes GIS as a tool for diagnosing and addressing environmental injustice in urban planning. Full article

Introduction: Advanced magnetic resonance imaging (MRI) techniques in neuroplasticity evaluations provide important information on stroke disease and the underlying mechanisms of neuronal recovery. It has been observed that gray matter density or volume in brain regions closely related to motor function can be a valuable indicator of the response to treatment. Objective: To compare structural MRI-evaluated gray matter volume changes in patients with post-stroke upper limb spasticity for >1 year between those undergoing surgery and those treated with botulinum toxin A (BoNT-A) and to relate these findings to upper limb function and quality of life outcomes. Materials and Methods: Design. A two-arm controlled and randomized clinical trial in patients with post-stroke upper limb spasticity. Participants. Thirty post-stroke patients with spastic upper limbs. Intervention. Participants were randomly assigned (1:1 allocation ratio) for surgery (experimental group) or treatment with BoNT-A (control group). Main outcome measures. The functional parameters were analyzed with Fugl-Meyer, Zancolli, Keenan, House, Ashworth, pain visual analogue, and hospital anxiety and depression scales. Quality of life was evaluated using SF-36 and Newcastle stroke-specific quality of life scales. The carer burden questionnaire was also applied. Clinical examinations and MRI scans were performed at baseline and at six months post-intervention. Correlations between brain volume/thickness and predictors of interest were examined across evaluations and groups. Results: Five patients were excluded due to the presence of intracranial implants. Eleven patients were excluded from analyses since they were late dropouts. Changes were observed in the experimental group but not in the control group. Between baseline and six months, gray matter volume was augmented at the hippocampus and gyrus rectus and cortical thickness was increased at the frontal pole, occipital gyrus, and insular cortex, indicating anatomical changes in key areas related to motor and behavioral adaptation These changes were significantly related to subjective pain, Ashworth spasticity scale, and Newcastle quality of life scores, and marginally related to the carer burden score. Conclusions: The structural analysis of gray matter by MRI revealed differences in patients with post-stroke sequelae undergoing different therapies. Gray matter volume and cortical thickness measurements showed significant improvements in the surgery group but not in the BoNT-A group. Volume was increased in areas associated with motor and sensory functions, suggesting a neuroprotective or regenerative effect of upper limb surgery. Full article

Background/Objectives: The aging population has increased the demand for home modifications to support aging in place. However, existing research primarily focuses on fall prevention and physical safety, leaving gaps in understanding long-term sustainability, social engagement, and cost-effectiveness. Additionally, the interaction between home modifications and health-related changes remains under-explored. This study systematically reviews home modifications, addressing these gaps by considering functional independence, quality of life, caregiving burden, and technological advancements. Methods: A systematic review was conducted following PRISMA 2020 guidelines. One researcher and an external expert performed study selection, data extraction, and quality assessment. Thematic analysis and narrative synthesis were applied to compare study results. Results: Among 20 studies, 13 (65%) confirmed the effectiveness of home modifications in fall prevention, functional independence, and cost savings. Seven studies (35%) highlighted housing accessibility and lifestyle factors. However, few studies examined personalized interventions, smart home technologies, and long-term adaptability. Conclusions: This study emphasizes the need for personalized, technology-driven, and long-term adaptable home modifications. Future research should explore smart home innovations, interdisciplinary approaches, and policy implementation feasibility to develop sustainable aging-in-place strategies. By adopting a holistic perspective, this study provides a new framework for advancing aging-in-place strategies. Full article

Chronic Rhinosinusitis (CR) is a common inflammatory condition with complex pathophysiology involving multiple interleukins. In times of precision medicine, it is mandatory to cluster our patients to offer the best tailored treatment with the lowest cost possible. Therefore, some triage markers can be used towards this goal, without raising much financial burden. The aim of this study was to identify the association of staphylococcal enterotoxin (SE)-specific IgE of types A, B, C, and TSST-1 (toxic shock syndrome toxin-1); and total IgE (tIgE) and specific IgE for Dermatophagoides pteronyssinus (DP), Dermatophagoides farinae (DF), and Blomia tropicalis (BT) in Brazilian patients with CRSwNP. Thirty-six patients with CSRwNP were analyzed for serum IgE levels: tIgE and specific IgE for: DP, DF, BT, and SE types A, B, C, TSST-1 by ImmunoCAP^®. The mean value of tIgE in SE-specific IgE-positive patients was 767 IU/mL and in house-dust-mite (HDM)-positive patients, the mean tIgE was 319 IU/mL (p < 0.005). A total of 86% of patients who had high tIgE levels but were SE-specific IgE-negative had positive specific IgE for at least one of the HDMs tested. The Fisher exact test statistic value for this association was significant (p < 0.05/p = 0.014). We found an association between high levels of tIgE and SE-specific IgE in patients with CRSwNP, possibly related to local and peripheric polyclonal IgE production. The mean value of tIgE—with a suggested cutoff point of tIgE levels of 767 IU/mL—can be used as a triage biomarker for positive SE-specific IgE in CRSwNP patients. Full article

Ulcerative colitis (UC) is a chronic and recurrent gastrointestinal disease that affects millions of humans worldwide and imposes a huge social and economic burden. It is necessary to find safe and efficient drugs for preventing and treating UC. The aim of this study was to determine whether ganoderic acid (GA), the main bioactive components of Ganoderma lucidum, has preventive and therapeutic effect on UC in a dextran sulfate sodium (DSS)-induced UC mouse model. Our experimental results showed that GA significantly ameliorated the body weight loss and disease activity index (DAI) of UC mice. GA significantly restored 11% of the colon length and 69% of the spleen index compared to UC mice. GA significantly decreased the intestinal inflammatory response and improved the barrier function of the intestine by upregulating the tight junction proteins Zonula occludens-1 (ZO-1), occludin and claudin-1. A co-housing experiment showed that gut microbiota accounted for the therapeutic activity of GA on UC, which was confirmed by fecal microbiota transplantation from GA-treated mice to the UC mice. Furthermore, 16S rDNA high-throughput sequencing of fecal bacteria showed that GA significantly enriched the abundance of Lactobacillus, Oscillospira, Odoribacter and Ruminococcus, which were positively correlated with colon length. Furthermore, this study found the functional metabolites, including Indole-3-acetaldehyde (IAAld), Glutamine (Gln) and Glutathione (GSH), reduced barrier damage in the Caco-2 cell model. In conclusion, this study suggests that GA could ameliorate UC by improving intestinal barrier function via modulating gut microbiota and associated metabolites. Full article

Objectives: This study investigates the prevalence, determinants, and educational implications of sensory disorders in Saudi Arabia. We hypothesize that sociodemographic factors (e.g., gender, marital status), genetic consanguinity, and regional disparities significantly influence sensory health outcomes, including vision, hearing, balance, and social participation, with consequences for learning environments and educational access. Participants: The primary data were analyzed data from 33,575 households across all administrative regions of Saudi Arabia. The sample includes Saudi nationals residing within the Kingdom and those temporarily abroad (e.g., for treatment, study, or tourism) who are considered household members. Households were selected via a stratified random sampling framework, drawing 25 households from each of 1300 statistical areas (out of 3600 total), ensuring nationwide representation aligned with the 2010 Population and Housing Census. Study Method: An observational analysis of secondary data from the nationally representative survey was conducted. Variables included vision, hearing, mobility, personal care, and communication disorders. Statistical methods encompassed chi-square tests for associations and Cramer’s V effect sizes, with regional, gender, and consanguinity-based sub-analyses. Findings: Males exhibited higher mild vision impairments (1.6% vs. 1.0% females; p < 0.001), while females had greater severe hearing disorders (2.3% vs. 1.8%; p < 0.001). Consanguineous groups showed autosomal recessive patterns (e.g., 91,512 mobility issues in first-degree relatives; Cramer’s V = 0.12). Regional disparities emerged, with rural Najran reporting elevated balance/motion deficits (3.1% vs. national 1.9%; p < 0.01). Never-married individuals faced extreme communication barriers (18.4% vs. 8.7% married; p < 0.001). Conclusions: Sensory disorders in Saudi Arabia are shaped by genetic, environmental, and sociocultural factors, with implications for educational access and inclusive learning environments. Gender-sensitive interventions, genetic counseling, and expanded sensory disability metrics are critical for equitable educational policies. Regional programs targeting trauma prevention, chronic disease management, and sensory-friendly accommodations in schools are recommended to address multisensory disorder burdens and enhance educational outcomes. Full article

Latinx communities face disproportionate environmental injustices and are targeted due to systematic economic and political inequities. This research evaluates the ease at which links between industrial releases and risk of adverse health effects can be defined to influence policy change in Houston, TX. The Environmental Protection Agency (EPA)’s Toxic Release Inventory (TRI) is the most comprehensive public database on industrial facilities’ toxic chemical releases in the US. TRI is presented within a risk-based context through the Risk Screening Environmental Indicators (RSEI) scores. TRI and RSEI datasets for Houston in 2022 were assessed in QGIS to analyze chemical release and risk in neighborhoods using Community Tabulation Areas (CTAs), identifying demographics of communities facing disproportionate industrial releases and consequent potential health risks. Geospatial visualizations reflected Latinx communities to house the heaviest polluting industrial facilities in Houston. As a result, these communities face the highest potential risk of adverse health effects due to exposure to a multitude of chemicals—particularly 1,3-butadiene, benzene, and chromium—as reflected in cumulative RSEI scores. An analysis of TRI and RSEI datasets elucidates the burden of gathering and analyzing chemical release data in a public health context, reflecting why change beginning at the local level can be difficult for under-resourced Latinx communities facing industrial pollution. Improving the accessibility and utility of the EPA resources will provide a resource to advocate for data-driven policy change. Full article