Search Results (10,536)

Background/Objectives: Sizeable between- and within-country inequalities in childhood immunization impair progress towards the goals set by the global Immunization Agenda 2030 (IA2030) of achieving universal coverage of all persons with essential life-saving vaccines. Monitoring global trends in immunization inequalities helps to identify population subgroups that are less likely to benefit from vaccines and provides evidence for tracking progress on regional and global goals and informing equity-oriented interventions. This paper assesses the state of within-country inequality in childhood immunization across low- and middle-income study countries. Methods: Using data from household health surveys, the analysis quantifies within-country inequality across up to 92 countries, areas and territories, for nine childhood immunization indicators (seven coverage indicators and two indicators of non-receipt of vaccines) by five dimensions of inequality (child sex, mother’s age, mother’s education, household economic status and place of residence). Absolute and relative summary measures of inequality (difference, ratio, slope index of inequality, relative index of inequality and population attributable risk) were calculated to assess the latest situation of inequality (i.e., using the most recent survey from 2014 to 2023) and change over time (i.e., comparisons with data from 2004 to 2013). Results: The latest situation of inequality revealed overall low or no inequality by child sex, mother’s age and place of residence, with more pronounced inequality related to mother’s education and household economic status. The median differences between the most and least educated subgroups ranged between 9 and 14 percentage points for immunization coverage indicators, and between 6 and 9 percentage points for non-receipt of vaccines indicators. The extent of inequality in childhood immunization tended to remain about the same as the previous decade, with modest reductions in absolute economic-related and place of residence inequality in DTP3 immunization, as well as place of residence inequality in full immunization (declining by 3.25, 2.42, and 2.16 percentage points over 10 years, respectively). Distinct patterns of economic-related inequality were evident across country income groups, with low-income countries reporting larger inequality than lower- and upper-middle-income countries; there was substantial variation at the country level. Conclusions: Economic- and education-related inequalities in childhood immunization within low- and middle-income countries have persisted over the past decade. Full article

In this paper, a non-decomposition approach is adopted to study the robust stability of quaternion-valued neural networks (QVNNs) with leakage, discrete, and neutral time delays, and the parameter uncertainty is also considered. The existence and uniqueness of the equilibrium of QVNNs are proved by the homogeneous mapping theorem. By constructing appropriate Lyapunov functions and employing quaternion modulus inequality techniques, sufficient conditions for the global robust stability of QVNNs are presented. Notably, the considered QVNN is treated as a whole rather than being decomposed into complex-valued neural networks (CVNNs) or real-valued neural networks (RVNNs), which faithfully reflects the internal connections between quaternion neurons. Two numerical examples are used to verify the validity of the obtained conclusions. Full article

Media-based cultural diversity education is approached here as an analytical synthesis that brings together established research traditions in media and communication studies, including mediatization, representation, and framing. It refers to the process through which media are understood to function as informal educational environments that shape how audiences learn about and interpret cultural differences. In contemporary mediatized societies, media institutions, including television and digital platforms, are understood to shape public understandings of diversity through the selection, framing, and visual representation of minority groups. Television is widely regarded as a particularly influential medium because of its wide reach and its institutional role in producing authoritative narratives about social reality. Through news reporting, documentaries, and other factual programming, television has been shown to circulate meanings about cultural diversity and provide audiences with interpretive frameworks through which minority groups are publicly understood. These communicative practices have been shown to influence how audiences perceive cultural difference, interpret social issues, and negotiate questions of belonging within society. By organizing narratives, frames, and visual repertoires through which cultural groups are portrayed, television has been shown to contribute to the formation of shared social knowledge about diversity and about relationships between majority and minority communities. In this sense, television can be understood not only as a channel of information but also as a cultural institution that shapes symbolic boundaries between social groups and influences perceptions of inclusion and exclusion. As an illustrative context, this entry also refers to representations of Roma communities in Central European media environments, where antigypsyism may be understood as a mediated cultural process embedded in everyday media communication. Full article

Background: Urticaria, particularly chronic urticaria (CU), is a highly prevalent inflammatory skin disorder characterized by recurrent wheals and/or angioedema with a fluctuating and unpredictable course that significantly impairs quality of life and requires long-term monitoring. Despite established therapeutic guidelines, disease control remains suboptimal in a considerable proportion of patients. Telemedicine has emerged as a promising adjunctive strategy for chronic disease management. This review aims to critically evaluate the role, applications, benefits, and limitations of telemedicine and digital health interventions in urticaria management. Methods: A scoping review of the literature was conducted focusing on studies addressing telemedicine, digital patient-reported outcomes, mobile health applications, and remote monitoring strategies in urticaria. Evidence from pandemic and post-pandemic telemedicine models was also analyzed to identify transferable approaches. Results: Telemedicine demonstrates significant potential in urticaria management by enabling structured symptom monitoring, facilitating remote follow-up during therapeutic escalation (including biologic therapies), improving patient empowerment and adherence, and reducing healthcare utilization and indirect costs. Digital tools such as electronic diaries and validated PRO-based applications support continuous disease assessment. However, telemedicine cannot replace direct clinical examination, and limitations include diagnostic uncertainty, digital inequalities, data privacy concerns, and lack of large disease specific trials. Conclusions: Telemedicine represents a valuable complementary and integrative model for urticaria care, particularly suited for chronic disease monitoring. Hybrid care pathways combining remote and in-person management appear to be the most effective and sustainable strategy. Further high-quality urticaria-specific studies and standardized digital frameworks are required to optimize its clinical implementation. Full article

This study presents a comparative analysis of residential segregation among the three largest foreign-born populations residing in Spain: Moroccans, Romanians, and Colombians. Using data from Spain’s Population and Housing Census (INE), the research analyzed the segregation index across 34 urban areas in medium-sized cities. Three urban areas in Catalonia were selected for the intraurban case studies, and Pearson correlation coefficients were calculated for 60 sociodemographic variables. The objectives were to identify indicators that helped diagnose potential segregation contexts and to explore residential patterns by country of origin. The study was grounded in a central premise: the foreign-born population cannot be treated as a homogeneous group, as aggregation conceals group-specific inequalities and differentiated spatial configurations. The findings showed that segregation occurred. Moroccans exhibited the highest levels of segregation, which was associated with socioeconomic vulnerability and also a marked residential preference for central urban areas. Colombians displayed lower levels of segregation and greater territorial dispersion, pointing to broader residential access. Romanians presented intermediate and heterogeneous patterns, which combined localized concentrations with peripheral settlement. The results highlighted how intraurban differentiation emerged from interactions between different migrant profiles, housing opportunity structures, and urban morphology, providing an empirical basis on which to design targeted urban policies. Full article

Thermodynamics is commonly presented as a theory of macroscopic systems in stable equilibrium, built upon assumptions of extensivity and scaling with system size. In this paper, we present a universal formulation of the elementary foundations of thermodynamics, in which entropy and energy are defined and employed beyond equilibrium and without assuming extensivity. The formulation applies to all systems—large and small, with many or few particles—and to all states, whether equilibrium or nonequilibrium, by relying on carefully stated operational definitions and existence principles rather than macroscopic idealizations. Key thermodynamic concepts, including adiabatic availability and available energy, are developed and illustrated using the energy–entropy diagram representation of nonequilibrium states, which provides geometric insight into irreversibility and the limits of work extraction for systems of any size. A substantial part of the paper is devoted to the analysis of entropy transfer in non-work interactions, leading to precise definitions of heat interactions and heat-and-diffusion interactions of central importance in mesoscopic continuum theories of nonequilibrium behavior in simple and complex solids and fluids. As a direct consequence of this analysis, Clausius inequalities and the Clausius statement of the second law are derived in forms explicitly extended to nonequilibrium processes. The resulting framework presents thermodynamics as a universal theory whose concepts apply uniformly to all systems, large and small, and provides a coherent foundation for both teaching and modern applications. Full article

In recent years, we have seen a constant increase in the capabilities of walking robots, leading to early cases of their practical use, and a much broader application is expected in the near future. However, creating a robust control design (in the presence of disturbances and model uncertainties) for walking robots still remains a challenge. One challenging source of uncertainty is the combination of the contact constraints and the lack of full state information, which can potentially lead to an offset (a steady-state error) in the robot’s position, interfering with tasks requiring high accuracy and deteriorating the overall performance of the robot. This is further exacerbated by the presence of multiplicative model uncertainties, common to mobile robots. In this work, we introduce an $H_{\infty }$ control formulation designed to attenuate this type of disturbance. The proposed method can handle norm-bounded multiplicative uncertainties in the state, control, and disturbance matrices using a full-state static feedback control. The resulting control design procedure is a single semidefinite program which provides a large computational advantage over the alternative dynamic feedback controller methods. We demonstrate the effectiveness of the method in comparison with the alternative formulations in simulation. We demonstrate that the method can be effectively tuned using a regularization term in the cost function. We show that the upper bounds on the $H_{\infty }$ gain of the closed-loop system can be effectively tightened post control design. Full article

Gender-based violence in public transportation is a global phenomenon that restricts women’s rights and autonomy. Most of the documentation relies on harassment and physical aggression, but the subtle internalized mechanisms that reproduce gender inequities remain insufficiently analyzed. This study involves the concept of symbolic violence as an analytical category to unveil how resignation and normalization of violence perpetuate gender power relations and limit women’s mobility. A cross-sectional survey of 263 women aged 15–60 was conducted in Querétaro, Mexico, a rapidly growing city with significant mobility challenges. The questionnaire included items on perceptions of safety, violent experiences, responses to acts of violence, and prevention strategies. An inductive–abductive analysis was implemented to construct empirical indicators derived from Bordieu’s concept of symbolic violence and habitus. Findings reveal that fear, avoidance, and self-regulation are normalized responses to violence in public transport. Women implement strategies such as changing routes, limiting night travel, or increasing their expenses to access safer options. Six empirical indicators were identified: perceived insecurity as normality, resignation to harassment, bodily and emotional self-regulation, preventive reorganization of mobility, personal costs of safety, and collective inaction. In conclusion, the study demonstrates how symbolic violence operates through behaviors, actions, perceptions, and thoughts that reproduce inequities. Operationalizing symbolic violence provides a methodological and conceptual tool to advance gender equality and inform gender-sensitive mobility policies. Full article

Students attending tracks in mainstream schools with low achievement levels, special needs classes in mainstream schools, or classes in special needs schools, and/or with migration backgrounds are disadvantaged in the school-to-work transition. Their chances of finding an apprenticeship and the level of their person–job fit are lowered. Migration background was differentiated into four clusters characterized by the dimensions high/low warmth and high/low competence according to the Stereotype Content Model. Teacher support can potentially have remedial effects. Data was collected using student questionnaires and student achievement tests. Stepwise multilevel regression analyses using a sample of 1388 ninth graders in Switzerland showed that for students attending classes with low achievement levels and with migration backgrounds, the chances for a direct transition to VET and to establish a high person–job fit are reduced. Further, teacher support can improve the chances in the labor market for those students whose nationality is stereotyped as warm. Teacher support can also improve the person–job fit for students of nationalities stereotyped as warm and competent. Therefore, teacher support can reduce disadvantages in the school-to-work transition only for students whose nationalities are stereotyped as warm. Full article

Background: Frequent and short-term repeat visits place significant pressure on primary care-centered health systems, particularly in large metropolitan areas. Istanbul, with its high population density and heterogeneous sociodemographic profile, presents a unique context for understanding short-interval healthcare utilization dynamics. Objective: To examine short-term repeat healthcare utilization following an index primary care visit and to explore how district-level population and socioeconomic characteristics shape early post-visit care-seeking dynamics in a large metropolitan setting. Methods: This retrospective cohort study analyzed protocol records from 225 randomly selected FMUs across Istanbul. A total of 11,101 individuals who presented on 7 July 2025 were followed for 21 days, during which 26,743 healthcare contacts (index family medicine unit visits, recurrent FMU visits, and secondary/tertiary care visits) were captured. FMU repeat visits, higher-level utilization, district-level population density, and socioeconomic development level (SEGE-2022) were analyzed using descriptive statistics and district-level comparative analyses. Results: During the 21-day follow-up period, participants generated a total of 26,743 healthcare contacts. Across the full cohort, the median number of recurrent FMU visits was 0 (IQR 0–1), and the median number of secondary/tertiary visits was 0 (IQR 0–1). Among individuals who had repeat contacts, the median number of recurrent FMU visits was 1 (IQR 1–2), and the median number of secondary/tertiary visits was 1 (IQR 1–2). Repeat visits clustered in the first 7 days, whereas higher-level visits increased between days 10–21. Districts with lower SEGE status and high population density (e.g., Esenyurt, Bağcılar, Pendik, Küçükçekmece, Ümraniye) exhibited markedly higher repeat visit intensity. Spatial patterns indicated substantial clustering in western and socioeconomically disadvantaged districts. Multivariable regression analysis showed that visitor patient status was associated with higher secondary/tertiary care utilization (OR = 1.14, 95% CI 1.04–1.24), while higher SEGE scores were modestly associated with increased repeat FMU visits. Conclusions: Short-term repeat visits in Istanbul appear to be influenced not only by clinical needs but also by broader contextual factors such as socioeconomic disadvantage, population density, and health system organization. These findings suggest potential structural pressures within Türkiye’s primary care-centered system and highlight the potential value of district-specific interventions. Full article

Globalisation, accompanied by the rapid advancement of digital technologies, has become the bedrock of contemporary economies. However, the global digital divide has hindered many economies from enjoying the benefits of enhanced digitalisation. This study addresses the question: to what extent is there evidence of digital convergence or divergence among global economies, and what specific patterns of club clustering exist within the African continent? Employing a quantitative research design with secondary panel data from 123 countries (38 African), the study applies the Phillips and Sul convergence and club clustering algorithm to analyse digitalisation trends. The findings reveal that African countries exhibit significantly stronger within-club convergence dynamics than broader developing country groups, with Africa’s adjustment speed (σ = 2.5624) exceeding the Global South average (σ = 0.8394) by more than threefold. This indicates that African nations are following a similar ICT development trajectory and catching up with other global regions at an accelerated rate. However, the study identifies substantial digital inequality within Africa itself, as countries fail to converge to a single steady state, instead forming distinct convergence clubs. These results underscore that digitalisation follows a systematic and continuous process determined by both technological advancement and countries’ absorptive capacity to adopt these technologies. Full article

Background: Informal sewing workers are widely exposed to ergonomic and workload-related risks but remain largely excluded from formal occupational health protection, particularly in low- and middle-income countries. This study evaluated integrated physical and mental workload risks associated with WMSDs among informal sewing workers to develop contextually feasible preventive guidelines based on the Hierarchy of Ergonomic Control. Methods: A mixed-methods study was conducted among 150 informal sewing workers in Ubon Ratchathani Province, Thailand. Quantitative data were collected using a structured questionnaire, the Rapid Upper Limb Assessment (RULA), the Nordic Musculoskeletal Questionnaire (NMQ), and the NASA Task Load Index (NASA-TLX). Associations between sociodemographic characteristics, ergonomic risks, and WMSDs were analyzed using chi-square tests and correlation analysis. Qualitative data were obtained through a focus group discussion with key stakeholders to develop ergonomic control strategies guided by the HEC framework. Results: The majority of participants were female and middle-aged, with widespread exposure to high-risk ergonomic conditions, including prolonged sitting, repetitive tasks, and awkward postures. A high prevalence of WMSDs was observed, particularly in the neck, shoulders, and back. Younger workers and those with lower educational attainment experienced significantly higher ergonomic risk exposure and WMSD prevalence. NASA-TLX results indicated that physical demand and performance pressure were the main contributors to overall workload. Application of the HEC framework showed that elimination and substitution controls were the most effective strategies for reducing ergonomic risks, followed by engineering controls, while administrative measures and personal protective equipment were less effective. Conclusions: Informal sewing workers face substantial ergonomic and mental workload risks that contribute to a high burden of WMSDs. Prioritizing higher-order ergonomic controls, integrating workload management, and implementing community-based ergonomic interventions are essential to improving occupational health and reducing inequities among informal workers. Full article

Respiratory Syncytial Virus infection is a significant cause of morbidity and mortality in infants. Maternal vaccination with the bivalent vaccine Abrysvo^® in the third trimester (24–36 weeks) is an effective strategy to prevent severe respiratory illnesses in newborns. However, the introduction of this new technology faces structural obstacles that amplify inequalities. This rapid literature review sought to map and synthesize evidence on inequalities and inequities in adherence and accessibility to maternal vaccination among Black pregnant women. A rapid literature review was conducted using a mixed-methods approach (narrative synthesis and thematic analysis), following guidelines adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Handbook. The research question was structured using the acronym Population/Problem, Exposure, Comparison, and Outcome, focusing on Black pregnant women, maternal vaccination, comparison with other groups, and barriers/determinants. The search was conducted in databases such as PubMed (via Medical Literature Analysis and Retrieval System Online), Scopus and Literatura Latino-Americana e do Caribe em Ciências da Saúde, covering studies published between 2022 and 2025 that presented disaggregated analysis by race. The analysis and interpretation of the findings were guided by Critical Race Theory. The analysis of the twelve included studies (mainly from the United States, the United Kingdom, and Brazil) revealed systematic and robust disparities. Black pregnant women had lower vaccination coverage and were less likely to receive timely recommendations compared to White pregnant women. The barriers identified include: institutional distrust (resulting from structural racism), poor access to prenatal care, inadequate communication, and socioeconomic factors. Inequities are structural and multifactorial phenomena. To ensure that the benefits of the vaccine are distributed equitably, strategies such as anti-racist training for healthcare teams, active vaccination outreach, and continuous monitoring of data disaggregated by race are essential. Full article

Background: Individuals with intellectual and developmental disabilities (IDD) experience persistent health disparities that result in poorer health outcomes, reduced quality of life, and inequitable access to healthcare. Objective: This narrative review synthesized existing literature to identify key barriers to health equity and contributors to health disparities among individuals with IDD. Method: This study was a narrative (non-systematic) review that adopted a qualitative synthesis approach. A literature review was conducted across PubMed, CINAHL, PsycINFO, Medline, and Google Scholar to identify peer-reviewed articles published between 2010 and 2025 that address health disparities, health inequities, healthcare barriers, and social determinants of health among individuals with IDD. Thematic analysis was employed to synthesize the included studies and identify recurring patterns and themes. Results: A total of 88 articles were included. Two overarching domains shaping health disparities were identified: barriers to health equity and contributing factors. Seven barrier categories emerged: attitudinal, communication, policy, programmatic, social, physical, and transportation. Five key contributors were also identified: limited access to healthcare, comorbid conditions, low health literacy, adverse social determinants of health, and caregiver burden. Conclusions: Health disparities among individuals with IDD are driven by intersecting social, structural, and healthcare system barriers rather than individual limitations alone. This review informs policymakers, public health professionals, and interventionists on how to advance health equity for individuals with IDD through targeted, person-centered interventions. Full article

Workspace digitalisation presents a transformative shift from traditional, physically bounded offices to virtual, technology-enabled environments. Digital technologies like cloud computing, artificial intelligence, and the Internet of Things enable remote collaboration, data accessibility, and operational efficiency, thereby accelerating this transformation. Digital workspaces transcend geographical limitations, enabling a more flexible, inclusive, and adaptive work culture. They offer better work–life balance, with flexible options, reduced commuting time, and increased personal autonomy and control over commitments, compared to traditional workspaces. Despite these benefits, digitalisation creates cybersecurity, data privacy, and digital divide issues, where unequal access to digital tools and skills can exacerbate social and economic inequalities. The lack of physical interaction affects team cohesion and company culture. Hence, this paper explores these phenomena to uncover their implications and consider possible strategies to optimise workspace digitalisation, providing a comprehensive systematic review of extant literature within the study context, offering pragmatic insights and recommendations for workspaces. This study has found workspace digitalisation to be a complex, multifaceted phenomenon that provides flexibility, efficiency, and innovation, but also poses challenges that must be carefully managed. It postulates that as technology and work progress, a hybrid model that blends digital and traditional workspaces would be suited to each organisation’s needs and goals. Full article