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This essay examines the breast cancer accounts of four Arab female celebrities who have spoken out in public about their illness experience: the Egyptian TV presenter Basma Wahba and the actress Yasmine Ghaith, the Iraqi actress Namaa al-Ward, and the Lebanese pop singer Elissa. By reading their testimonies against the backdrop of critical literature on illness narratives and memoirs, as well as on cancer narratives and activism, the essay asks: how are the accounts of these women's cancer diagnosis and treatment disclosed and described? In what medium do they communicate and circulate their breast cancer experiences? What significance do these public disclosures have on challenging and breaking the Arab taboo of cancer? In conclusion, the essay argues that these women's willingness to share their stories in public constitutes an important form of multimedia activist intervention-visual, sonic, and performative-that is playing a key role in the development of a breast cancer movement., (© 2024. The Author(s).)

There is limited literature on the long-term impact of political activism on mental wellbeing in the context of childhood political trauma and subsequent forced migration. Such information is important for developing mental health services suitable to this population. This qualitative study contributes to this gap by exploring the experience of an understudied population: adult Jewish Argentinian immigrants to Israel, who as children experienced the military dictatorship in Argentina (1976-1983). Thematic textual analysis of narrative interviews revealed that in the case of participants who escaped with their parents as political exiles to Israel, political activism during childhood and adulthood can be both a risk and protective factor and affect a range of positive and negative long-term mental health outcomes including resilience and symptoms that appear as Complex Post-Traumatic Stress Disorder.

Women's health activists laid the groundwork for passage of the law that created the U.S. Food and Drug Administration in 1906. The pharmaceutical and food industries fought regulatory reforms then and continue to do so now. We examine public health activism in the Progressive Era, the postwar era and the present day. The women's health movement began in the 1960s, and criticized both the pharmaceutical industry and the medical establishment. In the 1990s, patient advocacy groups began accepting industry funds; thousands of commercially-funded groups now dominate the advocacy landscape. As pharma funding became normalized, concerns arose regarding a) the lack of transparency and public accountability regarding funding, b) the distortion of groups' agendas, and c) the ability of pharma-funded groups to dominate the discourse and override less well-resourced patient and health advocacy groups. Although industry-funded groups argue that funding allows them to provide useful services, the trade-off in health risks, exorbitant prices and distorted information is far too high. Sincerity is beside the point; patients and the industry have differing interests when it comes to drug safety and efficacy, drug information and drug prices. A growing resistance movement is asserting the values of its activist predecessors and opposing the prevailing culture of pharma-funded advocacy.

This paper examines the criminal justice activism of tennis star Naomi Osaka as it evolved during the COVID-19 pandemic regarding matters of police violence and racial justice. Calls to reform and defund the police received much attention in the aftermath of the police killing of George Floyd in May 2020. The Floyd killing also motivated Naomi Osaka to begin her criminal justice activism, which has generally been very well received. Adopting a constructionist perspective, I investigate how Osaka's criminal justice activism has, in the broader context of the development of celebrity culture, been subjectively motivated and inter-subjectively received by the public and in the news media. Theoretically this paper has the two-fold objective of developing a model of the conditions favorable to the successful reception of celebrity activism and, additionally, of suggesting how such criminologically relevant activism can be understood in terms of a process of celebritization of criminal justice and police reform as causes worthy of attention. This case study of Osaka's criminal justice activism reveals the important role a celebrity can play in influencing public sentiments about key aspects of policing and crime control as an important element of criminal justice culture., Competing Interests: Competing InterestsThe author declares no competing interests., (© Southern Criminal Justice Association 2022.)

Exposure and experience with ethical dilemmas and controversial socioscientific issues provide a link to students' lives or a pathway for sympathy/empathy and care, where youth use emotion to engage with the scenario and develop critical thinking skills to respond to ethical issues. For this theoretical paper, I focus on how informal science can be used in science classes to provide such exposure and experience, creating spaces for students to foster erotic relationships with the nature-Other and their local environment. More specifically, this paper aims to discuss how educators can use these informal science experiences, and in this case-those involving marine mammals, to find value for natural phenomena through erotic generosity and phenomenological experiences within the environment and use their knowledge and power to act responsibly., (© The Author(s) 2022.)

A growing body of research has documented the phenomenon of climate change anxiety (CCA), defined broadly as negative cognitive, emotional, and behavioral responses associated with concerns about climate change. A recently validated scale of CCA indicated two subscales: cognitive emotional impairment and functional impairment (Clayton & Karazsia, 2020). However, there are few empirical studies on CCA to date and little evidence regarding whether CCA is associated with psychiatric symptoms, including symptoms of Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD), and whether engaging in individual and collective action to address climate change could buffer such relationships. This mixed methods study draws on data collected from a sample of emerging adult students (ages 18-35) in the United States ( N  = 284) to address these gaps. Results indicated that both CCA subscales were significantly associated with GAD symptoms, while only the Functional Impairment subscale was associated with higher MDD symptoms. Moreover, engaging in collective action, but not individual action, significantly attenuated the association between CCA cognitive emotional impairment and MDD symptoms. Responses to open-ended questions asking about participants' worries and actions related to climate change indicated the severity of their worries and, for some, a perception of the insignificance of their actions relative to the enormity of climate change. These results further the field's understanding of CCA, both in general and specifically among emerging adults, and suggest the importance of creating opportunities for collective action to build sense of agency in addressing climate change., Competing Interests: Conflict of InterestOn behalf of all authors, the corresponding author states that there is no conflict of interest., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.)

In this paper, we report on an intervention across continents and disciplines that brought together differently positioned students in South Africa and the USA. A collaboration between our classes-an introductory Geographic Information Systems (GIS) class in South Africa and a composition class in the United States-was facilitated and investigated by us. The point of departure of the intervention was to service socially just and anti-racist pedagogies through experimentation. Drawing on posthumanist, feminist, and new materialist theory, we investigate the hauntings of several prejudices and stereotypical tropes that foster racism. We link the concept of hauntology to Plumwood's (1993) theorization of dualisms. We then draw a cartography of geomatics education in South Africa, focusing on the subjectification of geomatics graduates in particular and engineering graduates in general. We then zoom to our collaboration, and focus on several interactions amongst the cohorts to show instances of hauntings that perpetuate anti-Black, anti-Muslim, and related silences. We find that analysis of dualisms can highlight racist hauntings, and can also provide guidance on how to flatten hierarchies. Our transdisciplinary activism allows us to harness the positivity of difference to trouble binaries. We conclude with some thoughts on pandemic pedagogy in an unequal world., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© Ontario Institute for Studies in Education (OISE) 2021.)

Abstract: Hashtag data are common and easy to acquire. Thus, they are widely used in studies and visual data storytelling. For example, a recent story by China Central Television Europe depicts Brexit as a hashtag movement displayed on an animated bubble chart. However, creating such a story is usually laborious and tedious, because narrators have to switch between different tools and discuss with different collaborators. To reduce the burden, we develop a prototype system to help explore the bubbles' movement by automatically inserting animations connected to the storytelling of the video creators and the interaction of viewers to those videos. We demonstrate the usability of our method through both use cases and a semi-structured user study., (© The Visualization Society of Japan 2020.)

Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) is a contested illness category. This paper investigates the common claim that patients with ME/CFS-and by extension, ME/CFS patient organizations (POs)-exhibit "militant" social and political tendencies. The paper opens with a history of the protracted scientific disagreement over ME/CFS. We observe that ME/CFS POs, medical doctors, and medical researchers exhibit clear differences in opinion over how to conceptualize this illness. However, we identify a common trope in the discourse over ME/CFS: the claim of "militant" patient activism. Scrutinizing this charge, we find no compelling evidence that the vast majority of patients with ME/CFS, or the POs representing them, have adopted any such militant political policies or behaviours. Instead, we observe key strategic similarities between ME/CFS POs in the United Kingdom and the AIDs activist organizations of the mid-1980s in the United States which sought to engage scientists using the platform of public activism and via scientific publications. Finally, we explore the contours of disagreement between POs and the medical community by drawing on the concept of epistemic injustice. We find that widespread negative stereotyping of patients and the marginalization and exclusion of patient voices by medical authorities provides a better explanation for expressions of frustration among patients with ME/CFS.

This paper demonstrates how implicit cultural evolution theory (CE) is used in adaptive management of grassroots campaigns of resistance against environmentally destructive industry and government to facilitate sustainable outcomes. For an action to be sustainable, it must be stable against political pressures. By bringing attention to the effects of social transmission-recruitment to a cause, learning across campaigns, and the transmission or cultivation of solidarity sentiments-cultural evolution presents a framework for tracking social dynamics essential for the sustainability of resistance projects. This is illustrated with examples from direct action grassroots activism in First Nations communities in northern British Columbia, Canada in the context of fights against unsustainable industrial projects. Specifically, grassroots activists work with an implicit CE theory of social transmission of values that posits that expansive, large-group organizing can get large numbers moderately committed to cause but that organizing focusing on small groups is more successful at transmitting intense commitment and adherence to First Nations norms. In the case of direct action resistance, such intense commitment is more vital than numbers for success. Further, grassroots activists have self-consciously developed institutions for the rapid transmission of policy innovations, accelerating the constructive evolution of tactics.

Research indicates that insufficient emphasis on community collaboration and partnership can thwart innovative community-driven work on the social determinants of health by local health departments. Appreciating the importance of enhancing community participation, the New York City Department of Health and Mental Hygiene (DOHMH) helped lead the development of the Health Equity Project (HEP), an intervention aimed at increasing the capacity of urban youth to identify and take action to reduce food-related health disparities. DOHMH partnered with the City University of New York School of Public Health and several local youth organizations to design and implement the intervention. HEP was conducted with 373 young people in 17 cohorts at 14 unique sites: six in Brooklyn, six in the Bronx, and two in Harlem. Partnered youth organizations hosted three stages of work: interactive workshops on neighborhood health disparities, food environments, and health outcomes; food-focused research projects conducted by youth; and small-scale action projects designed to change local food environments. Through these activities, HEP appears to have been successful in introducing youth to the social, economic, and political factors that shape food environments and to the influence of food on health outcomes. The intervention was also somewhat successful in providing youth with community-based participatory research skills and engaging them in documenting and then acting to change their neighborhood food environments. In the short term, we are unable to assess how successful HEP has been in building young leaders who will continue to engage in this kind of activism, but we suspect that more extended interactions would be needed to achieve this more ambitious goal. Experiences at these sites suggest that youth organizations with a demonstrated capacity to engage youth in community service or activism and a commitment to improving food or other health-promoting community resources make the most suitable and successful partners for this kind of effort.

This article describes the causes and health consequences of environmental degradation and social injustice. These issues, which impact primarily on the poor and underserved (both in the United States and internationally) are rarely or inadequately covered in the curriculums of traditional health care professions. The discussion offers ways for health care professionals to promote equality and justice and uses the example of Rudolph Virchow's social activism to illustrate how one physician can lead society toward major public health gains. There is also an examination of the roles of institutions and organisations in enhancing environmental preservation and promoting social justice. Specific curricular suggestions from history and the humanities are offered for those teaching and mentoring new health professionals.

Introduction: Few curricula train medical students to engage in health system reform., Aim: To develop physician activists by teaching medical students the skills necessary to advocate for socially equitable health policies in the U.S. health system., Setting: Montefiore Medical Center, the University Hospital of the Albert Einstein College of Medicine, Bronx, NY., Program Description: We designed a 1-month curriculum in research-based health activism to develop physician activists. The annual curriculum includes a student project and 4 course sections;health policy, research methods, advocacy, and physician activists as role models; taught by core faculty and volunteers from academic institutions, government, and nongovernmental organizations., Program Evaluation: From 2002 to 2005, 47 students from across the country have participated. Students reported improved capabilities to generate a research question, design a research proposal,and create an advocacy plan., Discussion: Our curriculum demonstrates a model for training physician activists to engage in health systems reform.

Experience has always been a hallmark of activist work; my work in AIDS activism began with my family's role as caretakers for two children whose parents died of HIV-related complications. Previously, my scholarly work critiqued political and medical establishments and their policies surrounding HIV/AIDS. At the NEH institute, I interacted with the medical world, shadowing nurses and doctors. Through this experience, I discovered the importance of interactivity as a crucial element of the critically engaged AIDS activist experience, creating a more thorough understanding of the medical establishment and a more humanized portrait of hospitals and their staff.

Background: Smoking prevalence rates are alarmingly high in developing countries at a time when the United States and the United Kingdom are mobilizing domestic anti-smoking forces. A resident at Dartmouth-Hitchcock Medical Center established an American-British partnership to promote international tobacco policy activism., Methods: The program assembled a coalition of physicians and public health experts from the two countries and provided them with an Internet-based chat resource., Results: The coalition utilized Internet resources to follow international trends in tobacco use policies and agreed to meet bimonthly through the site to promote anti-smoking activism., Conclusions: This report introduces a novel approach to international anti-tobacco policy activism. It provides a model that is transportable to other institutions and other public health measures.

This study investigated the predictors of participation in a school-based, anti-tobacco activism program. Subjects in this study consisted of 7th grade students participating in the intervention component of Project S.H.O.U.T., a tobacco use prevention program in San Diego County, California. In the activism component, a newsletter containing an activism contest was distributed to each student. Small prizes were awarded to contest winners at each school. "Activism" included letter and petition writing, anti-tobacco poster contests, merchant education, peer surveys and magazine subscription cards. A total of 170 students participated in the activities, with 81.1 percent participating two or more times. Of those who participated, 59 percent were female and 60 percent were White, non-Hispanic. Two sets of logistic analyses were conducted. Variables such as SES, gender, ethnicity, friends' tobacco use and parental tobacco use were used to predict participation in activism activities. The choice of variables was intended to provide information regarding activism participation in reference to known tobacco risk factors. Results of the first analysis indicated that students with a higher SES, and in an urban vs. rural location were more likely to participate in the activism activities. The second analysis used the same set of characteristics to predict "ever-use" of tobacco. Results of this analysis indicated that male gender, low grades, White, non-Hispanic ethnicity, friends' and parents' tobacco use were positively associated with tobacco experimentation.

In 1985, residents of a suburban community in South Florida became concerned when several young women were diagnosed with breast cancer. First as individuals, then through a community-based effort, they attempted to gain attention and action on what they believed to be a cluster of breast cancer. Through their efforts to find out whether some agent or toxic exposure existed in the community that might have caused breast cancer, the women formed a community-based organization. This paper describes the activism of the women to resolve the issue through an epidemiologic study of the breast cancer occurrence in their community. Furthermore, it substantiates the need and role of rational community response in resolving community threats and concerns.

During the COVID-19 pandemic, many advocacy groups and individuals criticized governments on social media for doing either too much or too little to mitigate the pandemic. In this article, we review advocacy for COVID-19 elimination or "zero-covid" on the social media platform X (Twitter). We present a thematic analysis of tweets by 20 influential co-signatories of the World Health Network letter on ten themes, covering six topics of science and mitigation (zero-covid, epidemiological data on variants, long-term post-acute sequelae (Long COVID), vaccines, schools and children, views on monkeypox/Mpox) and four advocacy methods (personal advice and promoting remedies, use of anecdotes, criticism of other scientists, and of authorities). The advocacy, although timely and informative, often appealed to emotions and values using anecdotes and strong criticism of authorities and other scientists. Many tweets received hundreds or thousands of likes. Risks were emphasized about children's vulnerability, Long COVID, variant severity, and Mpox, and via comparisons with human immunodeficiency viruses (HIV). Far-reaching policies and promotion of remedies were advocated without systematic evidence review, or sometimes, core field expertise. We identified potential conflicts of interest connected to private companies. Our study documents a need for public health debates to be less polarizing and judgmental, and more factual. In order to protect public trust in science during a crisis, we suggest the development of mechanisms to ensure ethical guidelines for engagement in "science-based" advocacy, and consideration of cost-benefit analysis of recommendations for public health decision-making., (© 2024. The Author(s) under exclusive licence to Monash University.)

Background: In recent years, organizational leaders have faced growing pressure to respond to social and political issues. Although previous research has examined the experiences of corporate CEOs engaging in these issues, less is known about the perspectives of healthcare leaders., Objective: To explore the experiences of healthcare CEOs engaging in health-related social and political issues, with a specific focus on systemic racism and abortion policy., Design: Qualitative study using semi-structured interviews from February to July 2023., Participants: CEOs of US-based hospitals or health systems., Approach: One-on-one interviews which were audio recorded, professionally transcribed, and analyzed using thematic analysis., Key Results: This study included 25 CEOs of US-based hospitals or health systems. Almost half were between ages 60 and 69 (12 [48%]), 19 identified as male (76%), and 20 identified as White (80%). Approximately half self-identified as Democrats (13 [55%]). Most hospitals and health systems were private non-profits (15 [60%]). The interviews organized around four domains: (1) Perspectives on their Role, (2) Factors Impacting Engagement, (3) Improving Engagement, and (4) Experiences Responding to Recent Polarizing Events. Within these four domains, nine themes emerged. CEOs described increasing pressure to engage and had mixed feelings about their role. They identified personal, organizational, and political factors that affect their engagement. CEOs identified strategies to measure the success of their engagement and also reflected on their experiences speaking out about systemic racism and abortion legislation., Conclusions: In this qualitative study, healthcare CEOs described mixed perspectives on their role engaging in social and political issues and identified several factors impacting engagement. CEOs cited few strategies to measure the success of their engagement. Given that healthcare leaders are increasingly asked to address policy debates, more work is needed to examine the role and impact of healthcare CEOs engaging in health-related social and political issues., (© 2024. The Author(s), under exclusive licence to Society of General Internal Medicine.)

Recent environmental research has found that people with higher incomes and in more developed countries are more willing to pay (WTP) to protect their environment than people in developing countries. Based on this assumption, the study investigated Pakistani citizens' attitudes toward environmental protection, precisely their willingness to pay higher prices and taxes to preserve the natural environment. The research was carried out in three Punjab cities (Hasan Abdal, Wah, and Taxila) and four KPK cities (Abbottabad, Havelian, Mansehra, and Haripur). The selected cities are home to knowledgeable people who work in various universities, schools, hospitals, medical colleges, and nearby industrial estates and have a sense of environmental protection and can understand the healthcare issues related to environmental damages. The survey was divided into two sections: one about the participants' socio-demographic information and the other about people's willingness to pay higher prices and taxes to protect the environment. Four hundred and sixty-two people took part in the survey, and the data were analyzed using the bootstrap regression approach. The results show that gender has a detrimental impact, although population density and education positively impact a country's willingness to pay for environmental protection (WTPEP). Women are more likely to engage in pro-environmental behavior than men, resulting in disparities in their perceptions of male and female respondents in the study. People who live in crowded places tend to pay for environmental protection because of population density, healthcare difficulties, and air pollution. The respondents are well-versed in the externalities of environmental pollution; they are hopeful about paying for a better healthcare environment. Other criteria, such as the respondent's income, health status, total pollution level in the country, and per capita income, enable respondents to pay for environmental preservation to achieve long-term sustainable growth. The government must embrace air quality regulations and empower its citizens by offering better healthcare services since they are enthusiastic about paying higher taxes and fees to protect the environment., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Spiritual healthcare providers (e.g., chaplains) working in healthcare settings across the United States were surveyed with the goals of (1) understanding their awareness of aphasia (a language disorder affecting reading, writing, verbal communication, and auditory comprehension); (2) determining whether they have received any training in aphasia and what type of training has been received; (3) whether they altered their approach to assessing the spiritual well-being of a person with aphasia; and, (4) what tools were used to augment communication. From a convenience sample of 203 respondents, the results indicated that 96% of respondents had previously heard of aphasia and 85% of respondents correctly identified the definition of aphasia. Seventy-three percent of respondents (N = 128) altered their approach to spiritual well-being assessment due to the aphasia diagnosis. Most respondents did not indicate receiving any formal training related to aphasia., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The study analyses the oil well blowout that took place at the Baghjan oil field in Assam, India, on 27 May 2020. This incident escalated into a massive fire on 9th June that lasted more than 5 months. The tragedy degraded the environment and inflicted substantial problems on the area's inhabitants. The present study employs the analytical case study approach and various data sources to unfold the disaster and its causes, impact, and response. It also examines the local inhabitants and environmental impact and tries to analyze the event comprehensively. The incident resulted from technical malfunctions and human errors, leading to the relocation of the adjacent settlement to refugee camps amidst the global COVID-19 epidemic. However, it is essential to mention that many households received adequate compensation for their damages. The incident has resulted in the contamination of the air, noise, soil, and water, causing significant damage to the fragile ecosystem and its rare species. The research employs the Normalized Difference Vegetation Index to quantify changes in vegetation cover resulting from the blowout, thus showing the extensive damage to the affected region. The incident shed light on legal and regulatory deficiencies alongside a lack of accountability and transparency within the Oil India Limited sector. Despite the numerous proposals for environmental restoration, it appears challenging to revert to the previous state swiftly. The present study reflects the collective and collaborative action to protect and preserve the environment., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

South African writer Phaswane Mpe (1970-2004) is often canonized and memorialized as a brave truth-teller who broke the silence on HIV/AIDS in the context of government silence and denial. And yet Mpe's writings-including poetry, short stories, a novel, and scholarly criticism-contemplate illness as a problem for truth and representation in works that linger in silence and ambiguity. This article analyses the tension between silence and speech in Mpe's creative writing in response to HIV/AIDS. Using Mpe's works as an illustrative example, I trouble the desire to read illness narratives as forms of truth-telling and silence-breaking. The desire for the transparency of speech in a global archive of illness narratives also informs a colonial politics of representation that instrumentalizes literature as ethnographic evidence. Mpe's writing on HIV/AIDS refuses a demand for authenticity by holding the embodied experience of disease at a slight remove from the reader in order to register the forms of spiritual and epistemological crisis that epidemic and social loss produce. My contention is that the political stakes of this writing lie not in Mpe's ability to render a public health crisis with verisimilitude, but in the capacity for writing to provide solace and sublimity faced with death. Through an analysis of Mpe's fiction and poetry, this article proposes a methodology for reading the politics of illness narratives across globalized space which attends to the world-building potential of creative expression as a radical practice that resists incorporative models of aesthetic intelligibility., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This article examines two autobiographical texts that address the relationship between migration and struggles with mental health: Karla Cornejo Villavicencio's The Undocumented Americans (2021) and Dina Nayeri's The Ungrateful Refugee: What Immigrants Never Tell You (2020). Both memoirs help bring mental health issues to light in situations of precarity, and the texts indicate that it is not just the experience of physical dislocation that may cause or exacerbate struggles with mental health, but the disconnect from other people, from citizenship, and the nation itself. Nayeri and Cornejo Villavicencio do not focus on narratives of recovery or healing but provide space for the experiences of other undocumented migrants trying to navigate the European asylum system or difficulties in obtaining American citizenship. The article argues that the two authors use their experiences of migration and mental illness for greater advocacy purposes with regard to human rights. The struggles with mental health present in the two memoirs intertwine with the treatment of undocumented migrants as described by the two authors, going beyond the personal experience of mental health, or illness, connecting it with migration practices and policies in the United States and Europe., (© 2024. The Author(s).)

Introduction: Medicare significantly influences reimbursement rates, setting a standard that impacts private insurance policies. Despite declining rates in various specialties, the magnitude of these trends has not been examined in breast surgery. This study examines Medicare reimbursement trends for breast surgery operations., Methods: Data for 10 breast operations from 2003 to 2023 were collected from the Medicare Physician Fee Look-Up Tool and yearly reimbursement was computed using the conversion factor. The year-to-year percentage change in reimbursement was calculated, and the overall median change was compared with the consumer price index (CPI) for inflation evaluation. All data were adjusted to 2023 United States dollars. The compound annual growth rate (CAGR) was calculated using inflation-adjusted data., Results: Over the study period, reimbursement for the 10 breast operations had a mean unadjusted percentage increase of + 25.17%, while the CPI increased by 69.15% (p < 0.001). However, after adjustment, overall reimbursement decreased by - 20.70%. Only two operations (lumpectomy and simple mastectomy) saw increased inflation-adjusted Medicare reimbursement (+ 0.37% and + 3.58%, respectively). The CAGR was - 1.54% overall but remained positive for the same two operations (+ 0.02% and + 0.18%, respectively). Based on these findings, breast surgeons were estimated to be reimbursed $107,605,444 less in 2023 than if rates had kept pace with inflation over the past decade., Conclusion: Inflation-adjusted Medicare reimbursement rates for breast surgeries have declined from 2003 to 2023. This downward trend may strain resources, potentially leading to compromises in care quality. Surgeons, administrators, and policymakers must take proactive measures to address these issues and ensure the ongoing accessibility and quality of breast surgery., (© 2024. The Author(s).)

Antimicrobial Resistance is a threat to individual and to population health and to future generations, requiring "collective sacrifices" in order to preserve antibiotic efficacy. 'Who should make the sacrifices?' and 'Who will most likely make them?' are ethical concerns posited as potentially manageable through Antimicrobial Stewardship. Antimicrobial stewardship almost inevitably involves a form of clinical cost-benefit analysis that assesses the possible effects of antibiotics to treat a diagnosed infection in a particular patient. However, this process rarely accounts properly for patients - above and beyond assessments of potential (non)compliance or adherence to care regimes. Drawing on a vignette of a pregnant woman of colour and migrant diagnosed with Mycoplasma genitalium, a sexually transmissible bacterium, this article draws out some of the ethical, speculative, and practical tensions and complexities involved in Antimicrobial Stewardship. We argue that patients also engage in a form of cost-benefit analysis influenced by experiences of reproductive and social (in)justice and comprising speculative variables - to anticipate future possibilities. These processes have the potential to have effects above and beyond the specific infection antimicrobial stewardship was activated to address. We contend that efforts to practice and research antimicrobial stewardship should accommodate and incorporate these variables and acknowledge the structures they emerge with(in), even if their components remain unknown. This would involve recognising that antimicrobial stewardship is intricately connected to other social justice issues such as immigration policy, economic justice, access to appropriate medical care, racism, etc., (© 2024. The Author(s).)

Purpose: This article evaluates the effectiveness of Career Services in supporting college students with disabilities to self-advocate for their accommodation rights during the job search., Method: A qualitative case study was conducted at one university to examine how their Career Services unit educates, trains, and supports students with disabilities in their professional development. Two rounds of interviews were conducted: one with university staff responsible for such services to assess policies and practices in providing support, and one with students and alumni with disabilities to gather feedback on their experiences with career planning and employment., Results: Three key themes emerged from the data: (1) Disability stigma negatively impacts a willingness to self-advocate among participants (this is especially true among those belonging to multiple marginalized groups); (2) the lack of transition support by the university further entrenches this stigma; and (3) participants report subsequent challenges in the crossover to employment., Conclusion: These identified barriers discouraged participants from planning for and seeking workplace accommodations and highlighted the need for universities to provide more comprehensive support for their professional development., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The post-secondary transition for autistic youth is a complex process, with hopes and expectations serving as malleable mediators often overlooked in research and practice. Career awareness, exploration, and counseling services play a critical role in facilitating vocational transition, but the vocational hopes and expectations of autistic youth and their parents are often disregarded. This study aims to explore these aspirations and their impact on the vocational transition process, seeking to harmonize elements to better align with the needs of autistic youth and their families. This study used a focus group design involving group interviews with three participant groups: autistic transition-aged youth, parents, and practitioners. The findings reveal five key themes: 1) Accepting Disability or Constrained by Ableism: Resisting Marginalization, 2) Finding the Sweet Spot: Are Parents and Youth's Expectations Too High or Too Low, 3) Market Forces at Work-Finding a Meaningful Vocational Path in a Capitalist Society, 4) Despite Meticulous Planning, there is a Disconnect Between Needs and Resources, and 5) The Hills and Valleys of Finding Resilience. Navigating the multifaceted landscape of vocational transition planning for autistic youth necessitates a collaborative and flexible approach. Identified tensions serve as opportunities for growth and transformation. Recognizing and addressing system shortcomings is crucial for informed decision-making. Challenges extend beyond individual circumstances, reflecting broader systemic issues, and identifying these gaps allows for a comprehensive understanding of available resources, cultivating a basis of hope as uncertainties are addressed., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Alice Dunbar-Nelson is mostly remembered as a poet, activist, and ex-wife of Paul Laurence Dunbar. Her volume The Goodness of St. Rocque and Other Stories (1899) has been largely overshadowed as a result. Yet, the collection contains a portfolio of heroines analogous and contemporaneous to the famed New Woman figure of the fin de siècle. In this article, I consider Dunbar-Nelson's heroines in light of their New Woman-esque agency and autonomy as they find remedies and power in objects and materials steeped in New Orleans's cultural heritage. Ceded neither social nor political self-governance nor domestic comfort, this article reads these transcendental, metaphysical objects as sources of self-care. With close analysis of "The Goodness of St. Rocque," "Tony's Wife," and "Little Miss Sophie," I argue that Dunbar-Nelson's protagonists exert influence over their lives, specifically in the negotiation of romantic relationships, through voodoo charms, Catholic candles, tarot cards, sewing machines, and knitting needles. Covering courtship, break-ups, and unhappy marriages, I demonstrate the ways in which these empowering spiritual objects respond to health concerns, including malnutrition and domestic violence, in turn, situating them as alternatives to patriarchal and historically racist medical institutions. Valorizing the cultural milieu of New Orleans and the customs of the Caribbean and European heritage, and thereby conveying Dunbar-Nelson's resistance to white and male supremacist ideologies in late-nineteenth-century Southern America, the article ultimately assesses the parallels with (predominantly white) New Woman fiction, through shared themes of fraught heterosexual dynamics and women's declining health., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Digital finance is a product of emerging technology-enabled innovation in financial services and has a critical impact on the green transformation of the manufacturing industry. We propose a new efficiency measurement model based on the slacks-based measure (SBM) to measure the efficiency of green transformation on regional manufacturing. Chinese interprovincial data from 2010 to 2019 were obtained for the study. In addition, we estimated the effect of digital finance on green transformation of manufacturing using a benchmark panel model. Finally, considering the regional heterogeneity and spatial effects of green transformation efficiency in the manufacturing industry, we constructed a spatial Durbin model based on an economic-geographic nested spatial weight matrix to analyze the spatial influence of digital finance on green transformation in the manufacturing industry. The results show that the green transformation of the manufacturing industry has significant positive spatial spillover effects owing to the existence of competition, demonstration, and economic correlation effects among regions., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The balance between human growth, economic prosperity, and the consumption of hydrocarbon energy factors has become a prerequisite for environmental sustainability. However, the complexities of these factors force researchers to work for more viable combinations of such a balance. Therefore, this study attempted to determine the factors driving environmental sustainability in leading populated economies. For this purpose, the Logarithmic Mean Division Index (LMDI) utilized to decompose critical factors such as activity, economy, real density, energy intensity, and suburban effects for the period 1999-2022. Both population and its consequences (economic activity) have been found to be the leading factors behind environmental fluctuations, and energy has a negative impact on hydrocarbon forms, while contributing positively to environmental sustainability with high efficiency and low intensity. Therefore, sustainable demographic and energy transitions can be leading pathways for environmental sustainability in developing economies., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The construct of personal control is crucial for understanding a variety of human behaviors. Perceived lack of control affects performance and psychological well-being in diverse contexts - educational, organizational, clinical, and social. Thus, it is important to know to what extent we can rely on the established experimental manipulations of (lack of) control. In this article, we examine the construct validity of recall-based manipulations of control (or lack thereof). Using existing datasets (Study 1a and 1b: N = 627 and N = 454, respectively) we performed content-based analyses of control experiences induced by two different procedures (free recall and positive events recall). The results indicate low comparability between high and low control conditions in terms of the emotionality of a recalled event, the domain and sphere of control, amongst other differences. In an experimental study that included three types of recall-based control manipulations (Study 2: N = 506), we found that the conditions differed not only in emotionality but also in a generalized sense of control. This suggests that different aspects of personal control can be activated, and other constructs evoked, depending on the experimental procedure. We discuss potential sources of variability between control manipulation procedures and propose improvements in practices when using experimental manipulations of sense of control and other psychological constructs., (© 2024. The Author(s).)

In light of the impact of gender roles on health, the aims of the present study are (1) to assess the associations between femininity/masculinity and gender typologies, and health indicators (mental health, wellbeing, and self-perceived health) and (2) to identify patterns of gender roles and health indicators, thus exploring new tendencies in gender and health in Spanish university students in the framework of the androgyny model. The sample was made up of 795 university students from Madrid and Toledo. Data collection was completed during 2019. Measures of self-rated health, mental health (GHQ12), and wellbeing (MHC-SF) were considered as health indicators, while the Bem Sex Roles Inventory (BSRI) was used to measure gender roles. Multilevel analysis was employed to value associations between masculinity and femininity and gender typologies with self-rated health, mental health, and wellbeing. Furthermore, cluster analysis was used to explore general tendencies in gender roles and health, while also considering biological sex composition. The best predictor of mental health was found to be masculinity, rather than femininity. Cluster analysis showed a dominance of androgyny and undifferentiated typologies with proportionally similar biological sex composition. Results confirmed the androgyny model, highlighting the role of androgyny and masculinity as protective factors of mental health. Cluster analysis suggested less gender-typed individuals and more flexible ways of adapting to gender roles in university students. Health systems, governments, and public institutions must take these results into account when designing health prevention and intervention policies. Social agents, educators, and the media must also collaborate in the achievement of equalitarian gender roles, which could result in a minimization of gender-related health differences.

Four behavior subjects, including governments, enterprises, and public and environmental non-government organizations (abbreviated as ENGOs), all play vital roles in environmental protection. As an important component, the ENGOs of all the world focus on environmental improvement and provide services for the whole society. In developed countries, the ENGOs have been formed earlier, and all kinds of regulation, supervision, and maintenance systems on the organizations are relatively mature. The development of the ENGOs in China started late, but the development speed was very fast. Some issues, including the exploring on their existing situation and how to promote their role in environmental protection, should be concerned. In total, 2510 ENGOs' information in China was collected and analyzed in the study. The ENGOs in the nation were not uniformly distributed, and there were great differences in the number of the ENGOs among the 34 provinces of China. With a few exceptions, the ENGOs in China were generally small in the scale and poor in the viability. They were mostly research-oriented and often less participating. The organizations' development and improvement still needed a long-term arduous course. Many negative factors might influence the sustainable and healthy development of the ENGOs in China, and the legislation might be one cause. Several aspects-related norms, including the registration system, the financial support mechanism, and the identification on their plaintiff qualification, needed to be improved to encourage the development of these organizations and then promote the improvement of environmental quality better in China.

Little is known about Community Health Workers (CHWs) who work in non-clinical settings to provide sexual health support around HIV, viral hepatitis, and other sexually transmitted infections (STIs) to men who have sex with men (MSM) in Europe and neighbouring countries. This article describes for the first time, who CHWs are, and how they contribute to the continuum of services for HIV, viral hepatitis, and other STIs amongst MSM. The first European Community Health Worker Online Survey (ECHOES) developed in the framework of the EU-funded ESTICOM project ( www.esticom.eu ), was available in 16 languages (October 2017-January 2018). Amongst the 1035 persons aged 18 and older reporting CHW activities in the previous 12 months, 28.2% were women, 30.7% were volunteers, 59.2% were men self-defining as gay/homosexual, bisexual or queer ('peer CHWs'), and most CHWs worked/volunteered in private not-for-profit organisations (86.4%). CHWs involvement in the continuum of services for HIV, viral hepatitis and other STIs was as follows: primary prevention (88.6%), consultation and counselling (58.0%), testing provision (50.6%), linkage to care (49.8%), and treatment and support activities (51.3%). CHWs were also involved in cross-cutting activities such as developing interventions, advocacy, and engaging in research (46.3%). CHWs as a public health workforce contribute to all steps of the continuum of services for HIV, viral hepatitis, and other STIs amongst MSM in Europe. National governments should recognise and support CHWs better in order to make their activities more visible and sustainable, and increase their impact on the continuum of services.

Background: Robust solutions to global, national, and regional burdens of communicable and non-communicable diseases, particularly related to diet, demand interdisciplinary or transdisciplinary collaborations to effectively inform risk analysis and policy decisions., Objective: U.S. outbreak data for 2005-2020 from all transmission sources were analyzed for trends in the burden of infectious disease and foodborne outbreaks., Methods: Outbreak data from 58 Microsoft Access ® data tables were structured using systematic queries and pivot tables for analysis by transmission source, pathogen, and date. Trends were examined using graphical representations, smoothing splines, Spearman's rho rank correlations, and non-parametric testing for trend. Hazard Identification was conducted based on the number and severity of illnesses., Results: The evidence does not support increasing trends in the burden of infectious foodborne disease, though strongly increasing trends were observed for other transmission sources. Morbidity and mortality were dominated by person-to-person transmission; foodborne and other transmission sources accounted for small portions of the disease burden. Foods representing the greatest hazards associated with the four major foodborne bacterial diseases were identified. Fatal foodborne disease was dominated by fruits, vegetables, peanut butter, and pasteurized dairy., Conclusion: The available evidence conflicts with assumptions of zero risk for pasteurized milk and increasing trends in the burden of illness for raw milk. For future evidence-based risk management, transdisciplinary risk analysis methodologies are essential to balance both communicable and non-communicable diseases and both food safety and food security, considering scientific, sustainable, economic, cultural, social, and political factors to support health and wellness for humans and ecosystems., (© 2024. The Author(s).)

In recent years, experts and academics in the environmental management field have developed an interest in the factors and evaluation techniques that influence corporate environmental investment decisions. However, there are substantial differences between studies employing the most recent evaluation methodologies and those that use indicator systems. To explore the mechanisms that influence corporate environmental investment, this study investigated the determinants of environmental investment through the perspectives of firm, board, chair, and chief executive officer (CEO) characteristics using a machine learning approach. Based on a large-scale data sample from Chinese-listed companies, the results indicated that the extreme gradient boosting (XGBoost) model had an accuracy of up to 97.63%, thus performing the best. Additionally, the model that used SHapley Additive exPlanations (SHAP) to interpret XGBoost showed that a company's sales performance was the most important factor that influenced environmental investment, followed by CEO tenure, board independence, board gender diversity, chair academic experience, and the company's level of internationalization. Furthermore, when examining the sample of heavily polluting enterprises, sales, board gender diversity, CEO tenure, chair academic experience, board independence, and chair-CEO duality, all were found to play crucial roles in predicting environmental investment. Overall, this study aids in evaluating the factors that influence corporate environmental investment decisions and provides policymakers and practitioners with a machine learning approach for use when assessing these factors., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Organophosphates are the most extensively used class of pesticides to deal with increasing pest diversity and produce more on limited terrestrial areas to feed the ever-expanding global population. Profenofos, an organophosphate group of non-systematic insecticides and acaricides, is used to combat aphids, cotton bollworms, tobacco budworms, beet armyworms, spider mites, and lygus bugs. Profenofos was inducted into the system as a replacement for chlorpyrifos due to its lower toxicity and half-life. It has become a significant environmental concern due to its widespread presence. It accumulates in various environmental components, contaminating food, water, and air. As a neurotoxic poison, it inhibits acetylcholinesterase receptor activity, leading to dizziness, paralysis, and pest death. It also affects other eukaryotes, such as pollinators, birds, mammals, and invertebrates, affecting ecosystem functioning. Microbes directly expose themselves to profenofos and adapt to these toxic compounds over time. Microbes use these toxic compounds as carbon and energy sources and it is a sustainable and economical method to eliminate profenofos from the environment. This article explores the studies and developments in the bioremediation of profenofos, its impact on plants, pollinators, and humans, and the policies and laws related to pesticide regulation. The goal is to raise awareness about the global threat of profenofos and the role of policymakers in managing pesticide mismanagement., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Nigeria has struggled to meet sustainable development goals (SDGs) on environmental sustainability, transportation, and petroleum product distribution for decades, endangering human and ecological health. Petroleum product spills contaminate soil, water, and air, harming humans, aquatic life, and biodiversity. The oil and gas industry contributes to environmental sustainability and scientific and technological advancement through its supply chain activities in the transport and logistics sectors. This paper reviewed the effects of petroleum product transportation at three accident hotspots on Nigeria highway, where traffic and accident records are alarming due to the road axis connecting the southern and northern regions of the country. The preliminary data was statistically analysed to optimise the review process and reduce risk factors through ongoing data monitoring. Studies on Nigeria's petroleum product transportation spills and environmental impacts between the years 2013 and 2023 were critically analysed to generate updated information. The searches include Scopus, PubMed, and Google Scholar. Five hundred and forty peer-reviewed studies were analysed, and recommendations were established through the conclusions. The findings show that petroleum product transport causes heavy metal deposition in the environment as heavy metals damage aquatic life and build up in the food chain, posing a health risk to humans. The study revealed that petroleum product spills have far-reaching environmental repercussions and, therefore, recommended that petroleum product spills must be mitigated immediately. Furthermore, the study revealed that better spill response and stricter legislation are needed to reduce spills, while remediation is necessary to lessen the effects of spills on environmental and human health., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study examined the nexus between per capita gross ocean product (GOP) growth and total nitrogen (TN), total phosphorus (TP), and chemical oxygen demand (COD) discharged from land-based sources in Guangxi and China. Multiple pollution indicators, such as red tide area (RTA), seawater quality area (SWQA), and eutrophication area (EA), were used as marine environmental quality indicators, and annual time series data during the period 2010-2019 were employed. The data were analyzed using the environment Kuznets curve fitting model. Results showed that the average annual growth rates of the GOP and gross domestic product (GDP) of China were 9.88% and 10.79%, respectively, and those of Guangxi were 13.62% and 10.02%, respectively. The average annual GOP ratio in GDP for Guangxi and China was 6.59 and 9.47, respectively. The marine tertiary industry was the most dominant marine industry; it accounted for 41.12-50.01% (mean: 46.12%) of Guangxi's GDP and 47-60% (mean: 52.47%) of China's GDP. The TP, COD, SWQA, and EA of Guangxi and the TP, TN, COD, SWQA, and EA of China displayed inverted U-shaped GOP growth. These findings indicate that the marine economic growth and marine environmental quality of Guangxi and China are harmonious. However, TN increased synchronously with marine economic growth in Guangxi. Therefore, the industrial structure must be further optimized, pollutant discharge management must be strengthened, and the harmonious development of Guangxi's marine economy and marine environment needs to be promoted., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The post-pandemic era has transformed work-life boundaries, driven by factors such as working hours, an increased number of working women and single parents, the implementation of various ICTs, and the rise of flexible work arrangements. This study examines the role of female workers and entrepreneurs in establishing and managing coworking spaces (CSs) designed to improve work-life balance through flexible scheduling and location options. The challenges faced by female entrepreneurs in promoting an inclusive society and economic system are also explored, as well as the benefits experienced by independent workers and teleworkers in terms of networking, social interaction, knowledge exchange, and community building. The "She Economy" is analyzed in three stages: germination, growth, and maturity, considering challenges from both family and workplaces. This paper investigates the background of female identity and the ideological transformation of female identity in the consumption process after the pandemic, using mass media, especially female-focused media, as a lens. Finally, the paper proposes recommendations for the future development of the "She Economy" from the perspectives of communicators, women, and the social environment., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Caring for children with different developmental trajectories brings various challenges, which are often exacerbated in low-resource settings. International research has shown that raising a child with autism strongly impacts family caregivers, particularly mothers. There is a dearth of information regarding caregiving for individuals with autism in the Kurdistan Region of Iraq (KRI) and for fathers as well as mothers. This study examined the similarities and differences in caregiving for mothers and fathers of a child with autism in KRI using validated rating scales to measure various aspects of their general well-being. Over two years, a sample of 118 parents of individuals with autism (81 mothers and 37 fathers) self-completed the rating scales, which were further discussed through individual interviews with service personnel mainly known to them. The findings indicated that mothers and fathers were similarly impacted. Although there were no statistically significant differences in the ratings of their general health, sources of stress, family functioning, and satisfaction with caregiving, the majority of parents had elevated ratings on all the measures. In addition, parents who rated their children higher on the Aberrant Behavior Checklist had significantly higher scores on their general health issues and were less satisfied with their caregiving role. Parents of female individuals with autism were also significantly more stressed compared to the male individuals with autism and parents of children who received a diagnosis before three years of age, reported fewer behavioral problems with their child compared to the parents who received a diagnosis when the child was older. In this sample, mothers and fathers seem to be similarly impacted by caring for a child with autism, which is contrary to findings from other countries. However, in this region, family bonds between couples and the wider family may have had an influence which further cross-cultural research in low-resource settings could help elucidate, notwithstanding the challenges this poses. The findings have policy implications for health authorities in the KRI to improve the support provided to both mothers and fathers who care for children with autism, which presently is rarely available to them., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Many of the world's most prosperous and secure nations owe much of their success to the contributions of their entrepreneurial spirit. Indian youth unemployment is among the worst in the world, posing serious problems for a country with the youngest population. Using the framework of planned behavior theory, this research examines how entrepreneurship courses affect future plans to start a business. We developed a theoretical framework by investigating the effect of college-level entrepreneurial programs on regional prosperity and quality of life. The research offers data from China on the connection between entrepreneurship education and the desire to start a business. The hypotheses indicate the mediating function of entrepreneurial skills in this relationship. If universities and colleges want their students to have an entrepreneurial attitude and launch successful businesses, they need to improve the way they teach entrepreneurship. The impact of entrepreneurship education and an entrepreneurial mentality on the choice to establish a company was studied by academics in the Chinese region from September 2021 to June 2022. The study's overarching goal was to investigate the connections between formal entrepreneurship education, attitudes toward entrepreneurship, the idea of planned behavior, an entrepreneurial mindset, and creative intent. We used an econometrically sound partial least squares structural equation model (PLS-SEM) to do the necessary empirical computations. Education in entrepreneurship, an attitude conducive to starting a firm, the notion of planned behavior, and an entrepreneurial mindset all positively correlate with the choice to do so. The impulse to launch a new venture is highly correlated with a person's level of creativity. These findings make it quite evident that, in order to achieve the dual goals of economic development and poverty reduction, the government must increase spending and advocate for a shift in the way enterprises are organized., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)