Background: Health insurance (HI) run by government is providing health care service to large population. Due to poor accountability, participation and sustainability, cooperative health insurance is becoming more popular and effective in low and middle income and some high-income countries too. In Nepal, there are public and cooperative HI is in practice. The aim of this study is to compare the effectiveness of public (government) and cooperative HI in relation to benefit packages, population coverage, inclusiveness, health care utilization, and promptness for treatment in these two health insurance models in Nepal. Method: This is an institution based concurrent mixed study consists of qualitative and quantitative variables from public and cooperative groups. We included all public HI operated by government hospitals and cooperatives groups those purchased hospital service in contract. Two separate study tools were applied to access the effectiveness of insurance models. The key questions were asked for the representatives of government and private health insurance. The numeric information consisted of in quantitative data and subjective response was included in qualitative approach. Descriptive statistics and Mean Whitney U test was applied in numeric data and qualitative information were analyzed by inductive approach Results: The study revealed that new enrolment was not increased, health care utilization rate was increased and the benefit package was almost same in both groups. The overall inclusiveness was higher for the government HI, but enrolment from the religious minority, proportion of negotiated amount during treatment were significantly higher (p<0.05). During illness, the response time to reach hospital was significantly faster in cooperative health insurance than government health insurance. Qualitative findings showed that level of participation, accountability, transparency and recording system was better in cooperative health insurance than public. Conclusion: Cooperative HI could be more sustainable and accountable to the community for all; low, middle and high-income countries.

Preschoolers with disabilities and their caregivers have been neglected in health and social service provision in most low-income countries and arguably too in low resourced areas of more affluent nations. Yet as this rapid review of published literature identifies, there are low-cost, evidence-based strategies to address their needs that can be implemented in communities by local people. Five key features of the necessary supports are examined. First the leadership functions required to create and implement the support services. Second, the family-centred, home-based support provided to caregivers and the personnel undertaking this form of support. Third, providing opportunities for peer support to flourish and encouraging the formation of advocacy groups across families. Fourth, mobilizing the support of significant groups within the community; notably traditional healers and leaders; health services and poverty alleviation initiatives. Fifth, devising ways in which preschool educational opportunities can be offered to children as a prelude to their inclusion in primary schools. The review serves a further purpose. It provides an example of how public health researchers and academics could achieve more rapid implementation of evidence-based knowledge into existing and new support services through dissemination to community practitioners.

A new intervention model for promoting healthy ageing grounded on integrated value-based care was developed and tested in the city of Valencia (Spain). Its implementation raised relevant barriers for older adults in their access to health, health promotion, and health self-management linked with their health and digital literacy. This new intervention model included several aspects. On the one hand, researchers together with older adults and their informal caregivers participating in the study, designed personalised care plans, based on older adults’ specific needs, to be implemented with the support of a digital solution. On the other hand, researchers and health and social professionals implemented a series of six workshops in different locations of the city to encourage the sense of community among participants, reinforcing their trust in the new care model and increasing their adherence. Social activities were at the core of the workshops to understand older people’s interaction with the health and social services provided in the neighbourhood. Qualitative and quantitative methods were combined to extract information from older participants on how to engage them as active actors of their own health and understanding their values and preferences. Qualitative results show that after a post-pandemic situation, they were more concerned about social isolation and desired face-to-face contact with their professional care team; however, feelings of loneliness and/or sadness were not considered amongst the reasons to visit health professionals. Some of the conclusions reveal that the use of technology as a supportive tool is well received but with a stress on its role as “supportive”, and not replacing the close contact with healthcare professionals. Professionals recognised the benefits of this new approach but required more time and incentives to dedicate the effort needed.

Populations with healthcare needs often reside in post-conflict settings where basic services needed to maintain good health may be non-existent or hard to access. Therefore, there is a need for better identification and reallocation of resources as part of the post-conflict health rehabilitation effort. This study applies an asset-based approach to explore the more optimal design of health services and to identify the resource constraints for basic health service delivery to the most vulnerable communities in eastern Congo. We implemented the asset mapping in two phases. Firstly, we combined a qualitative survey with community walks to identify the assets already present in the communities. Secondly, we conducted group discussions to map out assets that are the core of Asset-Based Community Development (ABCD) practice. We finally documented all assets in a Community Asset Spreadsheet. Overall, 209 assets were identified as available and potentially valuable resources for the communities in eastern Congo. Among them, 60 were local associations, 24 were land and physical environment, 43 were local institutions, 46 were individuals, 32 to economy and exchange, and only 6 were related to culture, history, and stories. Drawing upon the findings from the qualitative survey, community walks, and group discussions, we conclude that an important number of resources were in place for basic health service delivery. By activating the existing and potential resources, the most vulnerable populations in eastern Congo might have the required resources for basic health service delivery. Our findings support the use of an asset-mapping research method as appropriate to identify existing and potential resources for basic health services in a post-conflict setting.

Abstract Issue Addressed: Men’s Sheds (‘Sheds’) have been identified as inherently health promoting and as potential settings to engage ‘hard-to-reach’ men in more structured health promotion initiatives. However, little is known about the sociodemographic or health and wellbeing characteristics of Shed members (‘Shedders’) on which such initiatives might be based. This study captures a baseline cross sectional analysis of Shedders (n=384) who participated in ‘Sheds for Life’, a health promotion initiative tailored to Sheds. Methods: Objective health measure, (body composition, blood pressure, blood lipids) captured via health screening as well as sociodemographic and health and wellbeing measures (physical activity, subjective wellbeing, mental health, social capital, cooking and diet) via questionnaires were assessed. Results: Participants were mostly over 65 years, retired with limited educational attainment. The majority were in the ‘at-risk’ categories for objective health measures, with most being referred to their GP following health screening. Older Shedders were also more likely to meet physical activity guidelines. Mental wellbeing was positively correlated with life satisfaction and increased social capital and these were also positively correlated with physical activity. Conclusions: Findings highlight the potential of Sheds in reaching a ‘hard-to-reach’ and ‘at-risk’ cohort of men. Despite a high prevalence of ‘at-risk’ objective health measures, participants report their health in positive terms. Future health promotion initiatives should capitalise on the inherent health promoting properties of Sheds. So what? Findings raise important implications for prioritising and designing health promotion initiatives in Shed settings.

Cost-effective community engagement is needed to address causes of mental illness related to social issues (i.e. isolation, stigma and lack of purpose) that are typically outside the scope of healthcare. This pilot study evaluated the relationship between clinical healthcare resources and a community-based social engagement organization in a medium-sized community in the midwestern US. Analyses were based on a retrospective longitudinal comparison of clinical visit frequency from two cohorts that joined the Momentum Center for Social Engagement (MC) and either frequently participated (Engaged; n = 9) or had extenuating circumstances limiting participation (Non-engaged; n = 3). The frequency of >1800 visits to the member’s primary mental healthcare provider were compared during the period from November 2016 - May 2021. Engaged MC members reduced frequency of regular visits to their primary mental healthcare provider by 50%, while Non-engaged MC members maintained clinical visit frequency. The financial value of reduced healthcare visits and associated wellbeing improvements was estimated to be $1.0 million, 95% CI: [$0.6-1.4 million], or roughly four times the budget received by the MC from the healthcare provider. Thus, the MC appears to be a valuable approach to improving mental health in conjunction with existing community healthcare services. Clinical implications include considering the unique MC-style community-based support as a component of practice.

To assess the community health workers’ (CHWs) knowledge, attitude, and practices (KAP) in type-2 diabetes (T2D) and hypertension (HTN) management. We thus also sought to assess the potential health system barriers for incorporating CHWs in T2D and HTN management. Mixed-method study comprised (1) a survey among 153 active CHWs to assess their KAP of T2D and HTN, and (2) semi-structured interviews with key informants to understand challenges of the health system and proposed solutions in incorporating CHWs in T2D and HTN management. The majority of CHWs correctly answered general knowledge questions on NCDs, risk factors, and prevention; however, only one-quarter correctly answered questions on smoking, family history, or tobacco use as risk factors. Most respondents appeared to have positive attitudes and have been practicing some activities related to T2D and HTN. Both financial and non-financial resource constraints were cited as challenges of the health system; therefore, re-structuring the role definition of CHWs and task of responsibilities, and assessment the need and workload have been proposed as ways forwards to effectively incorporate CHWs in T2D and HTN care. CHWs in Cambodia have shown their potential in T2D and HTN management; however, a well-designed strategy including technical training, clearly defined roles and responsibilities, and strong supporting structure are important to maximize their potential in the health system.

Coronavirus disease-19 (COVID-19) has disproportionately affected certain demographics in England, exacerbating existing health disparities. Effective therapeutics are a critical line of defence against COVID-19, particularly for patients at elevated risk for severe disease. Surveillance systems were established to monitor usage of COVID-19 therapeutics in hospital and community settings and inform stewardship. Three antiviral therapies: nirmatrelvir plus ritonavir (Paxlovid®), remdesivir (Veklury®), and molnupiravir (Lagevrio®); and two neutralising monoclonal antibody therapies (nMAbs): sotrovimab (Xevudy®) and casirivimab with imdevimab (Ronapreve®); were in use in England between July 2020 to April 2023. This paper aims to illuminate trends in the utilisation of COVID-19 therapeutics treatment in both hospital and community settings, stratified by the Index of Multiple Deprivation (IMD) in England. Chapter 3 of the English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) report 2022 to 2023 also discusses the epidemiological surveillance of these five directly-acting antiviral COVID-19 therapeutics use in England between 2022 to 2023.

Community-engaged research is understood as existing on a continuum from less to more community engagement, defined by participation and decision-making authority. It has been widely assumed that more is better than less engagement. However, we argue that what makes for good community engagement is not simply the extent but the fit or alignment between the intended approach and the various contexts shaping the research projects. This article draws on case studies from three Community Engagement Cores (CECs) of NIEHS-funded Environmental Health Science Core Centers (Harvard University, UC Davis and University of Arizona,) to illustrate the ways in which community engagement approaches have been fit to different contexts and the successes and challenges experienced in each case. We analyze the processes through which the CECs work with researchers and community leaders to develop place-based community engagement approaches and find that different strategies are called for to fit distinct contexts. We find that alignment of the scale and scope of the environmental health issue and related research project, the capacities and resources of the researchers and community leaders, and the influences of the socio-political environment are critical for understanding and designing effective and equitable engagement approaches. These cases demonstrate that the types and degrees of alignment in community-engaged research projects are dynamic and evolve over time. Based on this analysis, we recommend that CBPR scholars and practitioners select a range of project planning and management techniques for designing and implementing their collaborative research approaches and both expect and allow for the dynamic and changing nature of alignment.

The prevalence of HIV infections in the province of Papua is rising. The study aimed to examine the effect of a sexual reproductive health-based HIV prevention program on knowledge, subjective norms, and attitudes, as well as the behavior control of reproductive health and HIV prevention. A quasi-experimental study was applied in this study with an equivalent control group. The total of 289 students is divided into the experimental group (n = 134) and the control group (n = 155). The experimental group received the sexual reproductive health-based HIV prevention program. The control group received the routine program from the school. The results found a significant difference in knowledge, subjective norms and attitudes, and behavior control of reproductive health and HIV prevention among intervention groups before and after receiving the Sexual Reproductive Health School-Based HIV Prevention program (p-value

In mountain communities like Sebei, Uganda, that are highly vulnerable to emerging and reemerging infectious diseases, community-based surveillance plays an important role in the monitoring of public health hazards. In this survey, we explored capacities of Village Health Teams (VHTs) in Sebei communities of Mount Elgon in undertaking surveillance tasks for emerging and reemerging infectious diseases in the context of a changing climate. We used participatory epidemiology techniques to elucidate VHTs’ perceptions on climate change and public health and assess their capacities in conducting surveillance for emerging and reemerging infectious diseases. Overall, VHTs perceived climate change to be occurring with wider impacts on public health. However, they have inadequate capacities in collecting sur-veillance data. The VHTs lack transport to navigate through their communities and have in-sufficient capacities in using mobile phones for sending alerts. They do not engage in reporting other hazards related with the environment, wildlife and domestic livestock that would ac-celerate infectious disease outbreaks. Records are not maintained for disease surveillance ac-tivities and the abilities of VHTs to analyze data are also limited. However, VHTs have access to platforms that can enable them to disseminate public health information. The VHTs thus need to be retooled to conduct their work effectively and efficiently through equipping them with adequate logistics and knowledge on collecting, storing, analyzing, and relaying data, which will improve infectious disease response and mitigation efforts.

Background: Since 2010, Burkina Faso has developed and initiated community-based management of childhood illnesses. Following the increased presence of community health workers and the adoption of free community health care, this study aims to assess community satisfaction with curative care administered by community health workers. Methodology: It was a descriptive and analytical cross-sectional study. Data were collected in the health districts of Boussé and Boussouma from 20 February to 30 March 2023 for quantitative data and from 12 to 30 January 2024 for qualitative data using a questionnaire (household survey) and an interview grid (focus groups). Analyses were conducted using SPSS IBM 25 and Nvivo 14. Results: Households benefit from oral curative care when using CHWs, but are not satisfied with the temporal accessibility of these community health workers. Temporal accessibility and awareness during care have a significant influence on household satisfaction. Conclusion: Curative care by community health workers is effective, but its use could be improved by addressing the unavailability of community health workers, inputs and better communication during care.

Maternal-child care is one of the foundations of primary health care. Nurses’ competency skills they have been taught. Community awareness is an important part of preventive healthcare, and nurses must be aware of the factors that impact the health of the community. This study examines the effectiveness of lecture-based instructions in maternal and child care and its implications to students' social competency skills and community awareness in Nursing Colleges in Nueva Ecija, Philippines. The researcher uses survey questionnaire and employed the descriptive design where fifteen (15) nursing students and five (5) teachers were purposively selected. The findings revealed that the weighted mean for the effectiveness of lecture based instruction in maternal and child care is 3.91 with verbal description of “Effective”, the effects of lecture based instruction in maternal and childcare to students’ social competency skills and community awareness got the weighted mean of 3.87 and interpreted as “very satisfactory” and the effectiveness of actual community-based instruction is very effective with weighted mean of 4.25 and is higher compare to lecture based instruction. The results also revealed that students and teachers were challenged in lecture-based instruction in maternal and chi8ldcare during distance learning. Recommendations for the enhancement of lecture-based instruction in maternal and childcare in social competency skills and community awareness were also made.

The WHO European Region defined the role of a new central professional for primary care, the Family and Community Nurse (FCN). The introduction of FCN in the framework of health policies highlight a key role of nurses in addressing the families’ and communities’ needs. A scoping review was conducted in order to identify and describe the available tools which has been adopted for the assessment of the community health needs by FNC. A comprehensive literature review on Embase, Cochrane Library, PubMed, CINAHL, Scopus and PsycInfo databases was conducted including all studies up to May 2021. A total of 1563 studies were identified and 36 of them were included. The literature review had made possible to identify studies employing twelve different community assessment's tools or modalities. Referring the WHO framework proposed in 2001 some common themes have been identified with an uneven distribution, as profiling the population, deciding on priorities for action and public healthcare programmes, implementing the planned activities, evaluation of health outcomes, multidisciplinary activity, flexibility and involving the community. To the best of our knowledge, this work is the first attempt to provide an overview of community assessment tools, keeping the guidance provided by the WHO as a reference.

A copula is a useful tool for constructing bivariate and/or multivariate distributions. In this article, we consider a new modified class of (Farlie-Gumbel-Morgenstern) FGM bivariate copula for constructing several dierent bivariate Kumaraswamy type copulas and discuss their structural properties, including dependence structures. It is established that construction of bivariate distributions by this method allows for greater flexibility in the values of Spearman's correlation coefficient rho,  and Kendall's tau . For illustrative purposes, one representative data set is utilized to exhibit the applicability of these proposed bivariate copula models.

(1) Background: Travel medicine practice has not been a part of practice in the community pharmacies in Japan. However, it’s getting more common for pharmacists to run travel clinic in North America. With ongoing globalization, Japanese pharmacists might be practicing travel medicine in future. This descriptive study is to examine the current knowledge, attitudes, and practices among Japanese community pharmacists. (2) Methods: Invitation to the study was sent to all pharmacies or corporates listed on Nippon Pharmacist Association member list plus one another large size pharmacy chain that was not member of NPhA. Community pharmacists working under those companies received a weblink to the survey. The survey was conducted from June to July 2017 by online questionnaire. (3) Results: The self-declared knowledge level of infectious diseases as well as travel vaccinations was generally low. The frequency of correct answer of the antibiotic resistance in South East Asia was 48.5%. Knowledge level of qunine resistance to Plasmodium falciparum malaria in Ghana and Nicaragua was very low. (4) Conclusions: Japanese community pharmacists are not familiar with travel related infectious diseases and vaccines used in travel medicine. The knowledge on the antibiotic resistance in traveler’s diarrhea and malaria prophylaxis was all low that is consistent with low degree of exposure to travel health questions from patients in daily practice and low percentage of intention to earn travel health certificates.

(1) Background: With continuous globalization and modernization of people's lives, lifestyle has changed dramatically, with decreased physical activity and increased unhealthy eating patterns in many nations throughout the world. With the COVID-19 pandemic and changes taking place in people’s health and lifestyles around the world, the need for rehabilitation is expected to rise in the coming years.(2)Methods: This paper analyzes the integration model of sports and health care using theoretical analysis, literature reviews, logical reasoning, and other methods.(3)Results: The integration of sports and health care in China has entered the stage of practical implementation after many years of development, forming a few representative integration patterns. Governments, communities, community hospitals, hospitals, and third-party institutions are the main participants, with the community playing an important role in the integration. Pharmacies, sports venues, and schools with sufficient staff have a relatively low participation rate.(4)Conclusion: The grading treatment has been applied in health management and sports rehabilitation, based on the development of digital medicine, a government-led grading treatment model of "health management center" can promote the participation of multiple subjects in the integration of sports and health care, solving the problems existing in the current integration process to a certain extent.

Rural areas of advanced industrial countries have frequently experienced a dualistic set of policies: one designed for the land-use sector, especially agriculture; and another dealing with rural development [1]. As problems of industrialised agriculture and forestry emerged, a more joined up approach to policy was advocated. Since the 1980s, at national and international level, new elements of rural policy have emerged to connect these two policy fields, including environmental payments, farm diversification grants, woodland creation within the farm sector and support for community-led local development. Rural land is also closely connected to the biodiversity and climate crises which have become important policy drivers. Policy towards community-led local development has moved further in Scotland than almost anywhere else as a result of policies for community-based land reform, community empowerment and community asset transfer. These communitarian approaches connect closely to collaborative landscape management as it addresses environmental challenges. As collaborative place-based and area-based approaches emerge as the guiding stars of the new rural development, this paper explores the challenges in the governance of sustainability transitions in moving from a sectoral rural policy hinging around support for land use to one based much more on communitarian values and place-based development.

Due to the continuing high suicide rates among young men, there is a need to understand help-seeking behaviour and engagement with tailored suicide prevention interventions. The aim of this study was to compare help-seeking among younger and older men who attended a therapeutic centre for men in a suicidal crisis. In this case series study, data were collected from 546 men who were referred into a community-based therapeutic service in North West England. Of the 546 men, 337 (52%) received therapy; 161 (48%) were aged between 18 and 30 years (mean age 24 years, SD=3.4). Analyses included baseline differences, symptom trajectories for the CORE-34 Clinical Outcome Measure (CORE-OM) and engagement with the therapy. For the CORE-OM there was a clinically significant reduction in mean scores between assessment and discharge (p<0.001) for both younger and older men. At initial assessment, younger men were less affected by entrapment (46% v 62%; p=.02), defeat (33% v 52%; p=.01), not engaging in new goals (38% v 47%; p=.02), and positive attitudes towards suicide (14% v 18%; p=.001) than older men. At discharge assessment, older men were significantly more likely to have an absence of positive future thinking (15% v 8%; p=0.03), have less social support (45% v 33%; p=.02) and feelings of entrapment (17% v 14%; p=.02) than younger men. Future research needs to assess the long-term effects of help-seeking using a brief psychological intervention for young men in order to understand whether the effects of the therapy are sustainable over a period of time following discharge from the service.

Due to the continuing high suicide rates among young men, there is a need to understand help-seeking behaviour and engagement with tailored suicide prevention interventions. The aim of this study was to explore help-seeking behaviour and engagement for young men aged 18 to 30 years who attended a therapeutic centre for men in a suicidal crisis. In this prospective cohort study, data were collected from 546 men who were referred into a community-based therapeutic service in North West England. Of the 546 men, 337 (52%) received therapy; 161 (48%) were aged between 18 and 30 years (mean age 24 years, SD=3.4). One third (n=54; 34%) of the men were seen within 48 hours of their referral. Analyses included baseline differences, symptom trajectories for the CORE-34 Clinical Outcome Measure (CORE-OM) and engagement with the therapy. For the CORE 34 there was a clinically significant reduction in mean scores between assessment and discharge (p<0.001), with all outcomes demonstrating a large effect size. Future research needs to assess the long-term effects of help-seeking using a brief psychological intervention for young men in order to understand whether the effects of the therapy are sustainable over a period of time following discharge from the service.

Background Community health workers (CHWs) drawn from the general population are an important human resource in health care systems, preventing non-communicable diseases (NCDs) and contributing to an increase in healthy life expectancy in Japan. Thus, we have developed the COmmunity health workers perceptual and behavioral Competency Scale for preventing Non-communicable diseases (COCS-N) to measure CHWs’ competence in preventing NCDs. The purpose of this study is to examine individual and community factors affecting CHWs’ COCS-N scores. Methods Municipal public health nurses and other public health professionals are responsible for training and supporting CHWs in Japan. Therefore, the existence of CHWs and their willingness to participate in the study were confirmed with the municipalities, who were asked to distribute the self-administered questionnaire to CHWs where consent was obtained (N = 6,480). Variables used included demographic characteristics, COCS-N scores, and individual- and community-related factors. Logistic regression analysis was used to assess associations between variables. Results A total of 3,120 people completed the questionnaire, a valid response rate of 48.1%. The respondents’ mean age was 67.0 years (standard deviation = 9.0), and 88.0% were female. Comparison of the high- and low- competence groups in terms of NCD prevention based on COCS-N scores identified 13 factors associated with significant differences, including years spent working as a CHW (p < 0.001), subjective sense of health (p = 0.005), European Health Literacy Survey Questionnaire (HLS-EU-Q47) scores (p < 0.001), and community commitment scale (CCS) scores (p < 0.001). Logistic regression analysis revealed that HLS-EU-Q47 scores (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.02–1.03) were a significant individual factor, while CCS scores (OR: 1.14, 95% CI: 1.11–1.16) were a significant community factor. Conclusions We found that the COCS-N score was associated with the individual factors overall health literacy (HL), perceptions of HL, and subjective sense of health, and with the community factor CCS scores. These results suggest that strengthening individual factors such as HL and subjective sense of health, and community factors such as sense of community is an effective strategy for increasing CHWs’ competence in preventing NCDs.

Type 2 diabetes (T2DM) presents an enormous global healthcare challenge, especially among rural communities due to limited access. To overcome this, many low- and middle-income countries are resorting to task shifting, using community health workers (CHWs) for diabetes management. However, its successful implementation depends on the practice behaviours and knowledge of these workers. This cross-sectional study from rural South India aimed to evaluate the proficiency of 275 CHWs in diabetes screening and management. A customized questionnaire, developed through experts and government was used to evaluate the practice behaviours and knowledge. Analytical methodologies consisted of descriptive statistics, logistic regression, and mosaic plots for comprehensive data interpretation. Results showed significant deficiencies of mean correct practice behaviours at 48 and 50% respectively. The identified gaps included diabetes diagnosis, HbA1c testing, diet, self-management, complications screening and risk assessment. In several areas, correct practice behaviour was reported by a relatively large number of CHWs despite incorrect answers to the related knowledge questions such as referral to the health centres, self-management and calculation of diabetes risk assessment. Addressing these deficiencies requires a thorough needs assessment and tailored training for improved diabetes management by CHWs. Training of CHWs, should not only identify prior knowledge and/or behaviour but also their interrelationship to help create a robust and flexible set of practice behaviours.

Pharmacists and pharmacies are highly visible and accessible to the public and have long been regarded as a source for immunization services in the United States. As international travel continues to increase and grow in popularity in this country, there is a pressing need for expanded access to preventative health services including routine and travel vaccinations and medications for prophylaxis or self-treatment of conditions that may be acquired overseas. In the United States, the scope of pharmacy practice continues to expand and incorporate these preventable health services to varying degrees on a state-by-state level. As a result, pharmacists can help to increase access to and awareness of the need for these services to insure that patients remain healthy while traveling abroad and that they do not acquire a travel-related disease while on their trip. For those pharmacists interested in starting a travel health service, considerations should be undertaken that ensures that they have the necessary training, education, and skill set in order to provide this specialty level of care and that their practice setting is optimally designed to facilitate this service. Outcomes from studies that have evaluated pharmacy-based travel health services are positive, which further supports the role of the pharmacist in this setting. Therefore, the purpose of this paper is to highlight United States pharmacy laws and regulations, pharmacist training, travel clinic considerations, and patient care outcomes from pharmacy-based travel health services.

Adaptation to the impacts of human induced global heating is inevitable. For a socially just and ecological sustainable adjustment to these new circumstances, we need to draw from diverse knowledge systems while, simultaneously, foster a social-ecological transformation. We approach these concerns through the concept of community-based adaptation (CBA) and discuss remedies. Synergies with feminist knowledge systems and indigenous ways of living show the transdisciplinary essence of CBA. By abstracting from its origin and overlapping disciplines, revealing the social metabolism as a common problem, CBA is prone to achieve more equitable and sustainable adjustments. Transdisciplinarity itself and the current related CBA literature point beyond mere adjustments and call for a redesign of the social metabolism, thereby shifting from adaptation to global heating towards adaptation with nature by focusing on social provisioning. An engagement with transformative adaptation and heterodox economics further shows the potential of CBA to serve as an instrument in support of a social-ecological transformation by addressing root causes of vulnerability and by fostering epistemic justice. Reflecting these points back on the epistemological and ontological assumptions of CBA, the viewpoint proposes critical realism as a guiding philosophy of science to move forward.

Participation by local communities in wildlife conservation projects have long been advocated since it is socially just and is effective to reach conservation and development goals. Socio–economic variables that drive participation and impact of participation have been studied, but the contextual process that stir up local community participation remains understudied. In this paper, we studied factors facilitating community participation in three wildlife conservation projects in Northeast India. Through ethnographic fieldwork at these sites we identified conservation actors and examined interactions between them.We found common modes of participation at these sites and these were related to gaining material incentives, providing labour, attending consultative workshops. Levels of interaction and coercion were found to be different in three sites. Three critical factors that drive participation were: (1) trigger, (2) negotiation and (3) sustenance. Trigger factors kickstart participation through establishment of a crisis narrative and facilitation by external actors. Negotiation factors emerge from day–to–day interaction between local community and external actors and involve effective entry stage activities, income opportunity, mediating voices within the community and intra–community dynamics. Sustenance factors affect the long term participation by community in the conservation project and involve tangible/intangible results, capability development of locals, funding and availability to critical information. In our paper we argue that investment of time and fund to understand the stakeholders and their concept of participation, periodic feedback sessions, capacity development of locals for self–mobilization, innovative information dissemination and securing long term funding are necessary for effective local community participation.

This review highlights the potential and limitations of mRNA vaccines with a particular focus on mucosal delivery as an alternative to parenteral administration. The strengths of mRNA vaccines are: a) Versatility: they can be adapted to target a wide range of pathogens; b) Faster development: designed and produced more quickly than traditional vaccines; c) High efficacy: effective in preventing severe disease, as demonstrated during the COVID-19 pandemic. Current challenges: a) Delivery: current methods (mainly intramuscular injection) may not be optimal for inducing mucosal immunity; b) Stability: mRNA is fragile and needs to be protected from degradation; c) Safety: potential side effects, including myocarditis, blood clotting, allergic reactions need further investigation. Mucosal delivery could be more effective in preventing the transmission of pathogens and is generally better accepted by the population. Pros: offers the potential to induce local immunity at the site of pathogen entry, potentially providing broader protection; Cons: developing effective delivery systems and adjuvants for mucosal delivery is difficult. Extracellular vesicles as a mucosal delivery system are promising and offer a potentially safe, scalable, and needle-free approach. Future directions: a) Optimizing mRNA constructs: strategies like codon optimization and self-amplifying RNA can improve stability and translation efficiency; b) Rigorous pre-clinical studies are essential before human trials.

Dysmenorrhea symptoms are frequent and often self-treated using non-prescription medicines. To further characterize women with dysmenorrhea using a combination of hyoscine butylbromide and paracetamol (PLUS) for self-management of their complaints, we performed a secondary analysis of a published pharmacy-based patient survey. 314 women (mean age 32.3 years) with dysmenorrhea reported a pain and cramps intensity of 7.45 ± 2.13 on a 0-10 Likert scale, which was reduced to 2.86 ± 1.81 upon treatment. Associated impairments of work/daily chores, leisure activities, and sleep were improved by 64.6%, 62.2% and 70.4%, respectively. The onset of symptom relief was within 60 min in 84.7%. Tolerability was rated as very good or good by 97.2%. These findings confirm the efficacy and tolerability data on PLUS from randomized controlled trials in a larger group of women conducting self-management of their dysmenorrhea.

The global burden of stroke is still high, particularly in developing countries, with hypertension serves as the main risk factor. Knowledge related to stroke is essential to establish better prevention strategies. This study aimed to identify factors associated with stroke awareness among hypertensive patients in Indonesia. This was a cross-sectional study conducted in five Community Health Centers in Indonesia. We used a standardized questionnaire to asses stroke awareness and the influencing factors. The knowledge on hypertension was assessed using Hypertension Knowledge Level Scale (HK-LS). Multivariate logistic regression analysis was performed to measure factors associated with stroke awareness. A total of 457 hypertensive patients were included. Majority of patients (77.46%) had low stroke awareness. Having higher knowledge on hypertension, higher income, and a history of previous stroke were associated with higher level of stroke awareness (odds ratio [OR] 1.878, 95%CI 1.176-2.999, p 0.008; OR 1.887, 95%CI 1.170-3.045, p 0.009; OR 5.276, 95%CI 2.210-12.594, p<0.001, respectively). This study suggests that knowledge on hypertension, income, and history of previous stroke are factors which may influence the level of stroke awareness. This emphasizes the need to provide better campaign and education program to raise stroke awareness in a community setting.

Wastewater-based epidemiology (WBE) has emerged as a key method for continuous monitoring of COVID-19 prevalence including circulating SARS-CoV-2 lineages. WBE addresses limitations of traditional clinical COVID-19 surveillance such as clinical test availability, fluctuating testing rates and increased reliance on rapid antigen tests. Our study in Perth, Western Australia, found a significant positive correlation between SARS-CoV-2 concentrations in wastewater and clinical PCR positivity rates (rs = 0.772; p < 0.001) over an 18-month period that included four successive COVID-19 waves. A strong positive correlation was apparent between the proportions of SARS-CoV-2 lineages in wastewater and clinical cases within the same region (rs = 0.728; p < 0.001), including earlier detection of Omicron and recombinant lineages in wastewater before clinical case confirmation. The successful integration of WBE with healthcare data underscores its critical role in enhancing public health decision-making and pandemic management. This approach not only demonstrates the value of WBE in current global health surveillance efforts but also highlights the potential of WBE to address future public health challenges, as a comprehensive disease monitoring and response approach.

Dust inhalation is a huge concern in the mining environment and within all its operations. In fact, dust to be one of the most serious occupational hazards in the mining industry. Coal and crystalline silica dust are the causes of serious, sometimes fatal lung diseases such as pneumoconiosis, which affects coal miners, as well as silicosis, tuberculosis, chronic bronchitis, emphysema, chronic obstructive pulmonary disease, and chronic renal disease, which affect coal and other types of miners. The resulting effects both affect workers and nearby communities. The mining industry has in the past, employed several approaches to reduce effects of dust. But these strategies have often been ineffective because the grass withers during the dry season and sprayed water is rapidly absorbed or evaporates. This paper endeavors to review information on dust in the mining environment and how it is a nuisance to workers and communities and establish what strategies exist for this.

Flooding during the rainy season poses a significant threat to the city of Hargeisa, impacting the well-being of both its residents and the local ecosystems. This research focuses on urban flood control, with a specific emphasis on finding sustainable solutions for managing large stream in Hargeisa. The study identifies five key dimensions, including infrastructure, transportation, environmental soil, life, and property, as critical factors in addressing the issue. By employing a comparative method and collecting data through closed-ended questions, the research aims to analyze and weigh eleven potential solutions, seeking to identify the most effective approaches. The findings of the study indicate that constructing a dam emerges as a promising and sustainable solution, with a weightage of 70 percent. This highlights the potential of a dam in mitigating the impact of floods in the region. Additionally, considering the government's economic capacity, the implementation of check dams is identified as another viable option, with a weightage of 95 percent for reducing the flood power of the stream. These solutions offer practical and effective measures to address the recurring problem of flooding in Hargeisa. To support future decision-making and planning, the research underscores the need for establishing a comprehensive rainfall data database. This database would store relevant information on rainfall patterns, enabling better understanding and prediction of flood events. The study emphasizes the importance of collaboration between local government authorities, environmental organizations, and stakeholders to develop and implement effective flood control strategies. This research provides a systematic approach that can inform and benefit regional and global researchers, policymakers, and municipal governments in their efforts to address urban flood control challenges, not only in Hargeisa but also in similar contexts worldwide.

Background: Community-based medical education (CBME) is an essential component of medical education, where primary healthcare physicians (PHPs) play a crucial role. This study explores PHPs' awareness and engagement in CBME and investigates the factors influencing their participation. Methods: This mixed study was conducted in two phases. In the first phase, a qual-itative study was conducted using semi-structured interviews with PHPs, and thematic analysis related to their awareness and engagement in CBME. In the second phase, a quantitative survey was conducted among 72 PHPs pre- and post-training programs. Results: Primary healthcare physicians had a positive attitude toward community-based medical education. The participants have an acceptable level of awareness and engagement, which increased substantially (p-value = 0.03) and (p-value = 0.003), respectively. Logistic analysis indicated that non-Saudi physicians were likelier to participate in the CBME (p-value=0.001). Professions and academic experiences influence their willingness and engagement to participate in CBME (OR= 7.5, p-value=0.001) and (OR=0.21, p-value=0.001), respectively. Conclusion: The study findings highlighted the importance of increased awareness and the factors that enhance PHPs' engagement in CBME. This positive perspective of the PHPs helps build effective partnerships and facilitates the extension of the curriculum to apply CBME.

Globally, sacred groves represent a traditional form of community-based conservation system, recognized for their capacity to preserve areas that are of cultural and religious importance to local people. In most cases, the entire community takes on a watchdog role to guard against encroachment and unauthorized access either by its members or outsiders who might desecrate such sites. Our paper investigates the effects of different governance arrangements on three sacred groves in southwest Nigeria⎯Osun Osogbo Sacred Grove (UNESCO World Heritage Site); Idanre Hills (Nigerian National Monument) and Igbo-Olodumare (local cultural site)⎯on their socio-economic and religio-cultural benefits and contribution to biodiversity conservation. Using a mixed-methods design of a semi-structured questionnaire (n=167), key informant interviews (n=2), and focus groups (n=7), we collected data from local community members, traditional priests, sacred grove devotees and tourism officials. We found that customary institutions have guided reverence for sacralized spaces and wise utilization of their unique resources. The growing recognition of sacred groves has paved the way for socioeconomic rewards for individuals and government as cultural tourism increases. We found that the involvement of formal institutions alongside customary institutions in sacred grove management reinforces compliance with conservation laws within the sacred groves, especially where traditional norms are weak or may be disregarded. We discuss the implications of these observations and offer suggestions to improve community engagement, uphold traditional ecological knowledge, and develop ecotourism within the groves. We conclude that the co-existence of community-based conservation through a system of established traditional norms and prohibitions as well as formal government legislation and management, offers assurance for the long-term preservation of sacred groves and their biodiversity.

This study explores the impact of the ‘pre-intervention effects’ of a community-based interventions. This refers to participatory research processes and parallel publicity in the media on changes in alcohol use and relevant mechanisms (rules and norms about alcohol, accessibility of alcohol in a formal setting) among adolescents before any intervention is implemented. In a quasi-experimental study, adolescent data were collected twice by means of self-report among adolescents living in two municipalities (control and experimental condition). Regression analysis showed pre-intervention main effects on adolescents’ perceived accessibility of alcohol in a formal setting. Moreover, among adolescents aged 15 years and older, the normative decline in strictness of rules and norms was less steep in the experimental condition compared to the control condition. Also, adolescents aged 14 years and younger in the experimental condition reported more weekly drinking compared to their peers in the control condition. No differential effects across gender were found. To conclude, applying a co-creational approach in the development of an intervention, not only contributes to more effective interventions in the end, but involvement of and discussions in the community at the start of intervention planning are contributing to changes in targeted factors. This implies that public discussions about the development of intervention strategies should be considered as an essential feature of co-creation in community-based interventions.

Malnutrition and dental caries in early childhood remain persistent and intertwined global health challenges, particularly for indigenous and geographically-remote populations. To examine the prevalence and associations between early childhood dental caries, parent-reported mouth pain and malnutrition in the Amazonian region of Ecuador, we conducted a cross-sectional study of the oral health and nutrition status of 1,407 children from birth through age 6 in the “Alli Kiru” program (2011-2013). We used multivariate regression analysis to examine relationships between severe caries, parent-reported mouth pain measures, and nutritional status. The prevalence of dental caries was 65.4%, with 44.7% of children having deep or severe caries, and 33.8% reporting mouth pain. The number of decayed, missing and filled teeth dmft) increased dramatically with age. Malnutrition was prevalent, with 35.9% of children stunted, 1.1% wasted, 7.4% underweight, and 6.8% overweight. As mouth pain increased in frequency, odds for severe caries increased. For each unit increase in mouth pain frequency interfering with sleeping, children had increased odds for underweight (AOR: 1.27; 95% CI: 1.02 – 1.54) and decreased odds for overweight (AOR: 0.76; 95% CI: 0.58 – 0.97). This relationship was most pronounced among 3-6 year-olds. Early childhood caries, mouth pain and malnutrition were prevalent in this sample of young children. Parent-reported mouth pain was associated with severe caries, and mouth pain interfering with sleeping was predictive of poor nutritional status. We demonstrate the utility of a parsimonious parent-reported measure of mouth pain to predict young children’s risk for severe early childhood caries and malnutrition, which has implications for community health interventions.

Public health is an important aspect of community activities, making research on health necessary because it is a crucial field in maintaining and improving the quality of life in society as a whole. Research in public health allows for a deeper understanding of the health problems faced by a population, including disease prevalence, risk factors and other determinants of health. This work aims to explore the potential of hospital patient data analysis as a valuable tool for understanding community implications and deriving insights for effective community health interventions. The study recognises the significance of harnessing the vast amount of data generated within hospital settings to inform population-level health strategies. The methodology employed in this study involves the collection and analysis of deidentified patient data from a representative sample of a hospital in Indonesia. Various data analysis techniques, such as statistical modelling, data mining and machine learning algorithms, are utilised to identify patterns, trends and associations within the data. A program written in Python is used to analyse patient data in a hospital for five years from 2018 to 2022. These findings are then interpreted within the context of public health implications, considering factors such as disease prevalence, socioeconomic determinants and healthcare utilisation patterns. The results of the data analysis provide valuable insights into the public health implications of hospital patient data. The research also covers prediction for the patient data to the hospital based on disease, age and geographical residence. The research prediction shows that in 2023, the number of patients was not considerably affected, but in in March to April 2024, the number significantly increased to 10,000 patients. These recommendations encompass targeted prevention strategies, improved healthcare delivery models and community engagement initiatives. The research emphasises the importance of collaboration between healthcare providers, policymakers and community stakeholders in implementing and evaluating these interventions.

Exposure to air pollution have detrimental effects on the elderly, women, people with pre-existing medical conditions, people living in poverty and children. The aim of the study was to investigate the extent of community awareness and knowledge on the health risks associated with exposure to air pollution. A cross-sectional study design was used for the study, using self-administered questionnaires. A simple random sampling technique was used to select 376 respondents. Systematic sampling method was applied to select the households. SPSS version 26 was used to analyze data. Of 376 respondents, 221 were males and 154 females. 113 were aged between 23-47years and 353 were aware that if they don’t protect themselves against polluted air, they may get sick, with age and educational status associated with their awareness (p &lt; 0.05). About 361 knew what air pollution is and 188 think the air they breathe in Annadale is moderate. A total number of 278 said they feel sick/uncomfortable when the quality of air is bad. About 293 knew that people are exposed to air pollution by breathing contaminated air and 237 identified sewage smell as the main cause of air pollution. Respondents who identified internet and television as the main source of information were 199 and 177 respectively. Those who were not aware of actions implemented to reduce air pollution were 180. Based on the results of the study, respondents are aware of the dangers of exposure to polluted air, and it is necessary that air pollution risk communication strategies be implemented to empower residents.

Online digital mental health communities can contribute to users’ mental health positively and negatively. Yet the measurement of outcomes and impact relating to digital mental health communities is difficult to capture. In this paper we demonstrate the development of an online experience measure for a specific children and young people’s community inside a digital mental health service. The development is informed by three phases: (i) item reduction through Estimate-Talk-Estimate modified Delphi methods, (ii) user testing with participatory action research and (iii) a pilot within the digital service community to explore its use. Rounds of experts talks help to reduce the items. User experience workshops helped to inform the usability and appearance, wording, and purpose of the measure. Finally, the pilot results highlight completion rates, difference in scores for age and community roles and a preference to ‘relate to others’; as a mechanism of support. Outcomes frequently selected in the measure show the importance of certain aspects of the community, such as safety, connection, and non-judgment previously highlighted in the literature. Self-reported helpfulness scales like this one could be used as indicators of meaningful engagement within the community and its content but further research is required to ascertain its acceptability and validity. Phased approaches involving stakeholders and participatory action research enhances the development of digitally enabled measurement tools.

Access to urban green and blue spaces (UGBS) has been associated with positive effects on health and wellbeing; however, the past decades have seen a decline in quality and user satisfaction with UGBS. This reflects the mounting challenges that many UK cities face in providing appropriate public facilities alongside issues such as health inequalities, an ageing population, climate change, and loss of biodiversity. At present, little is known about the preferences of different population subgroups and, specifically, the UGBS they visit and the spaces they avoid. Using a public participatory geographic information system (PPGIS), the overall aim of the research presented here was to investigate the preferences of different population subgroups in urban areas, and the UGBS they visit, using Edinburgh, Scotland as a case study. We created a baseline visitor demographic profile for UGBS use, and highlighted how visitors perceive, physically access, use, and engage with UGBS. The results revealed considerable variation in UGBS preference: one person’s favourite UGBS may be one that someone else dislikes and avoids. It is clear that adapting UGBS to suit local communities should not be a ‘one-size-fits-all’ approach. The conflicting views and preferences of different groups of respondents point to the importance of developing policies and park management plans that can accommodate a variety of uses and experiential qualities within individual parks. PPGIS offers an ideal tool for achieving this

COVID-19 appeared as an infectious disease of global health emergency and the highest public health concern of 21st century for this world due to its high-speed of spread across the globe. The disease started as one single case to a cluster of cases in Wuhan, China (Dec 2019) and within few months with its continuous upsurge of cases spreading globally which has created enormous threat and tension across the global Public health care field. Most significantly to share the fact that, this disease caused high level of Risk Group mortality, high morbidity, health care services burden, panic anxiety, mental trauma and tension, social and economic insecurity, which also collectively surfaced by diverse range of social reaction and political pressure across the world. Also with the appearance of new and unknown pathogenesis of the disease has created the most and significant attention and concern for the scientific community and political leaders as well. The disease also varies much with its pattern of virus, sign, symptoms, characteristics including its epidemiological and public health response (like prevention strategy, diagnoses, case management, treatment pattern) across the countries. However, this variance is comparatively less rather even more in commonality while it comes to basic public health prevention interventions like frequent hand washing, wearing face mask, maintaining social/physical distancing (2 - 6 meter in between), individual isolation and community quarantine for suspected exposure and lockdown in community areas where cases are identified. These are with the most commonly practiced public health interventions to deal with this disease in majority of the epicenters across countries. Also with the progress of the disease with its diverse categorical appearance of sign symptoms which are uniquely portraying this disease is more of a kind of COVID-19 syndrome than as COVID-19. Moreover, various factors including socio economic status, health status, population dynamics, health system and infrastructure, health behavioral pattern, nutrition and food habit and access to information and knowledge made this viral disease one of the historically counted on expensive disease of the modern world to fight for. Specially to mention here, the case fatality rate distinctively vary with the population dynamics and the health system infrastructure and ability factors which have already created clear evidence as explained in this paper how these factors are uniquely distinguished and different from country to country. Apart from the contextual differences, the various kind of ongoing preventive measures (like prevention, diagnosis and treatment) learnt every day from the emerging characteristics and pattern of this viral disease which are most commonly practiced across countries with a variance. According to the Public health prevention practice and interventions, the total world is connected and learning from each other’s public health experiences to fight for the virus. However, the world communities are eagerly waiting to see the result and outcome of the ongoing therapeutics and vaccine trial initiated in several countries, the people of the world are quite optimistic and hopeful that, global scientific community will be able to invent some miraculous and magic solution in upcoming months which ultimately will free the world from this most terrifying COVID-19 pandemic of 21st century.

The development of plant-based meat analogues has become a significant challenge for the food industry in recent years due to the increasing demand for sustainable and healthier proteins in the context of a global protein transition. Plant-based meat analogues imitate the visual, textural, and chemical properties of traditional meat products and are required to closely resemble meat to appeal to consumers. In addition, consumers demand natural, clean-label, and nutritional and healthy products. To address these challenges, the food industry must develop highly healthy, nutritious, and E-number-free meat analogue products. Understanding the functionality of each ingredient and its role in the food matrix is crucial to being a key player in the innovation of the meat analogues market. This review provides updated information on the primary ingredients utilized for the development of plant-based burger meat alternatives and their functionality. The key components of meat analogue burgers are outlined, including plant proteins, binding agents, fats and oils, flavorings, colorings, preservatives, fortificants, and clean-label considerations.

The study investigated the application of Wastewater-Based Epidemiology (WBE) as a tool for monitoring SARS-CoV-2 prevalence in a city in Northern Italy from October 2021 to May 2023. Starting from a widely applied deterministic model, this study proposed a variation to take into account population characteristics and virus biodegradation in the sewer network. The model calculated virus loads and corresponding COVID-19 cases over time in different areas of the city and was validated with healthcare data while considering viral mutations, vaccinations, and testing variability. The correlation between the predicted and reported cases was high across the three waves that occurred in the considered period, demonstrating the model’s capacity to predict relevant fluctuations in the number of cases. Population characteristics did not substantially influence the predicted and reported infection rates. Conversely, biodegradation significantly reduced the virus load reaching the wastewater treatment plant, resulting in a 30% reduction in the total virus load produced in the study area. This approach can be applied for comparing virus load values across cities with varying population demographics and sewer network structures, enhancing the comparability of WBE data for effective surveillance and intervention strategies.

Background: This year has seen the emergence of two major crises, a significant increase in frequency and severity of hurricanes and the COVID-19 pandemic. However, little is known as to how each of these two events have impacted the other. A rapid qualitative assessment was conducted to determine the impact of the pandemic on preparedness and response to natural disasters and the impact of past experiences with natural disasters in responding to the pandemic. Methods: Semi-structured interviews were conducted with 26 representatives of 24 different community-based programs in southern Louisiana. Data were analyzed using procedures embedded in the Rapid Assessment Procedure – Informed Community Ethnography methodology, using techniques of immersion and crystallization and focused thematic analysis. Results: The pandemic has impacted the form and function of disaster preparedness, making it harder to plan for evacuations in event of a hurricane. Specific concerns included being able to see people in-person, providing food and other resources to residents who shelter in place, finding volunteers to assist in food distribution and other forms of disaster response, competing for funds to support disaster-related activities, developing new support infrastructures, and focusing on equity in disaster preparedness. However, several strengths based on disaster preparedness experience and capabilities were identified, including providing a framework for how to respond and adapt to COVID and integration of COVID response with their normal disaster preparedness activities. Conclusions: Although prior experience has enabled community-based organizations to respond to the pandemic, the pandemic is also creating new challenges to preparing for and responding to natural disasters.

Grain production and storage are major components in food security. In the ancient times, food security was achieved through gathering of fruits, grains, herbs, tubers, and roots from the forests by individual households. Advancements in human civilization led to domestication of crops and a need to save food for not only a household, but the nation. This extended need for food security led to establishment of national reservoirs for major produces and this practice varies greatly in different states. Each of the applied food production, handling and storage approaches has got its benefits and challenges. In sub-Saharan Africa, several countries have a public funded budget to subsidize production costs, to buy grains from farmers and to store the produce for a specific period and/or until the next harvests. During the times of famine, the stored grains are later given free to the citizens. If there is no famine, the grain is sold to retailers and/or processors (e.g., millers) who later sell it to the consumers. This approach works well if the produce (mainly grain) is stored under conditions that do not favor growth of molds, as some of these could contaminate the grain with toxic and carcinogenic metabolites called mycotoxins. Conditions that alleviate contamination of grains are required during production, handling and storage. Most of the grain is produced by smallholder farmers under sub-optimal conditions, which make vulnerable to colonization and contamination by toxigenic fungi. Further, the grain is stored in silos at large masses, where it is hard to monitor the conditions at different points of these facilities, and hence it becomes vulnerable to additional contamination. Production and storage of grain under conditions that favor mycotoxins poses major food health and safety risks to humans and livestock who consume the grain. This concept paper focuses on how establishment of local grain production and banking system (LGPBS) could enhance food security and safety in East Africa. The concept of LGPBS provides an extension of advisory and finance support within warehouse receipting system to enhance grain production under optimal conditions. The major practices at the LGPBS, and how each could contribute to food security and safety are discussed. While the concept paper gives more strength on maize production and safety, similar practices could be applied to enhance safety of other grains in the same LGPBS.

Keywords: conservation; cultural pluralism; environmental regulation; community-based natural resource management; Indigenous law

Social and spatial characteristics of a population often interact to influence health outcomes, suggesting a need to jointly analyze both to offer useful insights in community health. However, researchers have used either social or spatial analyses to examine community-based health issues and inform intervention programs. We propose a combined socio-spatial analytic approach to develop a social network with spatial weights and a spatial statistic with social weights, and apply them to an ongoing study of mental and physical well-being of rural Latino immigrants in North Florida, USA. We demonstrate how this approach can be used to calculate measures, such as social network centrality, support contact dyads, and spatial kernel density based on a health survey data. Findings reveal that the integrated approach accurately reflected interactions between social and spatial elements, and identified community members (who) and locations (where) that should be prioritized for community-based health interventions.

The concept of a Social License to Operate (SLO) has become increasingly important in the sustainability literature in recent years. Having its origins in the business discourse of the mining industry with respect to limiting opposition to mining projects, the notion of a social contract above and beyond legal requirements has since become applied across a number of different industries. Despite the concepts adoption confusion exists over the practices and outcomes of SLO, and particularly the nature of engagement. Given this situation it is surprising that not more attention to the role of marketing, and social marketing in particular, in operationalizing the concept. The paper discusses the potential of social marketing to contribute to SLO. Economic, political and social relations are complex in SLO and exchange is intricate in such relational environments. A community-based social marketing orientation is proposed as a means to improve exchange relations and enhance engagement. Seven models of SLO related social marketing models are discussed with community-based social marketing and adaptive co-marketing models being regarded as the most positive for the achievement of an SLO. Potential barriers to adoption of these approaches are noted.

The study aimed to evaluate the impact of community policing on maintaining community safety and security by measuring the rate of crime prevention. Specifically, it sought to find out how the city administration of Addis Ababa demonstrated and promoted understanding of the community policing effort, information sharing, and community members' opinions regarding community policing in relation to local security procedures. Law enforcement initiatives to improve quality of life and reduce crime are also included. In order to be successful, community policing requires concrete actions and projects, and given the pervasive mistrust in today's public, both police departments and individual officers must take the lead. The findings demonstrated the influence of community policing, information sharing, and their results on local security practices as well as community policing among community members. According to one suggestion, the police should make sure that they interact positively with the community and that people are aware of their involvement in community policing. This way, people will be happy to provide the police with information that could help prevent crime. The public should be encouraged to maintain good connections with the police, as they can enhance community policing. Because it were obvious that doing so will improve society's peace and security, this study showed the need for additional efforts to further cement relationships of collaboration between the police and the community.

Background Globally the average age of the worlds’ population of older persons continues to upsurge and social support becomes increasingly relevant. Overall, in Malaysia, social support and networking prevalence was found to be lower among older persons at 30.76%. In view of the scarce data on social support and its association with smoking status and its associated factors among the older Malaysian population this study was conducted. Methods Data from the National Health and Morbidity (NHMS) 2018 survey on health of older Malaysian adults was analyzed. This was a cross sectional population-based study using a two-stage stratified random sampling design. Elderly population aged 60 years and above was selected. Data were collected were sociodemographic characteristics, smoking status, and social support. A validated Malay language, interviewer-administered questionnaire of 11-item Duke Social Support Index was applied for assessing social support among the elderly. A complex sampling design analysis was used for the descriptive statistics. The associated risk factors for social support were identified using Multiple Logistic Regression analysis. Results A total of 3923 elderly respondents participated in the study. The prevalence of good social support was significantly higher among the 60-69 years old respondents compared to the > 80 years old (73.1%, 95% CI :69.3% -76.5% vs 50.1 %, 95% CI:41.7 %- 58.6%).Multivariate logistic regression analysis showed that the odds of poor social support were 1.7 times (aOR: 1.72 % ,95%CI: 1.19 -2.48) higher for the respondents aged > 80 years old, than those aged 60-69 years. Respondents with no formal education were 1.93 higher odds of poor social support than the respondents with tertiary education (aOR: 1.93%, 95%CI: 1.13,3.30). Respondents with income < RM 1000 were 1.94 times more likely to have poor social support compared to respondents with income > RM 3000 (aOR: 1.94, 95% CI : 1.21 -3.13). Former smokers have good social support compared to current smokers (73.6% ,95% CI: 67.7-78.7 vs 65.1 %, 95%CI:58.4 -71.2). For current smokers, the odds of poor social support were 42.0% higher than for non-smokers (aOR: 1.42, 95% CI: 1.05 -1.91. Conclusion There is poor social support among the older persons who are current smokers, advancing age, no formal education and low income However, further longitudinal studies are needed to determine the exact effects of the studied variables. These findings could assist the policymakers to develop strategies at the national level to enhance social support among the older smokers to ensure cessation of smoking.

The quadruple burden of diseases, early discharge from hospital and hospital at home have resulted in home-based care services becoming a requirement in South Africa. The home-based care services generate a significant amount of health care risk waste that is mismanaged. However, more attention is given to the health care risk waste generated in hospitals and clinics than to health care risk waste generated by home-based caregivers. Therefore, this study investigates the health care risk waste management practices by home-based caregivers. The study adopted a mixed research approach, qualitative and quantitative methods, using a literature review, interviews, and questionnaires as means of data collection. Results show that there are different types of health care risk waste generated as a result of different activities performed by home-based caregivers, but that the waste was found to be managed in an unsafe manner. The majority of households receiving home-based care did not have basic sanitation facilities such as toilets, running water and waste removal services, aggravating the issue of health care risk waste mismanagement. The study recommends a new policy framework that will lead to safe management practices of generated health care risk waste to be adopted by home-based caregivers.

Background: The importance of community health psychology in providing complex bio-psycho-social care is well-documented. We present a mixed-method study monitoring the efficacy of health psychology services in the Public Health Focused Model Program for Primary Care Development (2012-2017) in four disadvantaged micro-regions in North-East Hungary. Methods: Study 1 assessed the availability of the services using a sample of 17003 respondents. Study 2 applied a follow-up design to measure the efficacy of the health psychology services in a sample of 132 clients. In Study 3, we conducted focus group interviews to assess clients’ lived experiences. Results: More mental health issues and higher education predicted a higher probability of service use. Follow-up showed that individual and group-based psychological interventions resulted in lower depression and (marginally) higher well-being. Thematic analysis of the focus group interviews indicated that participants deemed topics like psychoeducation, a greater acceptance of psychological support, and heightened awareness of individual and community support important. Conclusions: The results of the monitoring studies demonstrate the important role health psychology services can play in primary health care in disadvantaged regions. Community health psychology can improve well-being, reduce inequality, support the population’s health awareness, and address unmet social needs in disadvantaged regions in Hungary.

In response to the National Institutes of Health (NIH) All of Us Medicine Research Initiative, the Precision Medicine Research (PreMeR) Diversity Consortium was formed by four institutions from the Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN). This synergistic approach proposed evidence-based, best practices used by experienced researchers to engage, recruit and retain diverse populations in the All of Us initiative. Conceptualization of the proposed approach was aided by social influence theories to better understand how people’s beliefs and opinions should be modified to affect change leading to action [1]. The Social-Ecological Model (SEM), for Health Promotion [2], from Stokols [1] and Community-Based Participatory (CBPR) Models[3],[4] guided proposed engagement, recruitment, and retention strategies contextualized with the individual, interpersonal, organizational, community, and policy spheres of influence. The PreMeR produced a partnership to evaluate and improve the effectiveness of current engagement, recruitment, and retention strategies for minority participation in scientific studies. This approach illustrates the need to incorporate multiple methods of engagement to reach a diverse audience to participate in scientific research. Engagement, recruitment, and retention strategies in community and biomedical research must be viewed as community engaged public health interventions, utilizing the same theoretical principles and approaches.

This paper investigates the theoretical foundation for developing renewable geothermal resources locally. For this reason, we pay attention to the role of communities in geothermal development. This study presents arguments for a framework that approaches the geothermal resources as an endogenous factor of community development. To analyse it, we create a model that explains the local economic characters of the geothermal exploitation beyond its geological conditions. It aims to conceptualise a community based geothermal development standard referring to the endogeneity principle. Geothermal energy is given attention since the characteristics of this resource determine its use locally. We argue that the role of communities in geothermal exploitation is pivotal in the process of green growth for further expansion of geothermal energy use.

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes.

Background: There is lack of data on types of community first aids use and treatment given post injuries from many low-middle income countries, including India. Materials and Methods: A cross-sectional study was conducted among children up-to 18 years of age, in Ujjain district, India to understand types of first aid given and health seeking post injury. Results: A total of 1087 injuries, in 1049 children were identified in last one year, 729 (67%) received, first aid and 758 (72%) sought some healthcare. Children with burns received most (86%) first aid, while most children (84%) with road traffic accidents (RTA) sought health care. Most children (52%) sought healthcare from a private health set-up; most (65%) being transported within the golden hour; motorbikes being the most preferred (50%) mode of transport. Only 1% injured used ambulance services. Commonly reported first aid included: use of coconut oil on wounds from falls (38%) and burns (44%); antiseptic cream on wounds from RTA (31%), turmeric in falls (16%), and rubbing of metal on a bitten site (47%). Potentially harmful substances applied included lime, toothpaste, clay and mud. Conclusion: In most injuries, appropriate locally available substances, were used by the community. Our findings will help design community interventions to increase appropriate first aid in childhood injuries.

This study aimed at assessing the extent to which the Saudi general population has embraced digital health medical applications to meet their health-related needs so that the Saudi Ministry of Health and government can appropriately be guided on scaling up of digital health across the country. As such, this study was guided by the question of to what extent do the Saudi people use digital health mobile-based applications?. This was a cross-sectional study utilizing snowballing sampling approach. Frequencies, Chi-square, and Spearman rank correlation statistics were used to offer descriptive and inferential analysis of the variables. The majority of the participants were economically able to afford smart devices that have medical apps, had at least an app on such devices, and highly regarded the benefits of the apps. Unfortunately, their understanding of how to use such apps was limited and this posed a barrier to embracing digital health alongside difficulty downloading apps, and medical ethical concerns. Although there is a willingness, extra effort is needed from the Saudi Ministry of Health and government to promote the uptake of digital health in Saudi Arabia.

Background: This study aimed to develop and evaluate a dietary self-care promotion program for hemodialysis patients based on Hurley's self-efficacy model. Methods: The needs of hemodialysis patients were identified, and an online community-based dietary self-care promotion program was developed with expert evaluations. 44 hemodialysis patients were randomly assigned to an experimental group (n=22) and a control group (n=22). The program was applied to the experimental group for four weeks. Before and after the intervention, as well as four weeks after the intervention, dietary self-efficacy, dietary self-care behavior, interdialytic weight gain, serum phosphorus, and serum potassium were assessed in both groups. Results: Significant differences over time and between groups were observed in dietary self-efficacy, interdialytic weight gain, serum phosphorus, and serum potassium. The interaction between time and group was also significant. While no significant differences were found over time in dietary self-care behavior, significant group differences and interaction effects between time and group were identified. Conclusions: The results indicate that the dietary self-care promotion program using an online community for hemodialysis patients is more effective in enhancing dietary self-efficacy and dietary self-care behavior compared to conventional treatment. This suggests the clinical applicability of the proposed dietary self-care promotion program.

Nurses’ competency towards Evidence-based Practice (EBP) has been extensively investigated by several studies worldwide. However, factors affecting the competence of Greek nurses working in the NHS have not been fully investigated in terms of EBP. Thus, this study aimed to explore the impact of individual qualifications of nurses on their competence towards EBP. Data from 473 registered nurses working in 10 hospitals of in the Greek National Health Service (NHS) were collected between October and December 2022 using a convenience-sampling method in a cross-section design. The Greek version of the 35-item (5-point Likert scale) Evidence-Based Practice Competency Questionnaire for Professional Registered Nurses (EBP-COQ Prof) was used to assess the competence level of nurses focusing on the attitudes, skills, and knowledge as well as the utilization of EBP in clinical practice. One-way ANOVA and Pearson coefficient tests were applied to compare possible differences among variables (two or more groups) as appropriate. A multi-factorial regression model was applied to explore participants’ qualifications, including demographics (MSc degree, gender, English language knowledge, etc.) as independent variables, and to control for potential confounding effects toward EBP competency. P-values &lt;0.05 were considered statistically significant. The mean age of 473 participants (402 women and 71 men) was 44.7 ± 9.2 years old. The mean value of competence subscales was found as follows: attitudes 3.9±0.6, knowledge 3.7±0.6, skills 3.1±0.8, and utilization 3.4±0.7. A multivariate regression analysis revealed that associates of “Master's degree” (t=3.039, p=0.003), “Writing an academic article” (3.409, p=0.001), “Working in a University clinic” (2.203, p=0.028) and, “Computer Skills” (2.404, p=0.017) are positively affecting ‘Attitudes’, ‘Knowledge’, ‘Skills’ and ‘Utilization’. Respectively. The research data suggest that nurses working in Greek NHS are limited in competence towards EBP in comparison to other European countries. Therefore, Vocational, Educational and Training programs tailored to EBP enhancement are crucially important.

AbstractBackground: Empowering Communities, Combating HIV/AIDS: The Indispensable Role of Community-Based Strategies in Awareness and PreventionObjective: Highlight the significance of community-based approaches in addressing the ongoing HIV/AIDS pandemic through enhanced awareness, reduced stigma, and effective prevention measures.Method: This article provides a theoretical analysis of community-based HIV/AIDS interventions, drawing upon key strategies and successful examples from diverse settings.Results: Community-based initiatives emerge as critical factors in empowering individuals and communities to take ownership of their health. Through culturally-sensitive education, accessible testing, and comprehensive support services, these initiatives effectively diminish the social stigma surrounding HIV/AIDS and promote preventative behaviors. Examples of successful programs illustrate the potential of community-driven approaches to achieve measurable reductions in transmission rates and improved health outcomes.Conclusion: The fight against HIV/AIDS necessitates robust community engagement. Community-based interventions, grounded in local knowledge and addressing specific needs, offer a promising pathway towards fostering health equity, reducing stigma, and ultimately curtailing the spread of the virus. Further research and investment in these initiatives are crucial to ensuring their scalability and sustained impact on global HIV/AIDS prevention efforts.

Indonesia's government anticipates waste problems by managing them through a large number of waste reduction programs. From a governance perspective in Indonesia, it is known that actors from diverse governmental levels and across sectors are involved in waste management, and their involvement largely depends on their institutional goals and problems. Hence, they are expected to coherently collaborate together by developing and implementing sustainable instruments and resources for improving waste management problems. However, it is necessary to understand how supportive and restrictive the governance of waste reduction programs is to encourage successful trash reduction. This study is designed to evaluate and examine the application of Community-Based Solid Waste Management (CBSWM) in Makassar. In this research, The Governance Assessment Tool (GAT) was applied to analyze the governance context of the waste reduction programs in Makassar qualitatively. From the assessment, contexts can be described as either supportive or restrictive of the processes of implementing public policies on waste management. As a result of such an assessment, this study shed light on some opportunities to improve the governance of waste management implementation's impact on reducing waste in Makassar, South Sulawesi, Indonesia. The conclusion of this study depicts that the most important actors are affiliated with the local government and the community. Moreover, this study shows that the assessment of contextual governance is predominantly restrictive.

Social safety, security, and comfort of school-going children during the travel time to school becomes a subject of anxiety to the parents and is a crucial issue in recent times. In this regard, community-based transport can be a significant way to address social security issues in travel at a reasonable cost and reduce the burden on private mode. In Dhaka city, school van service already exists but due to some sort of problems the service has not been proved an efficient and formal mode of transport for solving mobility problems. This study seeks to identify the existing problems and prospects of the school van service and provide a unique, healthy, safe, and reliable transport mode for children. Applying different tools of the Participatory Rural Appraisal (PRA) method, the problems and solutions have been drawn from the community. The recommendations of this study will help the school van services (a community-managed para-transit system) to be more functional in playing a vital role in solving the problems of short-distance travel. This service has great potentialities to be adopted in other trips such as trips to and from offices which will lessen the road congestion at the peak periods.

Course-based Undergraduate Research Experiences (CUREs) provide the same benefits as individual, mentored faculty research while expanding the availability of research opportunities. One important aspect of CUREs is student’s engagement in collaboration. We developed a partnership with the Caenorhabditis elegans (C. elegans) database, WormBase, in which students submitted annotations of published manuscripts to the website. This activity provided students with a collaborative research activity that benefitted the greater scientific community and enhanced students’ understanding of molecular genetics during the COVID-19 pandemic. WormBase relies on community annotators to read published articles and input phenotypic data. Students submitted a total of nine annotations directly to WormBase, which were curated by WormBase to ensure correctness and to reduce overlap from redundant annotations. Due to the stress on students during this time of crisis, qualitative data were collected in lieu of quantitative pre-post analyses. Students described their learning experiences in terms of interactions with the scientific community and the “real world”, content knowledge and competencies, and changes in perspectives and use of resources. Students also reported that this activity was helpful in their understanding of critical molecular genetics concepts. Most students reported on cognitive processes that represent mid-level Bloom’s categories. The shift to online learning during the COVID-19 pandemic created an immediate need for meaningful, collaborative experiences in CUREs. By partnering with WormBase, students gained insight into the scientific community and contributed as community members. We describe possible modifications for future courses, potential expansion of the WormBase collaboration, and future directions for quantitative analysis.

The international debate on the adaptive re-use of cultural heritage sites following the Sustainable Development Goals becomes more central than ever in the implementation of circular economy models for urban policies. The new values that characterise the cultural assets, considered as the result of a collaborative process, can enhance both the manufactured capital and the human capital, and to carry out the system of relationships that bind them. At the same time, the values of historical-artistic assets and produced by community-based regeneration processes are particularly relevant when they characterise abandoned commons and cult buildings, to which communities attribute an identity and symbolic value. Starting from the definition of the concept of Complex Social Value, we propose a methodological process that combines approaches and techniques typical of deliberative evaluations and collaborative decision-making processes. The aim is to identify the complex value chains generated by adaptive re-use, in which intrinsic values can play a driving role in the regeneration strategies of discarded cultural heritage. The experimentation, tested with the project “San Sebastiano del Monte dei Morti Living Lab” (SSMOLL), activates a creative and cultural Living Lab in the former church of “Morticelli”, in the historic centre of Salerno, in southern Italy. The re-use project is part of a more comprehensive process of social innovation and culture-led urban regeneration triggered in Salerno starting from SSMOLL.

The simplified, combined protocol admits children with a mid-upper-arm circumference (MUAC) of <125 mm or edema to malnutrition treatment with ready-to-use therapeutic food (RUTF) prescribing 2 daily RUTF sachets to children with MUAC <115 mm or edema and 1 daily sachet to those with MUAC ≥115 mm but <125 mm. This treatment has previously been shown to result in non-inferior programmatic outcomes compared to standard treatment. We aimed at observing its effectiveness in a routine setting at scale, including via delivery by community health workers (CHW). A total of 27 601 children were admitted to the simplified, combined treatment. Treatment resulted in 96% overall recovery with a mean LOS of 40 days and a mean RUTF consumption of 63 sachets per child treated. Among children admitted with MUAC <115 mm or edema 94% recovered with a mean LOS of 55 days and consuming an average of 97 RUTF sachets. Recovery in all sub-groups studied exceeded 90%.Treatment by CHWs resulted in similar (96%) recovery as treatment by formal health care workers (96%). The simplified, combined protocol results in high recovery and low RUTF consumption per child treated, and can safely be adopted by CHWs to provide treatment in the community-level.

Background: With new challenges to the health system, many new competencies within the scope of teaching public health need to be addressed in medical schools’ curricula such as disaster risk management and health system science. The aims of this study were to identify the needs of public health competencies for medical doctors in Thailand and to assess the level of integration for technical collaboration in teaching public health. Method: A total of 17 out of 21 Thai medical schools participated in the national survey. Qualitative inquiries applied focus group interviews of community representatives from ten sample villages and in-depth interviews of representatives from stakeholder organizations particularly employers. The list of public health competencies framework recommended by WHO-SEARO was applied. Quantitative analysis applied descriptive analysis using STATA 15 and qualitative findings were validated by interrelating the meaning of themes from Word Clouds created in NVivo12. Data integration applied a mixed-method Quan-qual approach. Results: 17 medical schools returned the questionnaires (80.95 % yield). The most common regionally-defined public health competencies (in over 70% of schools) were shown to be: Biostatistics, Community Medicine, Epidemiology, Family Medicine, Medical Ethics and Professional Laws, Preventive Medicine, Health Promotion, Holistic Care, and Research. The curriculum in only one medical school lacked Health Economics, whilst Disaster Management was lacking in two other schools. Discipline-based subjects were found to be more prevalent than interdisciplinary competencies. A variety of methods were being applied for teaching public health. The majority of the schools applied lecture as the main teaching method and multiple-choice questions as the main assessment method. Thai communities expect the doctors to get in touch with the community more often, lead the primary health care team through training the health professionals and community health volunteers, and educate the community for better health. Conclusion: Human resource is the main challenge in addressing interdisciplinary competencies. It is necessary to establish a collaborating mechanism among the big and small medical schools and the faculties of public health to improve the teaching of public health to undergraduate students in medical schools. There is also a need to strengthen the health system science and leadership so that future MDs can lead health service delivery according to the needs of their employers such as the Ministry of Public Health and the Rural Doctors Association. The findings of this study may help to identify a national framework of public health core competencies for medical schools and create a common platform for interdisciplinary collaborations.

We assessed the use of Evidence-Based Practice (EBP) among pharmacists working in community pharmacies in France, and the factors linked to this practice. During 3 months in 2018 an online survey was sent to over 7,000 active pharmacists, and posted on pharmacist social media sites. The 40-item questionnaire described four clinical cases reflecting typical situations (conventional med-icine and Complementary and Alternative Medicine) encountered daily by community pharma-cists. Multiple-choice responses were proposed and scored according to whether they reflected EBP. A high total score indicated behavior in line with EBP. Univariate and multivariate analyses were used to evaluate factors that might explain adherence to EPB (pharmacy’s characteristics, the pharmacist’s status, mode of continuing education and sources of information). 595 pharmacists completed the questionnaire. The majority relied on pharmaceutical industry and other biased and/or non-evidence-based sources, particularly concerning information on homeopathic products. The consultation of independent reviews, health agency recommendations, and peer-reviewed scientific journals, was associated with evidence-based decisions. In contrast, reliance on phar-maceutical industry documents, personal experience and informal handbooks was linked to lower EBP scores. The level of EBP use by French community pharmacists needs to be improved to ensure that good quality scientifically-based advice is given to customers.

Wildlife tourism and wildlife trade may appear juxtaposed, but are two, potentially aligning, income generators that could benefit conservation in developing countries. Utilising data sets collated from Madagascar’s Ministère du Tourisme and CITES respectively for the period 2007 to 2018, this study estimated levels of income from wildlife tourism and wildlife trade for Madagascar. Between 2007-2018, tourism reported yearly incomes ranging from a low of US $1.4 million up to a high of US $15.7 million. However, it was unclear what percentage of this figure flowed to benefit local communities. Alternatively, using reported networks for the live wildlife trade, the estimated economic value reaching collectors and/or intermediaries on Madagascar was US $72,299.80 for the period 2007 to 2018. Both revenue generators operated within different geographical areas, with tourism opportunities presenting themselves to communities adjacent NPs, while wildlife trade networks were not restricted to NPs and operated sporadically across Madagascar. Hence, the economic benefits reached different Malagasy participants across the country. The management of both activities needs great care to ensure that environmental impacts and sustainability are core measures on any such activities. Whilst this study shines light on economic values and novel perspectives regarding these two trade types, it also highlighted knowledge gaps. Thus, indicating where much greater research attentions was required to allow better understanding of the specific benefits and risks from engaging with both trade types for local Malagasy people and their environments.

The traditional practice of harvesting and processing raw date palm sap is not only culturally significant but also an essential nutritional source in South Asia. Yet, the potential for bacterial or viral contamination from animals and environmental sources during its collection remains a real and insufficiently studied risk. Implementing improved food safety measures and collection techniques could mitigate the risk of these infections. Additionally, the adoption of advanced food analytical methods has the potential to identify pathogens and uncover the natural bacterial diversity of these products. The advancement of NGS technologies, particularly nanopore sequencing, offers rapid and highly mobile capabilities. In this study, we employed nanopore sequencing for bacterial metabarcoding of a set of raw date palm sap samples collected without protective coverage against animals in Bangladesh in 2021. We identified several bacterial species with importance in the natural fermentation of the product and demonstrated the feasibility of this NGS method in the surveillance of raw palm sap products. We revealed two fermentation directions dominated by either Leuconostoc species or Lactococcus species in these products at the first 6 hours from harvest along with opportunistic human pathogens in the background, represented with low abundance. Plant pathogens, bacteria with the potential for opportunistic human infections and the sequences of the Exiguobacterium genus were also described and their potential role is discussed.

Background: During the COVID-19 pandemic some family physicians were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psycho-social support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW in-terventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

U.S. Spanish-speaking populations experienced gaps in timely COVID-19 information during the pandemic and disproportionate misinformation exposure. Brigada Digital de Salud was established to address these gaps with culturally-tailored, Spanish-language COVID-19 information on social media. From May 1, 2021-April 30, 2023, 495 Twitter, 275 Facebook, and 254 Instagram posts were published and amplified by 10 trained community health workers. A qualitative content analysis was performed to characterize topics and formats of 251 posts. To assess reach and engagement, page analytics and advertising metrics for 287 posts were examined. Posts predominantly addressed vaccination (49.45%), infection risks (19.12%), and COVID-related scientific concepts (12.84%). Posts were educational (48.14%), and aimed to engage audiences (23.67%), promote resources (12.76%), and debunk misinformation (9.04%). Formats included images/text (55.40%), carousels (27.50%), and videos (17.10%). By June 9, 2023, 394 Facebook, 419 Instagram, and 228 Twitter followers included mostly women aged 24-54. Brigada Digital reached 386,910 people with 552,037 impressions and 96,868 engagements, including 11,292 likes, 15,240 comments/replies, 9,718 shares/retweets, and 45,381 video play-throughs. The most engaging posts included videos, trending topics, and music or audio-narration. This community-based model to engage Spanish-speaking audiences on social media with culturally-aligned content to counter misinformation shows promise for addressing public health threats.

This study assesses the impact and sustainability of community development initiatives in Awgbu, Anambra State, spanning from 2015 to 2023. Using qualitative research methods, including interviews with key informants from the Awgbu community and government personnel. The observatory method is also applied which helped the researcher to see activities executed in the community. The research investigates the specific contributions of the Awgbu community to the overall development of Anambra State, how the community has benefitted from state government initiatives, and the extent to which the community responds to government requests and initiatives. The study also explores challenges in the relationship between the state government and Awgbu in terms of community development initiatives and offers recommendations for enhancing this relationship. The findings reveal that the Awgbu community has made significant contributions to the development of Anambra State, particularly in areas such as security, education, and infrastructure. The community has actively responded to government calls, participating in initiatives like the Choose Your Project Initiative (CYPI) and vigilante groups, thus fostering a positive and mutually beneficial relationship with the state government. However, challenges such as leadership crises and communication gaps exist, hindering the community's progress. Recommendations include improving community leadership, enhancing communication, and promoting peace to ensure sustainable community development. This research contributes to a deeper understanding of the dynamics between communities and government in achieving sustainable development and highlights the importance of collaborative efforts for positive outcomes. The findings have managerial and policy implications for both local communities and governments seeking to enhance community development initiatives and foster mutually beneficial relationships.

The growing population with changing consumption patterns in developing countries is causing significant challenges with regards to solid waste management. Plastic wastes are particularly problematic, with single-use plastics leaking into the environment, including the marine environment, at an unprecedented rate. Approximately 80 percent of ocean plastics come from land-based sources or about 8 million tons are dumped into the ocean every year. Thailand was identified as one of the top 10 countries ranked by mass of mismanaged plastic wastes, with more than 60,000 tons per year entering the ocean through multiple outlets, including rivers. In the environment, plastic wastes can be degraded into small sizes (less than 5 mm), called microplastics (MPs), which could contaminate the ecosystems and the food chain, including foodstuffs and water supply. Tap water samples collected from a water supply treatment plant and Academic Institutions 1 and 2 in central Thailand were found to contain MPs about 304 ±90, 270 ±109 and 386 ±102 particles/L, respectively. In addition, MPs concentrations of 211 ±70 and 122 ±60 particles/L were also found in drinking water samples collected from commercial bottled water and membrane filtration water, respectively. The MPs sizes of 0-50 µm were most abundant in both the tap and drinking water samples whose shapes were mainly fragments and fiber. These data indicated potential health risks to the people who consume these water sources, and recommendations for health impacts minimization were proposed.

Wildlife tourism and wildlife trade may appear juxtaposed, but are two, potentially aligning, in-come generators that could benefit conservation in developing countries. Utilising data sets collated from Madagascar’s Ministère du Tourisme and CITES respectively for the period 2007 to 2018, this study estimated levels of income from wildlife tourism and wildlife trade for Madagascar. Between 2007-2018, tourism reported yearly incomes ranging from a low of US \$1.4 million up to a high of US \$15.7 million. However, it was unclear what percentage of this figure flowed to benefit local communities. Alternatively, using reported networks for the live wildlife trade, the estimated eco-nomic value reaching collectors and/or intermediaries on Madagascar was US $72,299.80 for the period 2007 to 2018. Both revenue generators operated within different geographical areas, with tourism opportunities presenting themselves to communities adjacent NPs, while wildlife trade networks were not restricted to National Parks and operated sporadically across Madagascar. Hence, the economic benefits reached different Malagasy participants across the country. The management of both activities needs great care to ensure that environmental impacts and sus-tainability are core measures on any such activities. Whilst this study shines light on economic values and novel perspectives regarding these two trade types, it also highlighted knowledge gaps. Thus, indicating where much greater research attentions was required to allow better understanding of the specific benefits and risks from engaging with both trade types for local Malagasy people and their environments.

Underpinned by the new world Kirkpatrick model and in the context of a community-based, sport psychology program (My Strengths Training for Life™) for young people experiencing homelessness, this process evaluation investigated: (1) young peoples’ reactions (program and facilitator evaluation, enjoyment, attendance, and engagement) to and learning (mental skills and transfer intention), (2) the relationship between reaction and learning variables, and (3) the mediators underpinning this relationship. 301 young people living in a West Midlands housing service completed questionnaires on demographics, reaction and learning variables. Higher levels of program engagement were positively associated with more favorable reactions to the program. Enjoyment positively predicted learning outcomes, which was mediated by transfer intention. Recommendations are made for: (1) a balance between rigor and flexibility for evaluation methods with disadvantaged youth, (2) including engagement as well as attendance for indicators of meaningful program participation, (3) measuring program experiences (e.g., enjoyment) to understand program effectiveness, and (4) providing opportunities for skill transfer during and after program participation. Findings have implications for researchers, program commissioners, and policy makers working designing and evaluating programs in community-based settings.

This paper summarizes over a decade of collaborative eco-archaeological research along the central coast of California involving researchers from the University of California, Berkeley, tribal citizens from the Amah Mutsun Tribal Band, and California Department of Parks and Recreation archaeologists. Our research employs remote sensing methods to document and assess cultural resources threatened by coastal erosion and geophysical methods to identify archaeological deposits, minimize impacts on sensitive cultural resources, and provide tribal and state collaborators with a suite of data to consider before proceeding with any form of invasive archaeological excavation. Our case study of recent eco-archaeological research developed to define the historical biogeography of threatened and endangered anadromous salmonids demonstrates how remote sensing technologies help identify dense archaeological deposits, remove barriers, and create bridges through equitable and inclusive research practices between archaeologists and the Amah Mutsun Tribal Band. These experiences have resulted in the incorporation of remote sensing techniques as a central approach of the Amah Mutsun Tribal Band when conducting archaeology in their traditional territories.

Relatives play an important role in mental health service users’ care. Interventions directed either at service users or their relatives may influence the other person as well. The project Activa’t per la salut mental (Get active for mental health) consisted of a series of four interventions addressed at people diagnosed with mental disorders and their relatives to help them in their recovery process, increasing their agency and quality of life. The objective of the present study is to evaluate the interaction of the participation of service users on their relatives’ outcomes and vice versa. The impact of the project was evaluated within an RCT. The treatment group had access to all the circuit interventions while the control group received treatment as usual and could only access one of the interventions. All participants were evaluated at baseline, six months, and twelve months after the end of the first intervention. Service users were evaluated with the Stages of recovery questionnaire, and relatives with the Family Burden Interview Schedule II and the Duke-UNC-11 questionnaires. The interaction between service users and their relatives was analysed by means of correlational analyses within the intervention group. Service users baseline characteristics influenced in the level of participation of relatives and vice versa. The results also indicated an interaction between service users’ recovery score changes on the change of care burden of relatives. Service users’ participation levels interacted with the decrease of relatives’ burden. These results can be extremely helpful in fostering interactive benefits in future projects addressing the wellbeing of mental health service users and their relatives. Future studies could use specific designs to explore the directionality of the causality of these effects.

Inequality of health service for different specialty categories not only occurs in different areas inequality of health service for different specialty categories in the world, but also happens in the online service platform. In the online health community (OHC), health service was often of inequality for different specialty categories, including both online views and medical consultation for offline registered service. Moreover, how the factor city-level impacts the inequality of health service in OHC is still unknown. We designed a causal inference study with data on distributions of serviced patients and online views in over 100 distinct specialty categories on one largest OHC in China. To derive the causal effect of the city-levels (two levels inducing 1 and 0) on the Gini coefficient, we matched the focus cases in cities of rich healthcare resources with the potential control cities. For the Gini coefficient of serviced patients in over 100 specialty categories, the average treatment effect of level-1 cities is 0.470, which is 0.029 higher than that of the matched group. Similarly, for the Gini coefficient of online views, the average treatment effect of Level-1 cities is 0.573, which is 0.016 higher than that of the matched group. For each of the specialty categories, we also estimated the average treatment effect the specialty category’s Gini coefficient ( ) with the balanced covariates. The results support the argument that the total Gini coefficient of all the doctors in OHC shows that the inequality of health service is still very serious. This study contributes to the development of the theoretically grounded understanding of the causal effect of city-level on the inequality of health service in an online to offline healthcare service setting.

Abstract: Background: To determine the impact of a patient's ethnicity on the seeking preventive dental services at the Community Health Centers (CHCs) in South-Central Texas. Methods: Pri-mary electronic health records (HER) data were collected regarding each patient's medical and dental history, and comprehensive treatment planning. The researchers retrieved EHR from Jan-uary 2016 to 2022. Bivariate analysis was completed to test outcome with predicator and covariates using appropriate statistical tests. A multiple linear regression model was used to understand the association between the predictor and outcome variable while controlling for confounders. Results: The study findings revealed significantly higher dental visits (2.26 ± 2.88) for Hispanic patients. The results from the multiple regression model indicated that non-Hispanic patients had a 8% fewer chance of visiting the CHCs for preventive dental services compared to the Hispanic population (p-value<0.001) when all other variables are held constant. However, the study results were not significant as the effect size was small to conclude the effect of ethnicity on the patients visiting the dental clinic at the CHCs for preventive services. Conclusion: The study concluded that there is no difference in the preventive dental services completed by Hispanics and Non-Hispanics when all other variables are controlled.

The global issues of overweight and sedentary lifestyles demand comprehensive responses from health systems, yet health education still needs to be more cohesive and less sporadic. This study focuses on primary school children as a specific target for instilling healthy habits, employing ac-tive learning strategies to address healthy diet and physical activity. Through Problem-Based Learning projects, the study engaged fourth-grade primary students in acquiring healthy habits. The study was carried out over four consecutive years at a school with two lines, allowing the employment of an opportunity sample and evaluating intervention and control groups by com-paring their corresponding scores. Control groups integrated a total of 54 students, while the in-tervention group included a total of 159 students. A pre-test and post-test questionnaire were used for data collection. Evaluation differential scores revealed statistically significant higher scores in the intervention groups: 3.62 points in control groups and 6,94 in intervention groups, particu-larly in attitudinal competences. These strategies not only facilitated the development of crucial skills such as information search, synthesis, representation, analysis, decision-making, teamwork, and intrapersonal awareness but also significantly broadened the knowledge acquired in aspects related to healthy habits. This approach proved effective in helping children comprehend the im-portance of healthy choices and encouraged integrating such habits into their daily lives.

While machine learning (ML) has been quite successful in the field of structural health monitoring (SHM), its practical implementation has been limited. This is because ML model training requires data containing a variety of distinct damaged instances captured from a real structure and the experimental generation of such data is challenging. One way to tackle this issue is by generating training data through numerical simulations. However, simulated data cannot capture the bias and variance of experimental uncertainty. To overcome this problem, this work proposes a deep learning-based domain transformation method for transforming simulated data to the experimental domain. Use of this technique has been demonstrated for debonding location and size prediction of stiffened panels using a vibration-based method. The results are satisfactory for both, debonding location and size prediction. This domain transformation method can be used in any field where experimental data for training machine learning models is scarce.

For women giving birth, every moment of delay in receiving skilled care significantly increases the risks of stillbirth, neonatal and maternal death. More than half of all births in developing countries including South Africa, take place outside a health facility and without skilled birth attendants. This has therefore, made it difficult to achieve the Sustainable Development Goals of global reduction in maternal mortality, which is a key health challenge globally, especially in developing countries and sub-Saharan Africa in particular. The aim of this study was to explore and describe the views of pregnant women regarding facility-based delivery. Focus group discussions were used to gather information from the pregnant women. Information was collected from six groups of pregnant women who had delivered babies at the antenatal care facilities in the past years. Results showed several factors associated with the failure to use institutional delivery service, such as long distance from the health care facility, lack of transport, lack of transport fare, shortages of skilled staff, failure to disclose pregnancy, cultural and religious beliefs, and staff attitudes.

Community peer review is a method that extends the ethics of consent into scientific practices. It gives communities affected by scientific research the ability to determine whether research may cause them harm and be part of determining how knowledge should best circulate to reduce or eliminate that harm. This paper introduces the method of community peer review by first looking at the concepts of consent and refusal, then outlining the steps to community peer review, using a case study of community meetings on a study of plastic ingestion by fish to elucidate the details of each step. Steps include: hiring a community member to the team; researching the social, cultural, and economic contexts of the community; identify the community; ensure skills for community conversation are in place; call the community meeting; conduct the community meeting; and analyze feedback for consent and refusal. Community peer review is premised on the idea that research is not inherently good and can cause harm, and that the best people to know whether and what kinds of harms are likely to occur are community members rather than researchers. The second premise is that the researcher’s “right” to research never supersedes a community’s right to not be harmed.

The COVID-19 pandemic has brought about unprecedented changes to human lifestyles across the world. The virus and associated social restriction measures have been linked to an increase in mental health conditions. A considerable body of evidence shows that spending time in and engaging with nature can improve human health and wellbeing. Our study explores nature’s role in supporting health during the COVID-19 pandemic. We created web-based questionnaires with validated health instruments and conducted spatial analyses in a geographic information system (GIS). We collected data on people’s patterns of nature exposure, associated health and wellbeing responses, and potential socioecological drivers such as relative deprivation, access to greenspaces, and land-cover greenness. We applied a range of statistical analyses including bootstrap resampled correlations and binomial regression models, adjusting for several potential confounding factors. We found that respondents significantly changed their patterns of visiting nature as a result of the COVID-19 pandemic. People spent more time in nature and visited nature more often during the pandemic. People generally visited nature for a health and wellbeing benefit and felt that nature helped them cope during the pandemic. Greater land-cover greenness within a 250 m radius around a respondent’s postcode was important in predicting higher levels of mental wellbeing. There were significantly more food-growing allotments within 100 m and 250 m of respondents with high mental wellbeing scores. The need for a mutually-advantageous relationship between humans and the wider biotic community has never been more important. We must conserve, restore and design nature-centric environments to maintain resilient societies and planetary health.

Background: Evaluation of nutrition programs is essential to guarantee the effectiveness of community-based management of acute malnutrition (CMAM). Methods: The Rainbow Project Supplementary Feeding Programs (SFPs) in Zambia were evaluated between years 2015-17, following implementation of new recommendations based on previous evaluations (years 2012-14). Outcomes of the program were compared with International Standards and with those of 2012-14. Cox proportional risk regression analysis was performed to identify predictors of mortality and defaulting. Results: Data for 900 under age 5 years malnourished children (48.8% male; mean age 19.7months ±9.9) were analyzed. Rainbow 2015-17 program outcomes met International Standards, for general malnutrition or stratified moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). When comparing with 2012-14 outcomes, better performance was noted: mortality rates were reduced by half (5.6% vs 3.1%, p = 0.01; for SAM: 12.4% vs 6.7%, p = 0.006), with significant improvement in average weight gain and mean length of stay (p<0.001), and increased awareness of HIV status (+30%; p < 0.001). HIV infection (5.5; 1.9–15.9), WAZ < −3 at baseline (4.6; 1.3–16.1) and kwashiorkor (3.5; 1.2–9.5) remained the major predictors of mortality. Conclusion: The effectiveness of the Rainbow SFPs for child malnutrition treatment and prevention in Zambia has significantly improved after evaluation and implementation activities, with impressive outcomes which resulted in a 50% reduction in mortality.

Background: Microbiome-Inspired Green Infrastructure (MIGI) was recently proposed as an integrative system to promote healthy urban ecosystems, through multidisciplinary design. Specifically, MIGI is defined as nature-centric infrastructure restored and/or designed and managed to enhance health-promoting interactions between humans and environmental microbiomes, whilst sustaining microbially-mediated ecosystem functionality and resilience. MIGI also aims to stimulate a research agenda that focuses on considerations for the importance of urban environmental microbiomes. Objectives: In this paper we provide details of what MIGI entails from a bioscience and biodesign perspective, highlighting the potential dual benefits for human and ecosystem health. We present ‘what is known’ about the relationship between urban microbiomes, green infrastructure and environmental factors that may affect urban ecosystem health (ecosystem functionality and resilience as well as human health). We discuss how to start operationalising the MIGI concept based on current available knowledge, and present a horizon scan of emerging and future considerations in research and practice. We conclude by highlighting challenges to the implementation of MIGI and propose a series of workshops to discuss multi-stakeholder needs and opportunities. Discussion: This article will enable urban landscape managers to incorporate initial considerations for the microbiome in their development projects to promote human and ecosystem health. However, overcoming the challenges to operationalising MIGI will be essential to furthering its practical development. Although the research is in its infancy, there is considerable potential for MIGI to help deliver sustainable urban development driven by considerations for reciprocal relations between humans and the foundations of our ecosystems –– the microorganisms.

This comprehensive review elucidates the profound relationship between the human microbiome and breast cancer managrement. Recent findings highlight the significance of microbial alterations in tissues, such as the gut and the breast, and their role in influencing breast cancer risk, development, progression, and treatment outcomes. We delve into how the gut microbiome can modulate systemic inflammatory responses and estrogen levels, thereby impacting cancer initiation and therapeutic drug efficacy. Furthermore, we explore the unique microbial diversity within breast tissue, indicating potential imbalances brought about by cancer and highlighting specific microbes as promising therapeutic targets. Emphasizing a holistic One Health approach, this review underscores the importance of integrating insights from human, animal, and environmental health to gain a deeper understanding of the complex microbe-cancer interplay. As the field advances, strategic manipulation of the microbiome and its metabolites presents innovative prospects for enhancing cancer diagnostics and therapeutics. However, rigorous clinical trials remain essential to confirm the potential of microbiota-based interventions in breast cancer management.

(1) Background: COVID-19 had devastating effects on both physical and mental well-being, prompting the need for interventions. This study aimed to explore the impact of mindfulness-based stress reduction on mental health, mindfulness, and sleep disorders in COVID-19 survivors.; (2) Methods: In this interventional parallel study, the sample was selected university students in nursing and midwifery faculties using total population sampling. The intervention included providing counseling on mindfulness methods by trained experts. General health, mindfulness and sleep quality questionnaires were used for data collection. Data were analyzed using SPSS22, descriptive and interferential statistic. A significance level of 0.05 was considered; (3) Results: In this study, the mean age of the students was 20.29 ± 2.03 years. 69.5% of the participants were female and 96% were single. 71.3% were studying nursing and 67% had a history of Corona infection. The intervention was only effective on general health questionnaire and the mean score of this questionnaire was 1.7 higher than the control group; (4) Conclusions: the study indicated that MBSR intervention improves mindfulness, mental health, and sleep quality in COVID-19 survivors. Regular assessment and use of this intervention can help address long-term challenges and improve overall well-being.

: Consumption of plant-based milk replacers has increased in recent years due to health benefits, benefits attributed mainly to the content of phenolic compounds, fatty acids, or bioactive compounds with antioxidant activity. In this context, we proposed to obtain two types of less studied plant-based beverages, namely lupine and chickpea beverages, as well as the possibility of getting these beverages using germinated seeds and even obtaining probiotic drinks through fermentation with Lactobacillus plantarum 299v. To evaluate the quality of the obtained products, we determined their content of proteins, fatty acids, organic acids, volatile compounds, and phenolic compounds. We evaluated the antioxidant activity of the obtained herbal drinks, and a load of probiotic microorganisms present after the fermentation process. Both lupine and chickpea drinks have the desired properties, high content of fatty acids and phenolic compounds, that bring probiotic benefits.

It is widely recognized that public health interventions benefit from community engagement and leadership, yet there are challenges to evaluating complex, community-led interventions assuming hierarchies of evidence derived from laboratory experimentation and clinical trials. Particular challenges include, first, inconsistency of the intervention across sites; and second, absence of researcher control over the sampling frame and methodology. This report highlights these challenges as they played out in the evaluation of a community-organized health project in South London. The project aimed to benefit maternal mental health, health literacy and social capital, and especially to engage local populations known to have reduced contact with statutory services. We evaluated the project using two studies with different designs, sampling frames and methodologies. In one the sampling frame and methodology were under community control, permitting comparison of change in outcomes from before to after participation in the project. In the other, the sampling frame and methodology were under researcher control, permitting a case-control design. The two evaluations led to different results however: participants in the community-controlled study showed benefits, while participants in the researcher-controlled study did not. The principal conclusions are that while there are severe challenges to evaluating a community-led health intervention using a controlled design, measurement of pre-/post-participation changes in well-defined health outcomes should typically be a minimum evaluation requirement, and confidence in attributing causation of any positive changes to participation can be increased by use of interventions in the project and in the engagement process itself that have a credible theoretical and empirical basis.

Resource conflicts represent a significant global challenge in regions abundant with natural re-sources. Modelling the myriad factors driving natural resource-based conflicts (NRBCs), spanning environmental, health, socio-economic, and political dimensions, is a complex endeavor exacer-bated by data scarcity. Furthermore, existing quantitative studies often focus solely on large-scale conflicts. This article introduces a novel algorithm, the Spatially Explicit Fuzzy Logic-Adapted Model for Conflict Management (SEFLAME-CM), which integrates the local knowledge of stakeholders into spatial decision-making technologies to support sustainable peace efforts. The results are validated with spatial multi-criteria evaluation (SMCE) using spatial statistics. The Moran’s I scatter plots for the overall conflicts reveal significant values of 0.99 and 0.98 for both the SEFLAME-CM and SMCE, respectively, with significant spatial autocorrelation. While there re-mains room for improvement in enhancing the model's quality, SEFLAME-CM demonstrates its capacity to transparently model complex real-world problems. The findings underscore the im-perative for a holistic approach to addressing environmental degradation, socio-economic, and political drivers of resource conflicts at the community level. Our paper demonstrates the signif-icance of spatial information technologies and knowledge exchange between experts and local stakeholders in effectively managing resource conflicts. These insights should inform national policies and international interventions, ensuring that the complex underlying issues are ad-dressed while prioritizing the knowledge and needs of affected communities.

Exploring the determinants of biological community structure is important not only for understanding the formation of the community, but also for promoting its biodiversity conservation. We monitored butterfly communities in a grassland and woodland area of Mount Fuji, Japan, and explored the environmental factors that influenced them. Multivariate regression tree (MRT) analysis generated a 3-leaved MRT (G1, G2, and G3) and showed the total explained variation of 64.4% in the species composition. The explanatory variables discriminating between the two branches in the first node and in the second node of the MRT were neighbouring plant community and management status, respectively. The neighbouring plant community was related to the distribution of butterfly dietary resources and contributed much in determining the species composition of the community. While the management status was largely related to the amount of their dietary resources, affecting the species richness and diversity. The PCA results revealed that the three key groups (G1, G2, and G3) were formed along the gradients of these two factors. Consequently, to maintain mowing management and the diversity of neighbouring vegetation is very important for the continuance of butterfly community diversity and composition and the conservation of Red Listed species in the area.

Community radios play a paramount role in the development of the community. Community radio stations have been highly engaged in addressing social, economic, cultural, educational, health, environmental, sanitation, and disaster issues effectively and strategically using local languages in context. Community radios are also used to express, and share indigenous views, thoughts, ideas, problems, and perspectives of local people. The purpose of this analysis is to explore the role of community radio for integrated and sustainable development in Ethiopia. It used a systematic narrative review. Nine research works and five assessments report were selected purposively and analyzed in a quantitative approach. Currently, in Ethiopia, there are 50 community radio stations that received broadcast licenses from Ethiopian Broadcast Authority with four types of licensing and broadcasting in 29 local languages. Community radio helps the community to identify their common goals, create holistic plans, monitor the progress of their developmental activities, and guide on sustainable development. It contributes to integrated and sustainable development in a collaborative and creative process that cultivates the social, economic, and political conditions needed for the community to succeed which aimed to improve and sustain the livelihoods of the community. However, the media can’t achieve its target goal to support the development activities and bring holistic development of the community. As a result; this review paper focuses on reviewing how Ethiopians use community radios for holistic development. And it suggested the way how we can use community radios for the prospective holistic development in Ethiopia.

Small, enclosed lake is in a tourist area called "Los Negritos", by the prominences a few steps from the lake on a perimeter of tens of meters with hot pools and mud bubbles. The lake originally belonged to Lake Chapala, so the group of fish present here derives from that. This is an endorheic vessel with at least one deep water inlet to the center, with a slight salinity (2.14 to 2.38 0/00), which is precisely greater at the point of upwelling and at a depth of approximately 36 m. This study to date has continued to collect and take data, also presents the characteristic of being an area of saline soils and halophilic vegetation. This body of water we consider is as relevant as that of Alchichica in Puebla. Its study is by monthly sampling with “chinchorro” and "chango" type trawl, recording morphological parameters, also environmental variables in the water, with a Data Sonde 4 brand Hydrolab. Knowing the structure and temporal dynamics of this fish community, along with the physical and chemical characterization of the water and implementa-tion of Importance Value Index (IVI).

The scientific community of the XX and XXI centuries is a very large companionship, very fragmented and spread all over the world. Moreover, the status of the scientist, which in most cases is a member of the States’ apparati, is significantly different with respect to the one of the scientists up to the First World War.The concepts of scientific revolution of Thomas Kuhn and scientific anarchy of Paul Feyerabend should be reconsidered in this contest. In particular, the anarchist modus operandi should be shifted from the scientific method, that has become significantly standardized with protocols, to the sociology of the scientific community. A pluralism of the scientific method is possible, but an anarchy in the relationships among scientists emerges as more important. The scientist is in many cases a parrhesiastes, a person that says the truth even when he is going to pay because of that, that defends the developed theory or model, by respecting the protocols established in the scientific community. On the other side, each scientist should be a patient beholder that accepts the more solid, and intersubjectively recognized, theories of other scientists.

Survivors of sexual and gender-based violence (SGBV) are often hindered in their quest to access quality healthcare. This could complicate the achievement of the laudable SDG Target 3.7. The study used an ethnographic approach to solicit information from health providers, adolescents, and young women (AYW) in 10 communities from Lagos and Ibadan; two major cities in Nigeria. Findings indicated that the structural system of services provided in the health services at the primary healthcare level was limited, which posed a great challenge in AYW’s utilization of services for sexual and gender-based violence (SGBV). Some of the challenges identified by health providers included non-existing counseling services, rehabilitation centers, referral problems, and a lack of training for health providers in handling victims of SGBV. The study provided the context of the health providers’ inadequacy and structural problem of health services in providing comprehensive support services to victims of SGBV like adolescents and young women in the slum setting. This poses a barrier to the utilization of services by the survivors. Necessary inclusive services that will meet the need of the victims of SGBV should be in place at primary healthcare centers close to the people in the community for accessibility.

Cambodia faces the challenge of managing excess water during the wet season and insufficient water during the dry season. This harms human life and endangers aquatic and natural resources, agricultural practices, and food security. In order to ensure the well-being of both people and food security, water governance is crucial. However, Cambodia's water governance is hindered by various obstacles, including sectoral and centralized influences, top-down and large-scale strategies, a lack of coordination among relevant agencies, and limited involvement of local communities. This study delves into water governance across different sectors, from centralized to community-based natural resources management to tackle these challenges. Through analyzing literature and case studies of farmer water user communities (FWUC), community fisheries (CFis), and community fish refuges (CFRs) in three Mekong Delta provinces in Cambodia, the study concludes that although water governance has improved, it has resulted in a decline in fishery resources from rivers and water bodies and an increase in water conflicts among farmers and sectors in the face of climate change. To enhance water governance in Cambodia, it is critical to integrate it at the district level. This will promote sustainable water use and management across the country and pave the way for a brighter future.

Telehealth is the delivery of many health care services and technologies to individuals at different geographical areas and is categorized as asynchronously or synchronously. The coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions in health care delivery to breast cancer (BCa) patients and there is increasing demand for telehealth services. Globally, telehealth has become an essential means of communication between patient and health care provider. The application of telehealth to the treatment of BCa patients is evolving and increasingly research has demonstrated its feasibility and effectiveness in improving clinical, psychological and social outcomes. Two areas of telehealth that have significantly grown in the past decade and particularly since the beginning of the COVID-19 pandemic are telerehabilitation and teleoncology. There two technological systems provides opportunities at every stage of the cancer care continuum for BCa patients. We conducted a systematic literature review that examined the use of telehealth services via its various modes of delivery among BCa patients particularly in areas of screening, diagnosis, treatment modalities, as well as satisfaction among patients and health care professionals. The advantages of telehealth models of service and delivery challenges in delivery to patients in remote arears are discussed.

The objective of the study was to investigate the gap between data and evidence-based decisions among healthcare professionals considering the enormous amount of individual and aggregate data collected. Our study assessed the capacity, skills, and knowledge of the Ministry of Health leadership staff to understand data management, analysis, utilization, and dissemination. Three key components were assessed: 1) Knowledge through true/false questions, 2) Level of Skill (and Competency) using a Likert scale, and 3) Understanding of Key Concepts and Tools based on a Likert scale. The 183 study respondents were diverse healthcare professionals from Kenya, Tanzania, and Rwanda. Majority of respondents had not received any training on data management, analysis, interpretation, and utilization techniques, further there was a significant difference between those who had received training versus those who had not(p=0.005). The respondents were competent in work-related experiences but lacked skills and knowledge on: data concepts and tools, study designs, and types of data analysis. These findings explain the gap between data management, analysis, utilization, and dissemination among health professional’s cadre. To enhance service delivery and optimal provision of health care, it is imperative to have all health care professionals receive a well-designed training on data management, analysis, interpretation, and utilization.

This study aimed to assess the ability of community pharmacists to recognize cases of Loperamide abuse at the point of sale, their perspective of and experience towards potential abuse cases. Methods: A cross-sectional study was conducted in Jordan, using a self-administered online questionnaire. The questionnaire consisted of 3 main parts: demographics, the experience of pharmacists with abusers' behavior, as well as their perspectives towards Loperamide abuse. Results: A total of 250 community pharmacists completed the survey, 54% (135) of which were female. Almost one-third (33.2%; 83) of the participants reported exposure to suspected cases of Loperamide abuse during the last six months. Pharmacists declared that most of the suspected Loperamide abusers were male (60.2%), of middle-low socioeconomic status (69.9%), and between 20-30 years of age (57.8%). The largest quantity (packs) of Loperamide requested by a single patient was around 33.2±14.9 at once. As reported by pharmacists, the suspected reasons behind Loperamide abuse included 50% seeking euphoria, 17% relieving anxiety, and 33% controlling addiction (weaning off other opioids). The multivariate logistic regression analysis demonstrated a significant correlation between male gender (OR=1.2, 95% CI 0.12-1.59), pharmacy location in the center of Jordan (OR=21.2, 95%CI 2.45-183.59), late-night working shift (Shift C, OR=1.29, 95% CI 0.12-2.08) and abuse to Loperamide during the last six months. Conclusion: This study shed light on Loperamide abuse which is highly influenced by different sociodemographic characteristics. Accordingly, close monitoring and thorough tackling of the abuse practices are mandated through an increase in educational and awareness campaigns about proper medication use.

Background: The dairy industry heavily relies on fermentation processes driven in high proportion by Lactococcus lactis. The fermentation process can be perturbed or even stopped by bacteriophage activity leading to complete loss of fermentation batch or decreased quality product. Monitoring of the phage diversity and dynamics in the process allows to implement protective measures (e.g. starter rotation) in order to maintain unperturbed production.; Methods: Universal primers were used to amplify sequences of the 936, c2, and P335 Lactococcus phage types. The amplicons were sequences with Sanger method and obtained degenerate sequences were analyzed using simple bioinformatic pipeline in R environment.; Results: The most prevalent phage type is 936, followed by P335, whereas c2 type is less frequent.; Conclusions: Curd cheeses prepared on non-pasteurized milk based on native milk microbiota had higher diversity of phages distinct of these found in dairy plants. Sanger sequencing of heterogenous amplicons generated on metagenome DNA can be used to asses low-complexity microbiota diversity.