Search Results (6,672)

Proximity-oriented planning aims to deliver everyday services within a short walk, yet closeness does not guarantee usable access for all residents. This study quantifies the gap between spatial proximity and functional accessibility in Timișoara, România, focusing on people with mobility and visual impairments. A three-stage analysis was conducted to evaluate accessibility to public amenities. First, (1) a survey was conducted with 605 respondents to identify distinct accessibility priorities based on 15-Minute City core dimensions defined by Carlos Moreno and adapted afterwards to the city context and needs. In the second stage (2), GIS mapping (radial buffers and isochrones) revealed major disparities among non-disabled residents and residents with mobility and visual impairments. Coverage decreased substantially across amenities under reduced-speed scenarios and after excluding wheelchair-inaccessible destinations. In the third stage (3), field-observed pedestrian routes in three areas of Timișoara were examined against the top-ranked criteria for each group, using the items sourced from the previous survey and grounded in the 15-Minute City concept. The route scoring is exploratory and specific to this context. The findings confirmed recurrent functional barriers, especially for vulnerable groups. These results expose a proximity-accessibility gap, where apparent nearness masks physical or sensory barriers. A shift toward experience-based accessibility planning is needed to ensure that proximity is not only spatial, but also usable by all and inclusive. Full article

Antimicrobial resistance (AMR) poses a significant global threat to human and animal health, necessitating robust surveillance and stewardship tools. While existing systems address aspects of veterinary AMR, a comprehensive, user-centric dashboard for U.S. veterinarians remains a critical unmet need. This study aimed to identify U.S. veterinarians’ preferences and perceived needs for such a dashboard, to help guide its design and development. A cross-sectional survey was conducted between January and March 2024, targeting U.S. veterinarians through professional channels. The survey instrument captured demographics, experiences with existing tools, preferences for data types and visualizations, desired technical specifications, and open-ended feedback. Of the 677 respondents, a near-unanimous consensus (over 75%) emerged on the importance of functionalities like antimicrobial stewardship education, off-label use guidance, surveillance data, and empirical treatment support. Over 70% expressed comfort sharing aggregated geographic and de-identified animal data. A strong preference was observed for making the dashboard accessible by veterinary colleges (78.87%), diagnostic laboratories (72.61%), and federal agencies (USDA: 71.47%, CDC: 66.67%, FDA: 62.11%), indicating a desire for a collaborative, authoritative system. The findings provide a robust foundation for developing a U.S. veterinary AMR dashboard. Future phases should adopt an iterative, user-centered design, incorporating qualitative research with diverse stakeholders and piloting a prototype with preferred institutional partners. This approach will ensure a trusted, sustainable tool that effectively translates surveillance data into actionable insights for improved animal and public health. Full article

Food and water security are essential components for Panama’s advancement toward the Sustainable Development Goals. This study aimed to quantify the prevalence of household food insecurity and water insecurity, and to explore the association between them using standardized measurement tools. A cross-sectional survey was conducted between January and June 2024 using an online questionnaire administered via Google Forms. The survey collected sociodemographic data and applied the Food Insecurity Experience Scale (FIES) and the Household Water Insecurity Experiences (HWISE) scale to assess water and food insecurity, respectively. A total of 222 adult household heads were included (66.2% female), with a median age of 31.4 years. The prevalence of moderate and severe food insecurity was 29.7% (95% CI: 24.8–34.6%) and 6.1% severe food insecurity (95% CI: 3.7–8.4%), while water insecurity affected 27% of households (10.4% high; 16.7% moderate). Multiple linear regression showed that moderate to severe food insecurity was significantly associated with water insecurity (β = 0.19; 95% CI: 0.08–0.31) and lower income levels. Specifically, food insecurity was associated with households reporting no income (β = 0.25; 95% CI: 0.05–0.44) and those with monthly income between 501 and 1000 USD (β = 0.11; 95% CI: 0.01–0.22), compared to households with income above 1000 USD. The results suggest that food insecurity is significantly associated with water insecurity, supporting the need for integrated approaches in public policy to address basic resource access in vulnerable populations. Full article

The primary goal of Transportation systems is to provide transportation accessibility to opportunities. Equitable access to essential destinations encompassing social, recreational, educational, and civic opportunities needs to be more consistent across different social groups. This study evaluates the disparities in social justice using social equity as a measure of transit access and walk access to non-work amenities. These non-work amenities include grocery stores, personal services, retail outlets, recreational venues, entertainment centers, and healthcare facilities in the U.S. Logistic regression models are developed using the 2017 National Community Livability Survey data. The results indicate regressive public transit access for socially disadvantaged groups, including older citizens, non-drivers, Medicare/Medicaid beneficiaries, and non-metropolitan residents. Walk access inequities similarly affect older individuals, non-drivers, the physically disabled, the unemployed, students, women, and non-metropolitan residents. This research emphasizes the importance of addressing transit and walk-access inequities to non-work amenities within transportation systems. By acknowledging the disparities in transportation equity, decision-makers and communities can foster more inclusive and equitable access to essential destinations, thereby promoting social cohesion and overall community well-being. Full article

Background: This study is particularly relevant to the Romanian context, where relatively few empirical investigations have examined post-pandemic health perceptions and levels of trust in public institutions. The purpose of this study is to investigate the long-term impact of the COVID-19 pandemic on health perceptions and trust in the healthcare system by examining key socioeconomic and epidemiological factors. Methods: A cross-sectional online survey was conducted among Romanian adults (N = 423), between March and April 2025. Demographic data, lifestyle habits, mental health, and access to healthcare were assessed. Statistical analyses included both bivariate (chi-square test) and multivariable logistic regression models to identify independent associations. Results: 31.9% of participants reported increased stress and anxiety during the pandemic. Decreased trust in the healthcare system (75.6%) and a perceived reduction in life expectancy (74.3%) were also noted as a consequence of the COVID-19 pandemic. Perceived life expectancy decline was linked to lower education and inconsistent healthcare behavior. Conclusion: In our sample, the perception of decreased life expectancy reflects not only epidemiological realities but also emotional and social responses to crises. Individuals’ trust, behavior, and shared vision of the future have also been challenged during the COVID-19 pandemic. Full article

Under the dual backdrop of the Healthy China strategy and the concept of sustainable development, optimizing the spatial layout of primary healthcare facilities is important for fairly distributing healthcare resources and strengthening the resilience of the public health system in a sustainable way. This study introduces an innovative 3D spatial resilience evaluation framework, covering transmission (service accessibility), diversity (facility type matching), and stability (supply demand balance). Unlike traditional accessibility studies, the concept of “resilience” here highlights a system’s ability to adapt to sudden public health events through spatial reorganization, contrasting sharply with vulnerable systems that lack resilience. Method-wise, the study uses an improved Gaussian two-step floating catchment area method (Ga2SFCA) to measure spatial accessibility, applies a geographically weighted regression model (GWR) to analyze spatial heterogeneity factors, combines network analysis tools to assess service coverage efficiency, and uses spatial overlay analysis to identify areas with supply demand imbalances. Harbin is located in northeastern China and is the capital of Heilongjiang Province. Since Harbin is a typical central city in the northeast region, with a large population and clear regional differences, it was chosen as the case study. The case study in Harbin’s main urban area shows clear spatial differences in medical accessibility. Daoli, Nangang, and Xiangfang form a highly accessible cluster, while Songbei and Daowai show clear service gaps. The GWR model reveals that population density and facility density are key factors driving differences in service accessibility. LISA cluster analysis identifies two typical hot spots with supply demand imbalances: northern Xiangfang and southern Songbei. Finally, based on these findings, recommendations are made to increase appropriate-level medical facilities, offering useful insights for fine-tuning the spatial layout of basic healthcare facilities in similar large cities. Full article

Background: Vision loss due to chronic eye diseases remains a significant public health challenge. Early detection through screening programs may reduce the burden of vision loss. This study aimed to assess the detection rate of eye diseases (glaucoma, AMD, and diabetic retinopathy), including those newly detected during opportunistic screening and ophthalmological consultations within the local government health policy program “Good Vision for Mazovians” in Mazovia, Poland. Material and methods: This study is a retrospective analysis of medical data from the registry of the Ophthalmology Department of the Międzylesie Specialist Hospital in Warsaw, which implemented the local government preventive program “Good Vision for Mazovians. Data from 1812 individuals (aged 18–92 years) participating in the “Good Vision for Mazovians” preventive program were analyzed. Results: Most participants were female (59.7%), aged over 60, and took medications regularly (62.7%). Excluding subjects with prior diagnosis of eye conditions, the detection rate was 38 suspected cases (3.8%) of glaucoma cases, 84 suspected cases of AMD (4.6%), and 21 suspected cases of diabetic retinopathy (1.2%). Most participants had not visited an ophthalmologist in the past two years (58.6%), reported low or average knowledge of eye health, had difficulty accessing ophthalmology services in their region (57%), and identified long waiting times for appointments as the main barrier to care (83.5%). Conclusions: Opportunistic screening for eye diseases in populations with limited access to eye care should be considered as a method for detecting common causes of irreversible visual impairment, particularly AMD. Older adults and individuals without higher education appear to face the greatest barriers to accessing ophthalmology services and may benefit the most from targeted opportunistic screening initiatives. Full article

The Mon Valley near Pittsburgh, Pennsylvania, consistently reports some of the poorest air quality in the United States. Recent studies have linked air pollution in this region to poor asthma outcomes but did not examine the impact on other respiratory conditions or vulnerable populations. This retrospective study examined the relationship between the air quality index (AQI) and respiratory exacerbations of asthma, bronchitis and chronic obstructive pulmonary disease (COPD) in the Mon Valley between January 2018 and February 2020. We linked daily Air Quality Index (AQI) values for ozone, PM_2.5, SO₂ and NO₂, plus temperature and wind speed to healthcare utilization for these conditions. Using a Poisson generalized linear model, we quantified the association between pollutant levels and same-day exacerbation rates, stratified analyses by age, sex and insurance type to identify vulnerable subgroups. Results indicated that higher AQI scores, driven primarily by PM_2.5 and SO₂, were significantly associated with increased asthma exacerbations on the day of exposure. Children and individuals with public insurance experienced the greatest impact. Bronchitis exacerbations showed a delayed response to SO₂. Our findings affirm PM_2.5 and SO₂ as key drivers of acute asthma events in the Mon Valley and extend this observation to include impacts on bronchitis and vulnerable populations. They also demonstrate the AQI’s value for public health surveillance and underscore the importance of tailored interventions such as issuing timely air quality alerts, strengthening emissions regulations and improving access to preventive care to protect at-risk populations from adverse air pollution effects. Full article

Public green spaces are vital to urban life, offering recreational opportunities, enhancing mental and physical well-being, and supporting environmental sustainability. This study presents a structured evaluation of ten public parks in Riyadh, categorized as neighborhood, local, and large parks, and compares their performance to two internationally recognized benchmark parks—Hyde Park and Regent’s Park in London. A partly original evaluation framework was developed to assess the design-related and environmental (nature-based) qualities of these parks. The framework integrates 50 criteria grouped into nine categories, combining quantitative scoring on a five-point scale with qualitative on-site observations. This method enables a comprehensive assessment of design quality, accessibility, and sustainability features. A city-wide map with a color-coded legend illustrates the distribution of the evaluated parks, while field observations and photographic documentation supported the data collection. Findings reveal notable variations in design quality, accessibility, and sustainability across the parks. The results highlight both strengths and gaps compared to international benchmarks, providing valuable insights for improving park design and management. This study contributes to ongoing efforts to enhance park usability and align with Riyadh’s Vision 2030 objectives, offering a practical decision-support tool for planners, managers, and policymakers seeking resilient and inclusive public green spaces. Full article

Background: Chemsex, the intentional use of psychoactive substances to enhance sexual experiences, is an emerging public health issue in Brazil, associated with increased risks of sexually transmitted infections and complex psychosocial vulnerabilities. Despite the universal coverage provided by the Unified Health System (SUS), individuals who practice chemsex often encounter barriers to healthcare, including stigma, discrimination, and a lack of specialized services. To date, no comprehensive reviews appear to synthesize evidence on how this population accesses healthcare in the Brazilian context; existing knowledge remains fragmented across individual studies. Objectives: The aim is to map and synthesize the available evidence regarding access to health services among people who engage in chemsex in Brazil, identifying health needs, professional demands, barriers, and facilitators. Methods: The protocol follows the Joanna Briggs Institute methodology for scoping reviews and PRISMA-ScR guidelines. A systematic search will be conducted in MEDLINE (PubMed), Embase, Scopus, SciELO, and LILACS for studies published between 2014 and 2024 in Portuguese, English, or Spanish. Data will be summarized using descriptive and narrative synthesis, presented in tables and thematic categories. Studies will be included if they address chemsex or sexualized drug use in Brazil and report on healthcare access, regardless of gender identity, sexual orientation, or drug type. Studies that do not address chemsex, focus on drug use outside a sexual context, or are unrelated to Brazil will be excluded. Expected results: The review is expected to identify key barriers and facilitators to healthcare access, highlight knowledge gaps for underrepresented groups, and support recommendations for research, policy, and practice to improve care for people engaging in chemsex in Brazil. By focusing on an underexplored intersection of drug use, sexuality, and healthcare access in Latin America, this study aims to provide an innovative contribution to public health literature. Full article

Late-stage cancer diagnoses of prevalent cancers are increasing in the Northern Province of Sri Lanka, a region currently rebuilding its healthcare system after a prolonged civil war. In this region, cancer prevention services are limited. We describe a community-centric approach to cancer education and prevention as a strategy to cancer control in this rural, post-conflict region. Nursing students were trained as Community Cancer Educators (CCEs), equipping them with essential knowledge about cancer symptoms, risk factors, and the importance of early detection. The training also included creative methods such as dance and drama to help CCEs communicate cancer-related messages in an engaging and culturally relevant manner. These CCEs supported the oncologist-led community health camps in delivering cancer education and screening directly to community members within their community. We planned the health camps in collaboration with the existing community-based public health system for better outreach. Feedback from community participants and healthcare providers suggests that this community-centric approach can improve cancer awareness, encourage participation in population screening, and support early cancer detection. This approach could strengthen community engagement and contribute to more equitable access to prevention and screening services in rural, post-conflict settings with limited healthcare infrastructure. Full article

Background/Objectives: The global threat of antimicrobial resistance is a significant public health challenge, leading to prolonged hospitalizations, increased costs, and elevated mortality. Romania faces one of Europe’s highest burdens of antimicrobial consumption and resistance. This study aimed to investigate the factors that influence antibiotic prescribing practices among physicians in pediatric care in Romania. Method: This quantitative, cross-sectional study collected data using a self-administered, structured questionnaire from 154 healthcare professionals (family physicians, pediatricians, and other specialists) providing pediatric care in Romania. Participants were recruited via non-probability convenience sampling. The 29-question survey gathered demographic data and explored perceptions and practices regarding antibiotic therapy in children using a 5-point Likert scale. Results: The majority of participants were family physicians (64.94%) with over 15 years of experience (53.90%), primarily practicing in urban settings (61.69%). Only 21.43% had attended an antibiotic stewardship course in the last three years. Physicians generally base their prescribing on clinical symptoms. While physicians strongly agreed they follow guidelines, personal experience also held significant weight. High parental demand for antibiotics was perceived, but physicians largely denied ceding to parental tone or insistence without a medical indication. A strong consensus existed on antibiotic overuse in Romanian children, and a high interest in continuous education on rational antibiotic use was noted. Pediatricians showed significantly higher guideline adherence and diagnostic test use than family physicians. Rural physicians reported lower guideline adherence and less frequent diagnostic testing. Stewardship course participation and access to rapid diagnostic tests were associated with more evidence-based practices. Conclusions: Romanian physicians exhibit a nuanced approach to antibiotic prescribing, balancing guidelines with personal experience and facing significant perceived parental pressure. Professional profile (specialty, experience, practice environment) and access to diagnostic resources significantly influence prescribing decisions. Full article

As of mid-2025, California maintains a target (and legal agreement with truck OEMs) to achieve 100% zero-emission medium- and heavy-duty (M/HD) truck sales by 2036. While the US federal government has relaxed its targets, fuel economy standards continue to incentivize electrification. To meet these ambitions, the adequate rollout of charging infrastructure at scale is needed. This paper reviews existing studies on M/HD charging and investment needs in California and the U.S. This paper introduces a novel matrix that delineates charging needs by charging power, truck type (Class 2b-8), charger-to-vehicle ratios, and charger investment costs. Results indicate that California may require 151,000 to 156,000 depot and public chargers on the road by 2030, growing to 434,000 to 460,000 chargers on the road by 2035. Corresponding investment—including new installation and replacement—could reach USD 7.1 to USD 7.4 billion by 2030 and USD 16.4 to USD 17.8 billion by 2035. Meeting this scale of infrastructure deployment represents not only a technical challenge but also a sustainability imperative, demanding unprecedented coordination among policymakers, utilities, and fleet operators to overcome barriers like financing and permitting and to ensure infrastructure growth aligns with climate commitments and equitable access. Full article

The electronic judicial evidence preservation systems face various challenges including regulatory control, data exchange, poor credibility, etc. To address these issues, a blockchain-based judicial evidence preservation framework, JudicBlock, is proposed in the present study. It combines the scalability of the Interplanetary File System with the transparency and security of public blockchain. By decentralizing data management and using cryptographic integrity, the system ensures reliable chronological tracking of investigative changes. Unlike traditional approaches, JudicBlock incorporates smart contracts and advanced consensus mechanisms to enforce strict access controls with secure collaboration among the stakeholders. The simulation results show that JudicBlock provides better results over traditional ELR (electronic law records) storage schemes in terms of mining cost, query fetching time, block processing IPFS (Interplanetary file systems) throughput, etc. At a USD 6 mining cost, it appends an average of 23,601 transactions. For 25 blocks, the average query fetching time is 0.852 ms with the cache support of 32 KB. The proposed scheme achieves an average ELR uploading latency improvement of 6.79% over traditional schemes. The results indicate the efficacy of the proposed scheme over the conventional schemes. Full article

Background/Objectives: Understanding the diverse neuron types within the hippocampal formation is essential for advancing our knowledge of its fundamental roles in learning and memory. Hippocampome.org serves as a comprehensive, evidence-based knowledge repository that integrates morphological, electrophysiological, and molecular features of neurons across the rodent dentate gyrus, CA3, CA2, CA1, subiculum, and entorhinal cortex. In addition to these core properties, this open access resource includes detailed information on synaptic connectivity, signal propagation, and plasticity, facilitating sophisticated modeling of hippocampal circuits. A distinguishing feature of Hippocampome.org is its emphasis on quantitative, literature-backed data that can help constrain and validate spiking neural network simulations via an interactive web interface. Methods: To assess and enhance its utility to the neuroscience community, we integrated Google Analytics (GA) into the platform to monitor user behavior, identify high-impact content, and evaluate geographic reach. Results: GA data provided valuable page view metrics, revealing usage trends, frequently accessed neuron properties, and the progressive adoption of new functionalities. Conclusions: These insights directly inform iterative development, particularly in the design of a robust Application Programming Interface (API) to support programmatic access. Ultimately, the integration of GA empowers data-driven optimization of this public resource to better serve the global neuroscience community. Full article