Search Results (13,432)

Background: Depression has become a prevalent and serious public health problem worldwide, attracting widespread attention from governments and international organizations and being included in key health policy issues. There is a close interaction between depression and economic factors such as household savings, a link particularly pronounced in Asian countries. However, evidence of a two-way association is limited. This study aims to explore the two-way relationship between depression and savings among middle-aged and older adults. Methods: Data were collected from 6746 respondents in the China Health and Retirement Longitudinal Study (CHARLS) in 2013, 2015, and 2018. A cross-lagged panel model was used to test the two-way relationship between depression and savings. Results: The results showed a significant cross-time effect of depression on savings (T0 → T1: β = −0.052; T1 → T2: β = −0.077), suggesting that higher levels of depression in the early stages are associated with lower levels of savings later. Moreover, savings had a stronger negative predictive effect on depression (T0 → T1: β = −0.463; T1 → T2: β = −0.510), indicating that higher levels of savings in the early stages are associated with lower levels of depression later. Furthermore, the grouping test showed that the two-way negative effect remained stable in both male and female groups (p ≤ 0.001). Conclusions: This study reveals the dynamic two-way influence between depression and savings, providing a basis for policy formulation that synergistically promotes residents’ mental health and household financial stability. Full article

Background: Hepatitis C virus (HCV) remains a major cause of preventable liver-related mortality in the United States despite highly effective direct-acting antivirals (DAAs). Contemporary assessment of mortality trends and disparities is essential for elimination efforts. Methods: Using CDC WONDER multiple cause-of-death data (1999–2023), we identified HCV-related deaths using ICD-10 codes for acute and chronic HCV (B17.1, B18.2) and calculated age-adjusted mortality rates (AAMRs) per 100,000 (2000 US standard). Rates were stratified by sex, race/ethnicity, census region, and 2013 NCHS urban–rural classification. Joinpoint regression quantified temporal inflection points and annual percent changes (APCs). Results: Overall HCV-related AAMR increased from 1.8 (1999) to a peak of 5.0 (2014), then declined to 2.3 (2023), with a marked post-2014 decrease (APC −8.2%). Mortality was consistently higher in males than females (2023 rate ratio 2.57). In 2023, American Indian/Alaska Native individuals had the highest mortality (AAMR 8.7; rate ratio 3.48 vs. non-Hispanic White), followed by non-Hispanic Black individuals (AAMR 6.2; rate ratio 2.48). Mortality remained highest in the West and was higher in non-metropolitan than metropolitan counties (AAMR 2.8 vs. 2.3; rate ratio 1.22), with a slower post-2014 decline in non-metropolitan areas. Conclusions: Our findings indicate that while the DAA era has been associated with a substantial reduction in HCV-related mortality at the national level, this progress has not been uniform across all populations. Persistent excess mortality among Native American and non-Hispanic Black individuals may reflect inequities in the HCV care cascade, including screening, confirmatory testing, linkage to specialty care, insurance-related restrictions, and the high cost of antiviral therapy. These results highlight the need for policies and public health strategies that improve equitable and affordable access to curative HCV treatment. Full article

Public data openness refers to the practice whereby governments make the raw data collected, generated, and managed during public administration freely available to society through unified platforms for public development and use. As a government-led reform in digital governance, public data openness offers a new approach to strengthen urban export resilience. Using panel data from 283 cities at the prefecture level and above in China from 2009 to 2023, we construct a comprehensive evaluation system to measure urban export resilience. Taking the launch of local public data platforms as a quasi-natural experiment, we employ a multi-period difference-in-differences (DID) model and a mediating effect model to examine the impact of public data openness on urban export resilience and its underlying mechanisms. The results show that public data openness significantly improves urban export resilience by improving the institutional environment and enhancing information acquisition efficiency. Heterogeneity analysis further shows that the effect is stronger in eastern cities with higher levels of economic development, higher administrative ranks, and larger urban size. These findings enrich the literature on the economic consequences of public data openness and provide policy recommendations for strengthening urban resilience through digital governance. Full article

Mauritius, as a Small Island Developing State (SIDS), depends heavily on tourism and is therefore exposed to external shocks; this study examines how the sector’s performance and value capture evolved from 2010 to 2025, with particular attention to the COVID-19 disruption and subsequent recovery. The analysis uses only secondary data, combining arrivals and source-market breakdowns published by the Ministry of Tourism with the monthly series of gross tourism earnings released by the Bank of Mauritius. Trends and seasonality are described for both arrivals and earnings, and three indicators are derived to support interpretation: revenue per arrival (as a proxy for value capture), the intensity of seasonality, and the concentration of source markets. The results document the magnitude of the pandemic-related break, trace the timing of the rebound, and show how value capture and market concentration shifted between the pre- and post-COVID periods. The paper concludes by discussing the implications for resilience in island destinations, highlighting the need for diversification and higher-value positioning, and proposing a replicable monitoring approach that can be updated as new official data become available. Full article

This study examines how digital transformation in higher education institutions (HEIs) contributes to public value creation, moving beyond efficiency-oriented narratives toward broader societal outcomes. Using a PRISMA-ScR approach, the study systematically reviews 47 peer-reviewed articles published between 2013 and 2025 across major academic databases. The review maps the evolution of scholarship and identifies the key mechanisms through which digital transformation influences public value. The findings reveal three interrelated dimensions shaping outcomes: digital competencies, institutional readiness, and governance alignment. Digital competencies enable the effective adoption and use of technologies, while institutional readiness—comprising digital infrastructure, leadership capacity, and organizational culture—acts as a mediating condition influencing implementation success. Governance alignment, including regulatory coherence, accountability mechanisms, and stakeholder engagement, plays a moderating role in determining whether digital transformation initiatives generate inclusive and socially beneficial outcomes. In addition to positive outcomes such as improved access, service quality, and transparency, the review identifies critical risks—including digital inequality, data governance challenges, and algorithmic bias—that may constrain public value creation, particularly in resource-constrained and Global South contexts. Building on these findings, the study develops the Global Digital Transformation—Public Value Creation (G-DTPVC) framework as an evidence-synthesized model derived from the reviewed literature. The framework specifies key constructs, causal relationships, and indicative measures to support future empirical research and policy application. By linking digital transformation processes in HEIs to broader public value outcomes and Sustainable Development Goals (SDGs 4, 9, and 16), this study advances theoretical understanding and provides actionable, context-sensitive guidance for policymakers and institutional leaders seeking to foster inclusive, accountable, and resilient higher education systems. Full article

Background: The impact of climate change on birds’ migration and ticks’ reservoir habits is contributing to the spread of Crimean–Congo hemorrhagic fever (CCHF), caused by CCHF virus (CCHFV), to new continents and countries. CCHF is endemic to the Eastern Mediterranean Region, including Iraq, and is witnessing a substantial surge in confirmed cases with considerable disparity and gaps in managing CCHF cases. The increasing CCHF spread across Asia, Africa, and Europe, including Spain and Turkey, highlights the danger of its expansion. Developing high-confidence diagnostic criteria, identifying risk factors, and accurate predictors of CCHF outcomes are critical to managing suspected and confirmed cases of CCHF and to reducing the current case fatality rate of CCHF, which is the goal of this study. Methods: We completed a retrospective evaluation of 61 confirmed cases of CCHF in Basrah (Iraq). The cases were screened according to the clinical presentation, and CCHF cases were identified by ELISA and validated by PCR. Data was analyzed using SPSS version 22. T-tests, chi-square/Fisher exact tests, and Pearson’s correlation were used, with significance set at p < 0.05 and high significance at p < 0.01. Results: We found that repeated exposure to animals during animal slaughtering was a significant risk factor. In addition, 5% of the patients with confirmed CCHF, mainly from rural areas, reported exposure to rats. Clinical presentations included fever, headache, gastrointestinal problems, eye and orbital symptoms, and hemorrhagic complications. Predictors of death included advanced age, decreased platelet counts, and neuropsychiatric symptoms such as delusions and confusion. Conclusions: Our findings identify clinical and laboratory features of CCHF cases in Iraq, which will help to implement the most effective interventions to manage CCHF cases and protect the public in all Iraqi governorates. In summary, this study highlights a recent and significant rise in CCHF cases in Basrah Governorate, Iraq. Notably, 5% of confirmed cases reported contact with rats. The paper also proposes diagnostic criteria and identifies key predictors of mortality to support improved clinical management of CCHF. These findings underscore the urgent need for strengthened public health interventions, including enhanced infection prevention and control measures, increased awareness, and improved surveillance systems. The findings have important implications for improving control procedures, guiding therapeutic development, informing vaccine strategies, and supporting evidence-based policy alongside future research efforts. Full article

Understanding COVID-19 transitions towards endemicity is vital by examining center-specific data within provincial and national contexts. This retrospective study aimed to enhance public health management and understanding of COVID-19 dynamics using data from Atma Jaya Catholic University of Indonesia (AJCUI) and open-source databases from Jakarta and Indonesia’s official websites from July 2020 to December 2022. Trends across data sources were compared, and correlations between positivity rates at AJCUI and Jakarta/Indonesia were assessed using linear regression. A total of 8,354,809 positive samples were analyzed nationally, showing similar trends and peaks of positivity rates across databases, with positive correlations between AJCUI–Jakarta (β = 1.154; p < 0.001; 95% CI = 0.86–1.45) alongside AJCUI–Indonesia (β = 1.262; p < 0.001; 95% CI = 0.74–1.79). Mobility restriction policies substantially reduced the positivity rate within the study period. Further analysis of AJCUI showed that higher proportions of low Ct value (≤30) were associated with increased contemporaneous positivity at AJCUI (β = 0.442; p < 0.001) and Jakarta (β = 0.319; p < 0.001), although inadequately reflected in Indonesia (β = 0.039; p = 0.589). This study highlights the potential of incorporating Ct value distributions as epidemiological indicators within surveillance systems. These findings support the importance of comprehensive laboratory data recording to better characterize COVID-19 transmission patterns across different surveillance levels, alerting policymakers to establish efficient policies. Full article

The climate emergency in Latin America and the Caribbean (LAC) has transformed sustainability from an aspirational goal into a strategic imperative, particularly in the context of decoupling economic growth from natural capital depletion. This research analyzes eco-innovation within the frameworks of the National Innovation System (NIS), open innovation, and absorptive capacity, with the objective of examining the moderating role of collaboration in overcoming financial, knowledge, and market-related obstacles to innovative behavior. Employing a quantitative methodology using firm-level microdata from the Latin American Harmonized Innovation Surveys (LAIS) between 2007 and 2017, this study focuses on eco-innovative outcomes specifically linked to reductions in energy and material consumption. By estimating models that assess the role of technical cooperation and public policy support, this study seeks to determine whether collaborative strategies operate as an effective buffer against uncertainty and the limitations of local innovation systems. Expanding the scope of previous analyses centered on a single country, this work provides a regional perspective that underscores institutional and sectoral disparities in emerging contexts. Ultimately, this research examines how integrating an environmental purpose into corporate strategy and strengthening absorptive capacity enable LAC firms to transform ecological pressures into sustainable competitive advantages, mitigating the barriers that traditionally hinder technological progress in the region. Full article

Background/Objectives: Despite legal progress and achievements regarding trans* rights in Portugal over recent decades, trans* individuals still face high levels of violence and discrimination, especially within family and intimate relationships. This qualitative study aimed to explore the experiences and perspectives of professionals working in the domestic violence field with the trans* population and service provision within the National Support Network for Victims of Domestic Violence (RNAVVD). Methods: Semi-structured interviews were conducted with eight participants, including psychologists, social workers, and program directors from organizations supporting victims of domestic violence in Portugal. Data were analyzed using Codebook Thematic Analysis to identify themes, resulting in two main themes: (1) Experiences in Working with Victimized Trans* Individuals; and (2) Framework of Portugal’s National Support Network. Results: The results showed that trans* individuals face significant vulnerabilities due to family and intimate partner violence, systemic discrimination, and inequalities in essential services. Young trans* individuals are seen as being particularly at risk due to the impacts of violence and lack of family support on their autonomy, and additional barriers to entering the labor market. Participants also identified barriers faced by this population when trying to access victim support services (e.g., lack of specialized training and low availability of specialized and culturally competent services), while highlighting efforts by LGBTQIA+ services to meet their psychosocial needs. Conclusions: In conclusion, public institutions must address the specific needs of trans* individuals by developing policies and services that adopt a cross-sectoral, intersectional approach across society. Full article

In response to inherent occupational and operational stress in public safety personnel (PSP), multiple policies and interventions have been implemented, often with sparse or low-quality research. The National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard) is a comprehensive framework aimed at promoting mental health and preventing psychological harm in Canadian workplaces. This longitudinal multiple-cohort implementation science project describes mental health strategies implemented and associated organizational outcomes across five PSP organizations implementing change within the standard framework. Data were collected at two levels over a three-year span from the five public safety organizations that identified priority areas for improvement within the Standard based on local data and consultations. The organization selected and implemented a range of proactive mental health interventions, including resiliency training. Individual pre-post surveys assessed a variety of mental health disorders and work-related items. Annual organizational data included sick leave hours and extended health benefits for psychological services. Survey responses were aggregated at the organizational level. Rank-based correlation analyses (Kendall’s tau) described associations among occupational stress, work engagement, stigma, and organizational indicators. Organizations demonstrated multiple indicators of progress in meeting the Standard. Post-mental health symptom scores were positively correlated with extended health costs. Higher organizational stress scores were associated with higher extended health costs (psychological) (τ = 1.0 at pre-intervention; 0.67 post-intervention). Positive changes in organizational stress scores and higher engagement scores over the implementation process were both associated with lower average extended health costs (τ = 1.0/−1.0 respectively). Resilience scores were inversely related to health costs (τ = −0.67), consistent with the protective role of resilience. The Standard can serve as a framework for improving workplace health and safety when integrated with multi-modal action plans and structured resilience programs. Full article

Transitioning to a circular economy (CE) is now a strategic priority for countries to decouple economic growth from environmental degradation. However, in developing contexts, the readiness of environmental resource sectors to adopt CE principles is unknown due to a lack of data and uneven institutional capacity. This study presents the first regional baseline assessment of circularity readiness in Vietnam’s environmental resource sectors, focusing on land, mining, water and waste. A five-dimensional readiness framework (policy, resource management, innovation, business, awareness) was developed and applied across Vietnam’s six ecological–economic regions. A Delphi process with 12 experts was conducted in three rounds to capture and refine expert judgments, supplemented by triangulated proxy indicators (e.g., plastic recycling rates, wastewater treatment coverage). Readiness scores were aggregated at dimension and regional levels and analyzed using radar charts, heatmaps and hierarchical clustering. Results showed significant regional disparities. The Southeast (SE) and Red River Delta (RRD) have high readiness due to clearer policy frameworks, stronger institutions and more dynamic business ecosystems. The Northern Midlands and Mountains (NMM) and Central Highlands (CH) have low readiness due to infrastructural gaps, weak innovation and limited public engagement. The Mekong Delta (MD) and North Central Coast (NCC) have medium readiness, reflecting partial progress but uneven implementation. The study made three contributions: (1) a new context-specific framework for CE readiness in environmental resource sectors; (2) the value of expert-based, proxy-informed methods in data-scarce contexts; and (3) a policy roadmap for different regional readiness levels. Findings suggest that the CE should be integrated into resource planning, regional observatories should be established and CE-related research and development (R&D) should receive investment. Future research should move towards standardized quantitative indicators and predictive models to track how readiness changes under policy interventions. Full article

Over the past 50 years, researchers have produced a considerable body of work substantiating that gross domestic product (GDP) is not a measure of social welfare. In response, numerous measures, collectively known as Beyond GDP (BGDP) measures, have been developed to provide a more balanced assessment of the social, environmental, and economic impacts of economic activity on current and future generations. BGDP measures have gained the attention not only of academics, but also of government practitioners concerned with prevailing measures of national and regional progress that overrepresent narrow economic objectives and underrepresent sustainability objectives. Despite this widespread support for alternatives, few governments have made significant progress in implementing BGDP measures to inform public policy. Viewed through an operational lens, this study examines strategies used by two governments that have progressed in implementing BGDP measures. We analyze their strategies against five practical considerations: (1) alignment with mission, (2) fiscal and resources constraints, (3) communication and public messaging challenges, (4) challenges with political and public commitment, and (5) gaps in internal agency knowledge and training. These five considerations were identified as the five most prominent barriers to implementing BGDP measure based on a systematic review of the BGDP literature published over the past 50 years. We conclude that these two governments implemented actions that addressed key elements of these five barriers and succeeded in adopting BGDP measures. We conclude that others could emulate these successes to advance the broader adoption of BGDP measures. Full article

Background: This study fills a gap in the literature by examining how perceptions of health news are associated with interpersonal trust in physicians and institutional distrust in the healthcare systems, particularly in the Türkiye context. While previous studies have examined trust in physicians and distrust in healthcare systems separately using different independent variables, evidence remains limited on the simultaneous association between health news perception and both trust in physicians and distrust in the healthcare system, particularly in the Türkiye context and using validated measurement tools. Therefore, the main objective of this study is to examine the association between health news perception, trust in physicians, and distrust in the healthcare system. Methods: The population of this cross-sectional study consisted of individuals aged 18–60 residing in the central district of Kutahya. The study data were collected face-to-face using a two-part questionnaire. A total of 719 completed questionnaires were analyzed. Results: 58% of the participants in the study were aged 41 and above. Commercial concerns and advertising, consumption promotion, behavioral change, health behavior exploitation, and trust in health news were positively associated with distrust in the healthcare system (β = 0.119, β = 0.196, β = 0.054, β = 0.061, β = 0.046; p < 0.01, p < 0.05). The model explained 22.4% of the variance (R² = 0.224). Commercial concerns and advertising, consumption promotion, behavioral change, health behavior exploitation, and trust in health news were negatively associated with trust in physicians (β = −0.221, β = −0.014, β = −0.014, β = −0.127, β = −0.211; p < 0.05, p < 0.01). The model explained 25.3% of the variance (R² = 0.253). Conclusions: The study found that health news perception was associated with trust in physicians and distrust in the healthcare system. Therefore, understanding the associations between health news perception, trust in physicians, and distrust in the healthcare system is important for improving individual and public health. For this reason, it is of great importance to raise the level of health and digital health literacy in society through policies developed under the leadership of public health experts. Full article

Asthma is a chronic respiratory disease with uneven prevalence across population groups. This study investigated the associations between socioeconomic status, health behaviours, and environmental exposures and asthma prevalence across European countries. We conducted a cross-sectional analysis using data from the European Health Interview Survey (EHIS) covering wave III (2019). The sample included 223,453 adults aged 20 or older from 26 European countries. Asthma prevalence was self-reported. Socioeconomic variables included education and employment status, while behavioural factors included smoking and overweight status. Environmental exposures encompassed urbanisation and air pollution. Multilevel logistic regression models examined associations between asthma prevalence and its socioeconomic, behavioural, and environmental factors. Asthma prevalence was higher among individuals with lower educational attainment (OR = 1.30; 95% CI: 1.20–1.40), those who were unable to work due to long-standing health problems (OR = 2.27; 95% CI: 2.04–2.52), and retired individuals (1.44; 95% CI: 1.31–1.57). Individuals with pre-obesity and obesity had increased odds of asthma (OR = 1.13; 95%CI: 1.07–1.19, and OR = 1.76; 95%CI: 1.66–1.86, respectively). Urbanisation (OR = 1.13; 95%CI: 1.07–1.19) and exposure to air pollution (CO₂ and PM_2.5) were both significantly associated with higher asthma prevalence. Six countries exhibited a significant deviation from the average asthma prevalence. Inequalities in asthma prevalence in Europe were linked to socioeconomic disadvantage, unhealthy behaviours, and adverse environmental conditions. Some variability in asthma prevalence was independent of individual characteristics. These findings highlight the need for integrated public health policies that address the structural, behavioural, and environmental determinants of respiratory health. Full article

Despite growing emphasis on financial firms’ engagement in environmental project financing (EPF), its impact on insolvency risk remains underexplored. Drawing on signaling theory, this study investigates how EPF influences financial institutions’ insolvency risk and examines the moderating roles of the existence of a public relations function and global climate policy uncertainty. By analyzing data of 291 financial firms from major developed economies over 2014–2023, this study finds that environmental project financing reduces insolvency risk. Furthermore, the presence of a public relations function strengthens this effect, while the rising global climate policy uncertainty weakens it. This study contributes to existing literature while offering both strategic insights and practical implications. Full article