Introduction: This article discusses social inclusion as a very important factor in public health that affects well-being and health equity. Objective: Analyze the role of social inclusion in public health and its relationship with social determinants and living conditions. Methodology: A literature review was conducted using the terms “social integration AND public health” and “social inclusion AND public health.” Results: Low social integration increases health inequalities by up to three times, while community participation improves well-being by 26%. Vulnerable groups experience more than 60% exclusion, confirming its impact as a critical determinant in public health. Conclusion; This study shows that social inclusion allows us to understand and address health inequalities, promoting more equitable systems. Further research is recommended to ensure inclusion and justice in healthcare. KEY WORDS: Social adjustment, social change, public health, health equity.

This article explores how e-commerce – particularly social commerce – is empowering women small entrepreneurs in developing countries to become ‘digital entrepreneurs’. Focusing on Ghana and Senegal, it examines how women-owned businesses are leveraging social media platforms to participate in both domestic and cross-border trade, opening new pathways to economic and social inclusion. Despite its rapid growth, social commerce remains under-researched and largely overlooked by policymakers. Responding to this gap, the study draws on regional data on internet access and digital use across gender and age groups, as well as insights from an original survey of ninety-nine micro and small entrepreneurs in the two target countries. It sheds light on the socioeconomic profiles of women-led digital businesses and evaluates the opportunities and barriers they face when using social commerce – from business performance to impacts on women’s economic independence, agency, and self-esteem. The article concludes with policy recommendations to better support this dynamic yet underserved segment of the digital economy.

Social enterprises are increasingly recognized for their potential to foster social inclusion and sustainable tourism by embedding economic activities within local communities. While existing literature often focuses on the measurable impacts of these initiatives, less attention has been paid to how social enterprises construct and narrate their own roles within complex territorial contexts. This study adopts an interpretive approach to study how the social enterprise Variabile K, based in Herculaneum, Italy, frames its mission and practices as tools for transforming the city's tourism model. Through a thematic analysis of qualitative interviews with enterprise members, the paper identifies five key dimensions: the contradictions of Herculaneum's landscape, the dual nature of tourism, the enterprise's commitment to community-based tourism, the role of collaborative networks, and future opportunities and challenges. Findings indicate that Variabile K challenges the dominant “hit-and-run” tourism model by promoting experiential, relational, and locally embedded activities. Through partnerships with schools, local businesses, and third-sector organizations, it fosters a participatory tourism model that enhances social cohesion and expands economic opportunities for residents. Nevertheless, structural limitations—such as weak institutional support, inadequate infrastructure, and exclusion from mainstream tourism circuits—continue to hinder its development. While social entrepreneurship offers a promising alternative for sustainable tourism, its consolidation requires greater policy recognition, institutional alignment, and long-term investment. The case of Variabile K contributes to broader debates on social innovation in tourism, emphasizing the importance of locally grounded, inclusive strategies for urban regeneration and cultural valorization. • Social entrepreneurship fosters inclusive and sustainable tourism in Herculaneum. • Variabile K challenges mass tourism by promoting community-based experiences. • Local collaborations enhance cultural heritage and social cohesion in tourism. • Institutional barriers limit the scalability of socially driven tourism models. • Policy support is crucial for integrating social enterprises into tourism strategies.

How government AI employees shape public participation perception: Evidence from "Shen Xiao-i" in Shenzhen.

Suburbs are often characterized by a scarcity of mobility options to access services. Introducing microtransit is a promising way to improve public transport in suburbs, ensuring greater social inclusion and connecting isolated areas to main transit hubs. The paper aims to develop a multi-step GIS-based methodology for designing semi-flexible stop-based microtransit, having fixed routes and flexible routes (detours) and operating with real-time ride bookings (zero lead time). We considered a suburban area in Palermo, Italy, as study area. The identification of fixed and flexible routes was based on the forecasted passenger flows, through the estimate and the assignment of the daily origin-destination matrix for microtransit, also considering safety, spatial, and technical constraints. A small-scale pilot was carried out between November and December 2022 to test microtransit routes and the reliability of a mobile application to operate the service. A customer satisfaction and a willingness-to-pay survey were addressed to the users. The small-scale pilot showed that microtransit could improve public transportation in suburbs, being more accessible and reducing waiting times at stops. Particularly, the result of the design process led to a semi-flexible service accessible by 90 % of the resident population and with waiting times of less than 15 min in 76 % of the rides, lower than those currently experienced by bus users (20 min).

What Matters to Residential Long-Term Care Residents: Contextualizing Perceptions of Person-Centered Care.

Social inclusion of parents of children with autism spectrum disorder (ASD) affects their well-being and caregiving capacity. However, evidence on its factors remains limited in China. This study aimed to assess the social inclusion of parents of children with ASD and identify key factors, with attention to gender differences. 1007 parents were enrolled from 33 rehabilitation centers in Hunan, China. Self-reported psychometric scales and a revised Chinese Social Inclusion Scale were used. Guided by the ecological model, univariate and multivariate regression analyses were performed to identify factors associated with social inclusion. Subgroup analyses and interaction effect tests were carried out to explore potential gender differences. At the individual level, higher education (B = 1.764, P = 0.02), self-esteem (B = 0.472, P < 0.001), and hope (B = 0.139, P = 0.03) demonstrated positive associations with social inclusion. At the external level, intergroup relations (B = 0.271, P = 0.001) and social support (B = 0.238, P < 0.001) showed significant positive associations, while perceived discrimination (B=-0.189, P < 0.001) exhibited a significant negative association. Gender subgroup analyses showed fathers' inclusion was mainly influenced by self-esteem and social support, while mothers' patterns aligned with the overall group, except hope was not significant. Both psychological and social factors influence the social inclusion of parents of children with ASD, with gender-specific patterns. To enhance social inclusion of parents, healthcare providers could consider gender-responsive approaches that strengthen psychological resources while addressing external barriers.

ABSTRACT Despite rapid railway expansion across Africa, integrated impact appraisals remain limited. This study evaluates Kenya’s Standard Gauge Railway (SGR) using a multidimensional framework that links financial performance to social welfare and environmental outcomes. Cost-Benefit Analysis is operationalised through three linked Net Present Value (NPV) models (monetary, socio-economic, and Decoupled Net Present Value) applied to both completed and proposed corridor sections. Spatial interaction modelling simulates passenger and freight flows for incomplete segments, while the DNPV framework decouples risk and inflation by treating risk as an explicit cost. Results show consistently positive NPVs, with social user benefits, employment and inclusion effects, and carbon emission reductions substantially reinforcing modestly positive financial performance. The analysis also highlights exposure to governance, fiscal, and environmental risks, underscoring the need for targeted mitigation and robust implementation that safeguards distributional outcomes and environmental performance over the project life cycle. By explicitly valuing carbon, accessibility, and jobs alongside financial flows, and by treating socio-environmental effects as core benefit streams rather than ancillary co-benefits, the paper demonstrates how CBA can be embedded within broader environmental and social appraisal, advancing integrated methods for project evaluation in the Global South.

Understanding frailty in adolescents with congenital heart disease: A dyadic phenomenological study.

This policy commentary argues that forecasting and supply planning (FSP) for immunization systems must integrate gender equity and social inclusion (GESI) to bridge the gap between vaccine supply and actual utilization. While FSP traditionally focuses on supply-side efficiency, this narrow approach risks perpetuating inequities by leaving systematically excluded populations invisible in data and planning processes. Drawing on experience from the Immunization Collaborative Supply Planning Strengthening project, we demonstrate how contextual factors including gender dynamics, mobility patterns, seasonality and conflict shape vaccination demand among marginalized communities. The commentary outlines key practice implications, including strengthening supply-demand collaboration, embedding GESI expertise into FSP teams and improving data disaggregation. We conclude that this integration is essential to transforming forecasting into an inclusive mechanism that ensures equitable immunization access.

Abstract: Conversational agents (CAs) are increasingly used to promote mental health, well-being, and social inclusion among adolescents. Despite growing interest, a comprehensive understanding of their effectiveness within an ecological perspective remains limited. This scoping review explored the existing literature on the impact of chatbots and virtual assistants on adolescents aged 10–25 years, adopting an ecological perspective. Following PRISMA guidelines, 56 studies published between 2011 and 2024 were identified across six electronic databases. Data extraction and thematic analysis highlighted that the majority of studies targeted symptom reduction (e.g., anxiety, depression), using CBT-based approaches and showing short-term positive effects. Fewer studies addressed social inclusion and well-being through positive psychology and mindfulness frameworks. Methodological heterogeneity limited longitudinal designs, and the dominance of Western samples was identified as a common limitation. Conversational agents show promise in promoting adolescent mental health and social inclusion. Future research should prioritize longitudinal designs, culturally sensitive adaptations, and standardized outcome measures to enhance the robustness and generalizability of findings.

This study examines the structural dilemmas and optimization pathways for digitally integrating urban-rural public services through a collaborative governance lens, using South Korea as a critical case. Despite possessing world-class digital infrastructure, Korea's digital-driven integration process remains mired in deep-seated collaborative failure across four dimensions: design, provision, governance, and institutional support. Drawing on New Public Service and Collaborative Governance theories, this research constructs a 4C analytical framework to systematically diagnose these failures and their underlying causes. The findings reveal a fundamental paradox: technological advancement does not automatically translate into governance effectiveness or social inclusion. The success of digital integration fundamentally depends on the congruent evolution of institutions, mechanisms, and social capital. Based on this diagnosis, the study proposes an integrated optimization pathway encompassing mandatory digital inclusion mechanisms, multi-actor provision ecosystems, hybrid governance systems, and robust institutional foundations. These interconnected strategies offer a coherent blueprint for transitioning from techno-centric governance toward a genuinely inclusive, responsive, and sustainable digital future.

Breaking Barriers To Social Inclusion: the Mediating Role of Reduced Discomfort in the Relationship between Service-learning and Inclusivity Attitudes

ABSTRACT Land degradation, climate variability, and socioeconomic marginalization are increasingly intertwined challenges across Sub‐Saharan Africa (SSA), undermining food security, rural livelihoods, and ecological stability. This study develops a comprehensive decision‐support framework to identify and prioritize sustainable intervention strategies addressing the nexus between land degradation, poverty, and migration. Using a hybrid multi‐criteria decision‐making approach integrating the Delphi method, Fuzzy Analytical Hierarchy Process (Fuzzy AHP), and Fuzzy VlseKriterijumska Optimizacija I Kompromisno Resenje (Fuzzy VIKOR). The Delphi process was conducted over three iterative rounds to refine the criteria, sub‐criteria, and strategies. The Fuzzy AHP analysis identified the environmental (weight = 0.214), social (weight = 0.191), and marginalization (weight = 0.175) dimensions as the most influential criteria. The environmental dimension emphasized ecosystem integrity, soil productivity, and vegetation health as foundations for agricultural stability and ecological resilience. The social dimension highlighted community cohesion, adaptive capacity, and institutional support as key determinants of household vulnerability and migration decisions. The Fuzzy VIKOR analysis further prioritized intervention alternatives, identifying Migration Management and Social‐Protection Mechanisms (Q = 0.019), Livelihood Diversification and Non‐Farm Employment (Q = 0.029) as the top strategies offering the most balanced compromise between sustainability, feasibility, and social inclusiveness. These findings emphasize that effective responses to land degradation must integrate livelihood security and migration‐sensitive measures alongside ecological restoration.

Technology usage in education has been a subject of scrutiny in recent years, especially after the “forceful” adoption of educational technologies by higher education institutions, which were otherwise largely reliant on traditional face- to-face modes of teaching and learning, during and after the COVID-19 pandemic. Recent debates imply that the adoption of educational technologies seemingly presents a paradoxical situation as, on one end of the spectrum, they outwardly promote social inclusion in the process of teaching and learning while, on the other end, they ostensibly evince categorical social inequalities that translate into unequal access to education. This article explores the implications of adopting educational technologies on equality and educating justice in one higher education institution in Lesotho, with emphasis on the concept of social inclusion/exclusion. This article was undergirded by the pragmatic paradigm, with students purposively sampled to generate data through open-ended questionnaires. The Conceptual Framework of Digital Inclusion was used to frame this study. Findings suggest that the adoption of educational technologies perpetuates pre-existing inequalities in education, especially between the “haves” and the “have-nots” in society. This suggests that achieving equality and educating justice in a disparate socio-economic context requires a deliberate and concerted effort from higher education institutions in developing policies and adapting practices that exalt equitable and inclusive use of educational technologies.

ABSTRACT In rural areas, limited economic resources for promoting cultural activities often constrain opportunities for leisure and social participation. In Andalusia (Spain), numerous women’s associations were founded in the late 1980s as a response to this scarcity and to the persistence of highly masculinised public spaces. Based on a qualitative fieldwork involving six focus groups, this study examines the role of rural women’s associations as spaces of leisure, rootedness and empowerment. Findings reveal how associational dynamics shape everyday practices that range from recreational and cultural activities to mutual support and social inclusion. By engaging in collective leisure, women transform these spaces into sites of social well-being and feminist agency, enabling the construction of new forms of visibility and citizenship in territories marked by depopulation and social isolation.

Although innovation is critical to economic development, its measurement in emerging markets remains a theoretical and practical challenge, given the difficulty of capturing context-specific features with conventional metrics. Accordingly, this study aims to compare how firm-level innovation outcomes are measured in developed and developing countries. Drawing on a systematic literature review of 84 empirical articles and guided by the Oslo Manual (2018), we identify profound structural asymmetries. The results indicate that, whereas developed countries predominantly employ financial and technical-efficiency metrics, developing countries increasingly rely on multidimensional indicators oriented toward sustainability, social inclusion, and organizational capabilities. We thus conclude that the uncritical transfer of “Global North” models generates measurement error by overlooking informality and frugal innovation. The study contributes by demonstrating the need for a multiscalar analytical approach (micro, meso, and macro) to capture the real impact of innovation in the “Global South,” integrating institutional and ecosystem determinants into firm performance.

Brugian filariasis continues to affect marginalized populations in central coastal Kerala, causing chronic disability despite effective disease control. To address this, a vocational rehabilitation initiative under the Morbidity Management and Disability Prevention program was launched in Cherthala taluk to promote economic self-reliance and dignity through microfinancing and livelihood support. The objective of this study was to determine the impact of this initiative on the quality of life (QoL) of disabled filarial lymphoedema patients in Cherthala taluk, South India. A sequential explanatory mixed methods study was conducted among disabled filarial lymphoedema patients across eight different localities of Cherthala taluk. Appropriate statistical tests were used to analyse the quantitative data while a thematic framework approach was used to assess the qualitative data. The study included 40 disabled filarial lymphoedema patients whose mean age was 65.03±7.3y and 52.5% were females. The mean QoL scores showed a significant difference compared with those with moderate-grade lymphoedema in the Lymphatic Filariasis Specific Quality of Life Questionnaire domains of usual activities and disease burden. After rehabilitation, there was a statistically significant increase in the monthly income of the beneficiaries. The main themes that emerged following the qualitative analysis were economic impact, psychological impact and social impact. The vocational rehabilitation initiative significantly enhanced the QoL of filarial lymphoedema patients by fostering economic independence, psychological well-being and social inclusion. These findings highlight the need for holistic, community-based approaches in chronic disease rehabilitation and reintegration efforts.

Background: Although leprosy ceased to be a global public health problem in 2000, some countries are still reporting new cases. Aim: To evaluate progress towards the interruption of leprosy transmission, and its elimination, in the Eastern Mediterranean Region. Methods: We extracted and analysed leprosy data for 2012–2023 for the Eastern Mediterranean Region countries from the WHO Global Health Observatory. We calculated the new case detection rates, the Grade 2 disabilities case rates and the new child cases per million population. Results: New case detection rate increased from 3.7 per million population in 2012 to 6.0 in 2018 and then decreased to 3.6 in 2023. Among children aged &lt; 15 years, new case detection rate increased from 0.6 cases per million in 2012 to 1.3 in 2017 and then decreased to 0.5 in 2023. The proportion of females among new cases increased from 34.4% in 2012 to 42.0% in 2023. Grade 2 disability rate decreased from 0.5 cases per million population in 2012 to 0.3 in 2023. By 2023, Egypt, Pakistan, Somalia, Sudan, and Yemen accounted for 94% of cases. Thirteen countries reported 0–10 new autochthonous cases annually. The proportion of non-autochthonous cases increased from 3.4% in 2016 to 4.2% in 2023. Conclusion: Some Eastern Mediterranean Region countries are progressing towards the elimination of leprosy. The decrease in leprosy cases among children in the region indicates a reduction in active transmission. Continuous investment by all the countries will enhance early diagnosis and detection, ensure effective disease management and promote social inclusion as outlined by the WHO global leprosy strategy.

Objectives Social isolation among older individuals whose living environment is changing is an issue that should be addressed. Retirement, social inclusion (SI), and building connections with community-dwelling individuals are important for preventing social isolation. Particularly in the case of older adults, it is important to clarify their subjective connections with community-dwelling individuals to build connections with them. The aim of this study was to clarify older adults' perceptions of community-based connectedness and related factors.Methods The participants, 800 men and women in their 70s and 80s living in urban areas, were surveyed in February 2024 using a self-administered, anonymous postal questionnaire. The survey items included attributes, perceptions of community-based connectedness, social networks (SN), SI, and community relationships. Multiple regression analysis using the forced entry method was conducted, with perceptions of community-based connectedness with people as the dependent variable; SN, SI, and community relationships as independent variables; and attributes as covariates.Results We collected 338 questionnaires and 316 valid responses (valid response rate: 39.5%). The participants' mean age was 79.0 ± 5.4 years, and 172 (54.4%) were men. The mean score for perceptions of community-based connectedness with people was 83.4 ± 17.6, with minimum and maximum scores of 36 and 131, respectively. Multiple regression analysis showed that SN (standardized partial regression coefficient (β) = 0.124, P = 0.012) and SI "connectedness" (β = 0.132, P = 0.023), SI "participation" (β = 0.100, P = 0.047), and community relationships (β = 0.469, P < 0.001) were significantly asso-ciated with perceptions of community-based connectedness with people.Conclusion The subjective connectedness of older adults was related to the objective connectedness of SN and SI in terms of "connectedness" and "participation." The results suggested that the perception of the community as a whole as connected is related to older adults' perceptions of community-based connectedness with people. We concluded that the spread of individual behaviors within the community and improvements in overall community quality are linked to perceptions of community-based connectedness.