Pub Date : 2025-01-01DOI: 10.1016/j.glt.2025.06.006
Sanju Kaladharan , Dhanya Manayath , G. Rejikumar , Ann Faria
Climate change poses a serious threat to human health. The health sector plays a crucial role in addressing the challenges posed by climate change. It must both manage the unavoidable health impacts and take steps to reduce its own greenhouse gas emissions, contributing to broader climate mitigation efforts. Kerala, an Indian state, has formulated its State Action Plan on Climate Change and Human Health (SAPCCHH), a comprehensive long-term planning document. Set to remain in effect until 2027, the plan has broader implications for promoting climate-resilient and sustainable healthcare. Kerala's public health system stands out for its emphasis on accessible primary healthcare at the community level and its decentralized governance.SAPCCHH leverages key opportunities in the state, including empowered local self-governments that are implementing democratic decentralization. Its success in tackling the COVID-19 pandemic and the Nipah virus offers valuable global insights on how health systems can be better prepared to address the health impacts of climate change across various levels. This collaborative governance model, which emphasizes local and decentralized governance, can play a vital role in mitigating the health impacts of climate change. In this paper, we examine how a decentralized health ecosystem can be instrumental in mitigating the health impacts of climate change, using Kerala's successful responses in the past. The paper highlights three key strengths of Kerala's health system, which have broader implications for addressing the health challenges posed by climate change: Local self-government-led primary health system, Community mobilization, and Intersectoral collaboration.
{"title":"Mitigating human health impacts of climate change: A case of Kerala state in India","authors":"Sanju Kaladharan , Dhanya Manayath , G. Rejikumar , Ann Faria","doi":"10.1016/j.glt.2025.06.006","DOIUrl":"10.1016/j.glt.2025.06.006","url":null,"abstract":"<div><div>Climate change poses a serious threat to human health. The health sector plays a crucial role in addressing the challenges posed by climate change. It must both manage the unavoidable health impacts and take steps to reduce its own greenhouse gas emissions, contributing to broader climate mitigation efforts. Kerala, an Indian state, has formulated its State Action Plan on Climate Change and Human Health (SAPCCHH), a comprehensive long-term planning document. Set to remain in effect until 2027, the plan has broader implications for promoting climate-resilient and sustainable healthcare. Kerala's public health system stands out for its emphasis on accessible primary healthcare at the community level and its decentralized governance.SAPCCHH leverages key opportunities in the state, including empowered local self-governments that are implementing democratic decentralization. Its success in tackling the COVID-19 pandemic and the Nipah virus offers valuable global insights on how health systems can be better prepared to address the health impacts of climate change across various levels. This collaborative governance model, which emphasizes local and decentralized governance, can play a vital role in mitigating the health impacts of climate change. In this paper, we examine how a decentralized health ecosystem can be instrumental in mitigating the health impacts of climate change, using Kerala's successful responses in the past. The paper highlights three key strengths of Kerala's health system, which have broader implications for addressing the health challenges posed by climate change: Local self-government-led primary health system, Community mobilization, and Intersectoral collaboration.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"7 ","pages":"Pages 383-386"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556930","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 : 2025-01-01DOI: 10.1016/j.glt.2025.04.003
Orgil Balgansuren , Narumon Arunotai
The 2030 Sustainable Development Agenda calls for integrating gender equality in all aspects of sustainable development. Still, there is limited understanding of how energy, poverty, and gender intersect in urban areas, particularly in Ulaanbaatar's ger districts, one of the world's coldest and most polluted capitals. Ger districts are disadvantaged residential areas consisting of traditional felt tents or self-built houses. This study addresses this knowledge gap using an intersectional gender perspective to explore how energy and air pollution impact residents. The study collected data through interviews with thirty-one ger district residents of various ages, (dis)abilities, health statuses, and observations and analysis of secondary data. The findings show the impact of severe air pollution and inequities on low-income residents, older individuals, and those with disabilities or poor health. The study reveals that energy poverty disproportionately affects women, highlighting the role of gender norms. It calls for more inclusive energy and environmental policies, emphasizing women's involvement in policy design and implementation for greater justice.
{"title":"Insights on energy, poverty, and gender nexus in urban ger district households: A case study from Ulaanbaatar, Mongolia","authors":"Orgil Balgansuren , Narumon Arunotai","doi":"10.1016/j.glt.2025.04.003","DOIUrl":"10.1016/j.glt.2025.04.003","url":null,"abstract":"<div><div>The 2030 Sustainable Development Agenda calls for integrating gender equality in all aspects of sustainable development. Still, there is limited understanding of how energy, poverty, and gender intersect in urban areas, particularly in Ulaanbaatar's <em>ger</em> districts, one of the world's coldest and most polluted capitals. <em>Ger</em> districts are disadvantaged residential areas consisting of traditional felt tents or self-built houses. This study addresses this knowledge gap using an intersectional gender perspective to explore how energy and air pollution impact residents. The study collected data through interviews with thirty-one <em>ger</em> district residents of various ages, (dis)abilities, health statuses, and observations and analysis of secondary data. The findings show the impact of severe air pollution and inequities on low-income residents, older individuals, and those with disabilities or poor health. The study reveals that energy poverty disproportionately affects women, highlighting the role of gender norms. It calls for more inclusive energy and environmental policies, emphasizing women's involvement in policy design and implementation for greater justice.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"7 ","pages":"Pages 189-198"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851364","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}
To develop an artificial intelligence (AI)-assisted chest x-ray diagnostic system for the detection, differential diagnosis, and follow-up of tuberculosis (TB), and prove its usefulness.
Methods
This is a retrospective study. In-house developed AI-assisted chest x-ray diagnostic system was used to identify and diagnose lung abnormalities in participants' chest x-rays and to compare imaging findings from two x-rays. First, 100 chest radiographs were reviewed including TB cases (N = 43) with positive sputum test confirmation and non-TB cases (N = 57) for initial diagnosis and differential diagnosis. Next, 45 pairs of TB cases from the identical patients were reviewed for follow-up. The AI system diagnosed TB and graded the comparison images into three categories (improved, stable, or worsening). The performance was evaluated by four expert radiologists or pulmonary medicine specialists.
Results
The AI system demonstrated an exceptional sensitivity of 100 %, successfully identifying all 43 TB cases. Nevertheless, it is also susceptible to misclassify other diseases as TB, resulting in low specificity score of 66.7 %. The comparison function determined that expert physicians and AI-assisted chest x-ray diagnostic system were 58 % in exact agreement and 100 % in within one grade agreement.
Conclusions
The AI system successfully detected all TB patients identified in this study and demonstrated a reasonable comparison function. Therefore, our AI assisted chest x-ray diagnostic system is feasible and practical for TB screening.
{"title":"Development and evaluation of an artificial intelligence (AI) -assisted chest x-ray diagnostic system for detecting, diagnosing, and monitoring tuberculosis","authors":"Lalita Kaewwilai , Hiroshi Yoshioka , Antoine Choppin , Thepasit Prueksaritanond , Thitisant Palakawong Na Ayuthaya , Chantapat Brukesawan , Somruetai Matupumanon , Sho Kawabe , Yuki Shimahara , Arthit Phosri , Orawan Kaewboonchoo","doi":"10.1016/j.glt.2025.02.005","DOIUrl":"10.1016/j.glt.2025.02.005","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop an artificial intelligence (AI)-assisted chest x-ray diagnostic system for the detection, differential diagnosis, and follow-up of tuberculosis (TB), and prove its usefulness.</div></div><div><h3>Methods</h3><div>This is a retrospective study. In-house developed AI-assisted chest x-ray diagnostic system was used to identify and diagnose lung abnormalities in participants' chest x-rays and to compare imaging findings from two x-rays. First, 100 chest radiographs were reviewed including TB cases (N = 43) with positive sputum test confirmation and non-TB cases (N = 57) for initial diagnosis and differential diagnosis. Next, 45 pairs of TB cases from the identical patients were reviewed for follow-up. The AI system diagnosed TB and graded the comparison images into three categories (improved, stable, or worsening). The performance was evaluated by four expert radiologists or pulmonary medicine specialists.</div></div><div><h3>Results</h3><div>The AI system demonstrated an exceptional sensitivity of 100 %, successfully identifying all 43 TB cases. Nevertheless, it is also susceptible to misclassify other diseases as TB, resulting in low specificity score of 66.7 %. The comparison function determined that expert physicians and AI-assisted chest x-ray diagnostic system were <strong>58</strong> % in exact agreement and 100 % in within one grade agreement.</div></div><div><h3>Conclusions</h3><div>The AI system successfully detected all TB patients identified in this study and demonstrated a reasonable comparison function. Therefore, our AI assisted chest x-ray diagnostic system is feasible and practical for TB screening.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"7 ","pages":"Pages 87-93"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552998","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}
Pub Date : 2025-01-01DOI: 10.1016/j.glt.2025.02.003
Mona Gamal Mohamed , Taliaa Mohsen Al-Yafeai , Shukri Adam , Md Moyazzem Hossain , Ramya Kundayi Ravi , Fatima Mohamed Jalo , Aamna Eltayeb Osman
Background
Emotional intelligence and resilience empower students in the academic settings to face and overcome the challenges that comes with demanding academic tasks and social pressure.
Objective
This study aimed to examine the role of emotional intelligence in managing academic stress, fostering resilience, and supporting the transition experience among Northern Emirati students in health sciences. Additionally, it sought to assess whether factors such as GPA are related to EI, stress, and resilience levels.
Methods
A cross-sectional, descriptive survey design was used, with data collected from 230 second -year students at RAK Medical and Health Sciences University. The questionnaire included sections on sociodemographic data, the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), the Brief Resilience Scale (BRS), and the Student Stress Inventory - Stress Manifestations (SSISM). Data analysis involved descriptive statistics in SPSS version 29, Structural Equation Modeling (SEM) for relational insights, and regression analysis in R to evaluate the predictive influence of EI on stress and resilience.
Results
Regression analysis indicated that EI significantly predicted resilience and stress levels, with GPA showing an additional positive relationship to EI and resilience. Regression analysis indicated that EI significantly predicted resilience (β = 0.52, p < 0.001) and stress levels (β = −0.33, p < 0.001). GPA exhibited a positive relationship with resilience (r = 0.29, p < 0.05) and well-being (r = 0.45, p < 0.001). Structural Equation Modeling (SEM) confirmed a well-fitting model (Chi-Square/DF = 2.879, RMSEA = 0.108, CFI = 0.785, TLI = 0.846). The path coefficients demonstrated that well-being had the strongest influence on GPA (β = 0.452, p < 0.001), while stress had a minimal but non-significant impact (β = 0.087, p = 0.107).
Conclusions
The findings suggest that emotional intelligence is a significant factor in helping health sciences students manage academic stress and foster resilience. These results highlight the potential benefit of EI development programs to support students during key academic transitions. However, the study's cross-sectional design and reliance on self-reported data suggest that further longitudinal research is needed to confirm these findings.
情商和适应力使学生在学术环境中能够面对和克服艰巨的学术任务和社会压力带来的挑战。目的本研究旨在探讨情绪智力在管理学业压力、培养韧性和支持阿联酋北部健康科学学生的过渡体验方面的作用。此外,它还试图评估GPA等因素是否与情商、压力和恢复能力水平有关。方法采用横断面描述性调查设计,收集来自RAK医学与健康科学大学230名二年级学生的数据。问卷内容包括社会人口统计数据、特质情商短表(TEIQue-SF)、简短弹性量表(BRS)和学生压力量表-压力表现(SSISM)。数据分析使用SPSS version 29进行描述性统计,使用结构方程模型(SEM)进行关系分析,使用R进行回归分析,评估EI对应力和恢复力的预测影响。结果回归分析表明,EI对心理弹性和压力水平有显著的预测作用,GPA与EI和心理弹性呈显著正相关。回归分析表明,EI显著预测心理弹性(β = 0.52, p <;0.001)和应力水平(β = - 0.33, p <;0.001)。GPA与弹性呈正相关(r = 0.29, p <;0.05)和幸福感(r = 0.45, p <;0.001)。结构方程模型(SEM)证实模型拟合良好(Chi-Square/DF = 2.879, RMSEA = 0.108, CFI = 0.785, TLI = 0.846)。通径系数显示,幸福感对GPA的影响最大(β = 0.452, p <;0.001),而压力的影响最小但不显著(β = 0.087, p = 0.107)。研究结果表明,情商是帮助健康科学专业学生管理学业压力和培养适应力的重要因素。这些结果强调了情商发展项目在关键的学业过渡期间支持学生的潜在好处。然而,该研究的横断面设计和对自我报告数据的依赖表明,需要进一步的纵向研究来证实这些发现。
{"title":"The significance of emotional intelligence in academic stress, resilience, and safe transition from high school to university: An SEM analysis among Northern Emirati university students","authors":"Mona Gamal Mohamed , Taliaa Mohsen Al-Yafeai , Shukri Adam , Md Moyazzem Hossain , Ramya Kundayi Ravi , Fatima Mohamed Jalo , Aamna Eltayeb Osman","doi":"10.1016/j.glt.2025.02.003","DOIUrl":"10.1016/j.glt.2025.02.003","url":null,"abstract":"<div><h3>Background</h3><div>Emotional intelligence and resilience empower students in the academic settings to face and overcome the challenges that comes with demanding academic tasks and social pressure.</div></div><div><h3>Objective</h3><div>This study aimed to examine the role of emotional intelligence in managing academic stress, fostering resilience, and supporting the transition experience among Northern Emirati students in health sciences. Additionally, it sought to assess whether factors such as GPA are related to EI, stress, and resilience levels.</div></div><div><h3>Methods</h3><div>A cross-sectional, descriptive survey design was used, with data collected from 230 second -year students at RAK Medical and Health Sciences University. The questionnaire included sections on sociodemographic data, the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), the Brief Resilience Scale (BRS), and the Student Stress Inventory - Stress Manifestations (SSISM). Data analysis involved descriptive statistics in SPSS version 29, Structural Equation Modeling (SEM) for relational insights, and regression analysis in R to evaluate the predictive influence of EI on stress and resilience.</div></div><div><h3>Results</h3><div>Regression analysis indicated that EI significantly predicted resilience and stress levels, with GPA showing an additional positive relationship to EI and resilience. Regression analysis indicated that EI significantly predicted resilience (β = 0.52, p < 0.001) and stress levels (β = −0.33, p < 0.001). GPA exhibited a positive relationship with resilience (r = 0.29, p < 0.05) and well-being (r = 0.45, p < 0.001). Structural Equation Modeling (SEM) confirmed a well-fitting model (Chi-Square/DF = 2.879, RMSEA = 0.108, CFI = 0.785, TLI = 0.846). The path coefficients demonstrated that well-being had the strongest influence on GPA (β = 0.452, p < 0.001), while stress had a minimal but non-significant impact (β = 0.087, p = 0.107).</div></div><div><h3>Conclusions</h3><div>The findings suggest that emotional intelligence is a significant factor in helping health sciences students manage academic stress and foster resilience. These results highlight the potential benefit of EI development programs to support students during key academic transitions. However, the study's cross-sectional design and reliance on self-reported data suggest that further longitudinal research is needed to confirm these findings.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"7 ","pages":"Pages 109-117"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143553001","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}
Pub Date : 2025-01-01DOI: 10.1016/j.glt.2025.01.001
Masyitoh Basabih , Eko Prasojo , Amy Yayuk Sri Rahayu
Context
Public-private partnerships (PPPs) have become the dominant solution adopted by regional hospitals in Indonesia for providing hemodialysis equipment. Analyzing the implementation of PPPs requires using a collaborative governance framework to provide a comprehensive analysis and depict the relationships between variables. This study aims to determine the influence of system context, drivers, and collaborative processes on the outcomes of PPP hemodialysis services in regional hospital in Indonesia.
Methods
This study employs a quantitative approach with primary data obtained through a survey. The research sample consists of 75 regional hospitals represented by 111 respondents. Analysis was conducted using the Partial Least Square-Structural Equation Modeling (PLS-SEM) technique.
Findings
The system context indirectly influences the process through mediation by the driver variable at 0.451, where the driver significantly affects the collaborative process at 0.534, and the collaborative process significantly influences the outcome at 0.773. The policy dimension makes the largest contribution to the systemic context, as does the consequential incentive dimension to the drivers. In the process variable, the capacity for joint action is the dimension with the greatest contribution.
Conclusions
The outcomes of implementing PPP in hemodialysis services at regional hospital are influenced by system context, drivers, and collaborative processes both directly and indirectly. Policy barriers, human resources, and corrupt practices also affect the process and outcomes of hemodialysis PPP, which are perceived not to be in line with good governance.
{"title":"Emerson's framework on the output of public-private partnership on hemodialysis services in Indonesia regional hospitals","authors":"Masyitoh Basabih , Eko Prasojo , Amy Yayuk Sri Rahayu","doi":"10.1016/j.glt.2025.01.001","DOIUrl":"10.1016/j.glt.2025.01.001","url":null,"abstract":"<div><h3>Context</h3><div>Public-private partnerships (PPPs) have become the dominant solution adopted by regional hospitals in Indonesia for providing hemodialysis equipment. Analyzing the implementation of PPPs requires using a collaborative governance framework to provide a comprehensive analysis and depict the relationships between variables. This study aims to determine the influence of system context, drivers, and collaborative processes on the outcomes of PPP hemodialysis services in regional hospital in Indonesia.</div></div><div><h3>Methods</h3><div>This study employs a quantitative approach with primary data obtained through a survey. The research sample consists of 75 regional hospitals represented by 111 respondents. Analysis was conducted using the Partial Least Square-Structural Equation Modeling (PLS-SEM) technique.</div></div><div><h3>Findings</h3><div>The system context indirectly influences the process through mediation by the driver variable at 0.451, where the driver significantly affects the collaborative process at 0.534, and the collaborative process significantly influences the outcome at 0.773. The policy dimension makes the largest contribution to the systemic context, as does the consequential incentive dimension to the drivers. In the process variable, the capacity for joint action is the dimension with the greatest contribution.</div></div><div><h3>Conclusions</h3><div>The outcomes of implementing PPP in hemodialysis services at regional hospital are influenced by system context, drivers, and collaborative processes both directly and indirectly. Policy barriers, human resources, and corrupt practices also affect the process and outcomes of hemodialysis PPP, which are perceived not to be in line with good governance.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"7 ","pages":"Pages 56-68"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143130069","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}
Pub Date : 2025-01-01DOI: 10.1016/j.glt.2025.05.002
Chuan-Guo Guo , Yufan Liu , Feifei Zhang
Background
The role of interactions of diet and air pollution in health outcomes remain unclear. This study investigated the combined effects of a pro-inflammatory diet and long-term air pollution exposure on the risk of five common diseases and all-cause mortality.
Methods
We included 120,000 UK Biobank participants with ≥2 Oxford WebQ 24-h dietary assessments. Cox proportional hazards models were employed to examine the associations between two exposures—Dietary Inflammatory Index (DII) scores and seven air pollutants (PM2.5, PM10, NO2, NOX, SO2, CO, and benzene)—with six outcomes: ischemic heart disease (IHD), stroke, diabetes (all diabetes types encompassing insulin- and non-insulin-dependent, and others), chronic obstructive pulmonary disease (COPD), lung cancer, and mortality. Non-linear exposure–response associations were modeled using shape-constrained health impact functions and penalized splines. Multiplicative interaction effects between DII and air pollutants were evaluated via likelihood-ratio tests.
Results
Our findings indicated exposure to air pollutants were associated with increased risks of diabetes, COPD, IHD, and stroke (hazard ratios 1.004–1.049). Higher DII predicted 1.034–1.086 fold greater risk of diabetes, COPD, lung cancer, and mortality. Significant multiplicative interactions (P for interaction <0.05) indicated that the effects of air pollutant on diabetes, COPD, and mortality were amplified among participants with higher DII, whereas no significant air pollutant-outcome associations were seen in those with low or intermediate DII.
Conclusions
A pro-inflammatory diet may amplify the adverse health effects of air pollution, highlighting potential for dietary interventions to complement environmental regulations.
{"title":"Association of air pollution with ischemic heart disease, stroke, diabetes, COPD, lung cancer, and all-cause mortality: Effect modification by pro-inflammatory diet","authors":"Chuan-Guo Guo , Yufan Liu , Feifei Zhang","doi":"10.1016/j.glt.2025.05.002","DOIUrl":"10.1016/j.glt.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>The role of interactions of diet and air pollution in health outcomes remain unclear. This study investigated the combined effects of a pro-inflammatory diet and long-term air pollution exposure on the risk of five common diseases and all-cause mortality.</div></div><div><h3>Methods</h3><div>We included 120,000 UK Biobank participants with ≥2 Oxford WebQ 24-h dietary assessments. Cox proportional hazards models were employed to examine the associations between two exposures—Dietary Inflammatory Index (DII) scores and seven air pollutants (PM<sub>2.5</sub>, PM<sub>10</sub>, NO<sub>2</sub>, NO<sub>X</sub>, SO<sub>2</sub>, CO, and benzene)—with six outcomes: ischemic heart disease (IHD), stroke, diabetes (all diabetes types encompassing insulin- and non-insulin-dependent, and others), chronic obstructive pulmonary disease (COPD), lung cancer, and mortality. Non-linear exposure–response associations were modeled using shape-constrained health impact functions and penalized splines. Multiplicative interaction effects between DII and air pollutants were evaluated via likelihood-ratio tests.</div></div><div><h3>Results</h3><div>Our findings indicated exposure to air pollutants were associated with increased risks of diabetes, COPD, IHD, and stroke (hazard ratios 1.004–1.049). Higher DII predicted 1.034–1.086 fold greater risk of diabetes, COPD, lung cancer, and mortality. Significant multiplicative interactions (<em>P</em> for interaction <0.05) indicated that the effects of air pollutant on diabetes, COPD, and mortality were amplified among participants with higher DII, whereas no significant air pollutant-outcome associations were seen in those with low or intermediate DII.</div></div><div><h3>Conclusions</h3><div>A pro-inflammatory diet may amplify the adverse health effects of air pollution, highlighting potential for dietary interventions to complement environmental regulations.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"7 ","pages":"Pages 323-332"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240413","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 : 2025-01-01DOI: 10.1016/j.glt.2025.06.003
Nophea Sasaki
Voluntary carbon markets (VCMs) are becoming increasingly central to corporate climate strategies and global emissions reduction efforts. However, recent carbon scandals and greenwashing controversies have exposed major integrity gaps. This review synthesizes evidence from academic research, regulatory reports, and case studies to analyze systemic weaknesses—such as fraudulent crediting, inflated baselines, lack of additionality, and unverifiable climate claims—that undermine the credibility and effectiveness of carbon offsetting. Poor governance, inadequate monitoring and verification (MRV), and limited accountability have triggered reputational and financial risks, diminishing trust in VCMs as legitimate climate finance mechanisms. To address these shortcomings, we propose a six-pillar reform framework comprising (1) transparency, (2) verification integrity, (3) accountability, (4) environmental and social safeguards, (5) smart technologies, and (6) strategic alignment with global goals. The framework is grounded in practical tools, including blockchain-enabled registries, AI-assisted MRV, rights-based standards, and legal mechanisms to improve credit quality and stakeholder confidence. We also evaluate emerging regulatory instruments—such as Article 6 of the Paris Agreement—and integrity initiatives aimed at harmonizing rules and preventing abuse. Drawing from real-world REDD + projects, we assess how digital innovations can support permanence, additionality, and leakage prevention, while also recognizing their limitations without institutional enforcement. Aligning carbon market reforms with broader sustainability and equity objectives can enhance co-benefits—such as biodiversity protection, air quality improvement, and community resilience—while supporting net-zero transitions and strengthening the legitimacy of post-2025 climate finance systems.
{"title":"Addressing scandals and greenwashing in carbon offset markets: A framework for reform","authors":"Nophea Sasaki","doi":"10.1016/j.glt.2025.06.003","DOIUrl":"10.1016/j.glt.2025.06.003","url":null,"abstract":"<div><div>Voluntary carbon markets (VCMs) are becoming increasingly central to corporate climate strategies and global emissions reduction efforts. However, recent carbon scandals and greenwashing controversies have exposed major integrity gaps. This review synthesizes evidence from academic research, regulatory reports, and case studies to analyze systemic weaknesses—such as fraudulent crediting, inflated baselines, lack of additionality, and unverifiable climate claims—that undermine the credibility and effectiveness of carbon offsetting. Poor governance, inadequate monitoring and verification (MRV), and limited accountability have triggered reputational and financial risks, diminishing trust in VCMs as legitimate climate finance mechanisms. To address these shortcomings, we propose a six-pillar reform framework comprising (1) transparency, (2) verification integrity, (3) accountability, (4) environmental and social safeguards, (5) smart technologies, and (6) strategic alignment with global goals. The framework is grounded in practical tools, including blockchain-enabled registries, AI-assisted MRV, rights-based standards, and legal mechanisms to improve credit quality and stakeholder confidence. We also evaluate emerging regulatory instruments—such as Article 6 of the Paris Agreement—and integrity initiatives aimed at harmonizing rules and preventing abuse. Drawing from real-world REDD + projects, we assess how digital innovations can support permanence, additionality, and leakage prevention, while also recognizing their limitations without institutional enforcement. Aligning carbon market reforms with broader sustainability and equity objectives can enhance co-benefits—such as biodiversity protection, air quality improvement, and community resilience—while supporting net-zero transitions and strengthening the legitimacy of post-2025 climate finance systems.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"7 ","pages":"Pages 375-382"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338509","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}
Addressing agricultural waste through digital innovation is vital for mitigating environmental harm and supporting sustainable farming. This study examines the adoption of KaseChar, a mobile application designed to reduce open-field burning and promote agriwaste management among Participatory Guarantee System (PGS) farmers in Chachoengsao Province, Eastern Thailand. Using the Technology Acceptance Model (TAM), we evaluated perceived usefulness (PU), perceived ease of use (PEOU), and behavioral intention (BI) through a structured survey of 150 farmers. Results show high ratings for PU (mean = 4.11), PEOU (mean = 4.08), and BI (mean = 4.03), with key adoption drivers including productivity, efficiency, digital proficiency, and social influence. Exploratory Factor Analysis identified efficiency, usability, and public support as core factors. Waste management cost significantly influenced PU (β = 0.126, p = 0.009), while internet usage was positively correlated with PEOU (β = 0.252, p = 0.002). Despite high smartphone access, barriers such as digital literacy, labor intensity, and infrastructure gaps—particularly among older farmers—limit adoption. The study recommends targeted training, subsidies, and digital infrastructure improvements to scale adoption. It also contributes to TAM literature by integrating contextual variables like digital readiness and financial capacity. Future research should explore long-term behavioral impacts and conduct multi-regional comparisons to enhance scalability and generalizability of findings.
通过数字创新解决农业废弃物问题对于减轻环境危害和支持可持续农业至关重要。本研究考察了KaseChar的采用情况。KaseChar是一款旨在减少泰国东部chachengsao省参与性担保制度(PGS)农民露天焚烧和促进农业废弃物管理的移动应用程序。通过对150名农民的结构化调查,我们使用技术接受模型(TAM)评估了感知有用性(PU)、感知易用性(PEOU)和行为意图(BI)。结果显示,PU(平均= 4.11)、PEOU(平均= 4.08)和BI(平均= 4.03)的评分很高,主要采用驱动因素包括生产力、效率、数字熟练程度和社会影响力。探索性因素分析确定了效率、可用性和公众支持作为核心因素。垃圾管理成本显著影响PU (β = 0.126, p = 0.009),互联网使用与PEOU正相关(β = 0.252, p = 0.002)。尽管智能手机普及率很高,但数字素养、劳动强度和基础设施差距等障碍——尤其是在老年农民中——限制了智能手机的采用。该研究建议有针对性的培训、补贴和数字基础设施改善,以促进大规模采用。它还通过整合诸如数字化准备和财务能力等上下文变量,为TAM文献做出贡献。未来的研究应探索长期的行为影响,并进行多区域比较,以增强研究结果的可扩展性和普遍性。
{"title":"Investigating farmers’ adoption of mobile Agri-Tech: A TAM-Based study of KaseChar in Eastern Thailand","authors":"Eain Dray Aung , Nophea Sasaki , Takuji W. Tsusaka , Chaklam Silpasuwanchai","doi":"10.1016/j.glt.2025.07.003","DOIUrl":"10.1016/j.glt.2025.07.003","url":null,"abstract":"<div><div>Addressing agricultural waste through digital innovation is vital for mitigating environmental harm and supporting sustainable farming. This study examines the adoption of KaseChar, a mobile application designed to reduce open-field burning and promote agriwaste management among Participatory Guarantee System (PGS) farmers in Chachoengsao Province, Eastern Thailand. Using the Technology Acceptance Model (TAM), we evaluated perceived usefulness (PU), perceived ease of use (PEOU), and behavioral intention (BI) through a structured survey of 150 farmers. Results show high ratings for PU (mean = 4.11), PEOU (mean = 4.08), and BI (mean = 4.03), with key adoption drivers including productivity, efficiency, digital proficiency, and social influence. Exploratory Factor Analysis identified efficiency, usability, and public support as core factors. Waste management cost significantly influenced PU (β = 0.126, p = 0.009), while internet usage was positively correlated with PEOU (β = 0.252, p = 0.002). Despite high smartphone access, barriers such as digital literacy, labor intensity, and infrastructure gaps—particularly among older farmers—limit adoption. The study recommends targeted training, subsidies, and digital infrastructure improvements to scale adoption. It also contributes to TAM literature by integrating contextual variables like digital readiness and financial capacity. Future research should explore long-term behavioral impacts and conduct multi-regional comparisons to enhance scalability and generalizability of findings.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"7 ","pages":"Pages 441-455"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696937","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 systematic review and meta-analysis aimed to assess the effectiveness of home-based programmes to prevent hospital admissions compared with traditional hospital-based care for older adults. Health outcomes analysed included readmission rates, mortality, and length of treatment. Data from 15 studies were synthesised using Review Manager (version 5.4), and heterogeneity was assessed using forest plots and I2statistics. Subgroup analyses were performed for randomised controlled trials and for specific patient groups, such as those with cardiovascular and respiratory disease. The results suggest that hospital at home programmes may reduce the risk of readmission (risk ratio = 0.76, 95 % CI 0.58 to 1.01, P = 0.05), especially for patients with respiratory diseases (risk ratio = 0.53, 95 % CI 0.39 to 0.73, P = 0.00007), with no significant differences in mortality or treatment duration between groups.
本系统综述和荟萃分析旨在评估以家庭为基础的方案与传统的以医院为基础的老年人护理相比预防住院的有效性。分析的健康结果包括再入院率、死亡率和治疗时间。使用Review Manager (version 5.4)对来自15项研究的数据进行综合,并使用森林样地和i2统计来评估异质性。对随机对照试验和特定患者组(如心血管和呼吸系统疾病患者)进行亚组分析。结果表明,居家医院方案可降低再入院风险(风险比= 0.76,95% CI 0.58 ~ 1.01, P = 0.05),特别是呼吸道疾病患者(风险比= 0.53,95% CI 0.39 ~ 0.73, P = 0.00007),两组之间的死亡率或治疗时间无显著差异。
{"title":"Effectiveness of admission-avoidance hospital at home as alternative to routine hospital care in older adults: a systematic review and meta-analysis","authors":"Mengyuan Cheng , Lulu Lin , Xiaowen Cao , Weiming Tang , Xin Xu , Xiaoxue Zhang , Yongshun Huang , Junzhang Tian , Zhongzhi Xu , Weibin Cheng","doi":"10.1016/j.glt.2025.06.002","DOIUrl":"10.1016/j.glt.2025.06.002","url":null,"abstract":"<div><div>This systematic review and meta-analysis aimed to assess the effectiveness of home-based programmes to prevent hospital admissions compared with traditional hospital-based care for older adults. Health outcomes analysed included readmission rates, mortality, and length of treatment. Data from 15 studies were synthesised using Review Manager (version 5.4), and heterogeneity was assessed using forest plots and <em>I</em><sup>2</sup>statistics. Subgroup analyses were performed for randomised controlled trials and for specific patient groups, such as those with cardiovascular and respiratory disease. The results suggest that hospital at home programmes may reduce the risk of readmission (risk ratio = 0.76, 95 % CI 0.58 to 1.01, P = 0.05), especially for patients with respiratory diseases (risk ratio = 0.53, 95 % CI 0.39 to 0.73, P = 0.00007), with no significant differences in mortality or treatment duration between groups.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"7 ","pages":"Pages 342-349"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366642","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 : 2025-01-01DOI: 10.1016/j.glt.2025.06.007
Priyanka Dixit , Anjali Bansal , Rahul Mishra , Eugine Paul , Shivalingappa S. Halli
The global rise in Caesarean sections (CS), including India's increase from 8.5 % in 2005-06 to 21.5 % in 2019–21, poses a significant public health challenge. This study investigates the factors driving elective CS decisions, focusing on how older women's childbirth experiences influence younger women's choices within the same household, using data from the National Family Health Survey-5. Multivariable logistic regression and propensity score matching (PSM) were applied to see the influence of older women's Elective CS decisions on their younger peers within the same household. Results show that younger women were more likely to choose elective CS if older women previously had one (29.0 % vs. 15.1 %, AOR = 1.72). Other significant predictors include mass media exposure (AOR = 1.13), private healthcare (AOR = 2.84), and older maternal age (AOR = 2.54 for ages 35–40 years). Regional differences were evident, with South India showing the highest CS rates among younger women (40.4 %), when their older household peer had undergone a CS rates. Wealth and education also played a role, with the richest women having higher odds (AOR = 2.00) and secondary education showing the greatest effect (AOR = 1.43). PSM analysis found an eight percent higher likelihood of elective CS among younger women if older women had one (ATT = 0.086; p < 0.001). In conclusion, the study shows that the childbirth experiences of older women strongly affect younger women's decisions to opt for elective CS, highlighting the important role of influence within households in shaping these choices.
{"title":"Understanding the surge in elective caesarean sections: Role of older women's childbirth choices on younger women in India","authors":"Priyanka Dixit , Anjali Bansal , Rahul Mishra , Eugine Paul , Shivalingappa S. Halli","doi":"10.1016/j.glt.2025.06.007","DOIUrl":"10.1016/j.glt.2025.06.007","url":null,"abstract":"<div><div>The global rise in Caesarean sections (CS), including India's increase from 8.5 % in 2005-06 to 21.5 % in 2019–21, poses a significant public health challenge. This study investigates the factors driving elective CS decisions, focusing on how older women's childbirth experiences influence younger women's choices within the same household, using data from the National Family Health Survey-5. Multivariable logistic regression and propensity score matching (PSM) were applied to see the influence of older women's Elective CS decisions on their younger peers within the same household. Results show that younger women were more likely to choose elective CS if older women previously had one (29.0 % vs. 15.1 %, AOR = 1.72). Other significant predictors include mass media exposure (AOR = 1.13), private healthcare (AOR = 2.84), and older maternal age (AOR = 2.54 for ages 35–40 years). Regional differences were evident, with South India showing the highest CS rates among younger women (40.4 %), when their older household peer had undergone a CS rates. Wealth and education also played a role, with the richest women having higher odds (AOR = 2.00) and secondary education showing the greatest effect (AOR = 1.43). PSM analysis found an eight percent higher likelihood of elective CS among younger women if older women had one (ATT = 0.086; p < 0.001). In conclusion, the study shows that the childbirth experiences of older women strongly affect younger women's decisions to opt for elective CS, highlighting the important role of influence within households in shaping these choices.</div></div>","PeriodicalId":33615,"journal":{"name":"Global Transitions","volume":"7 ","pages":"Pages 411-419"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596107","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}