Global Transitions最新文献

Breaking the hunger cycle: Can women's empowerment solve Africa's undernourishment crisis? 打破饥饿循环：妇女赋权能解决非洲的营养不良危机吗？

IF 3.1 Q1 Social Sciences

Global Transitions

Pub Date : 2026-01-10 DOI: 10.1016/j.glt.2026.01.003

Romaine Doline Ngo Nguéda Radler , Gautier Tchoffo Tameko , Arsene Mouongue Kelly

Women's empowerment is increasingly recognized as a vital factor in achieving global development goals, particularly the eradication of hunger (SDG 2) and the advancement of gender equality (SDG 5). Despite this relevance, existing studies remain limited in scope, often relying on cross-sectional, country-specific, or child-focused analyses that do not capture the broader, population-level relationship between women's empowerment and undernourishment across Africa. To address this gap, the present study offers a continent-wide assessment of how multiple dimensions of women's empowerment, including civil liberties, civil society participation, political participation, and political empowerment, shape undernourishment in 50 African countries from 2002 to 2020. Using a panel framework that combines fixed effects estimation, Driscoll–Kraay standard errors, and the two-step system GMM estimator, the analysis identifies a consistent and significant negative relationship between women's empowerment and the prevalence of undernourishment. All four empowerment dimensions contribute meaningfully to improved nutritional outcomes, and extensive robustness checks confirm the reliability of the findings. The study thus provides clear empirical evidence that strengthening women's agency is a multidimensional pathway to reducing undernourishment, offering a foundation for more targeted and gender-responsive policy strategies to advance food security across Africa.

人们日益认识到，增强妇女权能是实现全球发展目标，特别是消除饥饿（可持续发展目标2）和促进性别平等（可持续发展目标5）的关键因素。尽管具有这种相关性，但现有研究的范围仍然有限，往往依赖于横断面、具体国家或以儿童为重点的分析，无法捕捉到整个非洲妇女赋权与营养不良之间更广泛的、人口层面的关系。为了弥补这一差距，本研究对2002年至2020年期间50个非洲国家的妇女赋权（包括公民自由、公民社会参与、政治参与和政治赋权）的多个维度如何影响营养不良进行了全大陆范围的评估。该分析使用了结合固定效应估计、Driscoll-Kraay标准误差和两步系统GMM估计器的面板框架，确定了妇女赋权与营养不良发生率之间存在一致且显著的负相关关系。所有四个赋权维度都对改善营养结果有意义，广泛的稳健性检查证实了研究结果的可靠性。因此，该研究提供了明确的经验证据，表明加强妇女的作用是减少营养不良的多维途径，为制定更有针对性和促进性别平等的政策战略奠定了基础，以促进整个非洲的粮食安全。

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引用次数: 0

Leveraging AI innovation for a sustainable environment in G-7: Finance and governance roles 在七国集团中利用人工智能创新实现可持续环境：财务和治理角色

IF 3.1 Q1 Social Sciences

Global Transitions

Pub Date : 2026-01-07 DOI: 10.1016/j.glt.2026.01.001

Mohammad Ridwan , Md. Rajabul Hassan , Amit Debnath , Afsana Akther , Khurshid Khudoykulov , Md. Emran Hossain , Miguel Angel Esquivias

Rising ecological footprints in G-7 countries pose significant challenges to global sustainability, despite their economic and technological leadership. While prior research has examined individual drivers of environmental degradation in advanced economies, there remains a critical gap in understanding the integrated roles of artificial intelligence (AI), financial accessibility, and government effectiveness in mitigating ecological pressures, particularly through comprehensive panel data analysis in the G-7 context. This study addresses this gap by exploring how these factors influence environmental sustainability across G-7 nations, using the ecological footprint as a key indicator from 2010Q1 to 2022Q4. Employing the Panel Mean Group Autoregressive Distributed Lag model as the primary estimator, with Augmented Mean Group and Common Correlated Effects Mean Group estimators for robustness, the empirical results reveal that economic growth and urbanization significantly exacerbate ecological degradation in both the long and short run. Conversely, AI innovation, financial accessibility, and effective governance substantially reduce environmental impacts. These findings advance the discourse on Sustainable Development Goals (SDGs), especially SDG 9 (Industry, Innovation and Infrastructure), SDG 11 (Sustainable Cities and Communities), and SDG 13 (Climate Action). To foster a sustainable transition, policymakers should prioritize investments in AI-driven green technologies to optimize resource efficiency, expand inclusive financial mechanisms to fund eco-innovations and renewable projects, and implement governance reforms that enforce stringent environmental regulations in G-7 economies.

尽管七国集团在经济和技术上处于领先地位，但它们不断增加的生态足迹对全球可持续性构成了重大挑战。虽然之前的研究已经研究了发达经济体中环境退化的单个驱动因素，但在理解人工智能（AI）、金融可及性和政府有效性在减轻生态压力方面的综合作用方面，特别是通过G-7背景下的综合面板数据分析，仍然存在重大差距。本研究通过探索这些因素如何影响七国集团国家的环境可持续性来解决这一差距，将生态足迹作为2010年第一季度至2022Q4年的关键指标。采用面板均值群自回归分布滞后模型作为主要估计量，采用增广均值群和共同相关效应均值群作为稳健性估计量，实证结果表明，经济增长和城市化在长期和短期内都显著加剧了生态退化。相反，人工智能创新、金融可及性和有效治理大大减少了对环境的影响。这些发现推动了可持续发展目标（SDG）的讨论，特别是可持续发展目标9（工业、创新和基础设施）、可持续发展目标11（可持续城市和社区）和可持续发展目标13（气候行动）。为促进可持续转型，政策制定者应优先投资人工智能驱动的绿色技术，以优化资源效率，扩大包容性金融机制，为生态创新和可再生项目提供资金，并实施治理改革，在七国集团经济体实施严格的环境法规。

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引用次数: 0

How is food security threatened in Iran's agricultural sector? A grounded theory approach 伊朗农业部门的粮食安全是如何受到威胁的？扎根理论方法

IF 3.1 Q1 Social Sciences

Global Transitions

Pub Date : 2026-01-06 DOI: 10.1016/j.glt.2026.01.002

Pouria Ataei , Mostafa Alinaghizadeh , Hasan Alibakhshi , Naser Valizadeh , Hamid Karimi

Food security, one of the fundamental challenges facing developing countries, is influenced by a range of factors, including climate change, economic instability, ineffective policies, and international sanctions. Using a grounded theory approach, this study comprehensively examined the challenges of food security in Iran's agricultural sector by analyzing causal, contextual, and intervening factors, as well as identifying strategies and consequences. Data were collected through in-depth interviews with 38 agricultural experts and specialists and analyzed using open, axial, and selective coding. The results indicate that the primary obstacles to achieving sustainable food security in Iran include climate change, water scarcity, dependence on imports, weak infrastructure, economic fluctuations, contradictory policies, and international pressures. The study also proposes strategies such as improving water and soil resource management, developing new agricultural technologies, reducing food waste, strengthening farmer support policies, and increasing resilience to climate change. These insights provide a comprehensive framework for policymakers and practitioners to design evidence-based programs that strengthen national food security and promote sustainable agricultural development.

本研究采用扎根理论的方法，通过分析因果关系、背景和干预因素，以及确定战略和后果，全面考察了伊朗农业部门面临的粮食安全挑战。通过对38位农业专家和专家的深度访谈收集数据，并使用开放编码、轴向编码和选择性编码进行分析。结果表明，伊朗实现可持续粮食安全的主要障碍包括气候变化、水资源短缺、依赖进口、基础设施薄弱、经济波动、政策矛盾和国际压力。该研究还提出了诸如改善水土资源管理、开发新的农业技术、减少粮食浪费、加强农民支持政策以及提高对气候变化的适应能力等战略。这些见解为决策者和从业人员设计以证据为基础的方案提供了一个全面的框架，以加强国家粮食安全和促进可持续农业发展。

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引用次数: 0

An integrative model of public sphere environmental behaviors: The association between motivational and socio-political factors 公共领域环境行为的综合模型：动机与社会政治因素之间的关联

IF 3.1 Q1 Social Sciences

Global Transitions

Pub Date : 2025-12-12 DOI: 10.1016/j.glt.2025.12.001

Piyapong Janmaimool , Surapong Chudech , Jaruwan Chontanawat , Kriengsak Thamma-aphiphol

Citizens’ active engagement in public sphere environmental behaviors (e.g., environmental policy support and environmental activism) can drive sustainable policy development and implementation. This study aims to assess how motivational and socio-political factors predict the public sphere environmental behaviors, and to evaluate how motivational factors (e.g., norms, attitude, and environmental concerns) and socio-political factors (e.g., social and institutional trust) are associated. The target population is well-educated people living in Bangkok city of Thailand as their active participation in the behaviors can powerfully encourage other entities or organizations to act environmentally. Questionnaire surveys were conducted with 540 well-educated residents living in Bangkok city. First, model measurement was assessed via confirmatory factor analysis; subsequently, a path analysis was performed to test causal associations among the variables predicting public-sphere environmental behaviors. The results revealed that social and institutional trust were significantly associated with a motivational factor (the attitude toward public sphere environmental behaviors) and the attitude could subsequently predict the behaviors. There were also significant associations between motivational factors, and these associations had a significant power to explain public sphere environmental behaviors. Both social norms and personal norms were significantly associated with the attitude. Social norms could also significantly predict the behaviors, but personal norms could not. Personal norms had only an indirect influence on the behaviors via the attitude. Moreover, local environmental concerns were a weak predictor as they had only a significant indirect influence on the behaviors via the attitude. Global environmental concerns could directly and indirectly predict the behaviors. Thus, educating the public with global environmental issues and promoting the attitude and social norms could be powerful in promoting public sphere environmental behaviors. To promote a positive attitude towards the behaviors, both institutional and social trust could play an important role.

公民积极参与公共领域环境行为（如环境政策支持和环境行动主义）可以推动可持续政策的制定和实施。本研究旨在评估动机因素和社会政治因素如何预测公共领域的环境行为，并评估动机因素（如规范、态度和环境问题）和社会政治因素（如社会和制度信任）如何相互关联。目标人群是居住在泰国曼谷市的受过良好教育的人，因为他们积极参与这些行为可以有力地鼓励其他实体或组织采取环保行动。对540名居住在曼谷市的受过良好教育的居民进行了问卷调查。首先，通过验证性因子分析对模型测量进行评估；随后，进行通径分析，检验预测公共领域环境行为的变量之间的因果关系。结果表明，社会信任和制度信任与激励因素（对公共领域环境行为的态度）显著相关，态度可以预测行为。动机因素之间也存在显著的关联，这些关联对解释公共领域环境行为具有显著的作用。社会规范和个人规范都与态度显著相关。社会规范也能显著预测行为，但个人规范不能。个人规范仅通过态度对行为产生间接影响。此外，当地环境问题是一个弱的预测因素，因为它们通过态度对行为只有显着的间接影响。全球环境问题可以直接或间接地预测这些行为。因此，对公众进行全球环境问题教育，促进态度和社会规范，可以有力地促进公共领域的环境行为。为了促进对行为的积极态度，制度信任和社会信任都可以发挥重要作用。

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引用次数: 0

Performance of the large language model in general medicine 大语言模型在全科医学中的表现

IF 3.1 Q1 Social Sciences

Global Transitions

Pub Date : 2025-10-28 DOI: 10.1016/j.glt.2025.10.004

Liyuan Tao , Jue Liu , Xiaoqin Lu , Yali Zhao , Yifan Zhang , Zuyi Zhu , Ting Li , Zhishou Zhang , Yipin Zhang , Wenxin Yan , Min Liu , Wannian Liang

Background

Domain-specific large language models (LLMs) may aid primary care, but reliability and safety are uncertain, and general-practice evaluations remain limited.

Methods

Observational, exam-based comparison (Feb–May 2025) using standardized items from the Chinese General Practitioner Licensing Examination. A general-practice LLM (AIGP) was evaluated against 389 physicians on the same items under deterministic decoding. Each item was run 50 technical replicates. Outcomes: accuracy; stability (coefficient of variation, ICC(2,k)); and expert-rated potential clinical harm for incorrect outputs.

Results

AIGP achieved 88.41 % ± 1.87 accuracy vs physicians 72.12 % ± 4.97 (mean difference 16.29, 95 % CI 15.56–17.01; P < .001). Stability favored AIGP (CV 2.12 vs 6.89; agreement across replicates ICC(2,k) = 0.993, 95 % CI 0.991–0.995). Although overall errors were fewer, AIGP's mistakes were systematic and carried higher average harm ratings, clustering in red-flag contexts (pregnancy, pediatrics, anticoagulation, acute chest pain).

Conclusions

In a controlled test setting, AIGP outperformed physicians and showed excellent stability. Findings are exploratory and context-limited (exam-based, text-only) and reveal systematic higher-harm failure modes. AIGP is a starting point for decision support, not a deployable clinical tool without prospective real-world validation and safety guardrails (human-in-the-loop review, contraindication/dose checks, uncertainty-aware refusal).

领域特定的大型语言模型（llm）可能有助于初级保健，但可靠性和安全性是不确定的，并且一般实践评估仍然有限。方法观察性、基于考试的比较（2025年2月- 5月），采用中国全科医师执业资格考试的标准化试题。在确定性解码下，对一名全科执业LLM （AIGP）与389名医生在相同项目上进行了评估。每个项目都进行了50次技术重复。结果:准确;稳定性（变异系数，ICC(2,k)）；专家评估了不正确输出的潜在临床危害。结果saigp与医师的准确率分别为88.41%±1.87与72.12%±4.97（平均差16.29,95% CI 15.56 ~ 17.01; P < 0.001）。稳定性倾向于AIGP （CV 2.12 vs 6.89；重复间一致性ICC(2,k) = 0.993, 95% CI 0.991-0.995）。尽管总体错误较少，但AIGP的错误是系统性的，并且具有较高的平均危害等级，集中在红旗环境（怀孕，儿科，抗凝血，急性胸痛）。结论在对照试验环境下，AIGP表现优于内科医生，且具有良好的稳定性。研究结果是探索性的，上下文有限的（基于测试，仅限文本），揭示了系统性的高危害失效模式。AIGP是一个决策支持的起点，而不是一个可部署的临床工具，没有前瞻性的现实验证和安全护栏（人在环审查，禁忌症/剂量检查，不确定性意识拒绝）。

{"title":"Performance of the large language model in general medicine","authors":"Liyuan Tao , Jue Liu , Xiaoqin Lu , Yali Zhao , Yifan Zhang , Zuyi Zhu , Ting Li , Zhishou Zhang , Yipin Zhang , Wenxin Yan , Min Liu , Wannian Liang","doi":"10.1016/j.glt.2025.10.004","DOIUrl":"10.1016/j.glt.2025.10.004","url":null,"abstract":"<div><h3>Background</h3><div>Domain-specific large language models (LLMs) may aid primary care, but reliability and safety are uncertain, and general-practice evaluations remain limited.</div></div><div><h3>Methods</h3><div>Observational, exam-based comparison (Feb–May 2025) using standardized items from the Chinese General Practitioner Licensing Examination. A general-practice LLM (AIGP) was evaluated against 389 physicians on the same items under deterministic decoding. Each item was run 50 technical replicates. Outcomes: accuracy; stability (coefficient of variation, ICC(2,k)); and expert-rated potential clinical harm for incorrect outputs.</div></div><div><h3>Results</h3><div>AIGP achieved 88.41 % ± 1.87 accuracy vs physicians 72.12 % ± 4.97 (mean difference 16.29, 95 % CI 15.56–17.01; P < .001). Stability favored AIGP (CV 2.12 vs 6.89; agreement across replicates ICC(2,k) = 0.993, 95 % CI 0.991–0.995). Although overall errors were fewer, AIGP's mistakes were systematic and carried higher average harm ratings, clustering in red-flag contexts (pregnancy, pediatrics, anticoagulation, acute chest pain).</div></div><div><h3>Conclusions</h3><div>In a controlled test setting, AIGP outperformed physicians and showed excellent stability. Findings are exploratory and context-limited (exam-based, text-only) and reveal systematic higher-harm failure modes. AIGP is a starting point for decision support, not a deployable clinical tool without prospective real-world validation and safety guardrails (human-in-the-loop review, contraindication/dose checks, uncertainty-aware refusal).</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"8 1","pages":"Pages 101-109"},"PeriodicalIF":3.1,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145690784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trajectory optimization for UAV-based medical delivery with temporal logic constraints and convex feasible set collision avoidance 基于时间逻辑约束和凸可行集避碰的无人机医疗配送轨迹优化

IF 3.1 Q1 Social Sciences

Global Transitions

Pub Date : 2025-10-11 DOI: 10.1016/j.glt.2025.10.002

Kaiyuan Chen , Yuhan Suo , Shaowei Cui , Yuanqing Xia , Wannian Liang , Shuo Wang

This paper addresses the problem of trajectory optimization for unmanned aerial vehicles (UAVs) performing time-sensitive medical deliveries in urban environments. Specifically, we consider a single UAV with 3-degree-of-freedom dynamics tasked with delivering blood packages to multiple hospitals, each with a predefined time window and priority. Mission objectives are encoded using Signal Temporal Logic (STL), enabling the formal specification of spatial-temporal constraints. To ensure safety, city buildings are modeled as 3D convex obstacles, and obstacle avoidance is handled through a Convex Feasible Set (CFS) method. The entire planning problem—combining UAV dynamics, STL satisfaction, and collision avoidance—is formulated as a convex optimization problem that ensures tractability and can be solved efficiently using standard convex programming techniques. Simulation results demonstrate that the proposed method generates dynamically feasible, collision-free trajectories that satisfy temporal mission goals, providing a scalable and reliable approach for autonomous UAV-based medical logistics.

本文研究了在城市环境中执行时间敏感型医疗交付的无人机的轨迹优化问题。具体来说，我们考虑一架具有3自由度动力学的无人机，其任务是向多家医院运送血液包裹，每家医院都有预定义的时间窗口和优先级。任务目标使用信号时序逻辑（STL）编码，实现了时空约束的正式规范。为了保证安全，将城市建筑物建模为三维凸障碍物，并通过凸可行集（convex viable Set， CFS）方法进行避障处理。整个规划问题-结合无人机动力学、STL满足和避免碰撞-被制定为一个凸优化问题，确保可跟踪性，并可以使用标准凸规划技术有效地解决。仿真结果表明，该方法能够生成动态可行、无碰撞、满足时间任务目标的轨迹，为自主无人机医疗物流提供了一种可扩展、可靠的方法。

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引用次数: 0

Transforming health systems in Vietnam's demographic transition: sarcopenia screening thresholds 越南人口转型中的卫生系统转型：肌肉减少症筛查阈值

IF 3.1 Q1 Social Sciences

Global Transitions

Pub Date : 2025-10-11 DOI: 10.1016/j.glt.2025.10.003

Hien Thi Nguyen , Charuai Suwanbamrung , Apichai Wattanapisit , Thang Nguyen , Warapone Satheannoppakao , Dung Tam Nguyen Huynh , Tam Thai Thanh Tran , Khanh Hoang Pham , Cua Ngoc Le

Introduction

Vietnam is undergoing a rapid demographic transition, with an increasingly aging population, posing new challenges for the healthcare system. Sarcopenia, an important contributor to frailty, functional decline, and disability in older adults, remains underdiagnosed due to the inconvenience of standardized assessment tools and the lack of validated anthropometric thresholds for specific populations.

Methods

We conducted a cross-sectional study involving 416 community-dwelling individuals aged ≥60 years in Can Tho, Vietnam. Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Receiver operating characteristic (ROC) curve analysis was used to identify optimal cutoff values for body mass index (BMI), calf circumference (CC), arm circumference (AC), and waist circumference (WC), with the Youden index applied to determine the most accurate thresholds.

Results

The identified Vietnam-specific anthropometric thresholds for sarcopenia were: BMI ≤22.6 kg/m² for men and ≤21.2 kg/m² for women; CC ≤ 34.5 cm and ≤32.0 cm; AC ≤26.0 cm and ≤24.0 cm; WC ≤ 85.0 cm and ≤78.0 cm, respectively. These localized thresholds improved diagnostic accuracy, with BMI showing the strongest performance. CC and AC were less reliable among women, while WC offered high specificity but lower sensitivity.

Conclusion

Our results endorse Vietnam-specific anthropometric cutoffs, particularly BMI, as a practical, cost-effective sarcopenia screening tool for under-resourced primary care. Integrating these thresholds into national guidelines can accelerate universal health coverage and sustainable aging by enabling early detection and community-based interventions to avert functional decline in Vietnam's aging population.

越南正在经历快速的人口转型，人口老龄化日益严重，对医疗保健系统提出了新的挑战。骨骼肌减少症是老年人身体虚弱、功能下降和残疾的重要原因，由于标准化评估工具的不便和缺乏特定人群的有效人体测量阈值，骨骼肌减少症仍未得到充分诊断。方法我们对越南芹苴地区416名年龄≥60岁的社区居民进行了横断面研究。肌少症是根据2019年亚洲肌少症工作组（AWGS 2019）的标准诊断的。采用受试者工作特征（ROC）曲线分析确定体重指数（BMI）、小腿围（CC）、臂围（AC）和腰围（WC）的最佳临界值，并应用约登指数确定最准确的阈值。结果越南特有的肌肉减少症人体测量阈值为：男性BMI≤22.6 kg/m2，女性BMI≤21.2 kg/m2；CC≤34.5 cm和≤32.0 cm；交流≤26.0 cm和≤24.0 cm；WC≤85.0 cm,≤78.0 cm。这些局部阈值提高了诊断的准确性，BMI表现出最强的表现。CC和AC在女性中的可靠性较差，而WC具有高特异性但灵敏度较低。结论：我们的研究结果支持越南特定的人体测量截断值，特别是BMI，作为资源不足的初级保健中实用且具有成本效益的肌肉减少症筛查工具。将这些阈值纳入国家指导方针，可以通过早期发现和以社区为基础的干预措施来避免越南老龄化人口的功能下降，从而加速全民健康覆盖和可持续老龄化。

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引用次数: 0

Beyond food: Ultra-processed people are living in an ultra-processed world 食品之外：过度加工的人们生活在一个过度加工的世界里

IF 3.1 Q1 Social Sciences

Global Transitions

Pub Date : 2025-10-10 DOI: 10.1016/j.glt.2025.10.001

Bruna Menegassi , Jesus Rivera-Navarro

Since the term "ultra-processed food" was introduced in the fields of nutrition and public health, numerous studies have demonstrated its detrimental effects on health. Despite resistance from food companies and researchers with potential conflicts of interest, the concept has gained broad acceptance in both academic and non-academic circles. This article extends the discussion beyond nutrition by examining the wider concept of "ultra-processed," its implications, and its application to other domains, including the metaphorical notions of "ultra-processed people" and an "ultra-processed world." In doing so, we aim to raise awareness of the phenomenon of "ultra-processing," highlighting its pervasive influence across food, society, and digital environments, and encouraging reflection on its consequences for everyday life. This expansive approach aligns with notable philosophical and sociological perspectives, yet our exploration of these trends offers an innovative angle.

自从“超加工食品”一词被引入营养和公共卫生领域以来，许多研究已经证明其对健康的有害影响。尽管食品公司和研究人员有潜在的利益冲突，但这一概念在学术界和非学术界都得到了广泛的接受。本文通过研究“超加工”这个更广泛的概念、它的含义以及它在其他领域的应用（包括“超加工的人”和“超加工的世界”的隐喻概念），将讨论扩展到营养学之外。通过这种方式，我们旨在提高人们对“超加工”现象的认识，突出其在食品、社会和数字环境中的普遍影响，并鼓励人们反思其对日常生活的影响。这种广泛的方法与著名的哲学和社会学观点一致，但我们对这些趋势的探索提供了一个创新的角度。

引用次数: 0

Time series analysis of the impact of ambient temperature influence on healthcare service utilization by diabetes patients in the Special Capital Region of Jakarta, Indonesia: A study using Indonesian National Health Insurance data 环境温度对印度尼西亚雅加达特别首都地区糖尿病患者医疗服务利用影响的时间序列分析：一项使用印度尼西亚国民健康保险数据的研究

IF 3.1 Q1 Social Sciences

Global Transitions

Pub Date : 2025-09-15 DOI: 10.1016/j.glt.2025.09.004

Helen Andriani , Chairina Suci Andhisa , Paul LC. Chua , Miftahul Arsyi

Background

The rising global incidence of diabetes poses a major health challenge, with growing evidence linking diabetes mellitus (DM) and ambient temperature. Due to compromised heat stress responses, people with diabetes are more vulnerable to extreme weather, common comorbidities, insulin resistance, and chronic inflammation. This study examines the impact of ambient temperature on healthcare utilization among diabetes patients in Jakarta, Indonesia, using data from the National Health Insurance program.

Method

The study used 2015–2023 sample data from Indonesia's Healthcare and Social Security Agency (BPJS Health), comprising 2,407,300 participants diagnosed with DM. Claims data were stratified by residence, DM type, and healthcare facility type (primary vs. referral care). These were linked with daily, weekly, and monthly temperature records obtained from the Indonesian Agency for Meteorology, Climatology, and Geophysics (BMKG). Negative binomial regression model were applied to assess associations between temperature and DM-related healthcare visits, as the data indicated overdispersion in the count outcomes.

Results

Higher daily average temperatures were associated with increased healthcare visits, particularly in primary care. A 1 °C increase in the 7-day average temperature was associated with a 3 % rise in patient visits, while a 14-day average increase was linked to a 4 % rise. Lag structures reduced daily variability, highlighting consistent associations. Utilization patterns also showed peaks on Mondays and declines on weekends and public holidays.

Conclusions

Diabetic patients are vulnerable to elevated temperatures, potentially due to impaired thermoregulation and medication effects. As climate change exacerbates extreme temperatures, Jakarta's healthcare system may face increased demand. Interventions such as access to cool public spaces, enhanced patient monitoring, and resilient healthcare infrastructure are recommended.

随着全球糖尿病发病率的上升，越来越多的证据表明糖尿病（DM）与环境温度有关，这对健康构成了重大挑战。由于热应激反应受损，糖尿病患者更容易受到极端天气、常见合并症、胰岛素抵抗和慢性炎症的影响。本研究考察了环境温度对印度尼西亚雅加达糖尿病患者医疗保健利用的影响，使用的数据来自国家健康保险计划。该研究使用2015-2023年印度尼西亚医疗保健和社会保障局（BPJS Health）的样本数据，包括2407300名诊断为糖尿病的参与者。索赔数据按居住地、糖尿病类型和医疗机构类型（初级与转诊护理）进行分层。这些数据与从印度尼西亚气象、气候学和地球物理局（BMKG）获得的每日、每周和每月的温度记录相关联。应用负二项回归模型来评估温度与糖尿病相关医疗访问之间的关联，因为数据表明计数结果过度分散。结果较高的日平均气温与就诊次数增加有关，特别是在初级保健中。7天平均气温每升高1°C，就诊人数就会增加3%，而14天平均气温升高则会增加4%。滞后结构减少了日常变化，突出了一致的关联。使用模式也在周一达到峰值，在周末和公共假期下降。结论糖尿病患者易受体温升高的影响，可能与体温调节功能受损和药物作用有关。随着气候变化加剧极端气温，雅加达的医疗保健系统可能面临越来越多的需求。建议采取干预措施，如使用凉爽的公共空间、加强患者监测和弹性医疗保健基础设施。

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引用次数: 0

Green finance, innovation, and environment: Testing the EKC in ASEAN-4 with MMQR approach 绿色金融、创新与环境：基于MMQR方法的东盟四国EKC检验

IF 3.1 Q1 Social Sciences

Global Transitions

Pub Date : 2025-09-06 DOI: 10.1016/j.glt.2025.09.001

Md.Sazib Miyan , Calvin W.H. Cheong , Arshian Sharif , Sahar Afshan

Rising carbon emissions and environmental degradation in ASEAN-4 economies underscore the urgent need for sustainable financial mechanisms and innovative technologies to address climate challenges. Despite growing interest in green initiatives, limited research exists on their distributional impacts and causal links with environmental outcomes in this regional context. This study examines the nexus between green finance (GFIN), green innovation (GTI), and environmental sustainability within the Environmental Kuznets Curve (EKC) framework across Indonesia, Malaysia, the Philippines, and Thailand from 2000 to 2020. Employing advanced panel econometric techniques, Method of Moments Quantile Regression (MMQR), Bootstrap Quantile Regression (BSQR), and Dumitrescu-Hurlin Granger causality tests, the analysis reveals that both GFIN and GTI significantly reduce CO₂ emissions, with stronger effects at lower quantiles, indicating greater efficacy at early stages of environmental degradation. The EKC hypothesis is validated, as economic growth initially raises emissions but reduces them at higher income levels. Renewable energy (REN) consistently mitigates emissions, while non-renewable energy (NRE) worsens them across all quantiles, reinforcing the need for energy transition. Causality tests reveal a bidirectional relationship between CO₂ and NRE, and unidirectional causality from CO₂ to REN and GTI. These findings underscore critical policy imperatives: scaling up green finance, accelerating clean innovation, phasing out fossil fuel subsidies, and strengthening regional cooperation to decouple growth from emissions and advance Sustainable Development Goals (SDGs).

东盟四国经济体碳排放上升和环境恶化凸显了建立可持续金融机制和创新技术应对气候挑战的迫切需要。尽管人们对绿色倡议的兴趣日益浓厚，但在这一区域背景下，关于绿色倡议的分布影响及其与环境结果的因果关系的研究有限。本研究在环境库兹涅茨曲线（EKC）框架下考察了2000年至2020年间印度尼西亚、马来西亚、菲律宾和泰国的绿色金融（GFIN）、绿色创新（GTI）和环境可持续性之间的关系。采用先进的面板计量经济学技术、矩量分位数回归（MMQR）、Bootstrap分位数回归（BSQR）和dumitrescue - hurlin Granger因果检验，分析发现GFIN和GTI均显著减少了二氧化碳排放，且在较低的分位数上效果更强，表明在环境退化的早期阶段效果更好。EKC假设得到了验证，因为经济增长最初会增加排放，但在收入水平较高时排放量会减少。可再生能源（REN）持续缓解排放，而不可再生能源（NRE）在所有分位数上加剧了排放，从而加强了能源转型的必要性。因果关系检验表明，CO2与NRE之间存在双向关系，CO2与REN和GTI之间存在单向因果关系。这些研究结果强调了关键的政策要求：扩大绿色金融，加速清洁创新，逐步取消化石燃料补贴，加强区域合作，使增长与排放脱钩，推进可持续发展目标（sdg）。

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