• Bicycle delivery riders face safety risks beyond traffic or personal behavior alone. • This qualitative study explored safety, identity, and equity issues among them. • Riders report feeling underrepresented in policy, labor protection, and urban cycling dynamics. • Digital demands and precarious status undermine compliance with road safety norms. • Legal precarity, social marginalization, and inequity concerns intersect in work safety-related practices. The expansion of the gig economy has led to a growing number of urban workers engaged in app-based food delivery. This sector, often seen as flexible, conceals complex occupational, legal, and psychosocial risks. Recent evidence suggests that delivery riders’ safety is shaped not only by infrastructure or individual behavior, but also by precarious work conditions, limited legal protections, and forms of social exclusion that remain largely unaddressed. This qualitative study examined how safety, identity, and equity are experienced and negotiated in app-based bicycle delivery in Spain, with attention to algorithmic timing, organizational rules, and street-level conditions. Twenty semi-structured interviews were conducted with food delivery riders (mostly migrant men) in urban areas of Spain. A reflexive thematic analysis (inductive) was applied, with attention to patterns, contrasts across cases, and speech insights suggesting broader socio-labor dynamics. Three core themes were identified: (1) persistent exposure to traffic and environmental hazards, often aggravated by digital pressures and limited enforcement of safety regulations; (2) a fragmented social identity, with riders feeling excluded from both formal labor structures and mainstream cycling culture; and (3) strong perceptions of systemic inequity, including legal precarity, economic fragility, and marginalization in public and policy narratives, which may influence how riders manage risk in practice (e.g., rule compliance, incident reporting) and, in turn, safety outcomes. The findings highlight the vulnerabilities of bicycle food delivery riders and suggest the need to rethink how safety, labor protections, and urban inclusion are framed and implemented in this sector.

Reflective supervision (RS) is a central component of Infant and Early Childhood Mental Health Consultation (IECMHC), providing mental health consultants (MHCs) with space to slow down, reflect on practice, and cultivate professional growth. This exploratory qualitative study examined how MHCs build the capacity and skills needed to develop an equity stance through RS. Sixteen mostly white and Hispanic MHCs from a Southwestern IECMHC program participated in individual interviews about their supervisory relationships and experiences addressing equity issues. Data were analyzed inductively to identify patterns and generate an emerging framework grounded in participants' experiences. We identified a developmental and relational process in which supervisors' behaviors gradually built trust and connection, cultivating safety as the foundation for reflective and equity-focused dialogue. Two interconnected themes captured this progression: (1) supervisors' behaviors that cultivate safety and foster equity dialogue, and (2) consultants' experiences of felt safety that support their willingness and vulnerability to engage in, or withhold from, equity dialogue. These findings align with relational-developmental and parallel process models of RS, extending existing literature by illustrating how intentional, equity-centered supervision supports consultants' capacity to engage in reflection and promote equitable outcomes for diverse children and families.

Early detection is an essential component in averting preventable higher-stage pressure injuries (PI). However, decades of clinical practice have not yielded the elimination of preventable hospital-acquired PIs, especially in patients with dark skin tones. Late detection of PIs in dark skin tones is a health equity issue. As an equity-informed initiative, an interprofessional team in a large hospital complex developed an enabler for practice to address overreliance on simple visual inspection for detecting early skin and tissue damage. The 4Ts practice enabler provides a nontechnological and practical approach for the early identification of stage 1 PIs in all skin tones by examining skin tone, temperature, texture, and twinge (pain). This equity-informed comprehensive approach will impact early detection of PI, thereby triggering expedited measures for effective prevention.

Gender Equity in Women's Health and Sexual and Reproductive Health Services in Canada: Perspectives from Providers and Patients.

Purpose This study examines how non-traditional undergraduate students in online higher education environments utilize generative artificial intelligence (GenAI) as a tool to enhance academic engagement, personalize learning and improve productivity. Design/methodology/approach Using a quantitative, cross-sectional, correlational design, the study surveyed 491 non-traditional undergraduate students enrolled in online general education courses. Multiple regression analysis was conducted to evaluate how academic performance, skill confidence, technology proficiency and weekly time commitments relate to the frequency of GenAI use. Open-ended survey responses were also thematically analyzed to contextualize quantitative findings and explore student motivations, benefits and concerns. Findings Results indicate GenAI use is significantly associated with stronger academic performance and confidence in technology skills. Time constraints and lower academic confidence did not significantly predict use. High-performing and digitally proficient students were more likely to adopt GenAI to deepen understanding, generate ideas and streamline academic tasks. Qualitative responses described GenAI as a supportive thinking partner, while also highlighting ethical concerns around authorship, accuracy and academic integrity. Research limitations/implications This study examines GenAI use within a single large online university serving primarily adult, non-traditional learners in a flexible, asynchronous model. Findings should therefore be interpreted as contextually situated rather than broadly generalizable. The cross-sectional design captures adoption at an early stage and does not permit causal inference or analysis of long-term learning outcomes. Reliance on self-reported measures may introduce response bias. Future research should employ longitudinal, multi-institutional and mixed-method designs to examine how GenAI use evolves over time and how institutional context, discipline and learner demographics shape patterns of strategic AI integration. Practical implications Findings indicate GenAI adoption in online higher education is most strongly associated with digital confidence and academic motivation rather than remediation. Institutions serving adult and non-traditional learners should therefore embed structured GenAI literacy within curricula, emphasizing ethical use, critical evaluation and academic voice preservation. Faculty should design assignments that promote transparent, reflective engagement with AI tools instead of prohibition-based policies. Institutional leaders must develop coherent, context-sensitive AI frameworks and invest in digital skill development to prevent widening equity gaps as AI becomes normalized within asynchronous, autonomy-driven learning environments. Social implications As GenAI becomes integrated into online higher education, its social impact extends beyond productivity to issues of digital agency, equity and access. In adult-serving, asynchronous environments where learners self-manage academic decisions, disparities in digital fluency may amplify existing inequalities. Without intentional institutional support, students with lower technological confidence risk marginalization as AI-enhanced workflows become normative. Promoting inclusive, transparent and ethically guided GenAI integration can strengthen learner agency and participation, particularly among adult and non-traditional students balancing complex external responsibilities. Equitable AI adoption requires investment in digital empowerment alongside clear institutional standards. Originality/value This study offers contextually grounded empirical insight into how adult, non-traditional undergraduates in online higher education strategically integrate GenAI into their learning practices. By situating adoption within frameworks of technology acceptance, self-directed learning and digital agency, the findings challenge deficit-based narratives and demonstrate that GenAI use is associated with academic confidence and digital fluency rather than remediation. The study contributes student-centered evidence from an autonomy-driven, asynchronous learning environment and provides theoretically informed guidance for ethical AI integration, digital equity initiatives and future longitudinal research on AI-supported learning.

Scientific influence, or the capacity of ideas and concepts to shape future research, is crucial to developing and disseminating knowledge and sustained innovation. Here, using nearly 240 million scientific works published between 1990 and 2023 from OpenAlex to construct international networks of influence, discursive influence, which represents what global scientific communities consider important and worthy of investigation, is shown to be disproportionately and increasingly concentrated in a small group of resource-wealthy countries, including the United States, Canada, Western Europe and East Asia, in comparison to attributional influence. This concentration raises issues of equity and innovation in global scientific discourse, perhaps narrowing research perspectives, exacerbating biases and creating echo chambers that are associated with stifling innovation and marginalizing contributions from countries that are peripheral to global scientific discourse. The findings underscore the need to promote diverse and inclusive global research enterprises.

ABSTRACT Two-way bilingual education (TWBE) is a model of integrated language education with demonstrated success in supporting the academic achievement of minoritized students. Yet, there are growing critiques that TWBE programs fail to meaningfully change the structures and logics that contribute to inequitable schooling, particularly when programs also serve White students and families. With the aim of exploring how an equitable integrated language education might be possible, this article presents a case study of one equity-oriented TWBE school. Drawing upon politics of care to theorize equity work in schools, I explore how teachers, staff, and leaders at the focal school conceptualize, operationalize, and navigate issues of equity. Findings reveal five central tenets that comprise a politics of care in this TWBE school: care as (1) relational, (2) intersectional, (3) material, (4) political, and (5) dynamic. Examples of practices corresponding to each tenet are presented, alongside discussion of some tensions and challenges that arise in equity work. Ultimately, this case study reveals that integrated language education can play an important role in addressing structural inequities and promoting more equitable schooling.

ABSTRACT Conventional anthropocentric approaches to biodiversity conservation and agriculture have proven insufficient to halt biodiversity loss and climate change. This article argues that indigenous Buen Vivir approaches from the Andes and Amazon regions may contribute to current agroecology and convivial conservation practices by adding a distinct biocentric worldview. Most indigenous agricultural practices can be considered as agroecological practices. Agroecology offers an alternative vision and proposes that technology should be adapted to the specific regional, social and cultural circumstances. It aims to optimize interactions between plants, animals, humans, and the environment while addressing issues of equity and sustainability. Indigenous agroecological practices add additional – not merely technical – aspects, in the sense that they are imbedded in worldviews that are more biocentric that can benefit Western societies and may serve as a lesson for current Western agricultural practices and consequently benefit biodiversity. Therefore, a fundamentally different way of thinking – grounded in indigenous principles like mutual exchange, shared well-being, and equality – could significantly reshape how agriculture overall, and agroecology specifically, are carried out. Indigenous practices emphasize territorial autonomy, plural property and exchange relations, food sovereignty, reciprocity with nature, and agricultural systems that enhance biodiversity rather than undermine it. These include farming across ecological zones, watershed management, agroforestry, soil fertility practices such as terra preta, and mixed cropping systems. Drawing on a post-colonial critical realist framework, the article highlights the importance of recognizing indigenous knowledge systems as holistic socio-ecological, cultural, political, and spiritual systems.

ABSTRACT This article examines how minority language status and gender shape the identities and experiences of women working in Irish language broadcasting in Ireland between the 1970s and 2020s. It considers how women negotiate the dual minoritisation of being minority language speakers and women working in broadcasting. Drawing on interviews with ten women, at different career stages, the article identifies three key themes. First, women benefitted from the expansion of Irish language broadcasting especially after the establishment of Irish language television in the 1990s, finding career paths outside of those commonly available to Irish speaking women. Second, women championed Irish language broadcasting, as it sustains Irish language communities. They saw the provision and funding of it as a Diversity, Equity and Inclusion issue, more so than gender. Finally, some women were reluctant to suggest gender inequality in Irish language broadcasting but paradoxically relayed personal experiences of gender inequality especially as mothers in work, and structural issues related to gendered pay disparity. While the issues of pay disparity and women’s care roles are prominent in scholarship on media work, there has, to date, been little examination of how gender intersects with minority group status in Ireland. This article addresses that gap.

BackgroundDementia prevalence is increasing in Australia. It is unknown whether there are hotspots for dementia in metropolitan or non-metropolitan areas. This knowledge is important for healthcare planning.ObjectiveThis paper will examine where hotspots for self-reported dementia in Australia are, and whether they are adequately serviced by multidisciplinary memory clinics.MethodsWe used self-reported dementia data from the 2021 Australian Census at the local government area (LGA) level. LGAs represent public administrative regions within Australian states and territories. Standardized prevalence ratios (SPR) were calculated for each LGA by dividing the number of self-reported cases by the expected number of cases. Spatial relationships were investigated with Bayesian spatial regression using integrated nested Laplace approximations. Memory clinics were located using Australian Dementia Network and government websites.ResultsSelf-reported dementia prevalence was lower in metropolitan areas (72.3 per 10,000) compared to non-metropolitan areas (79.9 per 10,000). There are 108 multidisciplinary memory clinics in Australia, 83 of which are metropolitan. Hotspots for self-reported dementia occurred in non-metropolitan east coast of New South Wales (SPR: 2.13), southeast Queensland (SPR: 1.72), and northwest of greater city Adelaide (SPR: 2.55). LGAs in major cities had lower SPRs (Melbourne: 0.40; Sydney: 0.45), apart from Western Adelaide (SPR: 1.88).ConclusionsHotspots for self-reported dementia were mainly in non-metropolitan Australia, whereas memory clinic services were mostly in metropolitan areas, raising issues of equity and access to services.

Dynamic connectedness across U.S. state-level regional equity markets: The role of time-varying common and idiosyncratic factors

This review examines the convergence of wearable biosensors and artificial intelligence (AI) in personalized diabetes care. It addresses the limitations of traditional glucose monitoring and underscores the need for continuous, multi-analyte physiological surveillance. The manuscript evaluates multi-biofluid sensing platforms, specifically those utilizing interstitial fluid (ISF), sweat, saliva, tears, and urine. ISF, an extracellular medium and a plasma ultrafiltrate, exhibits low protein content, a property that reduces sensor biofouling. ISF glucose demonstrates a strong correlation with blood glucose (R² > 0.95) and can achieve high analytical sensitivity and specificity in clinically validated systems; however, diffusion-based time lags of 5-10 min present a kinetic challenge. Consequently, AI correction is necessary to ensure real-time accuracy, which is often achieved through minimally invasive microneedle arrays. Sweat analysis allows for non-invasive, multi-parameter measurements. Nevertheless, challenges such as pH instability and analyte loss due to evaporation complicate this sensing approach. Therefore, microfluidic techniques are essential for maintaining sample stability. A primary finding indicates that clinically validated Continuous Glucose Monitoring (CGM) systems yield substantial improvements in glycemic control, increasing Time in Range (TIR) by 10-15% and reducing the incidence of hypoglycemic events by 30-40%. AI-based predictive algorithms can forecast glucose excursions 30-60 min in advance, exhibiting an accuracy exceeding 94%. Key barriers to implementation include sensor calibration challenges, algorithmic bias, and significant healthcare equity issues. Future research should prioritize the development of multi-analyte implantable devices, leverage federated learning frameworks, and incorporate additional biomarkers to deliver continuous, multi-analyte, skin-conformal monitoring.

This commentary provides contextual information to support interpretation of new guidance for the use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence-to-decision (EtD) framework for environmental and occupational health (EOH) METHODS: Based on a systematic review and narrative synthesis of EOH decision frameworks, and input from subject matter experts in environmental health and GRADE, we developed and pilot-tested an EOH framework through a series of virtual workshops. The resulting guidance was approved by the GRADE Working Group in May 2023. The new EtD framework for EOH follows the same structure as the existing EtD frameworks, including a scoping and contextualization process and 12 assessment criteria. Modifications to the framework to improve applicability for the EOH context include changes to terminology, tailoring of the framework detailed judgments (eg, broadening the scope of the equity decision criterion to include nonhealth equity issues), and guidance for users (eg, emphasis on the scoping phase of the guideline development process).

The aim of this mixed methods systematic review was to identify oral health interventions in rural areas of high-income countries and synthesise the evidence on how access is addressed. Searches were conducted in Cochrane, CINAHL, Dentistry and Oral Sciences Source, PsycINFO and PubMed, with the last search in January-February 2025. All study types published in English since 2000 were included that reported oral health interventions aimed at addressing access to dental services. The Mixed Methods Appraisal Tool was used to assess study quality. The Penchansky and Thomas model of access, with Saurman's adaptation, guided the thematic synthesis. The final dataset was 73 articles. Most authors reported small-scale interventions delivered by dental and primary health providers. Fluoride varnish application, treatments and health promotion were most reported in clinics, community settings and schools. Lack of service availability and accessibility caused by geographic distance required alternative service models, including telehealth. Free or minimal cost interventions were needed in low-income settings. Stakeholder partnerships and understanding of local context were critical. Evaluations of community acceptability and awareness were rare. There was a dearth of studies addressing the six dimensions of access, with wide variation in study quality. There is an absence of robust, well evaluated studies, with lack of homogeneity preventing meta-analysis. Rural oral health interventions should be informed by comprehensive frameworks of access, be grounded in equity, involve communities in design, development and evaluation, should reduce silos between oral and general healthcare, and should prioritise prevention. Access to high quality oral health is a fundamental human rights and equity issue for rural people.

Reliable paratransit services are essential for urban mobility, particularly for individuals with disabilities who depend on demand-responsive transportation. However, service inefficiencies in urban paratransit systems, such as travel time variability, congestion impacts, and scheduling constraints, continue to pose significant challenges. This study introduces a multitier analytical framework that integrates spatial–temporal modeling, machine learning–based outlier detection, and causal inference to systematically evaluate the reliability of paratransit services in an urban context. Leveraging trip transaction data from a metropolitan paratransit system, we develop the paratransit efficiency index (PEI) to assess travel time reliability at both system-wide and individual trip levels. We then analyze PEI's spatial–temporal variability using geographically and temporally weighted regression and identify outlier trips with high PEI using XGBoost to pinpoint service unreliability and systemic inefficiencies. Later, we utilize causal inference techniques to show that peak-hour pick-ups causally contribute to travel time inefficiency (a 19.4% relative increase in outlier probability), whereas subscription-based bookings causally improve service consistency (a 33.9% relative decrease). The findings provide actionable insights for urban planners and transit agencies to optimize scheduling, mitigate congestion effects, and explore innovative strategies such as integrating transportation network companies for high-cost or unreliable trips. By addressing critical urban transportation equity issues, this study offers data-driven solutions to enhance the efficiency and resilience of paratransit services in growing metropolitan areas.

Background: Diversity in academia promotes research that can reduces health disparities and addresses equity issues for marginalized populations. This study aims to examine the effect of visible minority status on academic achievements in cancer physicians and scientists. Methods: Faculty at the tertiary cancer center in Calgary, Alberta, Canada, completed a survey in 2023 to evaluate demographics, academic rank, leadership positions, number of trainees mentored, number of publications, and amount of grant funding. Chi-square tests and regression analyses examined the impact of race and ethnicity on these academic achievements. Results: The survey was completed by 74 faculty members (47% male, 43% female, 9% gender fluid or providing no answer) with a response rate of 26%. Seven percent were Black or Latin American, 18% East Asian or Southeast Asian, 19% West or South Asian, 39% Caucasian, 6% mixed race, and 11% not providing an answer. Visible minorities were underrepresented in the full professor rank (19%) compared to non-visible minorities (38%) and were overrepresented in assistant/associate professors (28% and 53%, respectively), with 41% of non-visible minorities having the title of assistant professor and 21% as associate professor (p = 0.02). Visible minorities were less likely to have both parents college-educated (OR 0.30, 95% CI 0.09-0.92, p = 0.042) and also less likely to have been raised in a home with household income above $100,000 (OR 0.26, 95% CI 0.07-0.90, p = 0.040). Discussion: Visible minorities are underrepresented in the full professor academic rank. Larger studies are needed to evaluate whether race and ethnicity significantly impact achievements in oncology academics.

Racial and ethnic disparities in traffic stop outcomes remain a persistent issue in U.S. policing. There is a link between a driver’s race and gender, with male Black and Latino drivers being arrested at higher rates than white drivers. Literature suggests time of day influences arrest outcomes. This study examines whether racial and ethnic disparities in arrest outcomes in traffic stops vary by time of day in Travis County, Texas. Data from Austin’s Racial Profiling Dataset were analyzed using a binomial logistic regression (n = 44,316). Black (OR = 3.17) and Latine drivers (OR = 2.28) had higher odds of arrest compared to white drivers0. A race and ethnicity and nighttime interaction showed disparities differed under reduced visibility. Findings highlight traffic stops and subsequent arrest as a racial equity issue.

IntroductionInclusion of older adults in research ensures both equity and relevance. We used National Institute of Health and Care Research Year of Birth data to describe inclusion of older adults in contemporary UK clinical research.MethodsWe worked with English research networks to collect individual participant level data on recruits into National Institute of Health and Care Research portfolio studies. We used data from 2022–2023 to 2023–2024 to assess participation. We described data in terms of geography, primary speciality managing the study and study characteristics. In subgroup analyses, we assessed inclusion of the ‘oldest old’ (aged over 85 years) and inclusion in research from three exemplars: heart failure, Parkinson’s disease and palliative care.ResultsIn total, 455 734 participants were included in the analyses. The most common age group included in UK research was 65–74 years (15.5%). People aged over 85 years were 3.2% of all recruits, and this proportion decreased over time. There was modest geographical variation in participant age but marked variation by recruiting speciality. People aged over 85 years accounted for less than 5% of the total participants recruited in 9 of 14 specialities assessed. Older adults were less likely to be recruited into commercial studies. For three conditions of interest, recruitment did not match population epidemiology.ConclusionThis project has demonstrated feasibility of collecting participant age data at scale and provides important metrics for understanding study participation. While there is scope to improve older adult participation across all the study portfolio, there are major equity issues around inclusion in certain speciality areas and commercial research. To complement this abstract, a video abstract is available online.

ABSTRACT While the colonial legacy continues to linger in the socio-cultural domain, the influence of geopolitical power blocs has dramatically escalated due to the geostrategic location of Sri Lanka. The primary objectives of the present study were to identify the key causes behind the language policy and planning issues in Sri Lanka from a historical perspective and to examine their subsequent consequences on the current language ecology of the country. By using process tracing, the study has triangulated the interplay of colonial, postcolonial, and contemporary trajectories related to language planning, policy, and education. Mapping the local issues alongside the success stories of the Global South and South East Asia, the study proposes several conceptual insights in working towards a sustainable language policy and planning framework for Sri Lanka. The study underscores the need for comprehensive surveying of the current language ecology as the cornerstone move towards such a framework. Exploring the potentials of translanguaging is put forward as an effort towards both decolonizing language education and confronting the identity and iniquity crises in Sri Lanka while moving beyond the rigid binary oppositions and facilitating fluid use of multilingualism would potentially be instrumental in curbing the long-drawn language equity issues.

Robust evidence is required to support decision-making about incorporating genomics into healthcare; patient perspectives are crucial. Prior studies centre on people giving research consent for testing, yet significant differences between research and clinical cohorts are well established. We investigated 1690 patients offered genomic testing during clinical care by a range of medical specialists, for rare diseases and cancer. Ninety per cent (1515) accepted testing. Of 74 decliners providing their reasons, 20 gave genomic-specific concerns. Impact and experiences of care were captured using surveys after consent (S1:RR 73%) and return of results (S2:RR 53%). We actively included those often missing from research, e.g. 8% of S2 respondents accepted telephone assistance-typically with interpreters - to complete surveys. Those who spoke English as an additional language were less likely to have received enough information at pre-test counselling (88% v 96%) and less likely to correctly answer questions about potential genomic test results. After receiving results, 10% (52/534) of respondents had moderate-high decision regret; predictors included English as an additional language and not receiving enough information at consent. Value from testing was quantified and compared: those with informative results valued their medical and personal utility; those with uninformative results derived social utility. Perceived personal control increased post-result for those with diagnostic results and decreased for those with uninformative results. Our results expand the evidence base available for genomic health technology assessment. On balance, genomic test results provide more value than harm, but equity issues need to be addressed to ensure all patients can benefit.