Search Results (351)

The article addresses the question of the relative importance of human population size and growth in relation to the environmental problems of planetary heating and biodiversity loss in the current, Anthropocene era. To what extent could policies to encourage lower fertility be justified, while observing that this subject is an inherently contested one. It is proposed that a helpful distinction can be made between specific threats to habitats and biodiversity, as opposed to those related to global energy use and warming. Pressures of over-population can be important in relation to the former. But with regard to the latter—rising per capita energy usage—reduced fertility has historically been positively, not negatively correlated. A case can be made that the high-fertility nations of sub-Saharan Africa could benefit from culturally respectful fertility reduction policies. However, where planetary heating is concerned, it is the hydrocarbon-based, per capita energy-consumption patterns of already low-fertility populations on the other five inhabited continents that is rather more critical. While it will be helpful to stabilise global human population, this cannot be viewed as a solution to the climate crisis problem of this century. That requires relentless focus on reducing hydrocarbon use and confronting the rising inequality since c.1980 that has been exacerbating competitive materialist consumerism. This involves the ideological negotiation of values to promote a culture change that understands and politically embraces a new economics of both human and planetary balance, equity, and distribution. Students of populations can contribute by re-assessing what can be the appropriate demographic units and measures for policies engaging with the challenges of the Anthropocene. Full article

Famed lawyer Clarence Darrow (1857–1938) argued strongly for an early-life public health approach to crime prevention, one that focused on education, poverty reduction, and equity of resources. Due to his defense of marginalized persons and his positions that were often at odds with his legal colleagues and public opinion, he was known as the Big Minority Man. He argued that the assumption of free will—humans as free moral agents—justifies systems of inequity, retributive punishment, and “unadulterated brutality.” Here, the authors revisit Darrow’s views and expand upon them via contemporary research. We examine increasingly louder argumentation—from scholars across multiple disciplines—contending that prescientific notions of willpower, free will, blameworthiness, and moral responsibility, are contributing to social harms. We draw from biopsychosocial perspectives and recent scientific consensus papers calling for the dismantling of folk psychology ideas of willpower and blameworthiness in obesity. We scrutinize how the status quo of the legal system is justified and argue that outdated notions of ‘moral fiber’ need to be addressed at the root. The authors examine recent arguments for one of Darrow’s ideas—a public health quarantine model of public safety and carceral care that considers the ‘causes of the causes’ and risk assessments through a public health lens. In our view, public health needs to vigorously scrutinize the prescientific “normative” underpinnings of the criminal justice system. Full article

The evolving role of paramedics presents a unique opportunity to enhance care for people who use drugs, a population disproportionately affected by systemic barriers and inequities. In fragmented healthcare systems, paramedics are well-positioned to improve access through initiatives such as social prescribing and harm reduction. This theory-driven commentary explores how Network Theory and Actor Network Theory provide valuable theoretical underpinnings to conceptualize and strengthen the integration of paramedics into care networks. By emphasizing the centrality of paramedics and their connections with both human and non-human actors, these theories illuminate the relational dynamics that influence effective care delivery. We argue that leveraging paramedics’ positionality can address gaps in system navigation, improve patient outcomes, and inform policy reforms. Future work should examine the roles of other key actors, strengthen paramedic advocacy, and identify strategies to overcome barriers to care for people who use drugs. Full article

This study examines the impact of financial inclusion (FI) on reducing poverty and income inequality in Latin America and the Caribbean (LAC), using panel data from 15 countries for the period 2004–2021. System GMM with robust errors was used to address endogeneity issues, and FI was assessed in terms of access to and use of the financial system. The results indicate that increased FI contributes to reducing poverty and income inequality in LAC. While access to financial services plays a crucial role in poverty reduction, the utilization of financial services has a more profound impact on combating income inequality. These results underscore the importance of policies designed to improve financial access and promote the use of financial products and services. It is recommended to expand the banking infrastructure, facilitate the provision of low-cost accounts, and strengthen financial education programs. Full article

Objective: The objective of this study was to analyze the prevalence and key sociodemographic and lifestyle determinants of metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype in a large occupational cohort. Background: Metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype, defined as the simultaneous presence of elevated waist circumference and high triglyceride levels, are major predictors of cardiometabolic morbidity and mortality. Despite their clinical relevance, data on their distribution and determinants in large occupational populations remain limited. Methods: A cross-sectional analysis was conducted on 139,634 employed adults (56,352 women and 83,282 men) across Spain, based on standardized clinical evaluations and validated questionnaires assessing physical activity, diet, smoking, alcohol consumption, education, and occupational class. Logistic regression models were used to estimate associations with MetS and HTGW. A longitudinal subsample of 40,431 individuals was followed over a 10-year period (2009–2019) to assess trends in metabolic risk phenotypes. Results: Male sex, older age, lower educational attainment, and unhealthy lifestyle behaviors were associated with a higher prevalence of both MetS and the HTGW phenotype. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were significantly associated with increased risk. The HTGW phenotype proved useful in identifying high-risk individuals, with a steadily increasing prevalence over time. Conclusions: Sociodemographic disparities and modifiable lifestyle factors significantly influence the prevalence and progression of MetS and HTGW in the Spanish workforce. Preventive strategies should emphasize early workplace screening, promotion of healthy behaviors, and reduction in educational and socioeconomic inequalities to mitigate cardiometabolic risk. Full article

This study examines the trends, impacts, and challenges of HIV in Bangladesh from 2000 to 2024, with a focus on its epidemiology, demographic distribution, and socioeconomic determinants. Despite maintaining one of the lowest HIV prevalence rates globally (<0.1%), Bangladesh faces a concentrated epidemic among high-risk populations, including people who inject drugs (PWID), men who have sex with men (MSM), sex workers, transgender individuals, and migrant workers. Analysis reveals a steady increase in reported infections, attributed to enhanced diagnostic capacities and public awareness. The 25–49 year age group remains the most affected, accounting for over 65% of cases, underscoring the vulnerability of the economically active population. Gender disparities persist, with males representing the majority of infections but lower ART coverage among females and transgender individuals. While interventions such as PMTCT programs, ART expansion, and targeted awareness campaigns have contributed to improved outcomes, barriers such as stigma, healthcare inequities, and limited rural access hinder progress. The study also evaluates Bangladesh’s progress toward the 95-95-95 targets, highlighting significant strides in treatment and viral suppression but gaps in diagnosis. Future research must address behavioral trends, stigma reduction, and integration of HIV services for marginalized populations. This paper emphasizes the need for evidence-based strategies to ensure equitable healthcare delivery and sustainable progress in combating HIV. Full article

Gender equity is one of the most complex contemporary challenges, encompassing political, economic, labor, and cultural dimensions. This study aims to analyze the impact of public policies, labor practices, and social movements in promoting gender equity across various socio-political contexts. To answer the central question of how these elements influence a reduction in gender inequalities, a Systematic Literature Review (SLR) was conducted, complemented by a Bibliometric Analysis, following PRISMA protocol guidelines. The bibliographic search, carried out in the Scopus database, covered the period from 2015 to 2025 and identified 26 relevant studies that met the predefined inclusion criteria. The results reveal that, despite progress in formulating policies aimed at combating gender-based violence and promoting equality, the implementation of these measures is hindered by a lack of inter-institutional coordination and the persistence of deeply rooted cultural norms. Likewise, structural inequalities in the labor sphere are evident, such as the gender wage gap and barriers to professional advancement. On the other hand, social movements have emerged as key actors—including governmental institutions, civil society organizations, and healthcare providers—in highlighting and transforming these disparities by driving changes in political agendas and increasing women’s representation in decision-making positions. In summary, this study underscores the need to adopt intersectional and comprehensive approaches to achieve effective and sustainable gender equity, while comparing the influence of policies across different global regions. Full article

Heat waves affect the health and quality of life of older adults, particularly in urban environments. However, there is limited understanding of how extreme temperatures influence their mobility. This research aims to understand the pedestrian mobility patterns of older adults during heat waves in Madrid, analyzing environmental and sociodemographic factors that condition such mobility. Geospatial data from the mobile phones of individuals aged 65 and older were analyzed, along with information on population, housing, urban density, green areas, and facilities during July 2022. Multiple linear regression models and Moran’s I spatial autocorrelation were applied. The results indicate that pedestrian mobility among older adults decreased by 7.3% during the hottest hours, with more pronounced reductions in disadvantaged districts and areas with limited access to urban services. The availability of climate shelters and health centers positively influenced mobility, while areas with a lower coverage of urban services experienced greater declines. At the district level, inequalities in the availability of urban infrastructure may exacerbate the vulnerability of older adults to extreme heat. The findings underscore the need for urban policies that promote equity in access to infrastructure and services that mitigate the effects of extreme heat, especially in disadvantaged areas. Full article

Trajectory planning for autonomous vehicles is essential for ensuring driving safety, passenger comfort, and operational efficiency. Collision avoidance constraints introduce significant computational complexity due to their inherent non-convex and nonlinear characteristics. Previous research has proposed the drivable corridor (DC) method, which transforms complex collision avoidance constraints into linear inequalities by constructing time-varying rectangular corridors within the spatiotemporal domains, thereby enhancing optimization efficiency. However, the DC construction process involves repetitive collision detection, leading to an increased computational burden. To address this limitation, this study proposes a novel approach that integrates grid-based obstacle representation with dynamic grid merging to accelerate collision detection and dynamically constructs the DC by adaptively adjusting the expansion strategies according to available spatial dimensions. The feasibility and effectiveness of the proposed method are validated through simulation-based evaluations conducted over 100 representative scenarios characterized by diverse and unstructured environmental configurations. The simulation results indicate that, with appropriately selected grid resolutions, the proposed approach achieves up to a 60% reduction in trajectory planning time compared to conventional DC-based planners while maintaining robust performance in complex environments. Full article

Background: The present study seeks to examine how social disparities relate to the prevalence of poor glycemic control (HbA1c ≥ 7%), comorbidities such as hypertension and dyslipidemia, and diabetes-related complications (microvascular or macrovascular) among Saudi patients diagnosed with type 2 diabetes. Methods: A cross-sectional study was conducted among 574 patients with type 2 diabetes mellitus (T2DM) attending family medicine clinics at King Saud University Medical City in Riyadh. Participants were selected using a simple random sampling technique and interviewed via phone using a validated questionnaire. Data collected included demographic and clinical variables. Descriptive statistics and multivariate logistic regression analyses were performed to assess the association between socioeconomic status (SES) and cardiovascular complications, including stroke, dyslipidemia, hypertension, and acute coronary syndrome. Result: The analysis revealed that certain socioeconomic factors significantly increased the odds of cardiovascular complications among patients with T2DM. Being female was associated with higher odds of hypertension (OR = 2.29, p = 0.014), dyslipidemia (OR = 2.59, p = 0.012), acute coronary syndrome (ACS) (OR = 2.35, p = 0.001), and stroke (OR = 2.17, p = 0.003). Divorced or widowed participants had significantly increased odds of ACS (OR = 2.91, p = 0.001) and stroke (OR = 2.83, p = 0.002). A lower educational level (secondary school or less) was significantly associated with increased odds of hypertension (OR = 2.64, p = 0.031), dyslipidemia (OR = 2.22, p = 0.005), and stroke (OR = 2.88, p = 0.042). Monthly income between 3001 and 6000 SAR was significantly associated with higher odds of ACS (OR = 2.61, p = 0.003) and stroke (OR = 2.64, p = 0.012). Participants with diabetes duration >15 years had higher odds of dyslipidemia (OR = 2.86, p = 0.004) and stroke (OR = 2.89, p = 0.005). Being retired or not working increased the odds of all four cardiovascular outcomes, with stroke showing the highest risk (OR = 3.18, p < 0.001). Living outside the Riyadh region was also associated with elevated risk across outcomes, notably stroke (OR = 1.52, p = 0.046). Conclusions: The study concluded that notable social disparities exist among diabetic individuals affected by cardiovascular conditions, such as stroke and acute coronary syndrome (ACS), as well as risk factors for cardiovascular disease like dyslipidemia (DLD). These findings can inform targeted cardiovascular risk reduction strategies and address health inequities among diabetic populations in Saudi Arabia. Full article

The inequity in the distribution of green spaces in megacities has a detrimental effect on the physical and mental well-being of their inhabitants, highlighting the necessity for careful and strategic urban planning, along with appropriate regulatory interventions. Nevertheless, scholarly articles addressing the equity of access to urban green spaces primarily concentrate on urban parks, with limited studies examining the influence of alternative types of green spaces. This research initially recognized and categorized informal green spaces (IGS) located within the Third Ring Road of Chengdu, utilizing the UGS-1m dataset and area of interest (AOI) data, in accordance with a well-defined classification framework. Then, the G2SFCA method and Gini coefficient were employed to assess the impact of IGS on the green space accessibility, especially scenario analysis of open and shared use of green space. The findings indicate that (1) IGS in the narrow sense constitute 21.2% of the overall green spaces within the study area, resulting in a reduction of the Gini coefficient by 0.103; (2) IGS in the broad sense, including public affiliated green spaces, shows an even more positive effect on improving the equity of green space supply, with a reduction of the Gini coefficient by 0.28; (3) there exists great spatial disparity in accessibility improvement effect by different types of IGS, so public policies must be customized to reflect local circumstances, taking into account the practicality and associated costs of management and maintenance of various IGS as well as accessibility enhancement; (4) certain older residential areas may not be amenable to effective enhancement through the use of IGS alone, and these should then adopt a multidimensional greening strategy such as green-roof. The findings of this research offer valuable insights for the planning and management of green spaces in densely populated urban environments, thereby aiding in the development of more refined models for the development of “Garden Cities”. Full article

The increasing disparity in global food distribution has amplified the urgency of addressing food waste and food insecurity, both of which exacerbate economic, environmental, and social inequalities. Traditional food bank models often struggle with logistical inefficiencies, limited accessibility, and a lack of transparency in food distribution, hindering their effectiveness in mitigating these challenges. This study proposes a novel Food Bank Network Redesign (FBNR) that leverages the Quito Metro system to create a decentralized food bank network, enhancing efficiency and equity in food redistribution by introducing strategically positioned donation lockers at metro stations for convenient drop-offs, with donations transported using spare metro capacity to designated stations for collection by charities, reducing reliance on dedicated transportation. To ensure transparency and operational efficiency, we integrate a blockchain-based traceability system with smart contracts, enabling secure, real-time tracking of donations to enhance stakeholder trust, prevent food loss, and ensure regulatory compliance. We develop a multi-objective optimization framework that balances food waste reduction, transportation cost minimization, and social impact maximization, supported by a mixed-integer linear programming (MIP) model to optimize donation allocation based on urban demand patterns. By combining decentralized logistics, blockchain-enhanced traceability, and advanced optimization techniques, this study offers a scalable and adaptable framework for urban food redistribution, improving food security in Quito while providing a replicable blueprint for cities worldwide seeking to implement circular and climate-resilient food supply chains. Full article

This study proposes an intelligent prediction framework integrating native sparse attention (NSA) with the Chen-Guan (CHG) algorithm to optimize tunnel boring machine (TBM) operations in heterogeneous geological environments. The framework resolves critical limitations of conventional experience-driven approaches that inadequately address the nonlinear coupling between the spatial heterogeneity of rock mass parameters and mechanical system responses. Three principal innovations are introduced: (1) a hardware-compatible sparse attention architecture achieving O(n) computational complexity while preserving high-fidelity geological feature extraction capabilities; (2) an adaptive kernel function optimization mechanism that reduces confidence interval width by 41.3% through synergistic integration of boundary likelihood-driven kernel selection with Chebyshev inequality-based posterior estimation; and (3) a physics-enhanced modelling methodology combining non-Hertzian contact mechanics with eddy field evolution equations. Validation experiments employing field data from the Pujiang Town Plot 125-2 Tunnel Project demonstrated superior performance metrics, including 92.4% ± 1.8% warning accuracy for fractured zones, ≤28 ms optimization response time, and ≤4.7% relative error in energy dissipation analysis. Comparative analysis revealed a 32.7% reduction in root mean square error (p < 0.01) and 4.8-fold inference speed acceleration relative to conventional methods, establishing a novel data–physics fusion paradigm for TBM control with substantial implications for intelligent tunnelling in complex geological formations. Full article

This paper investigates whether countries’ investments in financial inclusion, beyond what their economic capacity would predict, help mitigate gender and income-group gaps in financial opportunities. We construct a novel index, the Abnormal Financial Inclusion Index (AbFII), as the residuals from a regression of financial inclusion on GDP per capita to isolate country-specific efforts in advancing financial inclusion. Using data from 100 countries between 2014 and 2021, we find that higher AbFII is associated with lower gender and rich-poor inequalities in financial inclusion, particularly in low-income and high-inequality countries. A one-standard-deviation increase in AbFII corresponds to a 1.2 percentage point reduction in gender and income-group disparities in financial access. We also find that AbFII predicts subsequent improvements in broader gender inequality, especially in reproductive health. The results are robust to various controls and remain consistent under instrumental variable analysis using broadband penetration as an instrument. Our findings suggest that financial inclusion policies exceeding the level expected by economic development can significantly reduce social disparities. Full article

Background/Objectives: The homeless population (HP) is a heterogeneous group characterized by the absence of stable and conventional housing, often relying on public spaces and deteriorated environments for shelter and survival, either temporarily or permanently. This group is exposed to multiple health vulnerabilities, with substance use disorder (SUD) identified as a significant risk factor for suicidal behavior. The aim of this study was to conduct a scoping review of the relationship between PAS use and suicide among homeless individuals. Methods: A comprehensive literature search was performed using five databases: PubMed, Scopus, SciELO, LILACS, and Google Scholar. Studies were selected based on their relevance to the topic, and data were extracted regarding substance use, suicide-related outcomes, and associated sociodemographic and clinical factors. Results: The findings indicated a strong association between PAS use and increased suicidal ideation and behavior among homeless individuals, particularly among youth, men, and women. Opioids and alcohol were the most frequently reported substances in this context. Additional factors such as unemployment, exposure to violence, social inequalities, and mental health disorders further exacerbated the risk of suicide in this population Conclusions: The reviewed literature underscores the urgent need for integrated, context-sensitive interventions addressing both substance use and mental health among the homeless. Tailored public health strategies focused on prevention, harm reduction, and psychosocial support are essential to reducing suicide risk and promoting overall well-being in this highly vulnerable group. Full article