Pub Date : 2026-05-01Epub Date: 2025-11-26DOI: 10.1016/j.glt.2025.11.001
Alfan Sarifudin , Hwai Chyuan Ong , Long Chiau Ming
Frequent and prolonged energy outages remain a critical challenge for healthcare facilities, jeopardizing patient safety and disrupting essential medical services. To ensure reliable and sustainable operations, there is an urgent need for alternative energy solutions with Hydrogen Energy Storage (HES) offering a promising pathway. This review explores the potential of HES in enhancing healthcare resilience which emphasizing its role in emergency preparedness, carbon footprint reduction, and energy stability. Drawing on systematic literature review, this study analyze existing applications, technological advancements, and the challenges of deploying HES in healthcare settings. Case studies from various geographical contexts demonstrate their versatility and efficacy in sustaining essential services. Although the potential of HES is evident, addressing economic barriers, regulatory obstacles, and infrastructure limitations is crucial for its extensive adoption. This study highlights the transformative capacity of HES to synchronize healthcare with global sustainability objectives, guaranteeing operational continuity and environmental responsibility.
{"title":"Hydrogen energy storage for healthcare resilience","authors":"Alfan Sarifudin , Hwai Chyuan Ong , Long Chiau Ming","doi":"10.1016/j.glt.2025.11.001","DOIUrl":"10.1016/j.glt.2025.11.001","url":null,"abstract":"<div><div>Frequent and prolonged energy outages remain a critical challenge for healthcare facilities, jeopardizing patient safety and disrupting essential medical services. To ensure reliable and sustainable operations, there is an urgent need for alternative energy solutions with Hydrogen Energy Storage (HES) offering a promising pathway. This review explores the potential of HES in enhancing healthcare resilience which emphasizing its role in emergency preparedness, carbon footprint reduction, and energy stability. Drawing on systematic literature review, this study analyze existing applications, technological advancements, and the challenges of deploying HES in healthcare settings. Case studies from various geographical contexts demonstrate their versatility and efficacy in sustaining essential services. Although the potential of HES is evident, addressing economic barriers, regulatory obstacles, and infrastructure limitations is crucial for its extensive adoption. This study highlights the transformative capacity of HES to synchronize healthcare with global sustainability objectives, guaranteeing operational continuity and environmental responsibility.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"8 1","pages":"Pages 193-222"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187481","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}
Pub Date : 2026-05-01Epub Date: 2025-08-18DOI: 10.1016/j.glt.2025.08.002
Abdul-Latif Alhassan , Mery Angeles Perez , Lakshman W. Galagedara
This study examines the intersection of climate change, agricultural innovation, and food security in Newfoundland and Labrador (NL), a province characterized by a short growing season, poor and acidic soils, and a small agriculture sector highly vulnerable to climate change. Despite being one of Canada's most food-insecure provinces, there is a significant lack of comprehensive studies on the Water-Energy-Food-Climate Change (WEF-CC) nexus and agricultural innovation in NL. The study aimed to (1) inventory innovative agricultural practices that promote food security and climate resilience, (2) identify key stakeholders in agricultural innovation, (3) explore factors influencing innovation in the province, and (4) assess the use of by-products in agriculture. Data were collected through semi-structured interviews and analyzed using NVivo content analysis. The findings revealed two primary types of relevant agricultural innovation in NL: practice-based and technology-based. Six key stakeholders in agricultural innovation were identified. However, the lack of an independent third-party innovation enabler or connector was perceived as a barrier to progress. To address this gap, the study proposes the establishment of the Newfoundland and Labrador Agricultural Innovation Centre (NLAIC), a collaborative body designed to support agricultural innovation. Additionally, opportunities for utilizing agricultural and industrial by-products, including plant-based and animal-based innovations, were identified as emerging in the province. Tackling innovation barriers and promoting nexus thinking and collaboration among stakeholders and sectors could enhance climate resilience and food security in NL.
{"title":"Integrating climate change, food security, and innovative agriculture in Newfoundland and Labrador (NL): A Water-Energy-Food (WEF) nexus approach","authors":"Abdul-Latif Alhassan , Mery Angeles Perez , Lakshman W. Galagedara","doi":"10.1016/j.glt.2025.08.002","DOIUrl":"10.1016/j.glt.2025.08.002","url":null,"abstract":"<div><div>This study examines the intersection of climate change, agricultural innovation, and food security in Newfoundland and Labrador (NL), a province characterized by a short growing season, poor and acidic soils, and a small agriculture sector highly vulnerable to climate change. Despite being one of Canada's most food-insecure provinces, there is a significant lack of comprehensive studies on the Water-Energy-Food-Climate Change (WEF-CC) nexus and agricultural innovation in NL. The study aimed to (1) inventory innovative agricultural practices that promote food security and climate resilience, (2) identify key stakeholders in agricultural innovation, (3) explore factors influencing innovation in the province, and (4) assess the use of by-products in agriculture. Data were collected through semi-structured interviews and analyzed using NVivo content analysis. The findings revealed two primary types of relevant agricultural innovation in NL: practice-based and technology-based. Six key stakeholders in agricultural innovation were identified. However, the lack of an independent third-party innovation enabler or connector was perceived as a barrier to progress. To address this gap, the study proposes the establishment of the Newfoundland and Labrador Agricultural Innovation Centre (NLAIC), a collaborative body designed to support agricultural innovation. Additionally, opportunities for utilizing agricultural and industrial by-products, including plant-based and animal-based innovations, were identified as emerging in the province. Tackling innovation barriers and promoting nexus thinking and collaboration among stakeholders and sectors could enhance climate resilience and food security in NL.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"8 1","pages":"Pages 22-36"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027278","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}
Pub Date : 2026-05-01Epub Date: 2026-01-10DOI: 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.
{"title":"Breaking the hunger cycle: Can women's empowerment solve Africa's undernourishment crisis?","authors":"Romaine Doline Ngo Nguéda Radler , Gautier Tchoffo Tameko , Arsene Mouongue Kelly","doi":"10.1016/j.glt.2026.01.003","DOIUrl":"10.1016/j.glt.2026.01.003","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"8 1","pages":"Pages 158-165"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975960","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}
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).
{"title":"Green finance, innovation, and environment: Testing the EKC in ASEAN-4 with MMQR approach","authors":"Md.Sazib Miyan , Calvin W.H. Cheong , Arshian Sharif , Sahar Afshan","doi":"10.1016/j.glt.2025.09.001","DOIUrl":"10.1016/j.glt.2025.09.001","url":null,"abstract":"<div><div>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 CO<sub>2</sub> 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 CO<sub>2</sub> and NRE, and unidirectional causality from CO<sub>2</sub> 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).</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"8 1","pages":"Pages 74-88"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266683","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}
Pub Date : 2026-05-01Epub Date: 2025-08-18DOI: 10.1016/j.glt.2025.08.003
Mara Ipa , Asep Hermawan , Rais Yunarko , Tri Ramadhani , Muhammad Choirul Hidajat , Harimat Hendarwan , Triwibowo Ambar Garjito , Aneta Afelt , Supriyati Supriyati , Tri Wibawa
Background
Dengue Virus (DENV) infection remains a significant public health issue in Indonesia, with incidence rates differing between urban and rural areas. This study aimed to identify individual and household factors driving self-reported dengue infections in these settings.
Methods
A secondary analysis of the 2023 Indonesian Health Survey (SKI) included 877,531 respondents from urban (n = 469,549) and rural (n = 407,982) areas. The study focused on individuals of all ages who had been diagnosed with dengue fever by a physician within the past year. Disparities in self-reported dengue infection were assessed using standardized questionnaires that covered individual factors (age, sex, education, occupation, and preventive measures) and household factors (health facility awareness, travel time, transport affordability, wealth, water source, and preventive behavior). Data collected from August to October 2023 were analyzed using weighted logistic regression models in STATA 17.0 MP to account for the complex sampling design.
Results
Self-reported dengue incidence was higher in urban areas (0.73 %) than rural areas (0.52 %). In urban settings, higher odds of dengue infection were associated with having school-aged children, living in crowded households, belonging to the wealthiest quintile, using bottled water, and neglecting regular cleaning of water storage containers. In rural areas, adults using refill water had increased odds of infection, while those working in the informal sector and practicing mosquito bite prevention showed reduced odds.
Conclusions
Our study highlights social determinants of dengue infection in Indonesia, emphasizing the need for targeted public health interventions that address educational disparities, economical access to healthcare, and effective preventive practices.
{"title":"Urban-rural disparities in self-reported dengue infection: A comprehensive analysis of the 2023 Indonesian health survey","authors":"Mara Ipa , Asep Hermawan , Rais Yunarko , Tri Ramadhani , Muhammad Choirul Hidajat , Harimat Hendarwan , Triwibowo Ambar Garjito , Aneta Afelt , Supriyati Supriyati , Tri Wibawa","doi":"10.1016/j.glt.2025.08.003","DOIUrl":"10.1016/j.glt.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Dengue Virus (DENV) infection remains a significant public health issue in Indonesia, with incidence rates differing between urban and rural areas. This study aimed to identify individual and household factors driving self-reported dengue infections in these settings.</div></div><div><h3>Methods</h3><div>A secondary analysis of the 2023 Indonesian Health Survey (SKI) included 877,531 respondents from urban (n = 469,549) and rural (n = 407,982) areas. The study focused on individuals of all ages who had been diagnosed with dengue fever by a physician within the past year. Disparities in self-reported dengue infection were assessed using standardized questionnaires that covered individual factors (age, sex, education, occupation, and preventive measures) and household factors (health facility awareness, travel time, transport affordability, wealth, water source, and preventive behavior). Data collected from August to October 2023 were analyzed using weighted logistic regression models in STATA 17.0 MP to account for the complex sampling design.</div></div><div><h3>Results</h3><div>Self-reported dengue incidence was higher in urban areas (0.73 %) than rural areas (0.52 %). In urban settings, higher odds of dengue infection were associated with having school-aged children, living in crowded households, belonging to the wealthiest quintile, using bottled water, and neglecting regular cleaning of water storage containers. In rural areas, adults using refill water had increased odds of infection, while those working in the informal sector and practicing mosquito bite prevention showed reduced odds.</div></div><div><h3>Conclusions</h3><div>Our study highlights social determinants of dengue infection in Indonesia, emphasizing the need for targeted public health interventions that address educational disparities, economical access to healthcare, and effective preventive practices.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"8 1","pages":"Pages 10-21"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019979","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}
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.
{"title":"How is food security threatened in Iran's agricultural sector? A grounded theory approach","authors":"Pouria Ataei , Mostafa Alinaghizadeh , Hasan Alibakhshi , Naser Valizadeh , Hamid Karimi","doi":"10.1016/j.glt.2026.01.002","DOIUrl":"10.1016/j.glt.2026.01.002","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"8 1","pages":"Pages 144-157"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975962","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}
Pub Date : 2026-05-01Epub Date: 2025-10-10DOI: 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.
{"title":"Beyond food: Ultra-processed people are living in an ultra-processed world","authors":"Bruna Menegassi , Jesus Rivera-Navarro","doi":"10.1016/j.glt.2025.10.001","DOIUrl":"10.1016/j.glt.2025.10.001","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"8 1","pages":"Pages 89-100"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465355","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}
Pub Date : 2026-05-01Epub Date: 2025-09-15DOI: 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.
{"title":"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","authors":"Helen Andriani , Chairina Suci Andhisa , Paul LC. Chua , Miftahul Arsyi","doi":"10.1016/j.glt.2025.09.004","DOIUrl":"10.1016/j.glt.2025.09.004","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"8 1","pages":"Pages 64-73"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220722","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}
Pub Date : 2026-05-01Epub Date: 2025-09-01DOI: 10.1016/j.glt.2025.09.003
Jie Wang , Minmin Wang , Minghui Ren , Yinzi Jin
Background
The misalignment between cancer burden and drug innovation poses significant challenges for global health. However, the global scope, temporal trends, and underlying factors contributing to this mismatch remain underexplored. We aim to evaluate the extent, trends, and driving forces behind the disparity between early drug development and cancer burden.
Methods
This retrospective cohort study encompasses a total of 9473 early phase cancer drug trials from 1990 to 2023. Concentration curves and concentration indices (CIs) were employed to measure and track the mismatch over time. Residual analysis derived from a regression model identified cancers that may be either overlooked or overly focused upon. Decomposition of CIs was applied to ascertain the contributors to this mismatch and its evolution.
Results
The CI between early drug development and cancer burden exhibited an upward trend over time, rising from 0.105 (95 % CI: 0.015 to 0.225) in the 1990s to 0.208 (95 % CI: 0.092 to 0.326) in the 2020s. Early drug development activities had disproportionately favored high-burden cancers. Demand-side factors, such as disease burden (average contribution: 53.35 %) and market size (average contribution: 25.16 %), were the primary drivers of both the mismatch and its growth.
Conclusions
The primary drivers of early drug development are medical and market demands, which lead to disproportionate focus on more prevalent or commercially attractive cancers. To address these disparities, targeted initiatives and policy reforms are necessary to ensure that drug development aligns more closely with global health needs, especially for cancers that receive insufficient attention.
{"title":"Mapping the divide: Early development of global cancer drugs and its mismatch with cancer burden","authors":"Jie Wang , Minmin Wang , Minghui Ren , Yinzi Jin","doi":"10.1016/j.glt.2025.09.003","DOIUrl":"10.1016/j.glt.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>The misalignment between cancer burden and drug innovation poses significant challenges for global health. However, the global scope, temporal trends, and underlying factors contributing to this mismatch remain underexplored. We aim to evaluate the extent, trends, and driving forces behind the disparity between early drug development and cancer burden.</div></div><div><h3>Methods</h3><div>This retrospective cohort study encompasses a total of 9473 early phase cancer drug trials from 1990 to 2023. Concentration curves and concentration indices (CIs) were employed to measure and track the mismatch over time. Residual analysis derived from a regression model identified cancers that may be either overlooked or overly focused upon. Decomposition of CIs was applied to ascertain the contributors to this mismatch and its evolution.</div></div><div><h3>Results</h3><div>The CI between early drug development and cancer burden exhibited an upward trend over time, rising from 0.105 (95 % CI: 0.015 to 0.225) in the 1990s to 0.208 (95 % CI: 0.092 to 0.326) in the 2020s. Early drug development activities had disproportionately favored high-burden cancers. Demand-side factors, such as disease burden (average contribution: 53.35 %) and market size (average contribution: 25.16 %), were the primary drivers of both the mismatch and its growth.</div></div><div><h3>Conclusions</h3><div>The primary drivers of early drug development are medical and market demands, which lead to disproportionate focus on more prevalent or commercially attractive cancers. To address these disparities, targeted initiatives and policy reforms are necessary to ensure that drug development aligns more closely with global health needs, especially for cancers that receive insufficient attention.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"8 1","pages":"Pages 56-63"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220720","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}
This study aimed to analyze the association between tobacco and its substitutes use and psychosocial symptoms among adolescents, and to investigate whether these associations varied based on the Universal Health Coverage (UHC) index.
Methods
A pooled cross-sectional analysis was conducted using data from the Global School-based Student Health Survey from 2013 to the most recent available year, covering 47 countries and involving 187,329 adolescents aged 12–17 years. Log-binomial regression models were applied to analyze the association between current tobacco and substitutes use and psychosocial symptoms including suicide ideation, being lonely, and worrying. Further stratified analysis was performed with log-binomial regression models to analyze whether the associations differed under different national UHC index.
Results
The prevalence of psychosocial symptoms, including suicide ideation, being lonely, and worrying, were 14.1 %, 12.8 %, and 10.3 %, respectively. The prevalence of tobacco and its substitutes use was significantly higher among boys (20.9 % vs. 10.7 %; P < 0.001). Tobacco and its substitutes use was associated with greater risk of suicide ideation (boys: OR = 1.89, 95%CI 1.82–1.97; girls: OR = 2.33, 95%CI 2.26–2.40), being lonely (boys: OR = 1.58, 95%CI 1.51–1.64; girls: OR = 1.68, 95%CI 1.63,1.73), and worrying (boys: OR = 1.78, 95%CI 1.70,1.87; girls: OR = 1.82, 95%CI 1.76,1.89). The differences were also significant in all sex-stratified subgroup analyses (P < 0.001). These associations were greater in countries with lower UHC index, particularly tobacco-related risk of suicide ideation among girls.
Conclusion
Tobacco and its substitutes use is associated with increased risks of various psychosocial symptoms, including feelings of suicide ideation, being lonely, and worrying, in adolescents, particularly among girls and in countries with lower UHC index.
{"title":"Examining the association between tobacco and its substitutes use with psychosocial symptoms among 187,329 adolescents: A comparative analysis across 47 countries with varied universal health coverage index","authors":"Zichen Ye , Manman Chen , Xijie Wang , Zhilan Xie , Daqian Zhang , Dandan Wu , Yuankai Zhao , Yimin Qu , Yu Jiang","doi":"10.1016/j.glt.2025.02.007","DOIUrl":"10.1016/j.glt.2025.02.007","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to analyze the association between tobacco and its substitutes use and psychosocial symptoms among adolescents, and to investigate whether these associations varied based on the Universal Health Coverage (UHC) index.</div></div><div><h3>Methods</h3><div>A pooled cross-sectional analysis was conducted using data from the Global School-based Student Health Survey from 2013 to the most recent available year, covering 47 countries and involving 187,329 adolescents aged 12–17 years. Log-binomial regression models were applied to analyze the association between current tobacco and substitutes use and psychosocial symptoms including suicide ideation, being lonely, and worrying. Further stratified analysis was performed with log-binomial regression models to analyze whether the associations differed under different national UHC index.</div></div><div><h3>Results</h3><div>The prevalence of psychosocial symptoms, including suicide ideation, being lonely, and worrying, were 14.1 %, 12.8 %, and 10.3 %, respectively. The prevalence of tobacco and its substitutes use was significantly higher among boys (20.9 % vs. 10.7 %; <em>P</em> < 0.001). Tobacco and its substitutes use was associated with greater risk of suicide ideation (boys: OR = 1.89, 95%CI 1.82–1.97; girls: OR = 2.33, 95%CI 2.26–2.40), being lonely (boys: OR = 1.58, 95%CI 1.51–1.64; girls: OR = 1.68, 95%CI 1.63,1.73), and worrying (boys: OR = 1.78, 95%CI 1.70,1.87; girls: OR = 1.82, 95%CI 1.76,1.89). The differences were also significant in all sex-stratified subgroup analyses (<em>P</em> < 0.001). These associations were greater in countries with lower UHC index, particularly tobacco-related risk of suicide ideation among girls.</div></div><div><h3>Conclusion</h3><div>Tobacco and its substitutes use is associated with increased risks of various psychosocial symptoms, including feelings of suicide ideation, being lonely, and worrying, in adolescents, particularly among girls and in countries with lower UHC index.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"7 ","pages":"Pages 128-135"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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