OBJECTIVE: Following an injury or disease, physical medicine and rehabilitation (PM&R) services are often necessary to help patients recover function, activity, and community participation. Ten years ago, there was a significant gap between PM&R services in central Israel and those in the rural north of the country in terms of quality, quantity, and layout. The purpose of this administrative case report is to outline the gap in PM&R services between regions in Israel, as portrayed above; to describe a decade of civil action; and to describe civil action administrative approaches and actions that contributed to changes in the PM&R services now available in northern Israel.
METHODS: A decade of civil action to promote PM&R services is reviewed, illustrating the main administrative steps, including initiating and organizing meetings with key partners, lobbying, testifying in front of parliament and government committees, garnering media attention to promote public awareness, and filing a case with the Supreme Court of Israel. The encountered challenges and the subsequent actions are also described.
RESULTS: Awareness of the significance of PM&R services and of the inadequacy of such services in the northern part of Israel rose due to our actions, with practical field results, including an 180-bed government rehabilitation center that plans to open during 2024, and 5 daycare rehabilitation clinics and a private inpatient center that opened between 2020 and 2023. Data-driven research will aid in understanding the current gaps and tracking improvements with the opening of the new rehabilitation facility.
CONCLUSIONS: When inequality is brought to light, and legislation for equality exists, civil action can promote change to reduce these gaps.
UNASSIGNED: Others can follow the steps taken in this administrative case report to achieve success in struggles aiming to correct comparative inequality.

This field note examines the disaster risk construction process in Lima, Peru. More commonly experienced hazard contexts are considered in the light of the COVID-19 pandemic. We provide an empirical analysis based on Lima-wide data and using findings from a single case study settlement to illustrate more general conclusions. We attempt to reveal how exposure and vulnerability factors signify that very different hazards, including COVID-19, predominantly affect the same population groups. Underlying causes and drivers, all related to different expressions of urban inequality, include problems of access to suitable urban land, land trafficking and invasion, State exclusion from social housing and basic services, unsafe building practice and corruption. The research confirms the usefulness of a social construction approach to disaster risk, based on the notion of underlying causes and drivers, and the need to reconfigure urban planning processes, breaking sector silos and encouraging integrated intersectoral and interspatial approaches.

This article examines the intersection of two structural developments: the growth of surveillance and the rise of \"big data.\" Drawing on observations and interviews conducted within the Los Angeles Police Department, I offer an empirical account of how the adoption of big data analytics does-and does not-transform police surveillance practices. I argue that the adoption of big data analytics facilitates amplifications of prior surveillance practices and fundamental transformations in surveillance activities. First, discretionary assessments of risk are supplemented and quantified using risk scores. Second, data are used for predictive, rather than reactive or explanatory, purposes. Third, the proliferation of automatic alert systems makes it possible to systematically surveil an unprecedentedly large number of people. Fourth, the threshold for inclusion in law enforcement databases is lower, now including individuals who have not had direct police contact. Fifth, previously separate data systems are merged, facilitating the spread of surveillance into a wide range of institutions. Based on these findings, I develop a theoretical model of big data surveillance that can be applied to institutional domains beyond the criminal justice system. Finally, I highlight the social consequences of big data surveillance for law and social inequality.

In recent years, the global health community has increasingly reported the problem of \'invisibility\': aspects of health and wellbeing, particularly amongst the world\'s most marginalized and impoverished people, that are systematically overlooked and ignored by people and institutions in relative positions of power. It is unclear how to realistically manage global health invisibility within bioethics and other social science disciplines and move forward. In this letter, we reflect on several case studies of invisibility experienced by people in Brazil, Malaysia, West Africa and other transnational contexts. Highlighting the complex nature of invisibility and its interconnectedness with social, political and economic issues and trends, we argue that while local and targeted interventions might provide relief and comfort locally, they will not be able to solve the underlying causes of invisibility. Building from the shared lessons of case study presentations at an Oxford-Johns Hopkins Global Infectious Disease Ethics Collaborative (GLIDE), we argue that in dealing with an intersectional issue such as invisibility, twenty-first century global health bioethics could pursue a more \'disturbing\' framework, challenging the narrow comforting solutions which take as a given the sociomaterial inequalities of the status quo. We highlight that comforting and disturbing bioethical frameworks should not be considered as opposing sides, but as two approaches working in tandem in order to achieve the internationally set global health milestones of providing better health and wellbeing for everyone. Insights from sociology, anthropology, postcolonial studies, history, feminist studies and other styles of critical reasoning have long been disturbing to grand narratives of people and their conditions. To rediscover the ethos of the WHO Alma Ata Declaration-a vision of \"health for all by the year 2000\"-these thinking tools will be necessary aids in developing cooperation and support beyond the narrow market logic that dominates the landscape of contemporary global health.

Market concentration among buyers of recycled materials is a phenomenon discussed since the 1980 s by the anti-trust literature. Yet, there is still a lack of studies on simultaneous market concentration on both the supply and demand sides. This is particularly relevant when Extended Producer Responsibility (EPR) policies produce two-sided waste generation and valorisation markets. Thus, the purpose of this study is to explore the link between market concentration on the generation side and market share on the valorisation side. Specifically, this research addresses the case of valorisation of commercial and industrial non-hazardous waste in Chile. The analysis covers 261 companies that valorised industrial and commercial non-hazardous waste between 2015 and 2019. Being part of the top 10 % of generator companies in Chile is significantly correlated to higher valorisation market share, in a context in which mean market share per company decreased, total tons valorised stagnated, and the country-level valorisation rate diminished.

This study documented existing knowledge on traditional fruits, vegetables and pulses in Kenya and Ethiopia. The aim was to identify neglected and underutilized species with high potential for food security, for their economic value and contribution to sustainable agriculture, based on a literature review and confirmation of existing data by local experts. In order of priority, the top 5 fruit species in Kenya are Tamarindus indica L., Adansonia digitata L., Sclerocarya birrea (A.Rich.) Hochst, Balanites aegyptiaca (L.) Delile, and Ziziphus mauritiana Lam., for vegetables are Amaranthus spp., Vigna unguiculata (L.) Walp., Solanum spp., and Cleome gynandra L. Top fruits in Ethiopia are Balanites aegyptiaca (L.) Delile, Ziziphus spina-christi (L.) Desf., Cordeauxia edulis Hemsl., Cordia africana Lam., and Mimusops kummel A. DC., for vegetables are Brassica carinata A. Braun, Cucurbita pepo L., and Amaranthus spp. In both countries, priority pulse species (no ranking) are Phaseolus lunatus L., Sphenostylis stenocarpa (A.Rich.) Harms, Mucuna pruriens (L.) DC., Lablab purpureus (L.) Sweet, and Cajanus cajan (L.) Millsp. Generally, these priority species are good sources of key nutrients known for their inadequate dietary intakes in sub-Saharan Africa, represent a safety net for household income, and contribute positively to ecosystem resilience in existing agricultural systems. Complete, accurate and reliable nutrient composition data are needed to raise consumer awareness about their nutritional and health benefits. Since women play a central role in traditional food systems, their empowerment, and hence resilience, increase the positive impact they can have on the households\' dietary diversity. In particular, introducing small-scale processing techniques and marketing strategies could enhance their supply and consumption.

BACKGROUND: Few studies have focused on the spatially clustered regions in the association between short-term exposure to temperature and mortality, which is important for identifying high-susceptibility population and enhancing the prevention of high/low temperatures. Previous studies have explored the association inequality, but no study has evaluated the inequalities of temperature-attributable burdens, which may be more meaningful for reducing temperature-related regional inequality.
METHODS: Taking the Sichuan Basin (SCB), an economically imbalanced area with high humidity and four distinctive seasons, as an example, we used a novel multi-stage strategy to investigate the two issues. First, distributed lag nonlinear models were independently constructed to obtain the county-level associations between daily temperature and cardiorespiratory mortality. Then, an estimation-error-based spatial scan statistic was used to detect the association-clustered regions. Third, multivariate meta-regression incorporating the identified clustered regions and socioeconomic and natural factors was used to obtain stable county-specific associations, based on which the heat- and cold-attributable deaths were mapped and their inequalities were evaluated using concentration indices and Lorenz curves.
RESULTS: On average, a U-shaped temperature-mortality association was examined. A significantly association-clustered region was detected (P = 0.017), in which heat and cold temperatures presented significantly stronger associations than those in the non-clustered region, particularly for heat temperatures. The cold-attributable deaths (3.5%) were substantially more than the heat-attributable deaths (0.5%). Both presented severe inequalities over counties. Significant temperature-attributable inequalities were also found over per-capital public budget, urbanization rate, employment rate and per-capital GDP. The directions of inequalities over GDP and urbanization rate were opposite between heat and cold temperatures.
CONCLUSIONS: Our analysis provided the first evidence about the clustering of temperature-mortality associations and the inequality of cold- and heat-attributable burdens. Significantly association-clustered regions and heavy temperature-attributable inequalities were found in the SCB. Rural people bore heavier cold-attributable but less heat-attributable mortality risk than urban people, suggesting that different policies should be designed to reduce the temperature-attributable inequalities for heat and cold temperatures and different regions. This novel strategy can provide an interesting new perspective in the association between environmental exposure and human health.

BACKGROUND: There is an important gap in the literature concerning the level, inequality, and evolution of financial protection for indigenous (IH) and non-indigenous (NIH) households in low- and middle-income countries. This paper offers an assessment of the level, socioeconomic inequality and middle-term trends of catastrophic (CHE), impoverishing (IHE), and excessive (EHE) health expenditures in Mexican IHs and NIHs during the period 2008-2020.
METHODS: We conducted a pooled cross-sectional analysis using the last seven waves of the National Household Income and Expenditure Survey (n = 315,829 households). We assessed socioeconomic inequality in CHE, IHE, and EHE by estimating their Wagstaff concentration indices according to indigenous status. We adjusted the CHE, IHE, and EHE by estimating a maximum-likelihood two-stage probit model with robust standard errors.
RESULTS: We observed that, during the period analyzed, CHE, IHE, and EHE were concentrated in the poorest IHs. CHE decreased from 5.4% vs. 4.7% in 2008 to 3.4% vs. 2.9% in 2014 in IHs and NIHs, respectively, and converged at 2008 levels towards 2020. IHE remained unchanged from 2008 to 2014 (1.6% for IHs vs. 1.0% for NIHs) and increased by 40% in IHs and NIHs during 2016-2020. EHE plunged in 2014 (4.6% in IHs vs. 3.8% in NIHs), then rose, and remained unchanged during 2016-2020 (6.7% in IHs and 5.6% in NIHs).
CONCLUSIONS: In pursuit of universal health coverage, health authorities should formulate and implement effective financial protection mechanisms to address structural inequalities, especially forms of discrimination including racialization, that vulnerable social groups such as indigenous peoples have systematically faced. Doing so would contribute to closing the persistent ethnic gaps in health.

BACKGROUND: While smoking prevalence in high income countries has declined over time, socioeconomic inequalities in smoking have widened. This study is one of the few studies to examine the longitudinal pattern of income-related smoking inequalities and only the second using concentration indices in its analysis.
METHODS: Income-related smoking inequalities were measured using concentration indices using the Northern Ireland Continuous Household Survey data. Smoking inequalities were compared quantitatively and visually across three periods: 1985-1995, 1997-2005 and 2007-2015. Joinpoint analysis was used to measure the overall time trend of smoking inequalities. Subgroup analysis was used to examine the nature of change in smoking inequalities across population sub-groups.
RESULTS: Throughout 1985-2015, smoking was more concentrated among the poor (standard concentration index of-0·131, p < 0·001). While prevalence declined sharply across population, income-related inequalities increased sharply in general and within subgroups. Income-related smoking inequalities were significantly larger among high educated group and those who were employed. No structural break was observed with respect to the adoption of any specific policy measures over the period.
CONCLUSIONS: Current approaches to tobacco control may be ill-suited to addressing smoking inequalities and may indeed be counterproductive. More tailored approaches that address the specific needs of population sub-groups or more draconian approaches such as extensions to prohibition may be required to reduce prevalence further while avoiding a widening of inequalities.

Time to reimbursement (TTR) of new anticancer medicines differs between countries and contributes to unequal access. We aimed to investigate TTR of new anticancer medicines and explore factors influencing the reimbursement process in seven high-income European countries.
We carried out a retrospective case study of anticancer medicines with European Union Market Access (EU-MA) and a positive Committee for Medicinal Products for Human Use opinion from 2016 until 2021 with subsequent national reimbursement approval (NRA). The National Health Technology Assessment (HTA) and reimbursement websites of Germany, France, UK, the Netherlands, Belgium, Norway and Switzerland were used to identify TTR, defined as time from EU-MA to NRA. Additionally, we investigated medication-, country-, indication- and pharma-related factors potentially influencing TTR.
Thirty-five medicines were identified for which TTR ranged from -81 days to 2320 days (median 407 days). At data cut-off, 16 (46%) were reimbursed in all seven countries. Overall, the shortest TTR was in Germany (median 3 days, all medicines reimbursed <5 days). The time limit for reimbursement of 180 days stated by the Council of European Communities after the EU-MA (EU Transparency Directive) was met for 100% of included medicines in Germany, 51% in France, 29% in the UK and the Netherlands, 14% in Switzerland, 6% in Norway and 3% in Belgium. The TTR was significantly different between countries (P < 0.001). In multivariate analysis, factors associated with shorter TTR were higher gross domestic product (GDP), absence of a pre-assessment procedure and submission by a big pharmaceutical company.
TTR of anticancer medicines varies significantly between seven high-income European countries and leads to inequality in access. Among explored medication-, country-, indication- and pharma-related factors we found that a high GDP, the absence of a pre-assessment procedure and submission by big pharmaceutical companies were associated with shorter TTR.