Search Results (791)

Background: Long-acting monoclonal antibodies have become an important strategy for preventing respiratory syncytial virus (RSV) disease in infants. Nirsevimab is the first product for which substantial post-licensure implementation data are available, whereas real-world evidence on clesrovimab remains limited. Although nirsevimab has demonstrated high efficacy, its uptake varies considerably across countries, healthcare systems, delivery settings, and population subgroups. This World Association for Infectious Diseases and Immunological Disorders (WAidid) consensus document examines the policy, organizational, economic, and equity-related determinants that shape real-world implementation of long-acting monoclonal antibodies for infant RSV prevention. Methods: This study was conducted as a structured narrative review and WAidid expert consensus document. A structured literature search was performed in PubMed and Embase for English-language publications relevant to nirsevimab uptake and implementation, complemented by targeted review of surveillance reports, policy documents, and public health guidance from the ECDC, UKHSA, and CDC, as well as reference lists of selected publications. Eligible sources included observational and real-world implementation studies, systematic reviews and meta-analyses, economic evaluations, guidelines, policy statements, surveillance reports, and relevant narrative reviews. Evidence was synthesized qualitatively according to policy frameworks, financing and reimbursement, delivery pathways, demographic and socioeconomic determinants, and healthcare-system factors influencing uptake. No statistical software was used because no quantitative re-analysis or meta-analysis was performed. Results: Nirsevimab uptake was strongly influenced by national RSV prevention policies, particularly whether countries adopted universal infant monoclonal antibody programs, maternal RSV vaccination strategies, dual maternal–infant approaches, or targeted risk-based models. Universal, publicly funded programs integrated into neonatal care achieved the highest and most homogeneous coverage, especially when administration occurred before hospital discharge and was supported by registry-based recall systems for infants born outside the RSV season. In contrast, fragmented, outpatient-only, insurance-dependent, or partially reimbursed models were associated with lower, delayed, or more variable uptake. Additional determinants included product cost, reimbursement pathways, provider practices, caregiver awareness and health literacy, insurance status, income, race and ethnicity, geographic deprivation, and access to primary pediatric care. Most available evidence comes from high-income countries, limiting generalizability to low- and middle-income settings, where RSV burden is greatest and implementation constraints may differ. Conclusions: Successful implementation of long-acting monoclonal antibodies for infant RSV prevention requires more than regulatory approval and demonstrated efficacy. Equitable uptake depends on clear national recommendations, sustainable public financing, reliable product supply, integration into neonatal and primary pediatric care, proactive identification and recall of eligible infants, and targeted strategies to reduce socioeconomic and geographic disparities. Although many determinants identified in high-income settings are likely relevant globally, their feasibility, relative importance, and impact require dedicated evaluation in low- and middle-income countries. Full article

China has emerged as one of the most influential actors in South–South scientific cooperation, progressively integrating agricultural innovation, technology transfer, and sustainable development into its international engagement strategy, with tropical agriculture positioned as a strategic domain in its relations with Latin America. However, despite China’s growing role as a driver of agricultural research collaboration, the specific mechanisms through which its institutions transfer knowledge and strengthen local scientific capacities in the Latin American region remain insufficiently studied, particularly in the case of Ecuador. This study adopted a qualitative scoping review methodology following PRISMA-ScR guidelines, screening 9199 records across Scopus, Web of Science, and SciELO, of which 61 documents were retained for thematic analysis. Results show that Chinese cooperation has evolved through three distinct phases: an initial phase centered on agricultural investment and resource-oriented cooperation (2000–2010); a second phase (2010–2018) characterized by the initial institutionalization of scientific and technological cooperation through bilateral agreements, joint action plans, researcher training, and institutional exchanges; and a third phase (2018–present), marked by the deliberate integration of science, technology, and innovation as central pillars of China’s engagement with Latin America, including long-term collaborative research, joint laboratories, scientific networks, and initiatives led by institutions such as the Chinese Academy of Tropical Agricultural Sciences (CATAS). In Ecuador, CATAS’s partnership with the National Institute of Agricultural Research (INIAP) illustrates China’s capacity to build joint research platforms, though sustained impact depends on long-term institutionalization, continuous financing, and transparent governance over genetic resources. The findings underscore China’s expanding support in shaping South–South agricultural cooperation and innovation, and the conditions required to translate this support force into durable, mutually beneficial scientific outcomes. From a public policy perspective, China and Ecuador could strengthen their international agricultural cooperation framework through long-term mechanisms supporting strategic scientific partnerships between the two countries, including multi-year joint research programs, dedicated funding instruments, researcher mobility, and institutional mechanisms for transparent governance of genetic resources and jointly generated intellectual property. Full article

Single-use plastic pollution is a critical global challenge, prompting nations to enact trade-restrictive environmental policies. This study evaluated the impact of Ecuador’s single-use plastic regulation on the imports of regulated plastic products. Analyzing five tariff headings from 2014 to 2025, we integrated official customs records with Interrupted Time Series (ITS) models to estimate regulatory effects. The results revealed sharply divergent trajectories across product categories: imports of plastic waste (HS 3915) declined from US dollars (USD) 4193 in 2020 to zero by 2024, while the remaining four regulated headings, plastic bags, packaging, tableware, and household articles, expanded continuously, with import volumes increasing between 48% and 74% in the post-regulatory period. ITS models confirmed statistically significant trend changes in headings 3915.00, 3923.29, and partially 3924.10, whereas headings 3923.21 and 3924.90 showed no statistically detectable response. Regulatory effects manifested primarily through gradual trend modifications rather than abrupt post-enactment contractions, and supplier structure analysis documented a systematic reorganization of international sourcing patterns, indicating that the trade response extended well beyond simple import reduction. Full article

In April 2024, the Hellenic Cadastre became one of Europe’s first land registries to use a generative AI model (a large language model served through Azure OpenAI) for the legal review of property deeds. Unlike similar European initiatives using classical NLP, Greece applied state-of-the-art generative AI to a massive legacy issue: 390 historical mortgage registries holding an estimated 600 million to one billion paper pages. By April 2026, the system had processed 310,000 acts, reducing the average per-act review time from about thirty minutes to under ten; a very large per-act cost reduction is also reported by the implementation partner, which we treat as a vendor-stated figure. Additionally, the cadastre’s geodetic infrastructure found a second use following the 2023 Tempi rail disaster. In 2026, the Hellenic Positioning System (HEPOS), a 98-station GNSS reference network, began providing corrections for Greece’s real-time train tracking platform. While satellite-based train positioning is not novel in Europe, where consortia such as CLUG have run a decade of research and pilots, this marks its operational deployment in Greece. The Greek case is unique institutionally rather than technically: it repurposed a national CORS network for a citizen-facing train tracking platform as a short-term crisis response, alongside an incomplete ETCS rollout. This paper documents both deployments, measures their impact, maps them onto the nine FELA pathways, and identifies transferable practices. Greece is not presented as a technological frontier, but as an example of how a country can put existing geospatial infrastructure and AI to rapid use in delivering build-back-better policies for the public, in line with the UN 2030 Agenda. Full article

Patient safety policies in Mexico have evolved through the incorporation and adaptation of the International Patient Safety Goals (IPSG) within the broader Essential Actions for Patient Safety (AESP) framework. This narrative policy review aimed to analyze this evolution, compare the main characteristics of both frameworks, and examine the available evidence concerning AESP implementation and current challenges in Mexico. A structured literature search was conducted between March and July 2026 in PubMed and SciELO, supplemented by Google Scholar and official sources from the World Health Organization and Mexican health authorities; the final search update was performed in July 2026. The narrative synthesis included 26 sources: 17 scientific or academic publications and nine official or institutional documents. The evidence indicates that the AESP retained the six principal clinical safety areas of the IPSG while adding incident reporting and analysis and patient safety culture as organizational components. However, available Mexican empirical evidence is limited and does not establish national implementation levels or demonstrate that the AESP have independently reduced adverse events or improved patient outcomes. Further national, multicenter, longitudinal, and comparative evaluations are needed to assess implementation, adherence, reporting performance, safety culture, and patient outcomes. Full article

Historic buildings occupy a sensitive position in contemporary energy and heritage management because they combine building-performance requirements, material-conservation constraints, and dynamic patterns of use. This study maps the broader historic-building literature at the intersection of energy-efficient restoration, building decarbonization, heritage conservation, and sustainable tourism, and interprets the resulting bibliometric structure with particular implications for historic stone places of worship. Records were retrieved from the Web of Science Core Collection and screened through a PRISMA 2020-aligned protocol, yielding 804 publications. Accordingly, the 804-record corpus represents a broad historic-building and heritage-management evidence base rather than an exhaustive dataset restricted exclusively to stone religious buildings. Performance analysis and science mapping were conducted using Bibliometrix, while bibliographic coupling and longitudinal thematic-evolution analyses were added to examine contemporary research fronts and their temporal continuity. Co-citation analysis identified two partially separated intellectual schools—European conservation microclimate and adaptive reuse management—whereas bibliographic coupling revealed five current research-front communities, including adaptive reuse and sustainability, microclimate-conservation-energy, and an emerging HBIM/digital-documentation front. Thematic evolution showed increasing post-2019 convergence of tourism and management with conservation and cultural-heritage research, but continued separation from technical energy and microclimate streams. The study therefore moves beyond descriptive rankings to identify structural fragmentation and three priority directions: integrated monitoring of visitor loads, energy, and conservation performance; HBIM-supported spatial integration; and stronger cross-national research collaboration. The findings are interpreted as bibliometric evidence and research-agenda signals rather than as causal proof of building or policy performance. Full article

The Cambodian Ministry of Education Youth, and Sport (MoEYS) has, over time, made noticeable progress toward Sustainable Development Goal 4 (SDG-4) to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. However, the pace and extent of that progress remain uneven, particularly in the area of teacher training, which is central to achieving inclusive and quality education. Utilising a document analysis framework, this study draws upon national policy reform documents including the Teacher Policy Action Plan to examine the extent to which the MoEYS’s policy commitments to professionalise the teaching workforce are meeting SDG-4.c goals. Changes to pre-service programmes including the 12 + 4 programme, investments in teacher training centres, and continuous professional development (CPD) frameworks have strengthened the system. Yet, significant challenges persist. Limited access to effective CPD, high student/teacher ratios, teacher shortages, especially in rural locations, and resource constraints continue to undermine the consistency and quality of instructional practice. A contention of this paper is that for Cambodia to fulfil its SDG-4.c target relating to teacher preparedness, progress is contingent upon sustained investment, targeted support for rural and remote regions, and stronger implementation capacity to ensure all learners benefit from well-trained and effectively supported educators. Full article

Health systems are fundamental to ensuring the right to health and maintaining the stability of welfare states. In this broad framework, this narrative review takes a look at Italy and China—two countries with very different historical backgrounds and institutional paths—as they deal with challenges like demographic aging, increasing chronic illnesses, and ongoing disparities in access to care. This paper aims to examine the most relevant peer-reviewed studies, as well as current legal and policy documents, in order to outline a comparative overview of the approaches to financing, coverage, and service provision in Italy and China, two very different countries. The Italian National Health Service, financed through general taxation and designed to be universal, aims to ensure equitable access to healthcare while having to contend with significant regional differences and financial difficulties. On the other hand, China, which operates with a mixed model, has rapidly expanded its insurance coverage using a variety of schemes and embracing technological advances, which has enabled large-scale access to healthcare, although considerable differences remain between urban and rural areas and provinces. When compared, each system shows particular strengths: Italy’s local care networks and focus on continuous services offer a model for inclusive welfare, while China’s use of digital tools demonstrates how innovation might help overcome obstacles in settings with limited resources and maintain continuity of care. There is a noticeable overlap in how both countries handle chronic diseases and their shared concern for equity in health policy. Considering these points, mixed approaches that combine universal coverage, financial viability, and flexible use of technology could provide useful ideas for crafting more fair, effective, and resilient health policies in various settings. Rather than proposing direct policy transfer, the comparison identifies context-dependent strategies that may inform future healthcare reforms. Full article

Green urban renewal requires coordination among climate adaptation, water management, biodiversity conservation, and spatial planning within coherent policy frameworks. This study presents a structured analytical framework for evaluating how nature-based solutions (NbS) and natural water retention measures (NWRM) are represented in local and national policy documents relevant to green urban renewal, using Zagreb, Croatia, as a case study. The analysis combined qualitative content analysis, semi-quantitative assessment, and comparative policy-coherence analysis of strategic, planning, and legislative documents. Recent strategic documents showed the broadest documentary coverage of climate adaptation, biodiversity conservation, sustainable water management, and green infrastructure, whereas legislative and statutory planning documents contained more function-specific provisions. Economic feasibility, adaptive management, and several implementation-related provisions were less consistently represented. Cross-level comparison further identified stronger alignment between several recent Zagreb strategic documents and national climate and water policy documents. The study contributes a structured adaptation of IUCN-derived criteria for cross-level policy-document analysis; its applicability in other legal and urban contexts requires comparative testing. Full article

International student mobility (ISM) is one of the most important and widespread features of international higher education today. One factor affecting ISM is the range and increase in scholarship providers, of which the China Scholarship Council (CSC) scholarship, is among the most influential and impactful globally. While many existing studies have focused on the national economic motivations of scholarship programmes, the research presented in our paper adopts a broader perspective, emphasising some of the organisational and political complexities in scholarship policy implementation. We use and build upon a framework that explains how scholarship policy is implemented. In it, scholarship organisations are mapped alongside the students as scholarship recipients as well as the universities as policy actors. The principal aim of this paper is to map out the roles and relationships of different actors in the implementation of scholarship policies, showing the importance of multi-level governance and stakeholder collaboration. The findings show that CSC scholarship policy involves multiple interconnected actors whose roles and relationships can be systematically identified through policy documents. By extending the framework, this study identifies not only scholarship organisations, universities, and sponsored students, but also local education departments and employers as important actors in the policy process. The analysis further shows that CSC scholarship policies have evolved over time, with changes in priorities, requirements, and selection criteria reflecting broader national development strategies. Given that fact that the complex structures and workings of the CSC are still little understood and under-researched in anglophone literature, our analysis provides practical insights as well as additional guidance for promoting effective, inclusive, and sustainable transnational higher education. The discussions offer valuable insights for policymakers and institutions committed to enhancing international scholarship programmes and global higher education capacity building. Full article

Background: Multiple chemical sensitivity (MCS), a recognized disability, is a chronic, multisystem condition in which exposure to common chemical substances provokes adverse health effects and functional impairment. Although population-level data and emerging clinical research support the pathophysiological basis of MCS, individuals living with the condition frequently encounter barriers to recognition and accommodation across employment, healthcare, and housing systems. This study examines patterns of accommodation requests, refusals, and associated socioeconomic impacts among adults living with MCS in Canada, with particular attention to how institutional recognition shapes access to supports. To our knowledge, this is the first national Canadian study to examine accommodation request outcomes across both employment and housing among adults with MCS, combining quantitative and qualitative data. A national cross-sectional survey of 119 Canadian adults living with MCS was conducted between January and February 2021. Quantitative data were analyzed descriptively to assess accommodation requests, outcomes, employment status, income, and housing stability. Qualitative responses were analyzed thematically to contextualize participants’ experiences of disclosure, and accommodation outcomes. Participants were predominantly female (87%) with post-secondary education (90%). Among participants who reported being unemployed (29%), 94% attributed it primarily to MCS-related limitations. Accommodation denial was common: 85% of respondents reported requesting accommodations, and 78% of those experienced refusals. On housing conditions, 52% reported living in unsafe housing (defined as housing with the presence of mould or symptom-triggering exposures), while 17% reported being homeless (e.g., moving frequently, personal vehicle, tent). Findings should be interpreted in light of the cross-sectional design, self-reported data, and community-based recruitment, which may limit generalizability. The findings suggest that inconsistent institutional recognition of MCS can function as a barrier to accommodation, contributing to health, economic, and social inequities. Addressing these barriers requires clarified guidance on the duty to accommodate multiple chemical sensitivity, proactive scent-free and lowest-emission policies in workplaces and housing, and improved healthcare provider education to support accommodation documentation. Full article

This article examines how gender shapes the framing, governance and lived experience of women’s health within a national health system, and what this reveals about translating gender equality commitments into social policy practice. Using a convergent mixed-methods design, the study combines analysis of national policy documents and parliamentary debates in Portugal (2014–2024) with interviews with key actors (n = 13) and an exploratory national survey of women (n = 268). Across policy and political arenas, women’s health is widely recognised within gender equality and rights-based discourse, yet remains weakly consolidated within mainstream health governance. Reproductive framings dominate, while life-course dimensions such as menopause, women’s mental health and health literacy are under-articulated and weakly operationalised. Actor perspectives emphasise prevention, health literacy, communication and continuity of care, pointing to diffuse ownership and limited accountability. Survey respondents’ accounts both reproduce and extend dominant framings, highlighting mental health, information needs, access barriers and the importance of accessible and trustworthy health information. Reported care experiences reveal a pattern of “respect without responsiveness”, where positive interpersonal treatment coexists with organisational and communicative shortcomings. The article conceptualises this as a governance paradox of recognition without consolidation and shows how policy silences shape not only what becomes actionable within gendered health systems but also the informational conditions that support informed engagement with health and care. The findings have implications for designing life-course-oriented, communication-sensitive and accountability-anchored approaches to women’s health governance. Full article

Background: Public health in Greece has undergone substantial changes since the COVID-19 pandemic, while challenges related to governance, workforce distribution, regional inequalities and service organization remain. This study aimed to map the current public health landscape in Greece by examining its institutional frameworks, stakeholder roles, policy implementation and public health data systems. Methods: A structured situation analysis combining a review of peer-reviewed and gray literature, policy analysis, and stakeholder mapping was conducted. PubMed, EMBASE, and CINAHL were searched for English- and Greek-language publications issued between 2005 and 2026, supplemented by reports, legislation, and policy documents from the Greek Ministry of Health, the World Health Organization, the Organisation for Economic Co-operation and Development, the European Commission, and other relevant institutions. Results: Public health responsibilities were distributed across multiple national, regional, and local institutions, creating challenges concerning coordination and accountability. Regional and socioeconomic inequalities continued to affect access to services, while workforce shortages and skill-mix imbalances constrained public health capacity. Public health information was dispersed across different institutions and data systems, with limitations concerning standardization, accessibility, and interoperability. Recent legislation, prevention programs, and digital-health initiatives indicated increased policy attention to prevention and population health, although publicly available evidence regarding their implementation and outcomes remained limited. Conclusions: Strengthening public health in Greece requires clearer institutional responsibilities, improved coordination across governance levels, sustainable workforce planning and interoperable data systems that support routine monitoring of program coverage, equity, and population-level outcomes. Full article

Background/Objectives: Perinatal care is essential for the health and well-being of women and adolescent girls from conception through the first year postpartum. The World Health Organization (WHO) provides evidence-based recommendations aimed at improving the quality of antenatal, intrapartum, and postnatal care. This study mapped 51 WHO perinatal care recommendations against Zambian guidelines to identify areas of alignment, as well as gaps and challenges related to their implementation. Methods: The review was conducted following Joanna Briggs Institute (JBI) guidance. Published recommendations and relevant documents issued from 2016 onwards were included. National guidelines, policy documents, professional standards, and literature related to perinatal care in Zambia were identified through searches of PubMed, Google Scholar, WHO resources, and relevant institutional websites. WHO recommendations were mapped against Zambian guidelines and classified according to their level of alignment. Results: The findings demonstrated significant alignment between WHO recommendations and Zambian guidelines in perinatal healthcare. However, important implementation gaps remain; for example, only 4.7% of pregnant women attended all eight recommended antenatal care visits. Intrapartum care largely aligns with WHO standards, though there are differences in pain-relief choices. Furthermore, difficulties in adopting WHO recommendations are mostly due to health system constraints. Conclusions: Most of the Zambian guidelines align with the WHO recommendations. However, ten were classified as partly aligned, and one did not align. This small proportion of non-alignment may reflect adaptation for a national context and require further evidence-based evaluation. In addition, consolidating existing recommendations, strengthening health-system capacity, and addressing implementation gaps may support the delivery of standardized, high-quality perinatal care and contribute to improved maternal and newborn health outcomes. Full article

Airports are complex infrastructure systems with important environmental, operational, and social impacts that require integrated sustainability governance. Although numerous international regulations, environmental management standards, certification schemes, and policy initiatives have been developed to support airport sustainability, existing research has largely examined these mechanisms independently, resulting in fragmented approaches to sustainability planning and implementation. This study develops an Integrated Airport Sustainability Policy Framework through a qualitative conceptual methodology based on a systematic literature review, guided by PRISMA-ScR principles, and comparative policy analysis. Peer-reviewed literature was systematically analyzed alongside international regulatory and policy documents, including guidance and standards published by the International Civil Aviation Organization (ICAO), the International Organization for Standardization (ISO), Airports Council International (ACI) Airport Carbon Accreditation (ACA), the European Commission, the Federal Aviation Administration (FAA), and the United Nations (UN). The thematic synthesis identified four connected dimensions that consistently underpin sustainable airport governance: environmental management and emissions reduction, operational and energy efficiency, community and social sustainability, and governance, collaboration, and compliance. These dimensions were integrated into a scalable conceptual framework that consolidates existing sustainability mechanisms into an integrated governance structure adaptable to airports with various operational characteristics and regulatory contexts. The proposed framework addressed the fragmentation of existing policy approaches and proposes a structured basis for integrating environmental, operational, social, and governance aspects into airport decision-making. As a conceptual model developed through secondary evidence synthesis, the framework is intended to support future research and policy development and requires empirical validation through application across airports of different sizes and geographical contexts. Full article