Global Transitions最新文献

Achieving financial inclusion in shorter timeframes is a grand societal challenge that can be addressed by digital technology. Nonetheless, how an innovative digital technology gets generalized is understudied in the literature. We present the generalization of a cloud-based core banking system to drive financial inclusion in the Philippines. We draw our material from the case of cloud-based core banking system adoption in the Philippines. Our results show that market formation is essential to the generalization, and this can be accomplished through a mix of laissez-faire and dirigisme mechanisms. Pure laissez-faire mechanisms alone, with minimal intervention from the central bank, may drive the generalization of digital innovations. Nonetheless, for the generalization of cloud digital technology to happen at an accelerated pace, the central bank must intervene more proactively, especially in establishing an industry-wide digital financial ecosystem. Furthermore, for the generalization of cloud digital technology to truly contribute to the societal mission of financial inclusion, the central bank ought to take the lead as a meta-governor directing the various elements of the digital finance ecosystem. Our study provides a nuanced understanding of the interplay between laissez-faire and dirigisme in the genesis of markets for digital innovations in pursuit of financial inclusion.

Background

Our study aimed to investigate the association between multimorbidity and the cognitive decline related functional limitations.

Methods

Data were obtained from the 2011–2018 China Health and Retirement Longitudinal Study, and generalized estimating equation models were used for estimation. A Chinese multimorbidity-weighted index (CMWI) was used to quantify the cumulative disease burden of multimorbidity. A margin plot was used to show the probability of functional limitations by global cognitive function and CMWI. Then, subgroup analysis was performed by demographic factors, the severity of functionally impaired ADL/IADL, and the trajectories of cognitive function.

Results

Multimorbidity was demonstrated to be associated cognitive decline related functional limitations over 8 years, with the coefficient of the interaction of cognitive function −0.001 (−0.001, −0.001). This moderating effect was only significant in the relationship between cognitive function and ≥2-item impaired ADL/IADL (coefficient = −0.008, 95% CI: 0.009, −0.007) but was not significant in the relationship between cognitive function and 1-item impaired ADL/IADL. The accelerated role of multimorbidity associated with more severe function limitations than the relatively mild limitations attributed to cognitive decline, and the role of multimorbidity was stronger in individuals with continuously high function of cognitive trajectories and gradually declining cognitive function than in those with low level of cognitive trajectories.

Conclusions

Effectively managing multimorbidity is important for preventing cognitive decline. Preventing the onset and progression of multimorbidity may be one potential strategy for early prevention and intervention to reverse or postpone cognitive decline and its further dementia risk.

Background

Depression has caused enormous health burden to human worldwide. Glycemia has been found as one important risk factor of depression. However, the biological mechanism underlying this relationship remained largely unknown.

Methods

This analysis was derived from a cohort of 33,151 participants in the UK Biobank who provided brain magnetic resonance imaging data from 2014 to 2020. Participants were classified into diabetic, prediabetic and non-diabetic groups, as well as groups aged ≥60 years and <60 years. We assessed the associations between glycosylated hemoglobin (HbA1c), grey matter volume (GMV) in 117 brain regions, and depression based on the multivariable linear and logistic regression. We further investigated the mediation effect of GMV on the relationship between HbA1c and depression.

Results

Higher HbA1c was found to be associated with reduced GMV and depression. Lower GMV was observed associated with depression. Moreover, the association was strongest in prediabetes compared to prediabetic and non-diabetic, and the association was greater in those aged ≥60 years. We further observed a significant mediation effect of GMV on the association between HbA1c and depression, and the proportions of the effect mediated by HbA1c-depression signatured regions was 7.29% (95% CI: 1.43%, 34.38%).

Conclusions

This study suggests that HbA1c is associated with cerebral grey matter abnormality especially in participants aged ≥60 years. In the context of global aging, the unhealthy blood sugar can contribute to more severe brain damage for the population and effective control of blood sugar levels among the elderly can have a positive impact on brain health and potentially reduce the risk of developing depression.

Introduction

While India's contribution and progress on environment protection has been applauded by global leaders, India continues to be one of the biggest carbon and greenhouse gas (GHG) emitter globally. Major sectors responsible for carbon emissions are also the major sectors attracting international investments. This paper intends review such investments and examine their impact on environment.

Methodology

A comprehensive review of the existing literature to identify the prevailing laws and policies that apply to corporations to meeting environmental standards was undertaken. In addition, extensive search was undertaken on the internet for reports and database that monitor corporate behavior and report about their disclosures and efforts on addressing environmental concerns. A review of the investment agreements signed, adopted and in-force in India was also undertaken to understand if they meet the standards of environmental protection. Data collection was done between July 2022 to June 2023.

Findings

The Constitution of India stipulates protection and improvement of public and environmental health of the country. Several laws and policies have been adopted to meet this constitutional standard in India, including The National Action Plan on Climate Change (NAPCC). The 17 SDGs have direct and indirect linkages and impact on the environment. It is evident that all international investment agreements up to 2017 have no mention of environment exemption clause nor incorporates the GATT Article XX exceptions. However, the recent IIAs do mention environment as exception to expropriation. It is also seen that investments by big corporations have been responsible for huge deforestation, water pollution, and fossil fuel globally and most of them have their footprints in India and continue to contribute to the countries carbon footprint. India's commitment to renewable and non-conventional energy is the silver lining to meeting the SDG goals and the net zero emission targets. Meeting ESG standards and its disclosures by regulatory body is another positive step towards environmental protection from international investments.

Conclusion

The biggest global contributors to GHG and carbon emissions have their presence in India and thus contribute to the overall carbon foot print of India. All international investments must be required to comply with the legal and policy regulations on public health and environment protection. In this regard, corporations should be mandated to follow ESG standards to meet the SDGs objectives.

In 2022, the 15th Conference of Parties (COP15) to the UN Convention on Biological Diversity (CBD) adopted the “Kunming-Montreal Global Biodiversity Framework” (GBF), which aimed to strengthen international protections on terrestrial and marine areas through biodiversity investments, corporate responsibility, and the elimination of environmentally damaging subsidies. China was fundamental in forming and passing this pivotal biodiversity framework. China's leadership in COP15 should result in escalated Chinese biodiversity protections, specifically through mandated biodiversity impact disclosures (BIDs) for companies associated with the Belt and Road Initiative (BRI). To achieve this, BID clauses should be inserted into BRI development agreements between Chinese foreign development institutions and BRI partner states or companies. Mandated BIDs would expand biodiversity and human health protections within China and globally. BRI-associated companies would be motivated to improve BID ratings for financial benefits, increased social capital, employee engagement, and customer loyalty. Biodiversity protection will also “future-proof” companies against any future environmental policy changes. By providing improved materiality to investors, governments, and other interested parties, BRI BIDs would enhance corporate oversight and awareness of biodiversity issues, advance the standardization and pervasiveness of BIDs, and elevate biodiversity and human health issues into more traditional commercial reporting systems. Thus, China's corporate responsibility measures under COP15 will influence global biodiversity, human health, and the future of BIDs.

Background & aims

Naturogenic aspects of global warming are amplified by the anthropogenic effects of the persistent exponential global population growth. Urbanization without proper planning escalates serious all-time disease pathologies in vulnerable populations, such as children, through pollution of toxic gases. We illustrate these associations with a retrospective study of respiratory heath in children living in downtown Rome when this dense urban center recorded one of the highest air pollution levels in Europe.

Methods

Lung and respiratory function parameters were evaluated from 2006 to 2007 in a cohort of 90 children including two age subgroups (>10 years and <10 years). Additionally, historical air pollution data from 2006 to 2008 and 2020–2021, collected from urban traffic and urban background stations in Rome, was obtained to allow for a correlational analysis between air pollution and children's respiratory health.

Results

Severe impairments on the Mead Expiratory Flow Rate were revealed alongside an increase in allergenic atopics. Historical data showed no differences between measurements from urban background and traffic stations for PM₁₀, PM_2.5, NO, and NO₂, and no significant time trends. However, although both declined over time, CO measurements were consistently higher from traffic than background stations.

Conclusions

Our correlational study indicates that decreases in respiratory health and function may be associated with air pollution, leading to increased susceptibility to viral infections, such as COVID-19, especially in vulnerable populations. In this context, vulnerable populations’ environmental health and disease prevention, also linked with climate change, could be addressed by focusing efforts on combatting urban pollution.

Background

In the 21st century, China experienced a rapid increase in urbanization, which has enhanced medical service availability, but has also increased exposure to adverse environmental and socioeconomic factors. Urbanization-related factors can affect the prognosis of stroke patients, particularly the progression of neurological disabilities. However, the overall association between urbanization and post-stroke disability remains unknown.

Method

A total of 21,678 stroke patients were selected from the China National Stroke Screening Survey (2013–2018); all included patients had at least one follow-up record. The modified Rankin Scale (mRS), a clinician-reported functional outcome measure for recovery from stroke, was utilized to assess post-disability at each visit. A larger mRS score means severer disability. The urbanization level before each visit was evaluated based on 5-year average satellite measurements of night-time light (NTL) or urban land cover (i.e., proportion of impervious surface). We used a fixed-effects model to estimate the association between urbanization level and risk of disability (i.e., mRS score). The non-linear relationship was modelled by penalized spline functions.

Results

According to linear models with multivariate adjustment, every 10 digital number (DN) increment in NTL was associated with a 0.050 (95% confidence interval [CI]: 0.026, 0.074) increase in mRS score, and every 10% increment in impervious surface was associated with a 0.052 (95% CI: 0.034, 0.070) increase in mRS score. The association was stronger in patients diagnosed with atrial fibrillation, dyslipidemia, hypertension, or diabetes compared with the corresponding reference group. Non-linear analysis showed a U-shaped relationship between urbanization and the mRS score, which indicates that high and low urbanization levels were both associated with an increased risk of post-stroke disability.

Conclusions

Our study revealed a complex association between urbanization and post-stroke disability. The optimal level of urbanization to prevent neurological disabilities in stroke patients could be inferred from the U-shaped curve. The reasons for the complex association between urbanization and post-stroke disability should be further explored to establish causality.

As Fine particulate matter (PM_2.5) levels declined in China in past years, the health and social benefits brought about by the air quality improvement are beginning to emerge. We did a time-stratified, case-crossover study which including in total of 106, 120, 862 hospital admissions from 1040 class 3 hospitals in 268 cities, 31 provinces in China, from January 1, 2013 to December 31, 2017, obtained from High Quality Monitoring System (HQMS). We obtained PM_2.5 and ozone concentrations from a high-resolution model and joined daily air pollution estimates for each patient based on hospital location. To assess the association between main air pollutants and hospital admission, hospital days, and hospitalization expenses, we applied conditional logistic regressions to perform a risk assessment associated with main pollutants (PM_2.5 and Ozone) in two-pollutant models. The results show that the risk of hospital admission was positively associated with short-term exposure to PM_2.5 in all major diseases. Specifically, every 10 μg/m³ increase in the concentration level of PM_2.5 (adjusted for ozone) was associated with 0.27% (95% CI: 0.25%, 0.29%) increase in hospital admission, 39.00 (95% CI: 36.11, 41.89) yuan increase in hospitalization expense per admission, and 0.0280 (95% CI: 0.0259, 0.0300) days increase in hospital days per admission. Moreover, the relative risk increases of mental disorders, respiratory diseases and circulatory diseases showed significant associations with short-term PM_2.5 exposure. Based on our calculations, improved air quality since 2013 saved 2.28 billion yuan in medical expenses in 2017.

Background

India implemented a basket of public health developmental packages to achieve the Sustainable Development Goal (SDG) 6—providing access to clean water and adequate sanitation for all by 2030. Though the country is getting closer to being free of open defecation, the pace of progress varies spatially. Therefore, the current study is relevant to explore determinants of practicing open defecation at the small area level in India.

Methods

The present study included the latest National Family and Health Survey (2019–21) and applied both non-spatial (bivariate statistics with ꭔ² test and multivariate logistic regression) and spatial analyses (Univariate and bivariate LISA Moran I, OLS, SLM, and SEM) to assess the national level predictors and spatially auto-correlated determinants of practicing open defecation.

Results

In India, almost one-fifth of households practiced open defecation, mainly clustered in the Middle Ganges Plain, central, and eastern region. A significant rural-urban and poor-rich gap in open defecation practice was also observed. The spatial clusters of lower-educated individuals, poorest wealth quintile, backward social groups, and rural residence were found to be prone to open defecation practice. Housing condition and water supply with the house were also significantly auto-correlated with open defecation practice.

Conclusion

Open defecation remains a public health challenge in India, particularly in the north and central parts, among rural populations, and in socioeconomically deprived areas. It is crucial to focus on small area-level program implementation and assessment approaches to eliminate open defecation in India by 2030.