Search Results (4,234)

The Street Clinic (Consultório na Rua—CnR) is a strategic component of Primary Health Care in Brazil, aimed at populations experiencing homelessness, a group characterized by high levels of social and health vulnerability. This study critically analyzes the experiences of healthcare professionals working within a CnR team, identifying the meanings attributed to their work, the challenges encountered, and the strategies developed within the territory. This is an exploratory study with a qualitative approach, grounded in health narratives and the philosophical hermeneutics of Hans-Georg Gadamer. Four professionals participated, representing the totality of eligible members of a team in a medium-sized municipality in Southern Brazil, with between one and eleven years of experience in the service. Hermeneutic analysis revealed that the CnR functions as an entry point to Primary Health Care and Psychosocial Care, with the bond between team and users serving as the primary mechanism for overcoming barriers to access. Professionals report ethical suffering arising from the tension between their commitment to comprehensive care and the structural limitations of the service, including shortages of supplies, institutional instability, and precarious employment arrangements. It is concluded that strengthening the CnR requires not only investment in infrastructure and expansion of the teams, but also policies that recognize and support the complexity of street-based work, including care for the caregivers themselves. Full article

With a modest estimate of 11 million workers and high greenhouse gas emissions, the Indian brick sector is a relevant study for understanding how low-carbon energy transition impacts justice for the society, environment, and livelihoods. This empirical article provides an analysis of the ongoing policy-driven energy efficiency transition and justice trade-offs and benefits in the brick production sector in the state of Bihar. The transition is explored in a larger framework of power relations and vulnerability to determine whether the policies enable or challenge transformative justice for the labour force, nature and future generations. Present policies focus on regulations and financial incentives relevant for entrepreneurs with pre-existing skills, network and financial resources. Further, present policy narratives lack attention to mechanisms that reproduce the socio-economic inequality of the brick labour force, and implications for balancing different livelihood and environmental objectives. We conclude that the findings emphasise the need for integrating a wider variety of social dimensions and relevant support schemes to overcome inequality barriers and safeguard the environment for future generations. Full article

Post-earthquake emergency response planning requires rapid and adaptive resource allocation under disrupted accessibility, uneven district-level demand, and hazardous field conditions. In large metropolitan areas, these challenges are intensified by spatial differences in social vulnerability, infrastructure disruption, operational feasibility, and responder exposure. Static allocation approaches are often insufficient in such environments because they cannot adequately reflect temporal change or the evolving relationship between urgency, accessibility, and operational risk. This study proposes a dynamic multi-objective model for district-level post-earthquake resource allocation that integrates social vulnerability, occupational safety, and Markov-based updating within a single analytical framework. First, district priority scores are derived through an Analytic Hierarchy Process based on building damage ratio, intervention time, social vulnerability, critical infrastructure damage, secondary hazard risk, team capacity, and occupational safety. Second, a Markov-based updating mechanism is used to represent time-dependent redistribution across response periods. Third, a constrained weighted-sum multi-objective optimization model is formulated to balance district priority, social vulnerability, and responder safety under capacity and accessibility limits. The model is applied to Istanbul using official district-level data from national and local institutional sources. Scenario-based analysis is conducted under balanced, priority-oriented, vulnerability-oriented, and safety-oriented settings, together with static and dynamic model comparisons. The results show that the dynamic structure produces a more adaptive allocation profile than the static structure, with the share of the Very High allocation class declining from 37.66% to 34.95% and the Low allocation class increasing from 12.89% to 16.00% over the response horizon. The findings also indicate that greater emphasis on social vulnerability shifts allocation toward more fragile districts, whereas stronger safety emphasis reduces cumulative operational exposure at the cost of moderate reductions in immediate coverage. Overall, the study contributes to the disaster response literature by linking multi-criteria district prioritization, dynamic redistribution, and safety-aware allocation within a unified district-level decision structure. Beyond the Istanbul application, the proposed framework offers a practical basis for more responsive, equitable, and operationally sustainable post-earthquake planning in complex urban environments. Full article

Background: Preterm birth is a significant early-life stressor associated with increased psychiatric vulnerability and long-term functional impairments in school-aged children. Objective: To compare behavioral–emotional outcomes and functional competence between school-aged preterm and term-born children, examining perinatal, cognitive, and socioeconomic predictors. Methods: 140 children aged 6–10 (70 preterm, 70 age-matched controls) were assessed using the Child Behavior Checklist (CBCL) and Strengths and Difficulties Questionnaire (SDQ). Functional competence—defined as participation in daily activities, social interactions, and school performance—was examined alongside behavioral–emotional outcomes. Predictors included gestational age, birth weight, SES, and cognitive ability. Results: Preterm birth was associated with higher SDQ scores in emotional problems, hyperactivity, and peer problems. CBCL results showed lower total functional competence scores, specifically in activities, social participation, and school performance. Longer NICU stay predicted higher internalizing problems and lower social participation. Cognitive ability was linked to lower SDQ externalizing and internalizing scores. SES was not a significant predictor. Conclusions: Preterm birth and prolonged NICU hospitalization are linked to persistent behavioral–emotional and functional vulnerabilities. These findings underscore the need for early, integrated developmental monitoring within a preventive psychiatry framework to identify psychiatric vulnerability and support functional participation. Full article

Australia’s ban on social media for under-16s, introduced in December 2025, made it the first country worldwide to implement a nationwide prohibition on major platforms for adolescents. This narrative literature review compares Australia’s age-based restriction with international approaches to protecting young people from online risks. The review synthesized 26 academic studies and 15 grey literature sources (policy documents, legislation, and official reports published between 2015 and 2025). It employed Bronfenbrenner’s bioecological systems theory to examine effects across family, platform, institutional, and broader socio-legal contexts. Three key themes emerged: (A) Empirical findings on age-threshold policies remain inconclusive and context-dependent. While unregulated use relates to psychological vulnerabilities, structured and intentional engagement can promote social connection, identity exploration, and support access, especially for marginalized youth. (B) Global responses vary, favoring alternatives like parental consent, platform duty-of-care obligations, and screen-time control measures. (C) Balanced, sustainable harm reduction depends on combining parental involvement, platform accountability, and digital literacy education. Overall, while Australia’s precautionary approach addresses legitimate developmental and public health concerns, its effectiveness seems limited by enforcement challenges, risks of digital exclusion, and potential human rights issues. Bronfenbrenner’s framework underscores the need for coordinated governance across interconnected systems to lessen online harm. Full article

Stock market investors and traders operate in high-pressure environments marked by volatility, uncertainty, financial risk, and intense performance demands. These conditions lead to substantial psychological distress, increasing vulnerability to psychiatric disorders and suicidal behavior. Key psychological risk factors in this population include acute financial loss, chronic stress, impulsivity, perfectionism, and identity fusion with professional performance. Evidence from behavioral psychology and clinical psychiatry indicates elevated rates of mood disorders, anxiety, and burnout in trading environments. Resilience—including emotional regulation, effective stress-coping mechanisms, strong social support, and cognitive flexibility—emerges as a critical protective factor that mitigates suicide risk and promotes adaptive functioning. Strengthening psychological resilience and implementing evidence-based mental-health strategies may help reduce suicide risk and support overall well-being. The medico-legal dimensions of this issue encompass duty of care within high-stress financial workplaces, clinical obligations related to suicide risk assessment and documentation, confidentiality and safety considerations, and questions of foreseeability of suicide in cases involving severe or catastrophic financial loss. Despite growing awareness of mental health challenges in financial professions, the intersection of suicide risk, resilience, and medico-legal responsibilities in this population remains underexplored. Further research is needed to refine assessment frameworks and develop targeted suicide prevention interventions for this at-risk group. Full article

To advance our understanding of the social and emotional development of minoritized youth in new destination areas, we examined whether same-day links between positive interactions with friends and mood vary by two contextual factors—(a) the racial–ethnic composition of adolescents’ close friends, and (b) the quality of parent–adolescent interactions—among Black and Latiné adolescents living in United States. Data were obtained from two daily diary studies, one of 36 Black adolescents (44% male; 11 to 17 years old; M = 13.65, SD = 2.29), and one of 21 Latiné adolescents (52% male; 11 to 14 years old; M = 12.76, SD = 1.00). Across 10 school days, youth completed afternoon reports of positive interactions with friends and bedtime reports of mood and positive parent–youth interactions; the race–ethnicity of the friend group were assessed at baseline. Multilevel models separated day-level from person-level effects and tested moderation by the racial–ethnic composition of friends and parent–youth interactions. For Black adolescents with few same-race friends (0 to 1 out of max 3), when youth reported more positive friend interactions, they reported lower positive mood. The opposite was true for Black youth with more same-race friends; when youth reported more positive friend interactions, they reported more positive mood at the end of the day. Among Black youth with higher mean levels of positive parent interactions, when youth reported more positive friend interactions, they reported lower negative mood. Results from the analysis of Latiné youth did not support study hypotheses. Findings extend cultural–ecological–transactional frameworks of development by showing that the short-term emotional yield of supportive interactions with friends hinges on contextual vulnerabilities and assets, such as peer group composition and family relationship quality, especially for Black youth. Full article

As university campuses increasingly open to the public and become integrated into urban tourism systems, campus spaces are evolving into institutionalized multifunctional environments shared by students and visitors. However, existing tourism conflict research has mainly focused on traditional resident–tourist relations, with limited attention to institutionalized educational spaces. Taking Hunan University in the Yuelu Mountain Scenic Area, Changsha, as a case study, this study develops a perceived conflict–place attachment–overall impact evaluation framework and tests it using data from 438 student questionnaires and structural equation modeling. The results show that perceived conflict significantly weakens place attachment and reduces students’ positive evaluations of campus tourism impacts, with place attachment serving as a significant mediator. More importantly, the effects are not uniform: only economic and social conflict significantly reduce place attachment, campus belonging amplifies rather than buffers the negative effect of perceived conflict, and study duration does not significantly moderate this relationship. In addition, students whose daily study or living spaces are closer to tourism core areas report stronger perceived conflict and greater vulnerability to its consequences. By showing that tourism conflict in campus spaces is selective and context-dependent, this study extends tourism conflict theory beyond conventional community settings and offers practical implications for conflict-sensitive, spatially differentiated, and student-oriented campus tourism governance. Full article

This study analyzes the closure, decommissioning, and abandonment (CDA) of a fuel storage and distribution facility in southern Quito, Ecuador, conceptualizing the process as a socio-technical urban transition embedded within territorial governance dynamics. While infrastructure decommissioning is commonly addressed from a predominantly technical perspective, limited research integrates reverse logistics design, stakeholder influence structures, and territorial development into a unified analytical framework, particularly in Latin American metropolitan contexts. Using a mixed-methods case study approach, the research combines documentary analysis, operational data, and 34 semi-structured interviews with public authorities, engineers, fuel marketers, business owners, and community representatives. A thematic analysis was applied to reconstruct the decommissioning logistics chain and to develop a stakeholder mapping and influence matrix assessing actor positions, economic interdependencies, and legitimacy claims. The findings show that decommissioning operates as a structured reverse logistics system embedded within asymmetric governance configurations, where economic dependency, risk perception, and urban redevelopment expectations generate competing territorial imaginaries. Technical feasibility alone proves insufficient to guide decision-making; instead, legitimacy emerges through the alignment of engineering planning, institutional coordination, and community-level expectations. The study advances an integrated socio-technical framework that articulates Engineering Management, Social Management, and Territorial Development, positioning decommissioning as a governance-driven transition rather than a purely technical operation. The results contribute to sustainability and infrastructure transition scholarship while offering practical guidance for managing urban hydrocarbon infrastructure closure in socially vulnerable territories. Full article

Preventive health behaviors play a critical role in reducing disease risks and improving public health outcomes, particularly among vulnerable populations such as women in rural communities. However, limited research has explored the determinants of intentions to adopt preventive health behaviors in developing contexts among women in rural communities. This study applies and extends the Theory of Planned Behavior (TPB) to examine these determinants in Algeria. A cross-sectional study was conducted using convenience sampling among 205 women in rural communities aged 20–60 years across five Algerian cities. Data were collected through a self-administered questionnaire and analyzed using hierarchical multiple regression. The results indicate that attitude, subjective norms, and perceived behavioral control have significant positive effects on behavioral intention. The inclusion of health literacy significantly enhances the model’s explanatory power, with higher literacy associated with stronger intentions. In contrast, perceived healthcare discrimination does not have a statistically significant effect. The extended model explains 57.5% of the variance in behavioral intention. These findings underscore the importance of psychosocial and informational factors in shaping preventive health intentions and support the extension of TPB in this context. They also provide practical implications for policymakers and healthcare practitioners to design targeted social marketing interventions aimed at improving preventive health behaviors and reducing health disparities among women in rural communities. Full article

Multimodal Named Entity Recognition (MNER) aims to integrate textual and visual information to identify entities with specific semantic categories. However, existing methods often suffer from insufficient intra-modal semantic modeling, coarse cross-modal alignment, and vulnerability to noisy or ambiguous expressions in social media. To address these challenges, we propose a Visual–Semantic Guided Interaction Network (VSGN), which improves multimodal representation learning from both semantic and structural perspectives. Specifically, we first design an adaptive visual–semantic fusion module that incorporates visual descriptions as semantic guidance, enabling more informative cross-modal interactions. To further enhance feature quality, we introduce a deviation-aware channel-wise inhibitory routing (CIR) mechanism, which jointly models channel importance and distributional deviation to suppress noisy or redundant visual signals. In addition, we propose a visual–semantic guided graph structure learning module (VSG), which explicitly captures structural dependencies across modalities. By enforcing distribution-level alignment between textual and visual graph representations, the model achieves structure-aware cross-modal interaction and reduces modality inconsistency. Extensive experiments on the Twitter-2015 and Twitter-2017 datasets demonstrate the effectiveness of the proposed method, achieving F1 scores of 76.72% and 87.86%, respectively. The results show that jointly modeling semantic enhancement and structural alignment leads to more robust and discriminative multimodal representations. Full article

In Latin America, the double burden of malnutrition is the region’s single most important public health concern for the incoming decade. Latin America’s burden of disease has distinct features in comparison to high-income countries: nearly 20 percent of NCDs are diagnosed in people under 60 years of age in Latin America, whereas only about 13 percent of people under 60 years of age in North America and Europe are diagnosed with these diseases. We aimed to better understand decision-making processes, preferences, and norms around food choices to provide input for future programming and policy suggestions at national and regional levels. We included key informant interviews and focus group discussions with parents and adolescents from urban and rural communities in three regions in Colombia and in Mexico. Results showed that food choices considered to be affordable, acceptable, accessible, and aspirational are driven by environmental and social factors that influence individual cognitive decisions. Across the study groups, cognitive biases influenced food decision-making in relation to eating out, natural, homemade, and “moderation”. At the sociological level, conversations, and social influences at home and in communities were strong indicators of dietary practices, health beliefs, and body size attitudes. Full article

Africa is historically celebrated as the cradle of humankind. However, there is doubt on whether she is maintaining her own originality and position as the motherland and fatherland of all humanity. Although globalisation has impacted all continents and states, its negative effects seem to be skewing towards African and in particular Zimbabwean Shona families. This paper examines how DNA testing has impacted on some of the Shona families in Zimbabwe. The Shona community in Zimbabwe is culturally porous and receptive in terms of traditional, religious, linguistic and cultural values. They embraced Western democracy that is premised on human rights principles, constitutionalism, and citizenship, which, however, do not guarantee their belongingness. As some of the Shona families in Zimbabwe drifted away from the traditional cultural belief system campus, they got into a foreign and alien worldview that is dictated by the host in the name of technology. This has led to excessive reliance on foreign systems that are appearing like global standards yet they are disempowering them and causing them emotional and social distress. The reliance is a result of neocolonialism, linguistic and cultural imperialism that needs decolonisation. Thus, the paper adopts a qualitative approach based on an illuminating multiple case study design of six purposively selected scenarios aired on the The Closure DNA Show programme broadcasted on Zimbabwe Television (ZTV). The Afrocentric paradigm serves as a lens to uncover some of the perceptions of Shona families in Zimbabwe on DNA testing and its implications on parenthood, the family unit, and identity. The findings reveal that DNA testing is perceived as gender divisive and a destroyer of the family unit and exposing children to vulnerability, while it is also perceived positively as a way of (dis)affirming identity, which is crucial among the Shona. The paper recommends that other television programmes be screened based on their implications on gender relations, the family unit and identity. Full article

Preserved ratio impaired spirometry (PRISm) is increasingly recognized as a clinically important non-obstructive spirometric phenotype associated with excess all-cause, respiratory, and cardiovascular mortality. PRISm is variably defined across studies and should be distinguished from pre-COPD and restrictive spirometric pattern, particularly in LMIC settings where diagnostic context may differ. Although most evidence has been generated in high-income settings, PRISm may be especially relevant in low- and middle-income countries (LMICs), where the phenotype appears to arise within a markedly different exposure environment. Rather than reflecting predominantly the smoking–obesity–metabolic profile commonly described in wealthier populations, PRISm in LMICs may more often emerge from the cumulative effects of tuberculosis, household biomass smoke, ambient particulate air pollution, poverty-related undernutrition, impaired lung growth, and other adverse life-course exposures. These factors may contribute both to low-volume lung-function impairment and to increased cardiovascular risk through shared pathways of chronic low-grade inflammation, immune activation, oxidative stress, endothelial dysfunction, and metabolic dysregulation. In this context, PRISm may represent a measurable interface between environmental and infectious lung injury, social disadvantage, and systemic vascular vulnerability. The emerging literature further suggests that PRISm in LMICs may include distinct leaner, poverty-related, and infection-linked phenotypes that differ from the obesity-associated patterns more often described in high-income cohorts. This perspective has important clinical implications, as PRISm may identify individuals at elevated risk of cardiometabolic comorbidity, heart failure, stroke, and cardiovascular death who may otherwise remain unrecognized within current respiratory care pathways. Although direct causal evidence remains limited, the convergence of epidemiological, mechanistic, and clinical data supports the view that PRISm in LMICs should be considered a meaningful cardiopulmonary risk state rather than a benign spirometric abnormality. Further LMIC-focused longitudinal, mechanistic, and implementation research is needed to refine phenotyping, clarify causal pathways, and inform integrated prevention strategies. Full article

Eco-anxiety refers to emotional and cognitive responses to environmental degradation and can manifest in both adaptive and maladaptive forms. This study aimed to identify distinct eco-anxiety profiles and examine their associations with resilience and vulnerability factors in a sample of 917 Portuguese-speaking adults. Latent profile analysis revealed five profiles: adaptive eco-anxiety, highly impaired maladaptive eco-anxiety, psychological distress independent of eco-anxiety, non-anxious/disengaged, and moderate I I have separated the addresses into different affiliations.have separated the addresses into different affiliations.eco-anxiety. These profiles differed significantly in psychological symptomatology, nature connectedness, pro-environmental attitudes, and prior exposure to cumulative social and environmental stressors. Higher-distress profiles were more likely among younger individuals, women, urban residents, unemployed participants, those without children, individuals with a prior psychiatric history, and those reporting direct exposure to drought. In contrast, stronger environmental identity and greater engagement with natural environments were associated with adaptive eco-anxiety, suggesting protective and resilience-promoting mechanisms. Overall, the findings highlight the multidimensional and heterogeneous nature of eco-anxiety and its complex relationship with psychological well-being and environmental engagement. Tailored interventions that promote adaptive coping, strengthen psychological resources, and facilitate access to natural environments may help mitigate maladaptive distress while supporting constructive environmental concern and action. Full article