Search

The International Working Group for Patients' Right to Nutritional Care presents its position paper regarding nutritional care as a human right intrinsically linked to the right to food and the right to health. All people should have access to food and evidence-based medical nutrition therapy including artificial nutrition and hydration. In this regard, the hospitalized malnourished ill should mandatorily have access to screening, diagnosis, nutritional assessment, with optimal and timely nutritional therapy in order to overcome malnutrition associated morbidity and mortality, while reducing the rates of disease-related malnutrition. This right does not imply there is an obligation to feed all patients at any stage of life and at any cost. On the contrary, this right implies, from an ethical point of view, that the best decision for the patient must be taken and this may include, under certain circumstances, the decision not to feed. Application of the human rights-based approach to the field of clinical nutrition will contribute to the construction of a moral, political and legal focus to the concept of nutritional care. Moreover, it will be the cornerstone to the rationale of political and legal instruments in the field of clinical nutrition. [ABSTRACT FROM AUTHOR]

Study Objective Heavy menstrual bleeding is a common symptom reported by approximately 30% of women. The Pictorial Blood Assessment Chart (PBAC) score is often used to quantify severity of menstrual bleeding. However, the traditional PBAC paper diary might be subject to recall bias and compliance issues, especially in adolescents. We developed a mobile application (app) version of the PBAC score and evaluated patient satisfaction and compliance with app reporting vs paper reporting. Design, Setting, Participants, Interventions, and Main Outcome Measures This study was a randomized cross-over study of 25 postmenarchal female adolescents and young women ages 13-21 years. Participants agreed to track bleeding in 2 consecutive menstrual cycles and were randomized to use the PBAC paper diary or mobile app format first. At the end of each cycle, a satisfaction survey and system usability scale (app only) was used to assess the acceptability of the format used. Results Twenty-five participants had a median age of 15 years. Cross-over analysis showed that satisfaction level was significantly higher for the app ( P < .001). Twenty of 25 (80%) participants preferred the app over the paper diary. For the app, 20 of 25 participants (80%) had high compliance for reporting bleeding, with a mean of 2 app entries per day. Participants' PBAC scores did not vary significantly between the paper diary (median, 95) and mobile app (median, 114). All paper diaries met definition for high compliance. There was no significant period or carryover effect. Conclusion This study showed that a PBAC app compared with the paper diary was the preferred method of recording menstrual bleeding in adolescents and showed feasibility as a research data collection tool. [ABSTRACT FROM AUTHOR]

Food contact materials (FCM) are any type of item intended to come into contact with foods and thus represent a potential source for human exposure to chemicals. Regarding FCMs made of paper and board, information pertaining to their chemical constituents and the potential impacts on human health remains scarce, which hampers safety evaluation. We describe an effect-directed strategy to identify and characterize emerging chemicals in paper and board FCMs. Twenty FCMs were tested in eight reporter gene assays, including assays for the AR, ER, AhR, PPARγ, Nrf2 and p53, as well as mutagenicity. All FCMs exhibited activities in at least one assay. As proof-of-principle, FCM samples obtained from a sandwich wrapper and a pizza box were carried through a complete step-by-step multi-tiered approach. The pizza box exhibited ER activity, likely caused by the presence of bisphenol A, dibutyl phthalate, and benzylbutyl phthalate. The sandwich wrapper exhibited AR antagonism, likely caused by abietic acid and dehydroabietic acid. Migration studies confirmed that the active chemicals can transfer from FCMs to food simulants. In conclusion, we report an effect-directed strategy that can identify hazards posed by FCMs made from paper and board, including the identification of the chemical(s) responsible for the observed activity. [ABSTRACT FROM AUTHOR]

The long-term consequences of exposure to excess stress, particularly during sensitive developmental windows, on the initiation and progression of many complex, common physical and mental disorders that confer a major global burden of disease are well established. The period of intrauterine life represents among the most sensitive of these windows, at which time the effects of stress may be transmitted inter-generationally from a mother to her as-yet-unborn child. As explicated by the concept of fetal or developmental programming of health and disease susceptibility, a growing body of evidence supports the notion that health and disease susceptibility is determined by the dynamic interplay between genetic makeup and environment, particularly during intrauterine and early postnatal life. Except in extreme cases, an adverse intrauterine exposure may not, per se , ‘cause’ disease, but, instead, may determine propensity for disease(s) in later life (by shaping phenotypic responsivity to endogenous and exogenous disease-related risk conditions). Accumulating evidence suggests that maternal psychological and social stress during pregnancy represents one such condition that may adversely affect the developing child, with important implications for a diverse range of physical and mental health outcomes. In this paper we review primarily our own contributions to the field of maternal stress during pregnancy and child mental and physical health-related outcomes. We present findings on stress-related maternal-placental-fetal endocrine and immune/inflammatory processes that may mediate the effects of various adverse conditions during pregnancy on the developing human embryo and fetus. We enunciate conceptual and methodological issues related to the assessment of stress during pregnancy and discuss potential mechanisms of intergenerational transmission of the effects of stress. Lastly, we describe on-going research and some future directions of our program. [ABSTRACT FROM AUTHOR]

• Case study at a paper mill, focusing on workers. • New OHS programme supported by the local trade union is resisted by workers. • Work identity, facilitation and visibility affect resistance. • Resistance is explained by socialising forms of accountability. The seemingly paradoxical phenomenon of workers' resistance to health and safety measures has been explained in various ways, for example through production or efficiency pressure, risk-taking behaviours or problematic safety cultures. This article addresses resistance but analyses it through the lens of hierarchical and social accountability. In a case study of a Swedish paper mill, a health and safety programme is resisted by workers even though it enjoys support from the local trade union. Explanations for this is found in the socialising form of accountability that conditions how workers perceive of work-related health and safety. The aspects of work identity, facilitation and visibility are identified and understood in terms of accountability. Who you are, how you perform work, and what is visualised is filtered and evaluated through horizontal relationships rather than in terms of hierarchical accountability to the company. [ABSTRACT FROM AUTHOR]

• This is the second of four papers updating standards for the care of pwCF. • This paper focuses on establishing and maintaining health. • Guidance is evidence-based with wide engagement from across the CF community. • The guidance reinforces the importance of a multi-disciplinary CF team. • An active and healthy lifestyle is key, which includes avoiding e-cigarettes. This is the second in a series of four papers updating the European Cystic Fibrosis Society (ECFS) standards for the care of people with CF. This paper focuses on establishing and maintaining health. The guidance is produced using an evidence-based framework and with wide stakeholder engagement, including people from the CF community. Authors provided a narrative description of their topic and statements, which were more directive. These statements were reviewed by a Delphi exercise, achieving good levels of agreement from a wide group for all statements. This guidance reinforces the importance of a multi-disciplinary CF team, but also describes developing models of care including virtual consultations. The framework for health is reinforced, including the need for a physically active lifestyle and the strict avoidance of all recreational inhalations, including e-cigarettes. Progress with cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy is reviewed, including emerging adverse events and advice for dose reduction and interruption. This paper contains guidance that is pertinent to all people with CF regardless of age and eligibility for and access to modulator therapy. [ABSTRACT FROM AUTHOR]

We examine trends in words/terms published in Health & Place between 1995 and 2018. Terms used have diversified over this period, including a decline in 'health' overall, as well as greater usage of 'diet', 'alcohol' and 'depression'. There was a noticeable increase in using 'neighbourhood' to describe context. Topic modelling reveals that papers are increasingly concerned with specific aspects of place (e.g. the built environment). Our findings emphasise that Health & Place has matured into the leading outlet for examining the geographical dimensions of health with important and enduring insights that continue to inform research and policy. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between historical cultural norms and attitudes towards loneliness, specifically within the context of second-generation immigrants. We uncover an intergenerationally transmitted cultural element that emphasizes restraint and adherence to strict rules characterizing highly-intensive pre-industrial agricultural systems. This cultural dimension significantly impacts how individuals perceive their social relationships and influences their likelihood of experiencing loneliness. Additionally, we demonstrate that the identified cultural trait serves as a predictor of loneliness in a two-stage model for health. Our research shows that loneliness directly impacts body mass index and specific mental health issues, and these findings hold true across a battery of sensitivity checks. The results add to the existing body of research highlighting the importance of attitudes in predicting economic and health outcomes, shedding light on how deeply ingrained geographical, cultural, and individual characteristics can shape economic development processes in both home and host countries. • Attitudes towards loneliness are historically determined. • Intergenerationally transmitted norms shape the likelihood of loneliness. • Historical determinants of loneliness are used as exogenous source of loneliness. • Loneliness has a direct impact on body mass index and specific mental health issues. • The effect of instrumented loneliness is much larger in magnitude. [ABSTRACT FROM AUTHOR]

Background: Given the potential for social media to spread health misinformation, it is important to understand how trusts impact adolescents' engagement with health content on social media. Objective: To explore the concept of trust when adolescents (13-18 years) engage with health information on social media. Five relevant databases (MEDLINE, EMBASE, PsycINFO, ERIC, and CINAHL) were systematically searched alongside Google Scholar and reference lists of included papers. Studies were included if they examined adolescents' trust when engaging with health information on social media. Study Appraisal and Synthesis Methods: Thematic analysis was used to synthesize the findings from this review. Results: Thirty-four papers were included. Three key domains were explored: trust in the social media platform/ service (general distrust of social media for health information; safety and privacy); trust in other users (mistrust of unknown users; fear of bullying or judgment; trust in friends or peers; celebrities and popularity; trust in others' experience and the importance of social support); trust in content (tone and appearance of health information; expertise and verification; advertising, pushed, and suggested content). Limitations: Narrow geographic representation of papers and limited quantitative studies. Conclusions and Implications of Key Findings: Adolescents' trust in health information on social media involves a complex interplay between trust in: social media platforms, other users, and health content. Central to many of the findings is the social and identity work done by adolescents on and through social media. [ABSTRACT FROM AUTHOR]

Hyperketonemia (HYK) is one of the most frequent and costly metabolic disorders in high-producing dairy cows and its diagnosis is based on β -hydroxybutyrate (BHB) concentration in blood. In the last 10 years, the number of papers that have dealt with the impact of elevated BHB levels in dairy cattle has increased. Therefore, this paper reviewed the recent literature on BHB concentration in blood and milk, and its relationships with dairy cow health and performance, and farm profitability. Most studies applied the threshold of 1.2 mmol/l of BHB concentration in blood to indicate HYK; several authors considered BHB concentrations between 1.2 and 2.9 mmol/l as subclinical ketosis, and values ⩾3.0 mmol/l as clinical ketosis. Results on HYK frequency (prevalence and incidence) and cow performance varied according to parity and days in milk, being greater in multiparous than in primiparous cows, and in the first 2 weeks of lactation than in later stages. Hyperketonemia has been associated with greater milk fat content, fat-to-protein ratio and energy-corrected milk, and lower protein and urea nitrogen in milk. The relationships with milk yield and somatic cell count are still controversial. In general, HYK impairs health of dairy cows by increasing the risk of the onset of other early lactation diseases, and it negatively affects reproductive performance. The economic cost of HYK is mainly due to impaired reproductive performance and milk loss. From a genetic point of view, results from the literature suggested the feasibility of selecting cows with low susceptibility to HYK. The present review highlights that milk is the most promising matrix to identify HYK, because it is easy to sample and allows a complete screening of the herd through BHB concentration predicted using mid-IR spectroscopy during routine milk recording. Further research is needed to validate accurate and convenient methods to discriminate between cows in risk of HYK and healthy animals in field conditions and to support farmers to achieve an early detection and minimise the economic losses. [ABSTRACT FROM AUTHOR]

What is already known about the topic?. • Quality of life is an essential factor in later life, exploring predictors of quality of life thereby conducting targeted interventions in old age is important for healthy aging. • On the basis of future demographic changes and technology development, investing in digital competences, especially eHealth literacy is significant for the aging population. What this paper adds. • This study provides experimental evidence for the integrative model of eHealth use model from the specific health personality perspective. • Lower levels of health neuroticism, higher levels of health openness and health conscientiousness are correlated with higher quality of life. • eHealth can significantly mediate the relationship between health personality factors and quality of life among older adults. To explore the relationship between health personality and quality of life among community-dwelling older adults and to examine the mediating effect of eHealth literacy on this relationship. A total of 413 community-dwelling older adults from central China were recruited from September 2022 to January 2023. A cross-sectional investigation was conducted using the Chinese versions of the Health Personality Assessment (HPA), eHealth Literacy Scale (eHEALS), and 12-item Short Form Health Survey (SF-12). Correlations between the three variables were examined by Pearson analysis, and mediation analysis was conducted to explore the direct, indirect, and total effects of the health personality on quality of life vis-à-vis eHealth literacy. Health personality factors (including health neuroticism, health openness, and health conscientiousness), eHealth literacy, and quality of life are significantly correlated (P <0.05); eHealth literacy can play a significant mediating role in the relationship between health neuroticism (β= -0.256, 95 %CI: [-0.405, -0.119]), health openness (β = 0.488, 95 % CI: [0.343,0.652]), health conscientiousness (β= 0.489, 95 % CI: [0.354, 0.634]) and quality of life. This study revealed that the effect of health personality factors (including health neuroticism, health openness, and health conscientiousness) on quality of life in older adults was mediated through eHealth literacy. Individual personality is essential to understanding eHealth literacy and quality of life among community-dwelling older adults. It may be helpful to identify the health personality traits of older adults first, then implement targeted interventions accordingly to enhance eHealth literacy and ultimately improve quality of life. [ABSTRACT FROM AUTHOR]

• Cultural politics of data knowledge often under-examined in geography and data studies. • Digital data can be experienced as decontextualised and reductionist. • Engaging with food-tracking technologies involves negotiating different knowledges. • Negotiating epistemological tensions has spatio-temporal implications on health. • Findings seek to develop a more contextually situated theorisation of datafication. Engagements with personal digital data are growing in recent decades, as many digital technologies offer any interested user the opportunity to track their habits and practices. Yet, far from being objective and neutral conduits of knowledge, digital data is often politicised, invested with particular values, norms, and assumptions about human experiences. Digital health technologies, in particular, are often found to be coded through biomedical understandings of health and the individualism of Western ethics. Such politics of data knowledge inevitably has implications on the ways people in different socio-cultural contexts make sense of their health, bodies, and correspondingly, experience spaces of health through engagements with digital data. Drawing on diaries and diary-interviews with users of digital food-tracking devices in Singapore, this paper develops the idea of 'epistemological tensions' to theorise the socio-cultural differences in digital practices beyond the dominant focus on Anglo-American experiences. The findings suggest that people's engagements with digital health technologies can be experienced as 'glitchy' and fraught with epistemological tensions, as they constantly position their healthy eating practices between algorithmic advice offered by these technologies, and the socio-cultural norms of health and eating that they subscribe to. In negotiating such tensions, people are also found to express agency that has spatial and temporal implications on their health practices. In sum, this paper underscores the importance of critically situating , instead of simply scrutinising , everyday geographies of datafication. Doing so can yield more contextually nuanced insight into the potential and limits of digital technologies in mediating health geographies in different social and cultural contexts. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The current staffing shortage across all disciplines of post-acute and long-term care (PALTC) settings is affecting the health and safety of residents, as well as the well-being of the current staff. The need to retain and recruit new talent to this challenging but fulfilling setting demands that we look to existing evidence-based strategies and identify ways to implement them quickly, effectively, and in a sustainable way. Using the 4 Ms Framework of the Age-Friendly Health System developed by the Institute for Healthcare Improvement and the John A. Hartford Foundation (What Matters, Medication, Mentation, and Mobility), we can build on successful strategies to address what matters to staff, mental health, career mobility, and the overall safety and wellness of our nation's careforce. This paper summarizes "More of a Good Thing: A Framework to Grow and Strengthen the PALTC Careforce," a series of 6 roundtable discussions held in 2022 that brought together clinicians, industry leaders, and change-makers to share strategies that have been researched and successfully implemented and discuss ways to scale and disseminate them to a broader audience. The role of PALTC leadership is highlighted, with key points from the final roundtable discussion outlined, and challenging leadership to think about what they can begin doing immediately to build trust with existing staff and lay the foundation for a stronger nursing home careforce. Next steps for "More of a Good Thing" include a survey of participants about what they have tried, what has been successful, and what barriers they face; a series of focused interviews with leaders; and potential collaboration with quality improvement organizations to help facilities build on and implement the strategies presented. [ABSTRACT FROM AUTHOR]

• Therapeutic landscapes are spatio-temporally constructed. • Nature's therapeutic effects are shaped by people's perceptions and imaginations. • People can (re)produce and mobilise the healing effects of therapeutic landscapes via mobilities. • A more comprehensive view of the dynamics and complexity of nature and its healing power in lifestyle migration. This paper explores older people's perceptions and imaginations of nature and the making of therapeutic landscapes during lifestyle migration. It explores therapeutic landscapes through three interrelated dimensions: in-person experiences, representations, and spatio-temporal dynamics. Specifically, it examines the seasonal migration of the Houniao ('snowbirds') from northern China to Sanya, a tropical city in Hainan province. The Houniao are mostly Chinese retirees traveling between the north and south across seasons in pursuit of healthy lifestyles. First, they reappreciate the healing power of nature through experiences of seasonal mobilities and health decline/improvement. Second, their therapeutic imaginations and representations of nature are shaped by medical science and more importantly by myths and magic, and are related to the meanings of lifestyle migration. Third, the Houniao (re)produce and mobilise the spatio-temporality of therapeutic landscapes and negotiate healthy lifestyles during regular movements and multi-site living. This paper highlights a mobilities perspective to understand the production of therapeutic landscapes and scrutinises the spatio-temporal dynamics and complexity of nature and its healing power in lifestyle migration. [ABSTRACT FROM AUTHOR]

Early childhood education programs have been found to effectively promote children's social and cognitive development. However, the health impact of these programs is less understood. Using a quasi-experiment of the first universal child care reform in China from 2010, this paper aims to identify whether the preschool reform produces any short-term effects on health-related outcomes of preschoolers (3-6 years old). Specifically, this reform expands access to affordable preschools that provide full-day center-based education, with school meals and essential health services on campus. I exploit the variation in the number of newly established preschools across provinces and implement difference-in-differences and triple-difference strategies. Results confirm the effectiveness of this reform by showing a strong and positive impact on preschool attendance. This paper then documents the benefits to alleviating underweight among preschoolers. Estimates show a larger effect in rural areas, suggesting that the reform narrows rural-urban disparities in education access and undernutrition prevention. I also explore the impact on caregivers' health consciousness and find improved health-seeking behavior when children get sick. [ABSTRACT FROM AUTHOR]

Drowning is a form of silent and neglected disaster. Hundreds of thousands die every year from drowning, with cumulated fatalities surpassing that of large-scale disasters. However, research on drowning is largely absent from disaster studies and global and national disaster risk reduction policy frameworks rarely mention drowning risk and the related strategies for strengthening water safety. Drowning is mainly framed as a public health issue being studied predominantly by scholars from injury prevention, public health, and medicine. This paper argues that both disaster studies and disaster risk reduction policies have a critical role to play in progressing drowning prevention. It reviews the existing drowning literature and highlights trends, challenges, and opportunities to bridge gaps in knowledge, policy, and practice for reducing drowning risk. The article highlights the strong conceptual underpinnings that characterize both the disaster risk and drowning fields, the need for data sharing, the potential for community-approaches to drowning risk reduction, and ultimately recommends a more systematic integration of drowning in disaster risk reduction initiatives. The paper ends by underlining some of the barriers and requirements to foster collaboration between the disaster risk domains and drowning prevention. [ABSTRACT FROM AUTHOR]

Under climate change, many parts of the world are warming with increasing frequencies and intensities of heatwaves, bringing heat-health risks to places including those that have a historically temperate or cool climate. These places may have extensive experience in managing cold-health risks, while experience is lacking in dealing with heat-health risks due to their lack of historical exposure to high temperatures. This paper explores this overlooked area of the challenges and opportunities of heat-health governance in cool places using Scotland as a case study. Various important themes of heat-health governance in cool places were identified by the study, including socio-cultural barriers to intervention, vulnerable population overlaps, temporal and geographical scales, and governance arrangements. The study found challenges in managing heat-health risks including a perceived lack of heat-health risks and policy priority as well as unsuitable building stock. Meanwhile, it also identified opportunities for governing cold and heat risks holistically within existing institutional systems and creating co-benefits of improving communication and information dissemination, reducing inequality and improving indoor thermal comfort of both cold and heat as well as providing good quality greenspace. Our findings contribute to the development or improvement of national/regional strategies to manage heat-health risks not only in Scotland but also in other places with a historically cool or temperate climate. • Temperature increase under climate change poses health risks to cool places as well. • Cool places have distinctive challenges and opportunities in heat-health governance. • Perceived lack of heat risks poses socio-cultural barriers to heat-health governance. • A holistic governance approach of cold and heat-health risks was preferred. • Building design and occupant behaviour are crucial for thermal comfort. [ABSTRACT FROM AUTHOR]

• Nursing faculty, despite a lack of knowledge, time, resources, and confidence, are charged with creating nurses that are prepared to meet the health needs of Lesbian, Gay, Bisexual, Transgender, Queer and/or Questioning, and others (LGBTQ+) individuals. • The LGBTQ+ health resources, strategies for evaluating for this content in curricula, and strategies for adding this content to nursing courses provided in this paper can assist nursing faculty in overcoming these barriers. • Greater inclusion of LGBTQ+ health topics in nursing curricula will generate nurses that can provide accurate, holistic, and culturally competent care to LGBTQ+ patients and improve their health outcomes. Individuals who identify as Lesbian, Gay, Bisexual, Transgender, and Queer and/or Questioning (LGBTQ+) have unique and complex health needs. Nursing programs must train nurses to provide culturally competent care to this population; however, nursing faculty have reported a lack of the knowledge and preparation needed to integrate this specialized health information into the nursing curriculum. This article provides nursing faculty with LGBTQ+ health-related teaching resources, tools for evaluating curricula evaluation, and evidenced-based course integration strategies. [ABSTRACT FROM AUTHOR]

One of the technological responses to concern about the healthiness and sustainability of red meat consumption as well as growing global food insecurity has been the development of plant-based meats. While still niche industries, plant-based meats are increasing in diversity and visibility and are often accompanied by scientific claims about their potential contribution to sustainability, health and nutrition. In this paper we analyse these claims from the perspective of critical metrology, looking not only at the state of knowledge about plant- and animal-based beef but also how knowledge is being produced. Such research is vital in understanding not only what is known about a topic but also the limitations of that knowledge in terms of influences and gaps, to shape how research can be done better. The research is based on a scoping review of scientific papers that compare the sustainability and nutritional properties of plant- and animal-based beef, with a particular focus on the Australian context. Our analysis shows that there are some points of consensus, such as plant-based beef having lower greenhouse gas emissions than animal-based beef and that plant-based burgers have lower total fat and saturated fat than animal-based burgers. However, we also find points of difference due to variability in production systems, products and approaches to measurement. We discuss how a metrological regime is forming that bears the imprint and interests of the industries involved, influencing the metrics and geographies that are studied and creating critical absences in understanding. [ABSTRACT FROM AUTHOR]

As the amount of available data in healthcare has increased significantly and only 20% of electronic health record data are in a structured format, data lakes have become a common solution for managing heterogeneous data in the healthcare domain. Nowadays, these are utilized far below their capabilities in medical research. Since previous reviews only partly address data lakes in the healthcare domain, a systematic literature review on this topic is missing. Therefore, this paper provides an overview of applications in the healthcare domain that benefit from data lakes. We review the literature and structure it according to data sources and players, and we identify applications and future research needs of data lakes in the healthcare domain. Overall, it turned out that all players could benefit from the capabilities of data lakes. We found that data lakes are currently not broadly implemented in the field, and the viewpoint of hospital operators and healthcare insurers seems to be an underresearched topic compared to the other players. [ABSTRACT FROM AUTHOR]

• Waste emissions scenarios are modelled with the rapid assessment software CCAC SWEET. • HIA for PM 2.5 and application of publicly available tool WHO AirQ+. • 94% reduction of long-term mortality due to reductions in PM 2.5 emissions in 2030. • A detailed analysis of the current situation provides suggestions for waste management policies. Despite the clear link between air pollution and health, research to investigate the relationship between municipal solid waste management and air pollution and health has not been prioritized. Such research may generate scientific information that would help reduce population exposure to air pollutants. This paper examines the case study of Accra in Ghana, a city dealing with serious waste management problems. The paper proposes a methodology to estimate the impact of waste management on urban air pollution and health. The analysis is described in the following four steps: (1) collecting data on the waste sector; (2) modeling the emissions arising from waste management; (3) transforming emissions to concentration values and (4) estimating the burdens on health. The assessment has been conducted using the CCAC SWEET tool and WHO AirQ+. The method presented can be used in different locations, depending on data availability, when analyzing the impact of and potential changes to waste sector policies. The results of this health impact assessment indicate that, based on the emissions of PM 2.5 from the waste sector in Accra, a change from the business-as-usual to more sustainable options would reduce air pollutants emissions and avert 120 premature deaths in 2030. Levels of air pollution in Accra are significant and interventions to reduce PM 2.5 exposure should be promoted. The detailed analysis of the current situation provides suggestions for waste management policies in terms of impacts on health and ideas to reconsider the waste policies in Accra. [ABSTRACT FROM AUTHOR]

The world is facing a new pandemic that affected all aspects of life and interrupted normal daily activities, which urges rethinking the ability of the urban realm to adapt to change especially when it comes to basic human needs. Urban markets play a vital part in securing daily access to food; thus, it is crucial to keep them operating safely during pandemic. The paper starts by discussing socioeconomic implications of pandemic in the urban realm in general and in markets in particular. Guidelines for designing markets are briefly reviewed, followed by guidance provided by responsible organizations for operating markets safely during pandemic. The paper demonstrates some of the solutions and ideas applied and suggested worldwide to avoid the consequences of markets' shutting down, then it introduces the case study: Tablita market as one of the enclosed urban markets in Cairo, Egypt, the market's situation during pandemic is studied through observation, structured and unstructured interviews with vendors. The results from market observation and interviews show some of the socioeconomic implications of COVID on the market as well as the behavioral challenges that require innovative solutions to force the adherence to protection measures. Accordingly, the paper suggests applicable short-term and long-term solutions for Tablita market redesign in the light of these implications, challenges and protection measures that can also be applied in similar cases in Cairo to help markets operate safely and avoid severe consequences of lockdown. [ABSTRACT FROM AUTHOR]

This paper aimed to summarize the findings of the third (2022) Active Healthy Kids Hong Kong Report Card on Physical Activity for Children and Adolescents and evaluate the secular trends of physical activity related indicators. Five behavioral indicators (Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, and Sedentary Behavior), three outcome indicators (Physical Fitness, Sleep, and Obesity) and four sources of influence indicators (Family and Peers, School, Community and Environment, and Government) were assigned a letter grade (ranging from A+ to F or incomplete) based on the best available evidence following a harmonized approach developed by the Active Healthy Kids Global Alliance. Data sources included published journal articles, government reports, manual searches, and personal contacts; and consisted of both pre-COVID-19 and after-COVID-19 evidence. Grades for Overall Physical Activity (D−∗∗) and Sedentary Behavior (D) deteriorated compared to the 2018 Report Card. The other three behavioral indicators, Organized Sport and Physical Activity, Active Play, and Active Transportation, were assigned B−, D, and B+, respectively. Physical Fitness (D), Sleep (C−), and Obesity (D−) obtained the same grades as in the 2018 Report Card. School (B) and Government (C+) grades slightly improved, while Community and Environment grade (B) was stable. Family and Peers was not graded due to insufficient evidence. Despite slight improvements in influence indicators, physical activity and sedentary behavior have changed unfavorably for children and adolescents in Hong Kong. Strategic investments are needed to improve adoption and implementation of effective interventions. [ABSTRACT FROM AUTHOR]

• A tipping point in the rate of cutting does not exist in every community. • Some communities have a stable rate of female genital cutting between 0 and 1. • The existence of a tipping point determines which policies will be effective. • Develops novel method to construct community distribution of household preferences. • This method can also be used to understand other social behaviors. More than 200 million women alive today have undergone female genital cutting (FGC). Despite the associated negative health outcomes, the practice has persisted for generations. The prevailing theory of FGC persistence is that FGC is a social coordination norm, which implies that if a sufficient number of community members agree to abandon FGC, a tipping point is reached and the rate of FGC will fall to zero. Recent empirical evidence is inconsistent with this theory. This paper formalizes an alternative theoretical explanation in which households have heterogeneous thresholds—i.e. the rate of FGC in their community at which the household switches from practicing to not practicing FGC. This threshold heterogeneity removes the certainty that a tipping point exists and introduces the possibility of a stable internal equilibrium in the rate of FGC in a community. Using a dataset of more than 27,000 women born across 4.5 decades in Burkina Faso, I use a novel technique to construct community-level distributions of household thresholds. These distributions show that some communities in Burkina Faso have tipping points while some have a stable internal equilibrium. I find suggestive, but statistically insignificant, evidence that communities with a larger share of educated women, higher poverty rates, and lower population density are more likely to have a tipping point. Additionally, the empirical method developed in this paper has applications to the evolution of other social phenomena such as technology adoption, voting behavior, and racial segregation. [ABSTRACT FROM AUTHOR]

A main mechanism of action proposed for oral probiotic supplementation is immunomodulation, which is expected to impart health benefits in the host by influencing circulating immune and inflammatory factors. To date, the effectiveness of probiotic supplementation for immunomodulation in healthy adults without disease has not been evaluated in a systematic review. The objective of this systematic review was to evaluate the effect of probiotic supplementation on circulating immune and inflammatory markers of healthy adults compared to placebo. PubMed, SCOPUS, ISI Web of Science, ProQuest, and Cochrane databases were searched for English articles up to May 15, 2019. Additional papers were identified by checking references of relevant papers. Only randomized controlled trials studying the administration of probiotic supplements compared to placebo on immune and inflammatory markers in healthy adults (aged 18 to 65 years), without acute or chronic disease, and in generally good health were examined. Independent extraction of articles was conducted by two authors using predefined search terms and restrictions/filters. The methodologic quality of each study was appraised using the Academy of Nutrition and Dietetics Evidence Analysis Library Quality Rating Worksheet and the body of evidence was assessed using the Academy of Nutrition and Dietetics Grade Definitions and Conclusion Grading Table. Eighteen articles, including 819 subjects, met eligibility criteria and were included in the present systematic review. Five articles were rated neutral in quality and 13 were rated high in quality. Eight articles reported a significant effect on immune and/or inflammatory parameters including increases in natural killer cells, lymphocytes, and monocytes, and decreases in proinflammatory cytokine concentrations. Based on the 18 articles extracted in this systemic review, probiotic supplementation was concluded to have a limited effect on immune and inflammatory markers in healthy adults. Overall, the evidence was heterogenous, precluding a meta-analysis, and difficult to aggregate and conclude on effect size. PROSPERO ref CRD42018110856. [ABSTRACT FROM AUTHOR]

In this position paper, I shall summarise the current status of sensor technologies in ruminant livestock farming with emphasis on dairy cattle, outline the case for why I believe that sensor technologies could revolutionise global dairy farming in a positive way, describe the significant barriers that exist if that goal is to be achieved and highlight the benefits to animal wellbeing, profitability and sustainability that could result if the technologies are implemented to a significant extent. I shall not provide a comprehensive review of the sensor technology literature since that has been done before, but I intend to provide a sensible amount of background information and data that will allow the reader to obtain a picture not only of today's sensor usage but, more importantly, the possible future direction of dairy animal-oriented sensor technologies, and I shall substantiate my claims and conclusions with relevant literature. [ABSTRACT FROM AUTHOR]

• We compare three urban informal settlements in South Africa, Kenya and Uganda using an urban societal metabolism approach. • We argue that different informal settlements raise different challenges of understanding and of governance. • Gender is important to understand urban poverty and informality: in all case studies, slums are inhabited mainly by women. • Energy policies for informal urban settlements impact both energy access and energy related health problems. • The focus on differences produces modest and localized policy recommendations that consider complexity. Urban development in Africa is a very diverse and ambivalent phenomenon with aspects that do not fall neatly into global standards. Informal settlements therefore challenge governance by standards. We argue that quantifying and interrogating differences offers a better basis for governance. By drawing on a comparative analysis of three different informal settlements in Sub-Saharan Africa, this paper explores what differences reveal about the governance of informal settlements. The paper uses an urban societal metabolism approach, focussed on gender, energy and health, based on questionnaires and focus group discussions in Enkanini (Stellenbosch, South Africa), Mathare (Nairobi, Kenya), and Kasubi-Kawaala (Kampala, Uganda). The contribution of the paper is both empirical and theoretical. Empirically, we provide new evidence about the metabolism of urban informality at multiple levels of analysis: the individual, the household and the settlement. Findings show the gender asymmetries in urban poverty and the intricate links between energy choices, health and economic status. Theoretically, we argue that different levels of analysis produce different understandings of urban informality, and that analyzing informal settlements only by population aggregates means missing information. We conclude by arguing that understanding differences leads to the formulation of modest and localised goals, which are better able to take into account the complexity of urban informality. [ABSTRACT FROM AUTHOR]

In an era of environmental anxiety, "re-wilding" has emerged as an ecological health and resiliency strategy across scales in the Anthropocene, from the human body to the planet. At the scale of the body, this has meant a reevaluation of dietary, consumption, and lifestyle behaviors among concerned consumers seeking to create healthy, resilient bodily ecosystems. Recent health trends including the Paleo Diet and Ancestral Health movements call upon an evolutionary perspective for insight as to how to re-wild one's bodily ecosystem in the face of ecological crisis across scales, using the Paleolithic era as a benchmark for dietary and behavioral re-wilding. This paper draws upon interviews with individuals adhering to a Paleo Diet to better understand whether and how the evolutionary discourse of Paleo influences their beliefs about healthy diet and lifestyles, and how they grapple with re-wilding in an urban context. This paper elucidates the paradoxical "ancestral futurism" of the Paleo movement, where re-wilding bodies and lifestyles in the name of health and sustainability is predicated upon the same technologies, spaces, political-economic structure, and human agency that created the messy ecological uncertainty of the Anthropocene. [ABSTRACT FROM AUTHOR]

We investigate the effect of early exposure to malnutrition on the cognitive abilities of the offspring of survivors in the context of a natural experiment; i.e., the Great Chinese Famine (GCF) of 1959–61. We employ a novel dataset – the China Family Panel Studies (CFPS) – to do so. The paper finds that the cognitive abilities of children whose fathers were born in rural areas during the famine years (1959–1961) were impaired by exposure to the GCF and the negative effect was greater for girls than boys, whereas children whose mothers were born in rural areas during the famine years were not affected. The uncovered gender-specific effect is almost entirely attributable to son preference exhibited in families with male famine survivors. • This paper focuses on the intergenerational legacy of the Great Chinese Famine (GCF) of 1959–61. • It investigates the effects of early exposure to malnutrition on the cognitive abilities of the offspring of the survivors of the GCF. • It employs a novel dataset that contains measures for cognitive abilities – the 2010 waves of the China Family Panel Studies (CFPS). • It finds that the cognitive abilities of children of rural male survivors were impaired by exposure to the GCF; the negative effect was greater for girls than boys. • The uncovered gender-specific effect is attributable to son preference exhibited in families with male famine survivors. [ABSTRACT FROM AUTHOR]

Achieving sufficient COVID-19 vaccination coverage has been hindered in many areas by vaccine hesitancy. Many studies based on large survey samples have characterized vaccine refusal, but there are fewer in-depth qualitative studies that explore hesitant adoption: the middle-ground between vaccine acceptance and refusal, and how individuals may move across this continuum depending on their lived experience. For this paper, we use the narratives of 25 adults living in off-road, predominately Alaska Native communities to describe the complex decision-making processes undertaken by ' hesitant adopters', defined in our study as those who completed their initial COVID-19 series despite reporting hesitancy. Interviewees' stories help illustrate how hesitant adopters' decision-making processes involved making sense of information through interactions with trusted individuals, lived experiences, observations, emotions, and personal motivations. For the majority of these hesitant adopters' (n = 20, 80%) interpersonal interactions were key in helping to make the decision to get vaccinated. Over half of the interviewees (n = 14, 56%) described how conversations with individuals they trusted, including healthcare providers, family, friends, and interactions through their professional network made them feel safe. One third of the hesitant adopters (n = 7, 28%) attributed their decision to get vaccinated based on the influence of Alaska Native Elders including their knowledge, personal experiences, as well as being motivated by the desire to protect them. Independent research was also important to about a quarter of hesitant adopters (n = 6, 24%), and for these interviewees it was the process of gathering information on their own and learning from others, especially healthcare providers who could answer their questions and alleviate their concerns. This paper illustrates the temporality of vaccine decision-making: vaccine acceptance for those who are hesitant may be an ongoing process that is influenced by personal experience, relationships, and context. • Understanding hesitant adoption provides insights into increasing vaccine acceptance • In remote Alaska, Elders may influence the decisions community members make • Images and conversations reinforced narratives of safety and efficacy • Agency in information-seeking increased vaccine confidence [ABSTRACT FROM AUTHOR]

Despite the cat's popularity as a companion species, many owners and practitioners lack high quality information about important aspects of their behavior and management. Myths, anecdotes, and narratives of cats as 'low maintenance, self-sufficient' animals are pervasive, and the degree to which these may underlie complacency about fully meeting cats' needs is unknown. Several studies suggest that cat welfare and the human-cat bond may benefit from improved education about how to optimize the domestic cat's management and husbandry needs in homes and elsewhere. This paper is the second of a two-part series addressing common myths about cats. The purpose of this paper is to review and debunk common misconceptions about optimal cat care, feeding behavior, genetics, and training. Replacing these misconceptions with scientifically generated information could have a significant impact on the behavioral management of cats, positively influencing their physical health, mental stimulation, and well-being, and reducing stress for both cats and the people caring for them. Areas where further research is required to address ambiguities, and to better meet cats' needs in homes and other environments, are also identified. • Cat owners need support to meet cats' behavioral, environmental and physical needs. • Training is useful for cats' behavioral and cognitive development and for basic care. • Feeding regimens for cats should balance satiety and healthy weight management. • There is a lack of evidence for a relationship between cat coat color and personality. • The most common health conditions appear in cats regardless of purebred status. [ABSTRACT FROM AUTHOR]

Healthcare worker burnout is a well-established phenomenon known to affect an individual's mental state, and has been shown to be diminished amongst individuals with higher levels of resilience. From a leadership perspective, practices that drive and inspire others to demonstrate resilience and surpass their own expectations fosters a resilient culture and allows employees to view adversity as an opportunity while knowing that support is omnipresent. In this paper, we describe and evaluate the outcomes of a virtual organizational intervention during the COVID-19 pandemic aimed to reduce healthcare staff burnout, and improve their levels of resilience, well-being, and self-compassion. Participants reported the workshops were relevant and provided strategies for wellness that were easy to incorporate into their daily routine. By nurturing one's own personal well-being through resiliency strategies learned in this educational series, staff can enact strategies to care for themselves, which in turn can contribute to organizational wide healthy work environments, improved health system outcomes, and enhanced patient care. [ABSTRACT FROM AUTHOR]

Healthcare workers have been particularly impacted by the COVID-19 pandemic, as have those educating them, albeit differently. Several papers have identified a gendered difference in the impact of the pandemic. This study aims to determine impact of COVID-19 on the health and wellbeing of Medical Imaging and Radiation Therapy (MIRT) academics. An electronic survey was designed in English on Qualtrics and distributed via email and online platforms to MIRT academics. Fifty-one questions were used; demographic (n = 9), work patterns (n = 11), general health (n = 8), mental health (n = 2), physical health (n = 10), and workload (n = 11). Overall, 46 were quantitative and five were qualitative 'open-ended' questions. The survey was open between 3rd March 2021 to 1st May 2021. Quantitative analysis was carried out using MS Excel v 16.61.1ss and SPSS v26. The survey reached 32 countries globally and 412 participants; 23.5% identified as men (n = 97) and 76.5% as women (n = 315). Women reported worse sleep quality than men and overwhelmingly felt they would not like to work remotely again if given a choice. A higher percentage of males, 73% versus 40.5% of females reported getting outdoors less. The CORE-10 validated questionnaire found that 10.3% of males (n = 42) and 2.7% of females (n = 11) experienced severe psychological distress the week immediately before the survey was conducted. While the study has identified some gender-related differences in the impact of COVID-19 on the mental and physical health of MIRT academics, both males and females have experienced significant deterioration in health and wellbeing due to the pandemic. Developing mental health support for MIRT academics and defining optimum methods for raising awareness is recommended. [ABSTRACT FROM AUTHOR]

This paper examines the influence of housing wealth on fertility outcomes through a regression discontinuity design based on a 2006 Chinese housing-market policy. Our analysis reveals that the positive impact of this policy on housing wealth significantly enhances the likelihood of fertility by 7.3 %. Our result implies that a 1 % increase in housing wealth can raise the fertility rate by 0.18 %. Furthermore, we observe that children born subsequent to the positive housing wealth shock exhibit improved health, not only at birth but also over the long term. Lastly, we present suggestive evidence suggesting that both parental pre-birth time allocation and parental health may help explain the documented positive effects of housing wealth on fertility rates. [ABSTRACT FROM AUTHOR]

Under the background of the COVID-19 pandemic, our paper attempts to advance a dual-process model from online social support to individual resilience via diverse social capital (bonding and bridging) and political beliefs (political efficacy, political trust and city identification). Drawing on a survey of 446 residents in Shanghai, China, the findings indicate that neither informational nor emotional social support directly affects individual resilience, but indirectly influences it through different pathways. Specifically, bridging social capital mediates informational social support and individual resilience, but bonding social capital might not follow a similar path. Notably, political efficacy and political trust are involved in the above mediation between informational social support and individual resilience. Besides, the serial mediation effect of emotional social support on individual resilience via bonding social capital and then city identification or political trust is also significant. Our findings are expected to reveal the mechanism of resilience construction and prepare for the future public health crisis. • Neither informational nor emotional social support directly predicts individual resilience in China during the COVID-19. • Bridging social capital mediates the relationship between informational support and resilience. • Political trust explains the mechanism from social support to resilience via both bonding and bridging social capital. • Political efficacy acts in the sequential mediation of informational support, bridging social capital, and resilience. • City identification acts as the pathway connecting emotional support, bonding social capital, and resilience. [ABSTRACT FROM AUTHOR]

The poor acoustic quality in educational buildings is a prevalent issue that can significantly influence teachers' and students' health, comfort, and performance. An integrative literature study was conducted to understand the current research on acoustic quality in educational buildings. The study aimed to identify (1) common research topics related to acoustics in educational buildings, (2) methods that were used to collect and analyze data in previous relevant studies, and (3) knowledge gaps that need to be addressed to evaluate and enhance acoustic quality in educational buildings. In total, 206 relevant studies collected from the Web of Science database were reviewed and analyzed. Three research topics emerged based on the co-occurrence links between terms in the abstract and title of these papers: acoustic conditions and improvements in educational buildings, impacts of acoustic quality in educational buildings on students' performance, and impacts of acoustic quality on teachers' and students' health. Four commonly employed data collection methods and three analysis methods were identified, and their advantages and disadvantages were discussed. Gaps in the research topics, methods, and ways of improvement were discussed to highlight directions for future research in the acoustics field. Two individually controlled acoustic improvement methods and the interaction effects between acoustic quality and other environmental factors were suggested to be considered for future studies. Furthermore, this study advocated incorporating electroencephalography (EEG) and machine learning techniques in future research to gain deeper insights into the effects of acoustic quality on occupants in educational buildings. • Studies on acoustic comfort in educational buildings were reviewed. • Three research topics were identified based on bibliometric networks. • Commonly employed data collection and data analysis methods were discussed. • Suggestions on future research topics and methods were proposed. [ABSTRACT FROM AUTHOR]

Evidence on the health benefits of spending time in nature has highlighted the importance of provision of blue and green spaces where people live. The potential for health benefits offered by nature exposure, however, extends beyond health promotion to health treatment. Social prescribing links people with health or social care needs to community-based, non-clinical health and social care interventions to improve health and wellbeing. Nature-based social prescribing (NBSP) is a variant that uses the health-promoting benefits of activities carried out in natural environments, such as gardening and walking. Much current NBSP practice has been developed in the UK, and there is increasing global interest in its implementation. This requires interventions to be adapted for different contexts, considering the needs of populations and the structure of healthcare systems. This paper presents results from an expert group participatory workshop involving 29 practitioners, researchers, and policymakers from the UK and Germany's health and environmental sectors. Using the UK and Germany, two countries with different healthcare systems and in different developmental stages of NBSP practice, as case studies, we analysed opportunities, challenges, and facilitators for the development and implementation of NBSP. We identified five overarching themes for developing, implementing, and evaluating NBSP: Capacity Building ; Accessibility and Acceptability ; Networks and Collaborations ; Standardised Implementation and Evaluation ; and Sustainability. We also discuss key strengths, weaknesses, opportunities, and threats for each overarching theme to understand how they could be developed to support NBSP implementation. NBSP could offer significant public health benefits using available blue and green spaces. We offer guidance on how NBSP implementation, from wider policy support to the design and evaluation of individual programmes, could be adapted to different contexts. This research could help inform the development and evaluation of NBSP programmes to support planetary health from local and global scales. [ABSTRACT FROM AUTHOR]

There are now 108.4 million forcibly displaced people worldwide, many of whom endure adversities that result in trauma, toxic stress, and potentially, altered epigenetic development. This paper provides a comprehensive review of current literature on the biological signatures of war and forced migration among refugee populations. To consolidate evidence and identify key concerns and avenues for future research, we reviewed 36 publications and one article under review, published since 2000, most of which focused on refugees relocated in Europe and the Middle East. This body of work – including cross-sectional, observational, and experimental studies - reveals heterogenous findings regarding human biological responses to war-related adversities and their associations with health outcomes. We conclude with four main observations, regarding why genomic and physiological biomarkers are valuable, what study designs advance understanding of causality and health-promoting interventions, how to prepare for ethical challenges, and why theoretical frameworks and research procedures need more detailed consideration in scientific publications. • We reviewed the genomic and physiological signatures of war and forced displacement. • Biomarkers are valuable for assessing biological and developmental responses to war. • More longitudinal work is needed to shed light on physiological and genomic processes. • Effective psychosocial support can have demonstrable impacts on human biology. [ABSTRACT FROM AUTHOR]

This paper explores the evolution of inequality of opportunity in the prevalence of chronic diseases along the life cycle and across different birth cohorts for individuals aged 50 or older and residing in 13 European countries. We adopt an ex-ante parametric approach and rely on the dissimilarity index as our reference inequality metric. In addition to a commonly used set of circumstances, we pay particular attention to the role of adverse early-life conditions, such as the experience of harm and the quality of the relationship with parents. In order to quantify the relative importance of each circumstance, we apply the Shapley inequality decomposition method. Our results suggest that inequality of opportunity in health is not stable over the life cycle - it is generally lower at younger ages and then monotonically increases. Moreover, it varies between different birth cohorts and is generally higher for younger individuals than for older age groups. Finally, the contribution of adverse early life conditions ranges between 25% and 45%, which is comparable to the share of socio-economic circumstances but significantly higher than the relative contribution of other demographic characteristics, especially at younger ages. [ABSTRACT FROM AUTHOR]

This paper estimates the negative effects of motorised road traffic on the travel and walking behaviour of local residents in Great Britain and the cost of the wider negative impacts on local economic activity, external effects of motorised transport, social exclusion, neighbourhood social capital, self-rated health, and subjective wellbeing. We use the results of a survey (n = 3038) and models linking the characteristics of roads and pedestrian crossing facilities in each participant's local area, travel and walking behaviour, and the level and monetary value of the wider impacts of travel behaviour. The costs of road traffic borne by local communities were estimated as £31.9 billion per year, i.e. 1.6% of the Gross Domestic Product, or £631 per person. This value varies within the interval £569-£698/person/year, depending on the assumptions made. The highest estimated costs of motorised road traffic are reduced neighbourhood social capital (£236) and reduced subjective wellbeing (£196/person/year). The costs for some population segments, such as London residents, city residents, and people aged 25–34 are higher than the average. The characteristic of roads causing the highest costs is volume of motorised traffic above low (£264/person/year), followed by multiple lanes (£148), traffic speeds above low (£119), and absence of a median strip (£60). By quantifying for the first time, at the national level, the costs of the negative community effects of motor vehicles, this study provides evidence supporting policies to reduce traffic volumes and speeds and reallocate roadspace to pedestrians. [ABSTRACT FROM AUTHOR]

This paper examines the health consequence of rising housing prices in China by exploiting spatial and temporal variation in housing price appreciation linked to individual-level health data from 2000 to 2011. Using an instrumental variable approach, we find that increases in housing prices significantly raise the probability of having chronic diseases. The deep-rooted marriage culture of males being obligated to buy a home before getting married and the growing marriage market competition are the main channels that exacerbate the negative health effects, particularly for parents with marriage-age sons. We also show that increased work intensity, high levels of stress, and lifestyle changes are other possible channels. Our results highlight the unintended health consequences of the real estate market prosperity. [ABSTRACT FROM AUTHOR]

Living with adversity can create wide-ranging challenges for people's health and wellbeing. This adversity may arise through personal embodied difference (e.g. acquiring a brain injury or losing mobility in older age) as well as wider structural relations that shape a person's capacity to adapt. A number of dichotomies have dominated our understanding of how people engage with health and wellbeing practices in their lives, from classifying behaviours as harmful/health-enabling, to understanding the self as being defined before/after illness. This paper critically interrogates a number of these dichotomies and proposes the concept of 'hopeful adaptation' to understand the myriad, often non-linear ways that people seek and find health and wellbeing in spite of adversity. We highlight the transformative potential in these adaptive practices, rather than solely focusing on how people persist and absorb adversity. The paper outlines an agenda for a health geography of hopeful adaptation, introducing a collection of papers that examine varied forms of adaptation in people's everyday struggles to find health and wellbeing whilst living with and challenging adversity. • This paper looks at how people adapt to personal and structural challenges. • People adapt to find health and wellbeing and to transform the challenges. • The paper proposes the idea of 'hopeful adaptation' to understand these practices. • It outlines an agenda for a health geography of adapting to adversity. • It introduces a special issue on this subject. [ABSTRACT FROM AUTHOR]