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Despite rising socioeconomic inequalities most people see individualised merit as crucial for social success. Drawing on surveys such as the ISSP a wealth of research examines trends in subjective perceptions, the relative importance accorded to merit and non-merit factors for getting ahead in life and factors which influence lay perceptions. However, varied conclusions emerge from the literature. Further, puzzles ensue from the measurement of lay perceptions of (non-)merit factors as drivers of social success. Drawing on new qualitative data I argue that the specific, individualised, and binary framings of merit and non-merit beliefs in conventional accounts under-explore the varied ways in which people recognise structural processes. I also argue that explanation is hampered by over-stating lay misapprehensions, or what people don't see, when a greater focus on what people do see, and what they believe to have mattered in their biographical lived experience, would support a more nuanced sociological analysis of situatedness and complexity in lay apprehensions of social inequality.

The 2022 global mpox outbreak was the first to involve sustained community transmission outside endemic regions, disproportionately affecting gay, bisexual and other men who have sex with men (GBMSM). News media plays a critical role during outbreaks by disseminating information, shaping public perception and influencing health protection behaviours. This qualitative study examined how UK news media represented mpox during the 2022 outbreak, with a particular focus on public health messaging and the discursive framing of affected communities. Using the NexisUK® database, we retrieved UK print and online articles mentioning "mpox", "monkeypox", or "monkey pox" in headlines, published between May and December 2022. Five national newspapers were selected based on readership and political stance (The Times/Sunday Times, The Guardian, The Sun, The Daily Mail/Sunday Mail and the Daily Mirror/Sunday Mirror). Following deduplication and screening, we applied a rotating weekday sampling frame and analysed articles thematically in NVivo. We identified 746 articles in the five selected newspapers between May and December 2022. Coverage peaked in May 2022 (n = 223 articles) and then waned, despite incident cases rising in June (n = 1,185) and July (n = 1,453). We analysed 79 sampled articles. Key themes included communication of mpox characteristics, delivery of health promotion, and 'anchoring' mpox to other infectious diseases (e.g. COVID-19, chickenpox) to aid understanding. Articles described mpox's epidemiological origins in Africa, transmission routes, and epidemiological updates, often noting transmission during GBMSM events. Public health messaging focused on advice about transmission reduction, access to care/prevention services, and vaccine availability (including concerns over supply). GBMSM were frequently depicted as being at high risk, sometimes drawing upon stereotypes and language that potentially reinforced stigma. Notably, few articles included perspectives from individuals with lived experience of mpox. UK news media interest in mpox peaked early in the outbreak and waned despite rising cases. News media played a vital role in disseminating information and public health messaging (often drawing parallels with other familiar infections) but the framing of GBMSM may also have reinforced stigma. The absence of personal testimonies represents a missed opportunity for inclusive messaging. Future outbreak reporting should involve affected communities to co-produce and promote accurate, non-stigmatising communication.

Over half of dementia cases remain undiagnosed, with persistent disparities across racial, ethnic, and socioeconomic groups. Dementia care navigation (DCN) has demonstrated value in post-diagnosis settings. If implemented earlier, DCN could address diagnostic delays and care gaps. We define the diagnostic window as the period from initial symptom awareness through diagnosis and early care planning. Drawing on deliberations from the Alzheimer's Association Dementia Care Navigation Roundtable, we present a pre-diagnosis DCN framework organized across six domains and describe navigator roles across three phases: pre-evaluation, diagnostic assessment, and immediate post-diagnosis and transition. We address special considerations, including people without a care partner and those with unmet care needs. The framework complements federal initiatives such as the Guiding an Improved Dementia Experience (GUIDE) Model and the National Alzheimer's Project Act and identifies existing reimbursement pathways for pre-diagnostic navigation activities. Generating evidence to refine these models across diverse settings will be essential to inform policy action and system-level integration.

Mainstream global mental health continues to privilege individual-level risk factors and biomedical approaches and treatments while sidelining the structural forces that shape mental distress. Despite calls for more socially embedded and decolonial approaches, policy and research too often neglect how structural phenomena such as globalization, colonialism, and neoliberal reforms directly drive mental health inequities. Drawing on Latin American traditions of social medicine-particularly Jaime Breilh's paradigm of social determination of health-this debate article critiques reductionist frameworks that fragment structural causation into depoliticized lists of risk factors. We articulate a social determination approach for mental health research and practice, emphasizing the multi-level embodiment of power relations, the historical-political organization of social life, structural drivers embedded in institutions and policies, and the role of collective agency and praxis. Illustrative vignettes from Latin America (employment, discrimination, and environment) demonstrate how historically structured processes linking global political economy, institutional arrangements, and everyday social relations become embodied as mental distress, and how participatory and mixed-method research can help document these dynamics while supporting transformative, community-led responses. We argue that adopting a social determination lens can reorient global mental health policy and scholarship toward structural justice, in line with recent international calls to decolonize and politicize mental health research. Not applicable.

Women during emerging adulthood are disproportionately susceptible to sexually transmitted infections due to biological and socioeconomic vulnerabilities. Central to safe sex is the process by which women seek information regarding their male partners' intentions to use condoms, which is complicated by the gendered nature of sexual risks and the influence of sociocultural factors. Drawing on the theory of motivated information management, we examined how relationship quality, sexual relationship power, and sexual shame were associated with sexual risk information-seeking among Chinese emerging adult women in committed heterosexual relationships. Analyses of data from 294 participants showed that relationship quality and sexual relationship power were positively associated with outcome expectancy and efficacy assessments, subsequently contributing to more information seeking behaviors about condom use. Additionally, higher levels of sexual shame were associated with lower levels of efficacy assessments, and the effect of shame on efficacy was completely mediated by negative emotions, relationship quality, and sexual relationship power. These findings contribute to theoretical understandings of sexual health information management situated within specific relational and socio-cultural contexts and offer practical implications for improving sexual negotiation in Chinese cultural contexts.

Routine semen analysis provides limited diagnostic and prognostic insight into male reproductive potential, contributing to the increasing use of sperm DNA fragmentation (SDF) testing in fertility evaluation. However, the clinical application of SDF testing appears to outpace the strength and consistency of the supporting evidence. This opinion paper critically appraises SDF testing through established screening, diagnostic, and prognostic test-performance frameworks, drawing on published observational studies, meta-analyses, and international guideline statements across natural conception and ART. The available evidence indicates that SDF testing does not meet the criteria for population-level screening or for routine diagnostic or prognostic use in unselected infertile populations and is frequently applied beyond its validated scope. Interpretation is further limited by assay heterogeneity, lack of standardization, variable thresholds, reliance on surrogate outcomes, and the limited effectiveness of available interventions. Routine implementation therefore risks overdiagnosis, unnecessary interventions, and premature escalation to assisted reproduction without proven benefit. When applied selectively within an aetiology-driven framework, particularly in defined subgroups, SDF testing may provide adjunctive risk stratification rather than deterministic clinical guidance. All stakeholders must be made aware of these limitations before the test is offered, interpreted, or used to modify treatment.

The circular economy (CE) has emerged as a prominent framework for addressing environmental challenges while promoting collective well-being. By aiming to "close the loop" of product life cycles through reuse and recycling, the CE encourages entrepreneurial and economic activities oriented toward ecological transition and sustainable urban development. However, CE implementation remains predominantly technology-centric and industry-driven, privileging innovation and system optimization - approaches increasingly seen as insufficient to support transformative socio-ecological change. Consequently, CE policies often remain confined to waste management, overlooking preventive strategies and the potential of social innovation. This study investigates the contribution of grassroots initiatives to circular transitions in the metropolitan city of Bologna (Italy) and examines whether gaps in the supporting ecosystem and infrastructure hinder their implementation. The analysis focuses on the participatory project R-innovare l'Economia Circolare, developed within the NRRP ECOSISTER program and involving 17 organizations engaged in reuse, repair, sharing, and regeneration practices. Using participatory methodologies - including contextual mapping and facilitated co-design workshops - the study identifies actors, circular practices, and business models, as well as implementation barriers emerging at the organizational, community and institutional levels. Rather than focusing on technological optimization or recycling, findings reveal a heterogeneous set of circular practices centered on waste prevention, community engagement, and social equity, which diverge from mainstream CE models. These practices point to emerging forms of collaboration and service-based approaches that generate socio-environmental value by integrating ecological care with community well-being. At the same time, identified challenges include limited access to spaces and resources, insufficient incentives for non-technological innovation and widespread reuse practices, and a fragmented governance landscape marked by conflicting policy domains. Drawing on the Bologna case, the study shows how grassroots actors reinterpret circularity and broaden the transformative potential of the CE beyond recycling and the economic sphere, reframing it as a process rooted in care, solidarity, and territorial well-being. The analysis also highlights gaps within policy and research infrastructures that must be addressed to advance a more just and place-based socio-ecological transition.

Accurately identifying "hot-spot pathways" in fishery science and technology (S&T) innovation is critical for food security, economic development, and ecological sustainability. Traditional technology foresight methods struggle to capture complex, dynamic evolutionary patterns in S&T innovation networks. Drawing on Dosi's conceptual framework of technological trajectories as domain-inspired design heuristics-whereby Dosi's qualitative concepts provide structural guidance for model design rather than formal axioms that exhaustively capture the theoretical framework-this study proposes DTH-GNN (Documents-based Temporal Heterogeneous Graph Neural Network), integrating Graph Neural Networks with dynamic evolutionary analysis to identify potential hot-spot pathways. We construct a dynamic heterogeneous knowledge graph from multi-source data (2010-2024) encompassing 32,847 publications, 8,956 patents, and 1,856 projects. DTH-GNN combines an R-GCN-based heterogeneous encoder with a GRU-based temporal evolution module, achieving AUC = 0.934 and AP = 0.928 (after rigorous leakage assessment), significantly outperforming GCN, R-GCN, and EvolveGCN baselines. Information-theoretic analysis indicates that temporal features account for a substantial share of mutual information in link prediction (31.8%, 95% CI: [28.4%, 35.1%]), comparable to structural features (29.1%) and higher than attribute features (19.7%). Three high-potential pathways are identified and validated through expert evaluation (Krippendorffś α = 0.804): Smart Aquaculture, Green Seed Industry, and Ecological Fisheries. These findings provide data-driven scientific support for S&T investment prioritization in the fishery sector.

Population ageing has been widely studied for its implications for healthcare demand. Yet much less attention has been paid to the parallel ageing of the medical workforce. Focusing on the Italian primary care setting, this study addresses this gap by examining whether GP performance changes as physicians approach the retirement age of 70. Drawing on human capital theory, retirement proximity may affect GP performance via two competing mechanisms: accumulated experience may enhance performance, while human capital depreciation, reflecting reduced effort or shifting focus, may offset these gains. We test the net effect of these mechanisms on selected utilization-based indicators of GP performance. Using administrative data from a large Italian Local Health Authority, we analyze type II diabetes patients continuously enrolled with GPs from 2018 to 2023. Exploiting variation in retirement proximity across GPs, we apply a staggered difference-in-differences approach to examine treatment effect dynamics. We find no evidence of systematic deterioration in potentially inappropriate use, hospitalizations, emergency department access, or diabetes-related avoidable hospitalizations. However, patients whose GPs are closer to retirement are less likely to receive at least two HbA1c tests per year, whereas their likelihood of receiving at least one HbA1c test remains unchanged. These findings suggest that, as GPs approach the retirement age of 70, utilization-based performance indicators are not systematically affected, although support for adherence to evolving chronic care monitoring standards may be needed.

Bicycle infrastructure preferences vary by rider experience and comfort, yet both bicyclists and motorists perceive separated bicycle lanes as safer than shared lane markings (sharrows). Despite widespread adoption, evidence on the real-world behavioral impacts of sharrows remains limited. This study evaluates a natural experiment in Santa Ana, California, where sharrows were installed in a downtown commercial corridor when separated bicycle lanes were not feasible. Researchers collected baseline data in September 2015 and follow-up data in February 2016 and early 2017, totaling 54 hours of direct bicycle observation across two target areas. Results revealed a mixed and cautionary pattern of change. West-to-East mean bicycle counts increased significantly from 0.986 (2015) to 1.734 (2016; p = 0.045) but declined to 1.500 by 2017. East-to-West counts showed modest, non-significant year-over-year growth. Critically, sidewalk riding increased significantly from 2015 to 2016 (p = 0.002) and remained elevated through 2017 (p = 0.009), and wrong-way riding increased significantly from 2015 to 2016 (p = 0.003). Female ridership declined from 2015 to 2016 (p = 0.036) but recovered by 2017. Ridership among adults over 65 declined post-installation without meaningful recovery. Overall, sharrow installation was not associated with lasting ridership gains or improved safe bicycling behavior. Declines among women and older adults suggest sharrows may not adequately meet the needs of all roadway users. Drawing on the present data and prior literature, policymakers should consider pairing sharrows with education programs, driver awareness campaigns, and enhanced infrastructure to support safety, equity, and sustained bicycling engagement.

This study examined indirect association patterns between Transformational Leadership and primary and secondary school teachers' Social-Emotional Competence, with supplementary analyses exploring whether these patterns varied across leadership dimensions. Drawing on Ecological Systems Theory and the Prosocial Classroom Model, data were collected from 760 primary and secondary school teachers and analyzed using a multiple mediation model. Transformational Leadership was significantly and positively associated with teachers' Social-Emotional Competence. In the overall model, the indirect association via Teaching Efficacy was the strongest; the pathway via Teacher-Student Relationship was significant but small, whereas the pathway via School Climate was not significant. Supplementary dimension-specific analyses showed that the relative prominence of these pathways varied across leadership dimensions. Overall, the findings indicate that Teaching Efficacy was the most prominent correlate in the estimated indirect association between Transformational Leadership and teachers' Social-Emotional Competence, while School Climate showed a less consistent pattern. These results highlight the relevance of both school contextual resources and teachers' confidence-related psychological resources for understanding teachers' social-emotional competence.

The ethical terrain surrounding feeding at the end-of-life is emotionally charged and complex. In the literature, the recently introduced notion of "minimal comfort feeding" (MCF), defined as deliberate limitation of feeding or hydration, given only in response to visible signs of hunger or thirst, for a patient with a longer prognosis, has been proposed as a comfort measure at the end of life and as an alternative to voluntarily stopping eating and drinking (VSED) in advance care planning. However, the same term may be applied to two morally distinct acts: 1) providing comfort in the context of active dying, and 2) a hastening death. In this paper, we argue for conceptual clarity around these two practices and their ethical valence, drawing on an Anscombean-Thomistic virtue ethics framework that deals with moral evaluation of human action and the doctrine of double effect. We present two clinical cases highlighting each of these ethical scenarios. Through the cases, we show how intentionality and some circumstances such as timing critically shape the morality of the act. We propose a new nomenclature with the aim of fostering ethical clarity of the morally distinct acts: "proportionate comfort feeding" (PCF) for MCF where nutrition and hydration is provided for comfort with the understanding that it may hasten death but is its foreseen, unintended outcome, and "minimal feeding to hasten death" (MFHD) for cases where MCF is chosen with the specific intention to hasten death.

The existing body of research offers limited insight into the detrimental effects of incivility phenomena on proactive customer service performance (PCSP) from the customer's perspective. Drawing on the stressor-strain-outcome (SSO) framework and conservation of resources (COR) theory, this paper examines how customer incivility is associated with PCSP, with a particular focus on emotional exhaustion as a mediator and proactive personality as a moderator. Utilizing survey methodology, customer-contact employees in China were sampled with a time lag of three weeks in three waves. SPSS 27.0, the PROCESS macro (Model 59) and AMOS 27.0 were utilized to analyze the data. The results showed that customer incivility had a positive impact on emotional exhaustion and reduced PCSP. Additionally, the indirect effect of customer incivility on PCSP through emotional exhaustion was significant, indicating a significant mediating effect. The results also revealed that proactive personality significantly moderated the association between customer incivility and emotional exhaustion and the moderated mediation index was also significant. These findings indicate that proactive personality serves as a positive psychological resource, enhancing employees' capacity to mitigate the adverse effects of customer incivility (stressor) and emotional exhaustion (strain) while enabling them to consistently engage in proactive service behaviors (outcome), thereby breaking the vicious path of the SSO framework.

This study investigates the nonlinear relationship between faculty mentoring and undergraduate innovation capacity within a universal tutorial system. Drawing on survey data from 1066 students at a Chinese provincial university, and grounded in motivational synergy theory and self-determination theory, we examine an inverted U-shaped effect of mentoring frequency, with an estimated inflection point of 13.35 sessions per semester. Bootstrap-based conditional indirect effects suggest that this pattern is consistent with both extrinsic (mentor pressure, peer influence) and intrinsic (academic identity, self-efficacy) motivational pathways, with the indirect effects themselves shifting from positive to negative as mentoring intensifies. Furthermore, the curvilinear pattern is more pronounced under low mentor-student research alignment, in smaller meeting cohorts, and within STEM disciplines. The mentoring benefits concentrate among students with moderate innovation capacity, suggesting an "expanding the middle" effect. These findings provide convergent evidence that the synergy-versus-crowding-out logic operates across mentoring intensity, motivational pathways, and student capacity, offering a more differentiated and mechanism-based understanding of how faculty mentoring shapes undergraduate innovation.

Timely access to emergency care is essential for preventing avoidable illness, disability, and death. Yet in many low- and middle-income countries, patients and families may still be asked to make consultation fees, registration payments, deposits, or other forms of financial clearance before urgent evaluation or treatment proceeds. Using Somalia as an illustrative case while drawing broader lessons for comparable settings, this commentary examines how weak public financing, limited financial risk protection, facility dependence on user fees, and administrative payment processes may delay emergency assessment, stabilization, diagnostics, referral, and admission. It argues that payment-related delay should be understood as a health-system, governance, and equity problem rather than only a household financing problem. Because direct Somali bedside measurement remains limited, the paper frames this pathway as a policy-relevant systems hypothesis rather than a directly quantified patient-level effect. It concludes by proposing a practical reform agenda centered on triage-first and stabilize-first policies, feasible emergency waiver and reimbursement mechanisms, separation of billing from urgent clinical triage, phased financing reforms, and stronger regulation of payment practices that interfere with time-critical care in Somalia and comparable fragile settings.

Laboratory medicine remains the cornerstone of disease detection, clinical management, monitoring, and public health surveillance. Increasing population needs and rising disease burdens, particularly in low- and middle-income countries (LMICs), continue to expand the volume of diagnostic testing, resulting in substantial generation of biomedical waste. Effective laboratory waste management is therefore essential for protecting personnel, maintaining high-quality service delivery, and minimizing environmental harm. However, many LMICs face persistent challenges due to inadequate infrastructure, insufficient training, limited financial resources, and weak regulatory enforcement - that compromise safe and efficient waste handling. This review explores affordable, scalable and sustainable measures to strengthen laboratory waste management in resource-constrained settings. It categorizes the main types of laboratory waste - infectious/biological, chemical, sharps, and general waste - and examines common barriers to appropriate disposal. Guided by various international standards including International Organization for Standardization (ISO) 15189 and 14001, Eco-Management and Audit Scheme (EMAS) and World Health Organization (WHO) recommendations, and drawing on experiences from other LMICs, the review discusses practical, low-cost interventions such as improved test utilization, workflow optimisation, Artificial Intelligence (AI)-supported waste classification and digital tracking systems. The importance of workforce training, government engagement, public-private partnerships, and involvement of non-governmental organisations is also emphasised. To foster a culture of responsible waste management, the review proposes behavioural and accountability mechanisms including linking efficiency to key performance indicators, providing institutional recognition, documenting non-conformances, and applying consequence management where necessary. Sustainable and cost-effective waste management is achievable in resource-limited settings when supported by committed leadership, coordinated stakeholder action, and continuous quality improvement. Corporate bodies can play a pivotal role by providing strategic leadership, mobilising resources and strengthening workforce capacity.

Marion Fourcade and Kieran Healy developed the notion of "classification situations" to describe how ordinal schema that sort and rank individuals, like credit scores, are used to differentiate opportunities, prices, and services in ways that structure life chances while masking inequality as meritocratic. We argue that contemporary criminal records increasingly function as such classificatory tools. The proliferation of alternatives to traditional case processing and record-relief policies challenge the widely-held view of criminal records as binary markers of exclusion by revealing a system that is increasingly gradational, dynamic, and responsive to intervention. Drawing on examples from criminal law, policy, and the private market, we show how opportunities to mitigate or remediate criminal record marks are structured to reward those with greater social and material resources. We then test our theory using linked, individual-level administrative criminal record, education, and unemployment insurance wage data. Our findings illustrate how the severity of a criminal record is not necessarily based on factual guilt or culpability but rooted in social advantage.

Nurses often have to manage anger from patients, relatives and carers in their practice. However, in emotionally charged situations, it can be challenging to maintain professionalism, respond with empathy and set clear limits. This article presents a practical, transferable strategy for responding to anger in healthcare settings using active listening and structured information gathering. Drawing on de-escalation literature, communication theory and evidence from communication skills training, the author outlines a stepwise approach that nurses can use to de-escalate confrontations involving patients, relatives and carers. This approach emphasises the importance of early recognition of escalation, empathic engagement, validation, collaborative problem-solving and clear limit-setting.

Zinc-based biodegradable stents offer a promising solution for temporary vascular support, aiding in vessel healing while reducing long-term complications such as thrombosis and restenosis. This study examined three zinc-based alloys: AMZ (Zn-4.0Ag-0.6Mn-0.1Zr), ACMZ (Zn-3.5Ag-0.5Cu-0.7Mn-0.1Zr), and CMM (Zn-1.0Cu-0.6Mn-0.05 Mg), all featuring reduced wire diameters of 0.12 mm. The focus was on their microstructure, mechanical performance, thrombogenicity, and in vivo biocompatibility. The alloys were processed through cold drawing and heat treatment, resulting in ultra-fine-grained structures measuring less than 1 μm. Energy dispersive spectroscopy (EDS) and x-ray diffraction (XRD) analyses confirmed the presence of strengthening intermetallic phases (AgZn3, CuZn4, and MnZn13), while a uniform elemental distribution indicated solid solution strengthening. Heat treatment enhanced ductility, especially in the AMZ and ACMZ alloys, without compromising tensile strength. In vitro hemocompatibility assays showed low thrombogenicity for these alloys, with lower fibrin and FXIIa generation compared to clinical control materials. Ex vivo assessments of platelet and fibrin attachment revealed similar results to those observed with pure zinc controls. In vivo implantation of the stent materials into the abdominal aortas of mice and rats produced distinct species-specific immune responses. Mice exhibited significant inflammation, extracellular matrix degradation, and necrosis, raising potential concerns about their biocompatibility in this model. In contrast, implants in rats resulted in only mild inflammation and limited neointimal growth, with no signs of necrosis. This suggests a more favorable and controlled healing response in rats. Morphometric analysis of Verhoeff-Van Gieson-stained cross-sections indicated that the 0.12 mm wires produced significantly less neointimal growth compared to previously tested 0.25 mm implants in rats, highlighting the advantages of smaller implant dimensions. Overall, these findings support the use of refined zinc-based alloys with smaller struts for next-generation biodegradable stents. However, the inflammatory response observed in mice emphasizes the necessity for careful selection of models in preclinical testing.