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Papua Province, known for its abundant natural resources and cultural diversity, faces significant challenges in achieving inclusive economic development. Persistent disparities in income, infrastructure, and access to essential services have hindered equitable growth and social welfare improvement. This study examines the inclusiveness of economic development in Papua and explores its driving factors. Utilizing secondary data from the Ministry of National Development Planning/National Development Planning Agency (Badan Perencanaan Pembangunan Nasional, Bappenas), BPS - Statistics Indonesia (Badan Pusat Statistik, BPS), and the Directorate General of Fiscal Balance (Direktorat Jenderal Perimbangan Keuangan, DJPK) for 2017–2021, the research employs descriptive analysis and panel data regression methods. The panel regression results highlight the critical role of fiscal policies in promoting inclusivity. Economic expenditures demonstrate a positive and significant impact on inclusive development, fostering equitable economic participation and productivity. In contrast, basic infrastructure spending shows a significant negative effect, possibly due to uneven allocation or misalignment with local community needs. While education expenditures are not statistically significant, they exhibit potential for enhancing inclusivity through long-term human capital development. These findings underscore the importance of targeted and well-distributed fiscal policies to address Papua’s unique socio-economic challenges. By prioritizing human capital, aligning infrastructure investments with local needs, and fostering balanced economic growth, policymakers can pave the way for more inclusive development across the province. This research provides valuable insights for designing effective policy interventions to reduce inequality and foster sustainable economic growth in Papua.

Abstract Background The ‘agentic demand’ of population health interventions (PHIs) refers to the capacity, resources and freedom to act that interventions demand of their recipients to benefit, which have a socio-economical pattern. Highly agentic interventions, e.g. information campaigns, rely on recipients noticing and responding to the intervention and thus might affect intervention effectiveness and equity. The absence of an adequate framework to classify agentic demands limits the fields’ ability to systematically explore these associations. Methods We systematically developed the Demands for Population Health Interventions (Depth) framework using an iterative approach: (1) developing the Depth framework by systematically identifying examples of PHIs aiming to promote healthier diets and physical activity, coding of intervention actors and actions and synthesising the data to develop the framework; (2) testing the Depth framework in online workshops with academic and policy experts and a quantitative reliability assessment. We applied the final framework in a proof-of-concept review, extracting studies from three existing equity-focused systematic reviews on framework category, overall effectiveness and differential socioeconomic effects and visualised the findings in harvest plots. Results The Depth framework identifies three constructs influencing agentic demand: exposure — initial contact with intervention (two levels), mechanism of action — how the intervention enables or discourages behaviour (five levels) and engagement — recipient response (two levels). When combined, these constructs form a matrix of 20 possible classifications. In the proof-of-concept review, we classified all components of 31 interventions according to the Depth framework. Intervention components were concentrated in a small number of Depth classifications; Depth classification appeared to be related to intervention equity but not effectiveness. Conclusions This framework holds potential for future research, policy and practice, facilitating the design, selection and evaluation of interventions and evidence synthesis.

Introduction: Cycling infrastructure policies yield health and environmental benefits. However, design variations may impact intervention effectiveness. This study explored relationships between infrastructure form (e.g., width, length) and function (e.g., access, safety) and cycling behavior. Methods: We analysed data from a study evaluating 15 streets with new cycling infrastructure improvements in Paris and Lyon. Comparison streets were chosen based on having similar pre-intervention cycling trends and periods of data availability as intervention streets. The outcome was the difference in daily cycle counts between intervention and control streets. We conducted a virtual street audit with Google Street View to assess 14 street features and derived a function score based on 7 components. We used induced smoothed LASSO regression to identify relevant form or function variables associated with cycle count changes. Results: The effects of new cycling infrastructure varied, with significant increases at half (7/15) of the sites and no change at the rest. For every 1 SD increase in cycle lane length, an increase of 83 cycle counts per day (95% CI 32, 134) was observed. Removing car parking and traffic lanes were associated with an increase of 197 counts (108, 285) and 154 counts (58, 249), respectively. Adding a public transport stop showed a negative association with a change of −83 counts (−158, −8). Functions positively associated with cycle count changes were improving safety (75, 95% CI 8, 141) and space (72, 95% CI 10, 135). Conclusions: This study sheds light on cycling infrastructure design influences on cycling behavior. These insights can help guide future policies and infrastructure development to maximize cycling benefits for health and the environment.

Background: Cycling is beneficial for health and the environment but the evidence on the overall and differential impacts of interventions to promote cycling is limited. Here we assess the equity impacts of funding awarded to support cycling in 18 urban areas between 2005 and 2011. Methods: We used longitudinally linked 2001 and 2011 census data from 25,747 individuals in the Office for National Statistics Longitudinal Study of England and Wales. Logistic regression was used to assess the impacts of funding on commute mode as the interaction between time and area (intervention/comparison) in individual-level difference-in-difference analyses, adjusting for a range of potential confounding factors. Differential impacts were examined by age, gender, education and area-level deprivation, and uptake and maintenance of cycling were examined separately. Results: Difference-in-difference analyses showed no intervention impact on cycle commuting prevalence in the whole sample (AOR = 1.08; 95% CI 0.92, 1.26) or among men (AOR = 0.91; 95% CI 0.76, 1.10) but found an intervention effect among women (AOR = 1.56; 95% CI 1.16, 2.10). The intervention promoted uptake of cycling commuting in women (AOR = 2.13; 95% CI 1.56, 2.91) but not men (AOR = 1.19; 95% CI 0.93, 1.51). Differences in intervention effects by age, education and area-level deprivation were less consistent and more modest in magnitude. Conclusions: Living in an intervention area was associated with greater uptake of cycle commuting among women but not men. Potential gender differences in the determinants of transport mode choice should be considered in the design and evaluation of future interventions to promote cycling.

Cognitive neuroscience seeks to discover the biological foundations of the human mind. One goal is to explain how mental operations are generated by the information processing architecture of the human brain. Our aim is to assess whether this is a well-defined objective. Our contention will be that it is not because the information processing of any given individual is not contained entirely within that individual’s brain. Rather, it typically includes components situated in the heads of others, in addition to being distributed across parts of the individual’s body and physical environment. Our focus here will be on cognition distributed across individuals, or on what we call the “community of knowledge,” the challenge that poses for reduction of cognition to neurobiology and the contribution of cognitive neuroscience to the study of communal processes.

We used routinely collected traffic data to compare travel before (September 2019 and February 2020) and after (September 2020) restrictions on movement due to Covid-19 in Cambridge, UK. Segmented quasi-Poisson time-series analyses estimated the degree to which travel behaviour had returned to pre-lockdown levels by September 2020, controlling for seasonal trends using hours of sunlight, temperature, and precipitation. In most cases walking and cycling remained below pre-lockdown levels at follow-up. Motor vehicle use was similar to pre-lockdown conditions in many locations, except where roads were closed to motor vehicles to support social distancing and on roads approaching the railway station.

Introduction MRI and MR spectroscopy (MRS) provide early biomarkers of brain injury and treatment response in neonates with hypoxic-ischaemic encephalopathy). Still, there are challenges to incorporating neuroimaging biomarkers into multisite randomised controlled trials. In this paper, we provide the rationale for incorporating MRI and MRS biomarkers into the multisite, phase III high-dose erythropoietin for asphyxia and encephalopathy (HEAL) Trial, the MRI/S protocol and describe the strategies used for harmonisation across multiple MRI platforms.Methods and analysis Neonates with moderate or severe encephalopathy enrolled in the multisite HEAL trial undergo MRI and MRS between 96 and 144 hours of age using standardised neuroimaging protocols. MRI and MRS data are processed centrally and used to determine a brain injury score and quantitative measures of lactate and n-acetylaspartate. Harmonisation is achieved through standardisation—thereby reducing intrasite and intersite variance, real-time quality assurance monitoring and phantom scans.Ethics and dissemination IRB approval was obtained at each participating site and written consent obtained from parents prior to participation in HEAL. Additional oversight is provided by an National Institutes of Health-appointed data safety monitoring board and medical monitor.Trial registration number NCT02811263; Pre-result.

Despite strong evidence for health benefits from active travel, levels remain low in many countries. Changes to the physical and social workplace environment might encourage active travel but evaluation has been limited.We explored associations between changes in the physical and social workplace environment and changes in commute mode over one year among 419 participants in the Commuting and Health in Cambridge study.In adjusted analyses, an increase in the presence of one physical characteristic (e.g. bicycle parking or shower facilities) was associated with a 3.3% (95% confidence interval 1.0–5.6) reduction in the proportion of commutes by private motor vehicle and a 4.4% (95% CI 1.2–7.7) increase in the proportion of trips including active modes among men. These associations were not seen in women.A change to a more favourable social environment for walking or cycling among workplace management was associated with an increased proportion of commutes including active modes in women (4.5%, 95% CI 1.4–7.5) but not men. However, in both genders a change to more a favourable social environment for cycling among colleagues was associated with a reduced proportion of commutes by exclusively active modes (−2.8%, 95% CI −5.0 to −0.6).This study provides longitudinal evidence for gender differences in the associations between workplace environment and commute mode. A more supportive physical environment was associated with more active commuting in men, while the social environment appeared to have more complex associations that were stronger among women.

Summary: Background: Active travel is increasingly recognised as an important source of physical activity. We aimed to describe associations between commute mode and cardiovascular disease, cancer, and all-cause mortality. Methods: We analysed data from the Office for National Statistics Longitudinal Study of England and Wales (ONS-LS), which linked data from the Census of England and Wales (henceforth referred to as the Census) for 1991, 2001, and 2011 to mortality and cancer registrations. The cohort included individuals traced in the ONS-LS who were economically active (ie, aged ≥16 years, not retired from work, and not a full-time carer). Commuting by private motorised transport, public transport, walking, and cycling were compared in terms of all-cause mortality, cancer mortality, cardiovascular disease mortality, and cancer incidence, using Cox proportional-hazards models with time-varying covariates. Models were adjusted for age, sex, housing tenure, marital status, ethnicity, university education, car access, population density, socioeconomic classification, Carstairs index quintile, long-term illness, and year entered the study, and were additionally stratified by socioeconomic group. Findings: Between the 1991 Census and the 2011 Census, 784 677 individuals contributed data for at least one Census, of whom 394 746 were included in the ONS-LS and were considered to be economically active working-age individuals. 13 983 people died, 3172 from cardiovascular disease and 6509 from cancer, and there were 20 980 incident cancer cases. In adjusted models, compared with commuting by private motorised vehicle, bicycle commuting was associated with a 20% reduced rate of all-cause mortality (hazard ratio [HR] 0·80, 95% CI 0·73–0·89), a 24% decreased rate of cardiovascular disease mortality (0·76, 0·61–0·93), a 16% lower rate of cancer mortality (0·84, 0·73–0·98), and an 11% reduced rate of incident cancer (0·89, 0·82–0·97). Compared with commuting by private motorised vehicle, rail commuters had a 10% lower rate of all-cause mortality (HR 0·90, 95% CI 0·83–0·97) and a 21% decreased rate of cardiovascular disease mortality (0·79, 0·67–0·94), in addition to a 12% reduced rate of incident cancer (0·88, 0·83–0·94). Walk commuting was associated with 7% lower cancer incidence (HR 0·93, 95% CI 0·89–0·97) Stratified analyses did not indicate differences in associations between socioeconomic groups. Interpretation: Our findings augment existing evidence for the beneficial health effects of physically active commute modes, particularly cycling and train use, and suggest that all socioeconomic groups could benefit. Funding: National Institute for Health Research.

Abstract Background Cardiotoxicity associated with anthracycline-based chemotherapies has limited their use in patients with preexisting cardiomyopathy or heart failure. Dexrazoxane protects against the cardiotoxic effects of anthracyclines, but in the USA and some European countries, its use had been restricted to adults with advanced breast cancer receiving a cumulative doxorubicin (an anthracycline) dose > 300 mg/m2. We evaluated the off-label use of dexrazoxane as a cardioprotectant in adult patients with preexisting cardiomyopathy, undergoing anthracycline chemotherapy. Methods Between July 2015 and June 2017, five consecutive patients, with preexisting, asymptomatic, systolic left ventricular (LV) dysfunction who required anthracycline-based chemotherapy, were concomitantly treated with off-label dexrazoxane, administered 30 min before each anthracycline dose, regardless of cancer type or stage. Demographic, cardiovascular, and cancer-related outcomes were compared to those of three consecutive patients with asymptomatic cardiomyopathy treated earlier at the same hospital without dexrazoxane. Results Mean age of the five dexrazoxane-treated patients and three patients treated without dexrazoxane was 70.6 and 72.6 years, respectively. All five dexrazoxane-treated patients successfully completed their planned chemotherapy (doxorubicin, 280 to 300 mg/m2). With dexrazoxane therapy, changes in LV systolic function were minimal with mean left ventricular ejection fraction (LVEF) decreasing from 39% at baseline to 34% after chemotherapy. None of the dexrazoxane-treated patients experienced symptomatic heart failure or elevated biomarkers (cardiac troponin I or brain natriuretic peptide). Of the three patients treated without dexrazoxane, two received doxorubicin (mean dose, 210 mg/m2), and one received daunorubicin (540 mg/m2). Anthracycline therapy resulted in a marked reduction in LVEF from 42.5% at baseline to 18%. All three developed symptomatic heart failure requiring hospitalization and intravenous diuretic therapy. Two of them died from cardiogenic shock and multi-organ failure. Conclusion The concomitant administration of dexrazoxane in patients with preexisting cardiomyopathy permitted successful delivery of anthracycline-based chemotherapy without cardiac decompensation. Larger prospective trials are warranted to examine the use of dexrazoxane as a cardioprotectant in patients with preexisting cardiomyopathy who require anthracyclines.

Public health professionals have the opportunity to impact middle school students’ dietary behaviors to combat childhood obesity. The purpose of this study was to investigate the dietary behavior results from the YRBS taken by middle school students in Duval County in 2009, 2011 and 2013. A two-stage cluster design was used and the survey was completed by 6th through 8th grade students following parent notification. Compared to other health zones, Health Zone 1 had the lowest intake of fruits and vegetables in 2009 (2.66 ±1.65) and 2011 (2.77 ± 1.60) and the second lowest intake in 2013 (2.92 ± 1.70). In 2009, 2011 and 2013, Health Zone 1 students’ response for soda intake was consistently higher compared to other health zones (2.39 ±1.54; 2.40 ±1.47; 2.29 ± 1.54 respectively). Health Zone 1, the urban core of Jacksonville, consistently had the lowest intake of fruits and vegetables and the highest intake of soda. Public health strategies should focus on improving fruit and vegetable intake and reducing soda intake within the school environment particularly focusing on Health Zone 1.

The purpose of this study was to compare the results of fruit and vegetable intake data from the 2009, 2011, 2013 Duval County Youth Risk Surveys (YRBS) by health zone. The survey instrument (questionnaire) is administered using a cluster sample design in all ninth grade classes in public schools (except charter schools) every two (odd) years. The surveys are anonymous and there is parental notification. Oversampling is done to allow for sub-county analysis. There were no statistically significant differences across health zones for any of the fruit and vegetable consumption questions for year 2009 however all health zones were below the recommended level of fruit and vegetable intake. For years 2011 and 2013 despite significant statistical differences by health zone in the frequency of consumption for fruits and vegetables, all health zones had a low mean intake of fruits and vegetables for years 2009, 2011 and 2013. Most respondents indicated consuming fruits, green salad, potatoes (not fried), carrots and vegetables “1 to 3 times during the past 7 days.” Overall intake of fruits and vegetables, however, was low for all health zones.