Search Results (10,551)

Flooding is one of the most persistent and destructive natural hazards in West Virginia. However, community-scale assessments that connect social vulnerability with physical flood vulnerability are still limited. Existing floodplain management plans often focus on infrastructure and hydrology, overlooking how socioeconomic disparities shape resilience. This study assesses flood resilience in West Virginia communities by connecting socioeconomic vulnerability with physical flood vulnerability. Using data from the American Community Survey (ACS) and state floodplain maps, we developed a Socioeconomic Vulnerability Index (SEVI) and combined it with physical indicators, such as the percentage of residential buildings in the 100-year floodplain, the share of mobile homes in flood-prone areas, the presence of essential facilities and community assets within flood zones, and the proportion of roads submerged by at least one foot of water. Incorporated and unincorporated communities were analyzed separately to reflect differences in governance and service capacity. The results reveal that high flood vulnerability areas often coincide with high socioeconomic vulnerability, especially in the southern and southeastern counties, where long-term economic decline has increased risks. Communities like McDowell and Mingo face a combined challenge of social and physical vulnerability, adding pressure to populations already dealing with limited resources. These findings emphasize the importance of integrated resilience planning that combines physical protection with social support. Considering the increasing intensity of extreme precipitation events associated with climate change, these findings also highlight the importance of incorporating long-term climate considerations into flood resilience planning. Policy suggestions include expanding targeted flood insurance subsidies for low-income households, prioritizing the relocation or retrofitting of mobile homes and essential facilities, investing in green and open spaces, and encouraging community-based mitigation strategies. Together, these actions can lower long-term flood risks while addressing structural inequalities that make certain populations more vulnerable. Full article

This study introduces an intelligent output feedback hybrid $H_2/H_{\infty }$ robust controller for a pumped storage unit regulation system (PSURS), utilizing an enhanced salp swarm algorithm (ISSA). A linearized PSURS model is developed through transfer function analysis. Utilizing this model, a robust controller design is executed using linear matrix inequalities (LMIs) to craft an output feedback hybrid $H_2/H_{\infty }$ controller that aims for both optimal and robust performance. The $H_2/H_{\infty }$ controller designed in this paper boasts a straightforward structure that eliminates the need for multiple-state feedback, simplifying its integration into practical PSURS applications. In addition, the ISSA plays a critical role in the design phase by optimally tuning the weight parameters of the controller to ensure its effectiveness. Simulation tests have demonstrated that this newly developed intelligent output feedback hybrid $H_2/H_{\infty }$ robust controller markedly enhances the stability of the PSURS. It shows superior control quality and robustness compared to traditional controllers. Furthermore, when applied to a multi-machine power system within PSURS simulations, this controller effectively improves system damping and helps mitigate frequency fluctuations. Full article

Background/Objectives: Secondary prevention after a first acute myocardial infarction (AMI) is crucial to reduce complications and improve long-term outcomes. Persistent gender inequalities in cardiovascular care suggest differences in post-AMI healthcare pathways between men and women. Understanding these trajectories could guide post-discharge clinical management, secondary prevention, and follow-up after acute myocardial infarction. This study aimed to describe healthcare pathways following a first AMI and explore gender inequalities within these trajectories. Methods: We conducted an observational, population-based study using real-world data (RWD) from the CARhES cohort. A total of 4298 individuals discharged alive after a first AMI between 2017 and 2022 were included. Healthcare trajectories during the 90 days following discharge were reconstructed across primary and specialised care, emergency services, and hospital admissions, and stratified by sex and the occurrence of clinical outcomes. Results: Post-AMI care pathways were highly heterogeneous. Although general practitioners often served as the first point of contact, most trajectories began in emergency departments. Patients with clinical outcomes showed higher healthcare utilisation. Women accessed primary care more frequently, whereas men showed greater use of specialised services and higher readmission rates, patterns that may reflect differences in follow-up strategies and clinical management during the early post-discharge period. Despite this variability, overall trajectories showed no significant sex-based differences. Conclusions: Post-AMI care pathways are complex and variable, with gender differences in patterns of service use. Women more often accessed scheduled care, while men relied more on emergency services. These findings highlight the need for gender-sensitive post-discharge follow-up to guide clinicians in secondary prevention strategies for AMI. Full article

This paper investigates how climate shelter initiatives implemented in European cities interact with National Adaptation Strategies (NAS) and National Adaptation Plans (NAP), assessing the degree of vertical integration between local practices and national climate adaptation frameworks. As urban heat increasingly threatens public health and exacerbates socio-spatial inequalities, climate shelters, conceived as networks of safe, accessible public spaces providing thermal comfort and social support, have emerged as innovative adaptation tools; however, their recognition within national policy architectures remains uneven across the EU. This study adopts a qualitative–comparative design structured in three phases: (i) a systematic review of NAS and NAP in the 27 EU Member States through keyword screening and classification of references as explicit, implicit, or absent; (ii) a mapping of climate shelter initiatives across 244 NUTS-2 capital cities; and (iii) an integrative cross-analysis of national frameworks and local implementation patterns. According to our results, only 4 Member States explicitly refer to climate shelters, 11 include implicit references, and 12 show no recognition, while 88 cities implement 97 initiatives, predominantly based on Nature-based Solutions and schoolyard transformations; 5 recurring governance configurations reveal bottom-up, top-down, and hybrid dynamics, demonstrating that local experimentation can anticipate, complement, and potentially reshape national adaptation policies. Full article

This study examines the impact of family multidimensional poverty on cognitive function among older adults in China using the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Filling a critical gap in the existing literature, we construct a multidimensional poverty index (MPI) based on the Alkire-Foster methodology to evaluate cognitive decline within the context of China’s post-poverty-eradication landscape. Utilizing quantile regression analysis, our findings demonstrate that multidimensional poverty exerts a significant, negative effect on cognitive function, which is more pronounced among individuals at lower cognitive quantiles, consistent with the cumulative disadvantage theory. Furthermore, we identify substantial urban–rural and regional disparities, revealing unique socio-economic inequalities. By linking multidimensional poverty to elderly cognitive health through psychosocial pathways, this study provides empirical evidence that reducing multidimensional deprivation among older adults is integral to achieving both SDG1 and SDG3 in China’s post-eradication context, demonstrating that income-based metrics alone are insufficient to capture the full burden of poverty on elderly cognitive health. Full article

Urban mental health is increasingly influenced by daily environmental exposures, yet limited empirical evidence exists regarding how the spatial configuration of blue–green environments, rather than their mere quantity, relates to emotional behavior in high-density cities. Guided by restoration theories and a perception-based perspective on landscape integration, this study analyzes the urban core of Shanghai by linking blue–green configurations to emotional states inferred from 20,907 geotagged social media facial photographs. Facial expressions serve to derive indices for emotional valence and arousal. The results demonstrate significant spatial clustering of emotional behavior, where hotspots are concentrated in higher-quality and more open settings, while coldspots cluster in dense areas with sparse vegetation. Emotional behavior also exhibits demographic heterogeneity, as females display higher valence and arousal than males. Furthermore, happiness tends to increase with age across both genders, whereas arousal declines specifically among male age groups. Crucially, emotional outcomes align more consistently with landscape integration and configuration than with isolated blue or green areas. Factors such as high connectivity, superior vegetation condition, and configurations featuring water embedded within green space are associated with favorable emotional responses. Conversely, extensive edge-dominated interfaces and high traffic exposure correlate with less favorable outcomes. These findings suggest a shift in blue–green planning from increasing total area toward optimizing spatial composition. Specifically, priority should be given to embedded and cohesive designs alongside the reduction of ambient stressors to foster emotionally supportive environments in dense urban cores. Methodologically, image-derived behavioral traces provide a scalable and ecologically grounded approach for investigating place-based affect at a city scale. Full article

Regional economic inequality remains a persistent challenge in developing economies, particularly in peripheral regions characterized by fragmented geography and uneven development. This study examines spatial spillovers in regional economic inequality by integrating spatial econometric analysis with remote sensing-based indicators. Using district-level data from Eastern Indonesia, the analysis captures how inequality is shaped by spatial interdependence and localized development patterns rather than isolated regional characteristics. Regional economic inequality is measured using a district-level relative Williamson-type index, allowing inequality to vary across space within provincial contexts. To account for spatial dependence, the study employs a spatial econometric framework and evaluates alternative model specifications. In addition to conventional economic indicators, the analysis incorporates satellite-derived measures of economic activity, urbanization, and energy potential to capture spatially observable dimensions of regional development. The results reveal pronounced spatial clustering of regional economic inequality, indicating that disparities are structured by localized spatial interactions. Economic development and spatially distributed urbanization are closely associated with inequality patterns, while the dispersion of economic activity appears to be linked to more balanced regional outcomes. In contrast, natural resource potential alone does not systematically explain spatial inequality, highlighting the importance of complementary institutional and spatial factors. This study contributes to the regional economics literature by demonstrating the value of integrating remote sensing-based indicators into spatial inequality analysis. The findings underscore the need for spatially explicit, place-based development strategies to address persistent regional disparities in peripheral regions of developing economies. Full article

This study examines how justice-oriented modeling lessons promote elementary students’ capacity to mathematize complex situations, develop civic empathy, and take action to address inequities and injustices in their communities. Through qualitative methods using multiple data sources including teacher interviews, lesson transcripts, student work, and classroom artifacts we share cases of modeling tasks that use mathematics as an empowerment tool to address empathy, representation, access, fairness and taking action. Findings illustrated critical moment-to-moment instructional decisions teachers made to elicit students’ justice-oriented reasoning. The modeling tasks involved addressing food waste in the school cafeteria, creating an inclusive play area, diversifying the school library collections, and choosing items for a sensory space to positively impact students’ individual and community well-being. Implications for teachers and teacher educators will be discussed. Full article

Inclusion and preference relations are fundamental comparison tools in intuitionistic fuzzy set (IFS) theory and play an important role in decision analysis under uncertainty. In IFS representations, the hesitation degree reflects information that is not captured by membership and non-membership values alone. This study investigates the structural relationship between hesitation and the inclusion and preference relations of IFSs. A proposed interpretation of membership and non-membership degrees is employed to provide a geometric perspective on hesitation. Within this framework, analytical relations between hesitation inequalities and preference conditions are derived. In particular, it is shown that the hesitation inequality constitutes a necessary condition for preference, whereas inclusion relations remain compatible with a wider range of hesitation configurations. The theoretical observations are illustrated using electoral datasets from the 2002 South Korean presidential election and the 2000 United States presidential election in Florida. Regional vote shares are transformed into intuitionistic fuzzy representations to analyze the distribution of hesitation across regions. The examples demonstrate how hesitation may influence the stability of preference relations while inclusion relations remain structurally preserved. Full article

Urban parks are vital for enhancing residents’ quality of life. With ongoing urban expansion, park visitation and quality expectations have risen, yet research on ecosystem disservices—i.e., the negative impacts of parks—remains limited compared with studies on ecosystem services. This study addresses this gap by investigating why residents may avoid parks, focusing on how negative perceptions vary across different park types. Through questionnaire surveys conducted in 68 parks across five categories in central Beijing, residents’ concerns were analyzed. Findings show significant differences among park type: users of small neighborhood parks emphasized internal noise, infrastructure, and cleanliness; while users of medium and large regional park users prioritized safety risks, followed by landscape and infrastructure issues. Users of historically significant parks raised concerns related to overcrowding and plant emissions, while those of special theme parks highlighted issues related to the cultural or natural atmosphere. Accordingly, park renovation should adopt type-specific strategies rather than uniform approaches. Drawing on successful Beijing cases, targeted improvements and a sustainable business operation model are proposed to address funding limitations. These results align with China’s park classification framework and offer insights for international urban park management, ultimately contributing to improved resident well-being and reduced urban inequality. Full article

Extreme heat poses growing health risks in high-density cities, yet static assessments often fail to capture dynamic pedestrian exposure. This study quantifies the supply and demand disparity between urban shade provision and actual pedestrian demand in Fuzhou, China, during a specific extreme heat event. Integrating high-resolution mobile signaling data with dynamic urban shade simulations, we classified the road network into risk quadrants and analyzed behavioral drivers using XGBoost and SHAP algorithms. Results show a pronounced disparity: high-risk zones carry the highest pedestrian flows (a mean daily volume of 28.6 pedestrian trajectories per segment) but exhibit minimal shade coverage (3.14%), while comfort zones provide 5.5 times greater shading coverage for comparable activity levels. In contrast, surplus zones exhibit substantial shading capacity but limited pedestrian use, indicating inefficient spatial allocation of cooling resources. Further analysis shows that pedestrian accumulation in high-risk zones is primarily driven by functional necessity, whereas pedestrian flows in comfort zones are more sensitive to thermal conditions. These findings reveal structurally embedded thermal exposure risk and support a shift from static metrics toward dynamic urban planning to protect vulnerable pedestrian flows. Full article

Structural racism and discrimination (SRD) is a fundamental cause of health inequities that emerge during adolescence and persist throughout adulthood. This scoping review systematically synthesizes the evidence on policy and community-level interventions designed to disrupt SRD exposure among Black adolescents and mitigate its impact on their health behaviors and outcomes. Following PRISMA-ScR guidelines, we searched five databases for peer-reviewed intervention studies published through October 2025. Of 3417 abstracts screened, 9 studies met inclusion criteria. We examined the study characteristics, theoretical frameworks, implementation strategies, and effectiveness of interventions targeting three primary mechanisms of SRD exposure for adolescents. The majority focused on neighborhood and social integration interventions, with limited representation of resource-based and school-based approaches. Culturally grounded, community-engaged interventions buffered SRD’s negative effects on mental health, empowered youth as change agents, and removed structural barriers to health-promotive resources. The review identified several gaps in the research, including methodological and theoretical rigor, geographic contexts, and follow-up. Findings underscore the potential of culturally grounded, multilevel interventions to reduce inequities across mental health, physical health, and social outcomes for Black youth. This review highlights the need to expand systems-level interventions that address the root causes of the persistent racial health inequities experienced by Black youth. Full article

Background: Sub-Saharan Africa is undergoing a rapid epidemiological transition marked by a growing burden of non-communicable diseases, including breast, cervical, ovarian, and uterine cancers, which constitute major causes of morbidity and mortality among women in the region; however, comprehensive assessments of long-term trends and regional heterogeneity remain limited. This study examines the burden and temporal trends of breast, cervical, ovarian, and uterine cancers across sub-Saharan Africa from 1990 to 2023. Methods: A retrospective ecological analysis was conducted using data from the latest Global Burden of Disease 2023 study. Age-standardised incidence rates, mortality rates, and disability-adjusted life year rates were estimated for breast, cervical, ovarian, and uterine cancers across 48 sub-Saharan African countries and four sub-regions. Temporal trends were assessed from 1990 to 2023, with percentage changes calculated to characterise epidemiological transitions. Geographic variation and age-specific patterns were examined to identify high-burden settings and priority populations. Results: Between 1990 and 2023, the burden of all four cancers increased substantially across sub-Saharan Africa, with significant regional and country-level heterogeneity. Breast cancer exhibited the largest absolute burden, with incidence increasing by over 120 percent and mortality by more than 80 percent, particularly in Central and Western Africa. Cervical cancer remained the leading cause of cancer-related mortality among women in Eastern and Southern Africa, despite evidence of stabilisation or decline in selected countries. Ovarian and uterine cancers demonstrated sustained upward trends, especially in Central Africa, with high mortality-to-incidence ratios indicating late diagnosis and limited treatment access. Across all cancer types, Central and Eastern sub-Saharan Africa consistently experienced the highest disability-adjusted life year burdens. Conclusions: The burden of the selected cancers in sub-Saharan Africa has increased markedly over the past three decades, with persistent regional inequities reflecting gaps in prevention, early detection, and treatment capacity. Strengthening cancer surveillance systems, expanding equitable access to screening and vaccination programmes, and improving diagnostic and treatment infrastructure are critical to reversing current trends. These findings provide region-specific evidence to guide cancer control priorities and resource allocation across sub-Saharan Africa. Full article

Mountain Social–Ecological Systems (MtSES) are global assets, providing essential ecosystem services to nearly half of humanity, yet they are disproportionately vulnerable to global change, experiencing “polytraps” of depopulation, poverty, and environmental degradation. Despite the inherent human dimension in sustainability, the social pillar remains conceptually chaotic, forming a highly fragmented “publication labyrinth”, and is often neglected in favor of more easily quantifiable environmental and economic metrics. These oversights leave mountain communities in a precarious state, underscoring an urgent need for robust, context-specific assessment tools. This paper addresses this critical gap by employing a two-step methodology: first, a literature review identifies prevailing social sustainability issues in mountain contexts; second, a comparative analysis evaluates prominent frameworks and indicator-based tools against these themes, using Ostrom’s multi-tier Social–Ecological Systems (SES) framework as the theoretical lens. Our findings reveal a persistent environmental bias in MtSES research and highlight the necessity for frameworks that integrate local knowledge, address power imbalances, and support bottom-up governance. A tool is proposed with indicators specifically for mountainous contexts. This study contributes to theory by offering a structured approach to unpack the elusive “social” in SES and to practice by providing a model and tool for developing actionable, context-sensitive social sustainability assessments, thereby fostering resilience and equitable development in vulnerable mountain regions. Ultimately, by operationalizing these social dimensions, this research provides a direct roadmap for achieving key United Nations Sustainable Development Goals in marginalized high-altitude contexts, particularly focusing on No Poverty (SDG 1), Good Health and Well-being (SDG 3), Reduced Inequalities (SDG 10), Sustainable Communities (SDG 11), and Peace, Justice, and Strong Institutions (SDG 16). Full article

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