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Asthma medication usage after environmental exposure to wildfire smoke:A systematic review
Get PDFAsthma is a chronic respiratory condition exacerbated by exposure to particulate air pollution. Smoke from landscape fires has been associated with increased mortality, asthma-related admissions to emergency and other hospital departments, and uptake in primary care services. With climate change and more frequent landscape fires, healthcare systems must prepare for disaster, including surges in asthma medication demand. Past reviews have not resolved the direction and magnitude of the association between PM 2.5 exposure during landscape fires and asthma medication use. The aim of this review was to investigate the relationship between exposure to landscape fire smoke and the use of asthma medications. We conducted a systematic review of PubMed, Scopus, and Web of Science, identifying peer-reviewed articles that examined asthma medication usage following environmental exposure to landscape fire smoke. After a full-text review, we identified twelve articles, three from Canada, three from the USA and six from Australia, with five being retrospective cohort studies. Despite differences in study design, outcome and exposure assessment, the included studies reported a consistent increase in asthma medication use after exposure to wildfires. There is consistent evidence that exposure to wildfire smoke is associated with an increase in the use of reliever medications, particularly salbutamol. Increases in other asthma management medications were also consistently identified. Increases in demand for asthma medications after exposure to wildfire smoke highlight the urgent need to address the growing frequency and intensity of wildfires driven by climate change. </p
Corruption, sustainable development goals performance and modern slavery practices:an international evidence
Get PDFPurpose: This study examines the two key research question; (1) Does country-level corruption give rise to modern slavery (MS) practices and (2) Does sustainable development goals (SDGs) performance of different jurisdictions reduce MS practices? Design/methodology/approach: Using a sample of 431 country-year observations (for the period of 2016, 2018 and 2023) from 146 countries, the study test hypotheses applying different econometrics analysis and conducts robustness tests. Findings: Our results indicate that country-level corruption practices increase MS practices in different contexts. These results hold when we use alternative measures for MS construct. Our study also reported that MS practices in different jurisdictions are lessened when country-level SDGs performance is higher. Our additional analysis finds that higher country-level debt serves as a channel between corruption and MS practices. Research limitations/implications: Practically, the findings of the study have a take-away message for different global actors, in particular, different countries’ governments, national regulators working to abate corruption and slavery issues. For other actors such as the United Nations, the ILO and others, the findings will have practical value for their new policy development and interventions. Originality/value: To the best of our knowledge, this study is the first that investigated the role of country-level corruption on MS practice at the country level. Similarly, our attempt towards exploring the impact of country-level sustainable development goals (SDGs) performance on the MS practices is also primary in the literature. Lastly, developing a single framework by integrating different countries’ MS practices with corruption and SDGs performance and providing related empirical evidence with global level data is a new initiative in the accounting and sustainability literature.</p
Redrawing Boundaries:Systemic Impacts of Rehabilitation Robots in Clinical Care Settings
No full textHow does the implementation of robotic systems impact patient care, therapist roles, and clinical workflows in rehabilitation care? This study presents preliminary findings on the real-world implementation of the Lokomat® robotic gait therapy device in a rehabilitation hospital, focusing on the experiences of clinicians. Through qualitative methods, including interviews and direct observations, the study identifies both anticipated benefits and unforeseen challenges. Participants expressed optimism about the device's ability to extend therapy duration, improve patient outcomes, and alleviate therapists' physical workloads. However, operational realities such as time- and labour-intensive setups and staffing constraints revealed unexpected costs, both in terms of workload and logistics. The findings highlight the need for holistic implementation approaches that address both patient-centric benefits and clinician-centric challenges to ensure the sustainable adoption of robotic systems in healthcare.</p
Online misinformation in Australia:Adults' experiences, abilities and responses
No full textThe rapid uptake of social media, which Australians now use more than any other type of media, presents many opportunities for accessing information, but also presents the highly significant challenge of misinformation. The sheer volume of information online can be overwhelming and very difficult to navigate. As a result, bad actors seek to undermine democratic processes and target individuals. This has been widely recognised as a global problem. However, Australians lack the confidence and ability to verify misinformation.This report is based on analysis of four linked datasets and finds that the vast majority of adult Australians want to be able to identify misinformation and are trying to do so. It also finds that many adult Australians overestimate their ability to verify information online. The research findings illustrate the need for media literacy initiatives. These might include videos that show people how to fact check online or how to identify high-quality news sources, quizzes or games that help people develop their digital media knowledge and skills, explainers that show how platform business models operate and how this relates to the spread of misinformation, or in-person media production training that can help people think critically, and accurately represent people, places and ideas
The zero suicide approach:Style over substance
No full textThe zero suicide approach is based on the belief that all deaths from suicide in healthcare settings are preventable. We caution that the narrow focus on suicide prevention as a key indicator for measuring mental health system performance may have adverse consequences.</p
From parental education to under-5 mortality:how antenatal care and hand hygiene mediate the pathway mechanisms
No full textBACKGROUND: Reducing the under-5 mortality rate (U5MR) to as low as 25/1000 live births globally by 2030 to reach the sustainable development goal (SDG) 3.2.1 appears to be a race against time. Amidst this situation, Bangladesh experienced stagnancy in U5MR at the beginning of the SDG era. While a comprehensive understanding of this stagnancy is crucial, research on stagnancy is scant and limited to investigating the direct effects of the key predictors. Therefore, building on the existing evidence, this research investigated the effect of one of the key predictors, parental education, on under-5 mortality (U5M) mediated through antenatal care (ANC) and the availability of hand washing stations.METHODS: This study conducted weighted mediation analyses using the Bangladesh Demographic and Health Survey data from 2011, 2014 and 2017-18, with sample sizes 4,658, 4,367, and 4,826, respectively, and estimated a generalised structural equation model. The "nlcom" post-estimation command of STATA was used to obtain the direct effects (coefficients), which were then multiplied to estimate the indirect effects for the indirect parallel and sequential pathways. The indirect effects were added to obtain the total indirect effect, which was added to the direct effect of education to estimate the total effect of education.RESULTS: This study reveals inconsistent parallel and sequential mediation of parental education's effect across the three surveys. The direct effect of education on U5M reduced over time. The total (parallel and sequential combined) mediated effects of either parent's education on U5M were negative (reduced U5M risk). While the mediated effect of mother's education on U5M was not significant, the mediated effect of father's education was significant in 2011. The total effect of education (direct and indirect combined) on U5M was negative (reduced U5M risk) and significant in 2011. However, the effect reduced over time and changed direction in 2017-18. Since 2011, the effects decreased and changed direction to become positive (increased U5M risk) in 2017-18. Due to the weakening direct effect of education and the opposite nature of the indirect effect, the indirect effect of education appeared to be greater than the total effect in 2014 and 2017-18. In 2011, approximately 50% of the total effect of either parent's education was mediated. However, in 2014 and 2017-18, the proportions were greater than 100%, except for the proportion of the mediated effect of father's education in 2014.CONCLUSIONS: This study reports a weakening and inconsistent mediated effect of both parents' education on U5M. Using existing literature, it also justifies that improving the quality of education and ANC could more effectively reduce U5M to achieve SDG 3.2.1. To improve the quality of education, this study recommends updating the school curriculum with a greater emphasis on maternal and child health education. To improve the quality of ANC, it is recommended that the mandatory use of ANC cards be strictly monitored.</p
Can a book help the left rebuild the good life? Ezra Klein’s Abundance is the talk of Washington – and Canberra
No full textTransforming Water Research Through Human Rights-Based Approaches:A Framework for Implementation
No full textThe integration of human rights-based approaches (HRBAs) into water resource governance has gained significant momentum, particularly in regions facing complex water security challenges. It is now recognized that to address water security, we must address the human side of insecurity, and the HRBA endeavors to do this. Importantly, research projects are primary drivers of water management innovation. As research methodologies directly influence subsequent water management practices, the integration of HRBA in research becomes crucial for ensuring human rights considerations in future water governance. This study examines HRBA implementation in water research programs within the Mekong sub-region, where water insecurity significantly impacts local communities dependent on the Mekong River basin. Through an analysis of six research projects under the Sustainable Mekong Research Network, we assessed HRBA implementation using five dimensions: accountability, transparency, policy engagement, participation, and empowerment. Our mixed methods approach combined document analysis with semi-structured interviews. Projects revealed a spectrum of HRBA implementations from ‘thick’ to ‘thin’ applications, with political sensitivities and varying institutional capacities influencing implementation depth. This study introduces a novel framework for evaluating HRBA in water research, offering practical guidance for researchers and policymakers working in regions with complex socio-political dynamics. The resulting frameworks provide actionable tools that can be immediately applied in research design, stakeholder engagement processes, and policy development, enabling more equitable and effective water governance practices across diverse institutional contexts.</p
Associations Between the Built Environment and Adult Obesity and the Mediating Role of Physical Activity:A Systematic Review
No full textAssociations between the built environment (BE) and adult obesity are well established. Physical activity (PA) is shown to mediate this association; however, no review has comprehensively synthesized the evidence required to understand this mediating relationship and its variation across different measures of the BE, PA, and obesity. Four electronic databases were searched, and 19 articles published between 2005 and 2022 were reviewed. PA partially explained the associations between the BE and obesity, with effects varying widely across studies (0.48%–48.7%). Objectively measured moderate-to-vigorous PA consistently mediated the association between walkability and obesity, with higher PA accounting for 8.5%–11.6% of the relationship. Domain-specific PA such as walking for transport mediated walkability–obesity associations, but only few studies examined such relationships. PA was an inconsistent mediator of associations between other BE exposures (street connectivity, land-use mix, accessibility, and greenspace) and obesity. PA's mediating role in the BE-obesity relationship is context-dependent; BE features that promoted PA in less dense urban areas of some countries showed different effects in denser urban settings of other countries. Despite limited longitudinal studies from diverse settings, evidence from this review suggests that the BE has the potential to facilitate PA and reduce global obesity and related chronic conditions.</p