Search Results (796)

Background: Subclinical respiratory impairment among non-smokers in regions with haze-affected regions is still under-recognized, particularly in low- and middle-income countries (LMICs). This study assessed the prevalence of subclinical respiratory impairment among non-smoking adults and examined its determinants and associations with health-related quality of life (HRQoL) in Chiang Mai, Thailand. Methods: In this cross-sectional study, 244 non-smoking adults (18–65 years) from three rural districts underwent standardized spirometry and completed the Thai WHOQOL-BREF-26. Subclinical impairment was defined as an FEV₁/FVC < 0.70 or FVC < 80% predicted in the absence of symptoms. Demographic, occupational, and environmental information was obtained through structured questionnaires. Statistical analyses included non-parametric tests, univariate linear regression, and logistic regression. Results: A total of 37 participants (15.2%) had subclinical respiratory impairment. No demographic, occupational, or environmental factors such as sex, age, BMI category, agricultural work, marital status, and self-reported pollution exposure were found to be independently linked to impaired lung function. There was no correlation between spirometry indices and any WHOQOL-BREF domain. Elderly participants (>50 years) reported a higher level of physical and psychological HRQoL. Those with a higher Body Mass Index (BMI) were more likely to have a lower environmental quality of life. Farmers reported a better QoL, while women reported a lower QoL than men. Conclusions: Subclinical respiratory impairment occurs frequently in non-smoking rural adults exposed to haze pollution in Chiang Mai, and isn’t presently assessed by general HRQoL instruments. These findings support early spirometry screening for asymptomatic adults in polluted regions, as well as more stringent air cleanliness strategies to prevent the evolution towards overt respiratory pathology. Full article

Cervical cancer remains a significant global health burden, disproportionately affecting women in low- and middle-income countries despite being preventable. Since 2018, rapid advances in molecular profiling, immunotherapy, refinement of minimally invasive surgery, and targeted therapeutics have transformed diagnostic and therapeutic paradigms. This narrative review synthesizes clinical and translational progress across the continuum of care from 2018 to 2025. We summarize the evolving landscape of precision screening—including HPV genotyping, DNA methylation assays, liquid biopsy, and AI-assisted cytology—and discuss their implications for global elimination goals. Surgical management has shifted toward evidence-based de-escalation with data from SHAPE, ConCerv, and ongoing RACC informing fertility preservation and minimally invasive approaches. For locally advanced disease, KEYNOTE-A18 establishes pembrolizumab plus chemoradiation as a new curative standard, while INTERLACE underscores the benefit of induction chemotherapy. In the metastatic setting, survival outcomes have improved with the integration of checkpoint inhibitors (KEYNOTE-826, BEATcc, EMPOWER-Cervical 1), vascular-targeted therapies, and antibody–drug conjugates, including tisotumab vedotin and emerging HER2 and TROP-2–directed agents. We further highlight emerging biomarkers—PD-L1, TMB, MSI status, HPV integration patterns, APOBEC signatures, methylation classifiers, ctHPV-DNA—and their evolving role in treatment selection and surveillance. Future directions include neoadjuvant checkpoint inhibition, PARP-IO combinations, HER3-directed ADCs, DDR-targeted radiosensitizers, HPV-specific cellular therapies, and AI-integrated precision medicine. Collectively, these advances are reshaping cervical cancer care toward biologically individualized, globally implementable strategies capable of accelerating WHO elimination targets. Full article

Background: Studies on the association between cognitive and physical fitness in older adults from particularly vulnerable settings are scarce. This study aims to analyse the relationship between different protocols for assessing physical fitness and the cognitive function of low-income older adults. Methods: A total of 312 adults aged 60–96 years (M age = 72.63, SD= 7.81) living in the urban area of Amazonas, Brazil, participated in the study. The following measures of physical fitness were assessed: body composition, handgrip strength, the Five Times Sit-to-Stand Test and Senior Fitness Tests. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Linear regression models were used to analyse the relationship between physical function measures and cognitive function. Results: For men, only the 30-chair stand test power (β = 0.33, p < 0.001) presented favourable association with cognitive function. For women, significant associations between MMSE score were observed for every fitness test, except for the chair sit-and-reach test. Conclusions: Physical fitness is differently associated with cognitive function among low-income older men and women from Amazonas. Muscular fitness particularly seems to be an important indicator of cognitive function. It should be considered for monitoring, promoting, and managing health-ageing of low-income elderly populations of both sexes. Full article

In the context of China’s dual-carbon agenda and the Digital China initiative, elucidating the role of digital literacy in shaping consumption-based household carbon emissions (HCE) is essential for advancing low-carbon urban living and supporting a broader green transition. Existing research has rarely examined, at the individual level, how digital capability shapes household consumption decisions and the structure of carbon emissions. Accordingly, this study draws on matched household-individual microdata from the China Family Panel Studies (CFPS). We employ a two-way fixed effects model, kernel density analysis, and qualitative comparative analysis. We test the nonlinear effect of digital literacy on household consumption-related carbon emissions and examine its heterogeneity. We also examined the mediating role of perceived environmental pressure, social trust and income level. The research results show that: (1) The net impact of digital literacy on carbon emissions related to household consumption shows an inverted U-shaped curve, rising first and then falling. When digital literacy is low, it mainly increases emissions by expanding consumption channels, reducing transaction costs and improving convenience. Once digital literacy exceeds a certain threshold, the mechanism will gradually turn to optimize the consumption structure, so as to support the low-carbon transformation of individuals. (2) The impact of digital literacy on HCE is structurally different in different types of consumption. In terms of transportation and communication expenditure, the emission reduction effect is the most significant, and with the improvement in digital literacy, this effect will become more and more obvious. For housing-related consumption, the turning point appeared the earliest. With the improvement in digital literacy, its effect will enter the emission reduction stage faster. (3) Digital literacy can reduce carbon emissions related to household consumption by enhancing residents’ perception of environmental pressure and strengthening social trust. However, it may also increase emissions by increasing residents’ incomes, because it will expand the scale of consumption, which will lead to an increase in carbon emissions related to household consumption. (4) The heterogeneity analysis shows that as digital literacy improves, carbon emissions increase more strongly among rural residents, people with low human capital, low-income households, and women. However, the turning-point threshold for emission reduction is relatively lower for women and rural residents. (5) Low-carbon transitions in household consumption are shaped by dynamic interactions among multiple factors, and multiple pathways can coexist. Digital literacy can work with environmental responsibility to endogenously promote low-carbon consumption behavior. It can also, under well-developed infrastructure, empower households and amplify the emission-reduction effects of technology. Full article

Lavender is a perennial Mediterranean plant that has been cultivated throughout history for medicinal, aromatic, and cosmetic purposes. Due to its high economic and commercial value, it has become an important agricultural product worldwide. The low production cost, adaptability to environmental conditions, and demand for its versatile use in the global market make it a significant potential source of income for developing Mediterranean countries. This study aims to identify commercially suitable cultivation sites for Lavandula angustifolia Mill. using remote sensing (RS) and geographic information systems (GIS) technologies to support rural development. Within this scope, suitable cultivation habitat parameters for the species in open fields and natural conditions were determined; these parameters were weighted according to their importance using multi-criteria decision analysis (MCDA), and thematic maps were created for each parameter. The created maps were combined using weighted overlay analysis, and a final map was generated according to the suitability class. The results indicate that within the study area, 75,679.45 ha is mostly suitable, 388,832.71 ha is moderately suitable, 24,068.43 ha is marginally suitable, and 229,327.20 ha is not suitable. As a result, it has been observed that Lavandula angustifolia Mill., which is currently cultivated on approximately 4045 ha of land and contributes 429 tons of product to the regional economy, covers only a relatively small portion of the suitable cultivation sites identified in the study and is not utilized to its full potential. It is understood that the expansion of lavender cultivation in determined suitable sites has significant potential to substantially develop the region and its rural population in terms of both yield and production volume, and to involve women and youth entrepreneurs in agricultural employment. Full article

Background: Maternal health behaviors during pregnancy are crucial for maternal and fetal outcomes. While global research has explored that demographic, clinical, and psychosocial determinants significantly influence these behaviors, evidence from low- and middle-income countries (LMICs), including Albania, remains limited. This study aims to evaluate psychosocial perceptions and health behaviors related to lifestyle among pregnant women in a local Albanian community in order to identify which are higher risk subgroups that need targeted and tailored antenatal care interventions. Methods: This multicenter cross-sectional study included 200 pregnant women attending antenatal clinics from May to August 2024 in Vlora city, Albania. Participants were selected using consecutive sampling based on inclusion criteria. Data were collected through a validated questionnaire composed of five sections: demographic/obstetric data; maternal health behaviors; dietary diversity; physical activity, perceived stress; and social support. Clinical and anthropometric measurements were assessed by trained health professionals during antenatal visits. SPSS version 23.0 and binary logistic regression with p-value ≤ 0.05 statistically significant were used for data analysis. Results: Mean age was 28.3 ± 6.4 years, 71% employed and 83.5% urban residents. Key unhealthy behaviors included tobacco use (25.5%), alcohol consumption (10.5%), exposure to toxins (15%), and low dietary diversity (32%). We found significant correlations between low dietary diversity and rural residence (Adj OR = 2.48), hypertension (Adj OR = 6.88), and overweight/obesity (Adj OR = 2.33). Tobacco use was associated with unemployment and alcohol use with unemployment and hypertension variables. Low/moderate social support and high perceived stress were significantly related with multiple unhealthy behaviors, such as low dietary diversity, inadequate physical activity and antenatal care. Conclusions: Unhealthy nutritional behaviors, tobacco and alcohol use and low physical activity are more prevalent risk factors among pregnant women in Vlora city. Priority should be given to vulnerable groups, including rural residents, pregnant women with low social support, high perceived stress and those with hypertension and obesity. Interventions that integrate psychosocial support and health education into antenatal care services are urgently needed to enhance pregnancy outcomes in Albanian communities. Full article

Cervical cancer remains the fourth most common malignancy among women worldwide. Despite well-developed prevention measures, incidence and mortality continue to rise, especially in low- and middle-income countries due to low screening coverage and unavailability of human papillomavirus (HPV) vaccination. The cervical cancer screening coverage could be improved by the implementation of a self-sampling modality for HPV testing. Multiple research pieces support the validity and reliability of a self-sampling modality as an alternative approach to clinician-collected samples for primary cervical cancer screening via HPV genotyping. Moreover, growing research evidence on the self-sampling modality reception shows high acceptance of the method among screened populations. Studies on the self-sampling approach economic efficiency also revealed a high cost-effectiveness of HPV testing through a self-sampling modality compared to other screening modalities for cervical cancer. It is specifically important for low-resource settings, which should use the self-sampling cost advantages to improve cervical cancer screening coverage by attracting underscreened populations. Overall, self-sampling modality has a higher participation rate and better patient satisfaction reported; thus, the method is highly recommended by the World Health Organization for cervical cancer screening. Full article

Climate action has been deemed as fundamental to counteract the impacts of rising global temperatures on health which will disproportionately affect low-income populations, racial and ethnic minorities, women, and other historically marginalized groups. Along with poverty reduction, inequality mitigation, gender equality promotion, and public health protection, climate action has been recognized as a fundamental goal for achieving Sustainable Development Goals (SDGs). However, despite growing recognition of the need to align climate action with development goals, there is a knowledge gap regarding how the implementation of climate change mitigation and adaptation policies impacts social inequalities. To address this knowledge gap, this document proposes a scoping review protocol aimed at identifying and synthesizing research that examines the impacts of climate policies on inequalities at the subnational scales, within the transport, infrastructure and health. The objective of this review is to map existing evidence, identify conceptual and empirical gaps and inform policy strategies that promote climate action in line with values of social justice and equality. Full article

E-bikes are emerging as a competitive alternative to private cars in both urban and suburban contexts, enhancing accessibility to daily amenities and aligning with the proximity-oriented principles of X-minute city development. However, empirical knowledge remains limited regarding e-bike adopter profiles, trip purposes, influencing factors, and modal substitution patterns, particularly in urban Global South contexts. This exploratory pilot study employs correlation analysis and exploratory factor analysis to examine the sociodemographic characteristics of e-bike users in Surabaya, identify trip behavior patterns, and uncover potential determinants associated with e-bike usage within the X-minute city framework. Based on a sample of 71 e-bike users, the preliminary findings reveal notable socioeconomic patterns in e-bike adoption, with lower-income inner-city residents, particularly women in informal employment, emerging as early adopters. Additionally, two potential influence dimensions are identified: utilitarian trip chaining and active mobility infrastructure. While these findings require validation through larger-scale studies, they suggest potential for e-bikes to expand feasible X-minute city catchments and support low-carbon mobility transitions in similar Global South contexts. Full article

Urbanicity is a recognized determinant of mental health, yet conventional measures such as population density or the rural–urban divide often fail to capture the complex realities of informal settlements in low- and middle-income countries. This paper conceptualizes neighborhood effects through the lived experiences of young women in Kampala, Uganda, drawing on participatory research from the NIH-funded TOPOWA study. Using community mapping and Photovoice, participants identified neighborhood features that shape wellbeing, including sanitation facilities, drainage systems, alcohol outlets, health centers, schools, boda boda stages (motorcycle taxis), lodges, religious institutions, water sources, markets, and recreational spaces. These methods revealed both stressors—poor waste management, flooding, violence, gendered harassment, crime, and alcohol-related harms—and protective resources, including education, places of worship, health centers, social networks, identity, and sports activities. We argue that urbanicity in slum contexts should be understood as a multidimensional construct encompassing deprivation, fragmentation, exclusion, and resilience. This reconceptualization advances conceptual clarity, strengthens the validity of mental health research in low-resource settings, and informs interventions that simultaneously address structural risks and promote community assets. The case of Kampala demonstrates how participatory evidence can reshape the understanding of neighborhood effects with implications, for global mental health research and practice. Full article

Cancer is one of the biggest health burdens for women in the Middle East and North Africa (MENA), with the incidence of breast, cervical and colorectal cancer on the rise. Although preventive measures such as the HPV vaccination and population-based screening are available, access to them remains very unequal. Women in rural, low-income and refugee communities face additional barriers, cultural stigmatisation, low health literacy, gender norms and fragile health systems, leading to delayed diagnoses and poorer outcomes. This review summarises the results of 724 peer-reviewed publications to assess the current situation of cancer screening in MENA and Mediterranean countries. The studies were classified into four dimensions: cancer type (breast, cervical, colorectal), behavioural constructs (awareness, uptake, education), vulnerability factors (e.g., migrants, refugees, low-literacy groups), and geography (indigenous MENA populations versus diaspora and Mediterranean immigrant communities). The results show large inequalities in access and participation due to fragmented policies, socio-cultural resistance and infrastructure gaps. Nevertheless, promising approaches are emerging: community-led outreach, mobile screening programmes, AI-assisted triage and culturally appropriate digital health interventions. Comparisons between the local and diaspora populations make it clear that systemic and cultural barriers persist even in well-equipped facilities. Closing the screening gap requires a culturally sensitive, digitally enabled and policy aligned approach. Key priorities include engaging religious and community leaders, promoting men’s engagement in women’s health and securing sustainable funding. With coordinated action across all sectors, MENA countries can build inclusive screening programmes that reach vulnerable women and reduce preventable cancer mortality. Full article

Cervical cancer remains a significant cause of cancer-related mortality among women, particularly in low- and middle-income countries. High-throughput technologies, such as microarrays, have facilitated the comprehensive analysis of gene expression profiles in cervical cancer, enabling the identification of key differentially expressed genes (DEGs) involved in its pathogenesis. The publicly available microarray datasets, including GSE39001, GSE9750, GSE7803, GSE6791, GSE63514, and GSE52903 in combination with bioinformatics database predictions, were used to identify differential expression genes, potential biomarkers, and therapeutic targets for cervical cancer; additionally, we undertook bioinformatic analysis to determine gene ontology and possible miRNA targets related to our DEGs. Our analysis revealed several DEGs significantly associated with cervical cancer progression, such as cell death, regulation of DNA replication, protein binding processes, and transcription factors. The most relevant transcription factors (TFs) identified were SP1, ELF3, E2F1, TP53, RELA, HDAC, and FOXM1. Importantly, the DEGs with more important changes were 11 coding genes that were upregulated (KIF4A, MCM5, RFC4, PLOD2, MMP12, PRC1, TOP2A, MCM2, RAD51AP1, KIF20A, AIM2) and 14 that were downregulated (CXCL14, KRT1, KRT13, MAL, SPINK5, EMP1, CRISP3, ALOX12, CRNN, SPRR3, PPP1R3C, IVL, CFD, CRCT1), which were associated with cervical cancer. Interestingly, hub proteins KIF4A, NUSAP1, BUB1B, CEP55, DLGAP5, NCAPG, CDK1, MELK, KIF11, and KIF20A were found to be potentially regulated by several miRNAs, including miR-107, miR-124-3p, miR-147a, miR-16-5p, miR-34a-5p, miR-34c-5p, miR-126-3p, miR-10b-5p, miR-23b-3p, miR-200b-3p, miR-138-5p, miR-203a-3p, miR-214-3p, and let-7b-5p. The relationship between these genes highlights their potential as candidate biomarkers for further research in treatment, diagnosis, and prognosis. Full article

Guided by Sustainable Development Goal (SDG) 5 on achieving gender equality and empowering all women and girls, our study examines the age, period, and cohort effects of gender income inequality across China’s public and private sector employment by utilizing hierarchical age–period–cohort cross-classification random-effects models (HAPC-CCREMs) and repeated cross-sectional data from the Chinese General Social Survey from 2003 to 2021 (N = 29,367). The results demonstrate the following: (1) Age effects of gender income inequality diverge between public and private sector employment. In public sector employment, inequality undergoes a progressive decline over individuals’ career spans, as age is institutionalized as a sector-specific capital and compresses inequality through seniority-based accumulation. In private sector employment, inequality follows an inverted U-shaped trend as age is marketized as a proxy for labor productivity, producing steeper inequality in individuals’ early careers and sharp declines thereafter. (2) Period effects of gender income inequality manifest significant developing differences across public and private sector employment between 2003 and 2021. In public sector employment, the state redistributive mechanism maintains inequality at a consistently low and stable level. In private sector employment, inequality fluctuates with China’s post-transition economic restructuring, expanding during rapid market growth (2003–2008), contracting amid structural upgrading (2010–2013), and rising again under deeper market integration (2015–2021). (3) Cohort effects are negligible, reflecting that mechanisms sustaining gender income inequality exhibit intergenerational continuity. These results demonstrate that institutional segmentation structures gendered income dynamics throughout the life course via distinct resource allocation mechanisms. Our study extends life course approaches to social inequality, emphasizing the role of gender-equality-oriented governance, lifecycle-spanning support mechanisms, and cross-sectoral coordination in mitigating gender disparities. Full article

This study aimed to identify scientific evidence that addresses women’s experiences in the process of illness and care during tuberculosis treatment. A systematic review of qualitative studies was conducted based on the Joanna Briggs Institute’s Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Searches were performed in the Web of Science, MEDLINE, Embase, SciVerse Scopus, and LILACS databases. The following descriptors were used: “Women,” “Tuberculosis,” “Gender Perspective,” and “Qualitative Approach.” Studies reporting the experiences of women with active tuberculosis, published in any language, without time restrictions, were included. Of the 16,029 studies initially identified, 7079 duplicates were removed and 8895 were excluded after title and abstract screening. A total of 55 studies were read in full, of which 41 did not meet the eligibility criteria, resulting in a final inclusion of 14 studies. Most selected studies were conducted in high-tuberculosis-burden, low- and middle-income countries between 2000 and 2024. All studies focused on pulmonary tuberculosis, with one addressing drug-resistant tuberculosis. The results revealed that women’s experiences with tuberculosis are shaped by the following four thematic categories: (1) stigma and social vulnerability of women with tuberculosis; (2) gender factors in access to health services and in the interruption of tuberculosis treatment among women; (3) intersectionality and social determinants of health; and (4) the importance of social, family, and healthcare support in the experience of tuberculosis illness. The experience of illness due to tuberculosis among women is profoundly shaped by vulnerabilities related to gender, stigma, and social class, which intensify social exclusion, hinder access to diagnosis and treatment, and deepen physical and emotional suffering. Stigma reinforces isolation and weakens support networks, while the burden of domestic labor, caregiving responsibilities, and economic dependence makes it difficult for women to prioritize their own health. In this context, family support and gender-sensitive, humanized healthcare are essential. Therefore, the implementation of public policies that address these specificities and confront structural inequalities is urgent to ensure comprehensive care and a dignified, effective recovery for women with tuberculosis. Full article

Background/Objectives: Breast cancer is the most common malignancy among women globally, with survival rates improving due to earlier detection and better treatment. As a result, cancer survivors now constitute a growing segment of the population, and addressing their long-term health and well-being is a public health priority. Diet and nutrition represent modifiable factors that may influence recurrence, comorbidities, and quality of life (QoL), yet clear evidence-based guidance remains limited. This umbrella review thus synthesized evidence from published reviews on the effects of dietary and nutrition interventions among breast cancer survivors. Methods: Following a prospectively registered protocol in PROSPERO (CRD420251185022), six databases (PubMed, EMBASE, Scopus, Cochrane Library, PsycINFO and CINAHL) were systematically searched for systematic reviews/meta-analyses evaluating dietary or nutrition interventions in adult breast cancer survivors. Eligible reviews reported anthropometric, metabolic, psychosocial, or survival outcomes. Methodological quality was appraised using the AMSTAR-2 tool, and findings were narratively synthesized. Results: Nine systematic reviews encompassing more than 10,000 breast cancer survivors were included. Interventions ranged from general dietary counselling and structured weight-management programmes to Mediterranean-style dietary patterns, dietitian-led primary care, multiple health behaviour change interventions, mobile nutrition apps, and broader lifestyle programmes incorporating diet. Across reviews, interventions consistently improved diet quality and fruit–vegetable intake, produced modest but meaningful reductions in weight, body mass index, and body fat, and enhanced several QoL domains (e.g., fatigue, physical functioning, body image). Higher adherence to Mediterranean-style diets was associated with lower all-cause and non–breast cancer mortality, though certainty was limited by observational designs. However, evidence for long-term maintenance, survival endpoints, and ethnically diverse or low- and middle-income populations remains sparse. Conclusions: Dietary and nutrition interventions, particularly structured, dietitian-supported, and Mediterranean-style approaches, contribute to improved diet quality, sustainable weight control, and enhanced QoL among breast cancer survivors. Integrating nutrition care into survivorship pathways should be the focus of future research. Full article