Search Results (571)

Abstract: Citizen participation is a crucial aspect of the national health system, empowering individuals to contribute to improving local health services through Health Committees (HCs). HCs promote the participation of citizens in the delivery of primary healthcare services. The study explores the perceptions of citizen participation in the context of the Ruhama County Ntungamo local government area, Uganda. This study aims to understand the impact of HCs on healthcare service delivery. Using a qualitative approach of inquiry grounded in thematic analysis and rooted in principal–agent theory in a single case study, this study examined citizens’ participation in the delivery of a local healthcare service. The study is based on interviews with 66 participants comprising health workers, patients, residents, health administrators, local councillors, and HC members. The findings reveal a notable absence of a health committee in healthcare delivery in Ruhama County. The absence is attributed to a need for a formalised citizen participation structure in managing health facilities and service delivery. It raises concerns about the limited influence of citizens in shaping healthcare policies and decision-making processes. The study recommends the incorporation of health committees into the local health systems to enhance participation and grant communities greater influence over the management of health facilities and service delivery. Incorporating health committees into local health systems strengthens citizen participation and leads to more effective and sustainable healthcare services aligned with people’s needs and preferences. Integrating health committees within Itojo Hospital and similar facilities can grant citizens a meaningful role in shaping the future of their healthcare. Full article

The expansion of urban centers and peri-urban zones significantly impacts both the natural world and human well-being, leading to issues such as increased air pollution, the formation of urban heat islands, and challenges in water management. The concept of multifunctional greening serves as a cornerstone, emphasizing the interconnectedness of ecological, social, and health-related factors. This study aimed to identify potential locations for three specific types of blue-green infrastructure (BGI): bioswales, infiltration trenches, and green bus stops. Leveraging geospatial datasets, Geographic Information System (GIS) technology, and remote sensing methodologies, this study conducted a comprehensive analysis and modeling of spatial information. Initial cartographic representations were developed to identify specific locations within Olsztyn, a city in Poland, deemed appropriate for the implementation of the designated blue-green infrastructure (BGI) components. Following this, these models were combined with two additional models created by the researchers: a surface urban heat island (SUHI) model and a demographic model that outlined the age structure of the city’s population. This synergistic approach resulted in the development of a detailed map, which identified potential locations for the implementation of blue-green infrastructure. This was achieved by utilizing vector data acquired with a precision of 1 m. The high level of detail on the map allows for an extremely accurate representation of geographical features and infrastructure layouts, which are essential for precise planning and implementation. This infrastructure is identified as a key strategy for strengthening ecosystem resilience, improving urban livability, and promoting public health and well-being. Full article

This article discusses current challenges in the field of global health and the World Health Organization’s (WHO) strategies to address them. It highlights the importance of measuring the health impacts of global recession and globalization and the need for human-centered approaches to sustainable development. Emphasis is placed on commitment to health equity and the use of strategic partnerships for health at global, national, and local levels. Improving the health and well-being of populations, as well as public health equity, are core principles of the 2030 Agenda for the Sustainable Development Goals (SDGs). These principles are expressed in SDG 3, which promotes universal access to health services and systems and recognizes global health as a basic human right. It highlights the importance of strategic partnerships to combat emerging health crises, improve public health indices, and address the burden of chronic disease. These partnerships are contemplated in SDG 17 and are manifested in different modalities, such as network governance, cross-sector collaboration, public–private partnership, and social participation. This diversity of alliances has played an important role in scaling up and strengthening universal health systems around the world, including in Latin America and the Caribbean. The text concludes by presenting the essential characteristics of these inter-organizational and inter-institutional alliances in the field of global health. Full article

The development and utilization of unconventional water resources has become a strategy to alleviate the agricultural water crisis in many countries and regions. To understand the research progress, hot spots, and future trends in the field of unconventional water agricultural irrigation (UWAI), this paper systematically analyzes 6738 publications based on the core database of Web of Science 1990–2023 using the scientific bibliometric analysis software CiteSpace, VOSviewer, and Scimago Graphica. The results showed that the research on UWAI is always rapidly developing. Soil science, crop science, and bioengineering are the main disciplines involved. Most research on WUAI has occurred in China and the United States. Countries with higher levels of development tend to have more influence. Collaboration among authors is fragmented, and collaboration between authors and states needs to be strengthened. Through keyword analysis, the research hotspots are summarized as follows: (1) The effects of traditional and emerging pollutants brought by unconventional water irrigation on soil physicochemical properties, crop growth, and groundwater quality; (2) the health threats caused by pollutants entering the food chain and groundwater; (3) unconventional water utilization technologies, including rainwater harvesting agriculture, precision agriculture, and urban agriculture. Future research hotspots will focus on the mechanisms of pollutant solute transport and transformation in the water–soil–crop system under non-conventional water irrigation conditions and crop physiological responses. We suggest that the research on traditional and emerging pollutants in unconventional water should be strengthened in the future, and the risk control system of unconventional water irrigation should be improved. International cooperation should be strengthened, especially with poor countries in arid regions, to promote the formation of unified international standards and guidelines for non-conventional water irrigation in agriculture. Full article

Integrated ocean management (IOM) aligns with the United Nations’ Sustainable Development Goals (SDGs) and serves as a crucial strategy for promoting the enduring health of marine ecosystems and the sustainable utilization of marine resources. An analysis of the evolution of China’s integrated ocean management policy (IOMP) is crucial for providing valuable guidance in achieving sustainable growth in marine management and the marine economy for both China and other coastal nations worldwide. This paper studies the evolution characteristics, challenges, and prospects of IOMP in China since 1978 using content analysis. The findings indicate that the evolution of IOMP can be categorized into four stages: the germination period (1978–1998), the construction period (1999–2009), the systematization period (2010–2017), and the strategization period (2018–present), based on the state of international marine management. The IOMP has transitioned over time from its initial emphasis on resource development during the germination period to a strategization period that prioritizes the full development of all parts of the system. However, the ultimate goal has consistently been to achieve harmonious coexistence between people and the sea. China’s IOMP has experienced a progressive development; nevertheless, it continues to encounter obstacles such as the pressing requirement to revise sea-related policies and the absence of policy alignment. The objective of this paper is to explore the evolution, challenges, and prospects of China’s IOMP to better improve the land–sea coordination policy, strengthen international judicial cooperation. and provide effective policy reference for other maritime countries. Full article

To actively respond to the challenges posed by population aging, people are paying more and more attention to healthy behavioral lifestyles, and the impact of social capital as an informal system on health behaviors cannot be ignored. This paper explores the impact of social capital on health behaviors of middle-aged and older adults based on 2020 CHARLS data. Using binary logistic regression models, we discussed the association between social capital and five health behaviors. The results suggest that structural social capital significantly increases physical activity and physical examination behaviors among middle-aged and older adults but also decreases the probability of abstinence behaviors. Cognitive social capital increases the probability that middle-aged and older adults will have a reasonable amount of sleep and physical activity. However, it also decreases the probability that smoking cessation behaviors will occur. Further attention needs to be paid to the role of social capital, the creation of a harmonious social environment and the enhancement of social trust, the strengthening of communities and grass-roots social organizations, and the provision of more platforms for the participation of middle-aged and older adults in social activities, to improve the quality of the healthy lives of middle-aged and older adults and, in turn, to promote the establishment of healthy behaviors. Full article

Background: This retrospective analysis of an ongoing prospective cohort study aimed to assess the outcome of revascularisation for treating lifestyle-limiting intermittent claudication caused by peripheral artery disease (PAD) in Aboriginal and Torres Strait Islander Peoples and non-Indigenous North Queenslanders. Methods: Consenting patients with PAD who underwent endovascular or open revascularisation procedures for treating lifestyle-limiting intermittent claudication were included. The primary outcome measure was major adverse limb events (MALEs), defined as major amputation or the requirement for repeat open or endovascular revascularisation. Results: Of the 378 included patients, 18 (4.8%) identified as Aboriginal and/or Torres Strait Islander Peoples. During a mean follow-up (standard deviation) of 6.0 (3.9) years, the incidence of MALE was similar in the Aboriginal and Torres Strait Islander People and non-Indigenous Australians (absolute percentage: 50.0% vs. 40.6%, log rank p = 0.59). In both unadjusted and adjusted analyses, Aboriginal and Torres Strait Islander Peoples and non-Indigenous Australians had similar risks of MALE (unadjusted hazard ratio, HR, 1.20, 95% confidence interval, CI, 0.61, 2.36; adjusted HR 1.02, 95%CI 0.50, 2.06). Conclusions: This study suggests that Aboriginal and Torres Strait Islander People are under-represented in the population of patients undergoing revascularisation to treat intermittent claudication. Due to small numbers it cannot be reliably concluded that Aboriginal and Torres Strait Islander People and non-Indigenous Australians have similar rates of MALE. Full article

Dengue is an endemic disease in tropical countries, mainly in South America, Southwest Asia, and Africa, which, despite having a low lethality rate, can overwhelm health systems. Strengthening the immune system through regular physical activity can be an important tool to prevent contagion, worsening, hospitalizations, and deaths caused by the disease, as seen in the COVID-19 pandemic. Therefore, this point of view aims to analyze the possible association between physical activity and dengue and its repercussions on public health. Comments were made on the main characteristics of dengue as well as on the main vaccines available to date. It was also discussed the impacts of dengue on health systems, in addition to the main repercussions for public health when a very large number of people are infected. It was also commented on the main factors that contribute to the worsening of the clinical stage of dengue, in addition to discussions and reflections on physical activity, strengthening the immune system, and dengue. There are assumptions that regular physical activity can be an important public health strategy to prevent contagion, severity, and hospitalizations caused by dengue and that it needs to be promoted by governments around the world as a tool for preventing and treating not only chronic communicable diseases but also infectious diseases. Full article

Thus, this review aims to deepen the understanding of buffalo farming in the Amazon, presenting the quality and nutritional value of buffalo meat and liver. This information serves as a subsidy to improve practices related to the breeding system, nutrition, health and sustainability associated with aquatic buffaloes. For this, a review of the databases was carried out using the descriptors “nutritional value of buffalo meat”, “nutritional value of buffalo liver” and “buffalo breeding in the Amazon”. Thus, the consumption of foods derived from aquatic buffaloes has important nutritional value for human consumption. In view of this, it is possible to conclude that the nutrition of these animals is influenced by the biodiversity of the Amazon, giving unique characteristics to its products, also highlighting the importance of carrying out research that aims to value the potential use of this species and strengthen the economy of the region. Full article

This paper provides empirical evidence using two studies to explain the primary factors facilitating electronic health record (EHR) systems adoption through the lens of the resource advantage theory. We aim to address the following research questions: What are the main organizational antecedents of EHR implementation? What is the role of monitoring in EHR system implementation? What are the current themes and people’s attitudes toward EHR systems? This paper includes two empirical studies. Study 1 presents a research model based on data collected from four different archival datasets. Drawing upon the resource advantage theory, this paper uses archival data from 200 Texas hospitals, thus mitigating potential response bias and enhancing the validity of the findings. Study 2 includes a text analysis of 5154 textual data, sentiment analysis, and topic modeling. Study 1’s findings reveal that joint ventures and ownership are the two main enablers of adopting EHR systems in 200 Texas hospitals. Moreover, the results offer a moderating role of monitoring in strengthening the relationship between joint-venture capability and the implementation of EHR systems. Study 2’s results indicate a positive attitude toward EHR systems. The U.S. was unique in the sample due to its slower adoption of EHR systems than other developed countries. Physician burnout also emerged as a significant concern in the context of EHR adoption. Topic modeling identified three themes: training, healthcare interoperability, and organizational barriers. In a multimethod design, this paper contributes to prior work by offering two new EHR antecedents: hospital ownership and joint-venture capability. Moreover, this paper suggests that the monitoring mechanism moderates the adoption of EHR systems in Texas hospitals. Moreover, this paper contributes to prior EHR works by performing text analysis of textual data to carry out sentiment analysis and topic modeling. Full article

Community inclusion is a human right for all people, including people with mental illness. It is also an important part of individualized support to enable people experiencing mental illness to live in their preferred communities and to recover. In Taiwan, no study has investigated the social experiences of healthcare professionals. To fill this knowledge gap and inform ongoing mental health system strengthening, this study examined the not-in-my-backyard (NIMBY) phenomenon observed while establishing community mental health clubhouses in Taiwan and corresponding experiences of community inclusion. Data were collected through semi-structured interviews of 16 purposively sampled frontline healthcare professionals from Taiwanese mental health clubhouses. Data were analyzed using qualitative content analysis. Two themes were identified: “NIMBY phenomenon: Community residents’ resistance to clubhouses” and “Measures adopted by the clubhouse for community inclusion”. Two categories with eleven subcategories emerged. The findings demonstrate the following conclusions. First, the NIMBY phenomenon is related to the stigmatization and discrimination faced by individuals with mental disorders in society. Second, in Asian societies, mental disorders are associated with a particular social and cultural context. Third, the fear and rejection of individuals with mental disorders deepen their social exclusion. Forth, community mental health clubhouse models employ seven strategic approaches to community inclusion, listed as follows: capacity building for individuals, direct interaction with the public through community activities, provision of community services, life skills training, repairing and managing neighborhood relationships, assisting individuals in obtaining community employment, and conducting social education for community residents. Clearly, we need to combat social exclusion of people with mental illness and promote inclusive and accessible services and systems across sectors. Full article

Undernutrition among under-fives is one of the major public health challenges in Tanzania. However, there are limited studies assessing the contribution of cultural-related strategies in the prevention of child undernutrition in Tanzania. This study aimed at exploring participants’ experiential views regarding developing culturally sensitive strategies for the elimination of child undernutrition for under-fives in Rukwa, Iringa, Ruvuma, Songwe and Njombe regions located in the Southern Highlands in Tanzania. This study applied focus group discussions (FGDs) with forty practitioners to explore culturally-sensitive strategies for effectively preventing child undernutrition in Tanzania. The study participants were purposively selected, and thematic analysis was used to identify themes within the data. This study revealed that district- and lower-level administrative systems should prioritize nutrition interventions in their plans, allocating adequate resources to implement culturally sensitive nutrition interventions, while national-level organs need to strengthen institutional capacity and ensure the availability of funds, skilled human resources and a legal framework for the effective implementation and sustainability of nutrition interventions at the district- and lower-levels. This study highlights that for the successful implementation of culturally sensitive strategies towards the elimination of child undernutrition, there is a need to use a systems approach that allows for collaborative governance whereby different sectors act together to address the persistent malnutrition epidemic. Full article

In order to effectively identify the shortcomings and potential health risks in the construction of healthy cities and achieve sustainable development, relevant improvement strategies have been formulated. According to the National Healthy City Evaluation Index System, with the concept of “Making improvements is more important than reaching standards”, the healthy city construction levels of the first batch of 13 cities in East China were evaluated by combining entropy weight and linear coefficient weighting from the five dimensions of environment, population, society, service, and culture, based on the data of statistical yearbooks, bulletins, and government websites. The results show that Suzhou, Jiading, Wuxi, Hangzhou, Ningbo, Tongxiang, and Zhenjiang are in the first-grade group, Xiamen, Yantai, Jinan, and Weihai are in the second-grade group, and Yichun and Ma’anshan are in the third-grade group. There is also more significant heterogeneity in the healthy environment indicator among the 13 cities; at the same time, there are specific differences in the healthy culture indicator, and there are slight differences in the indicators of healthy population, society, and service. The study reveals the gaps and problems in the construction of healthy cities. It proposes constructive ideas for promoting follow-up improvement of “making up for shortcomings and strengthening the weaknesses”. Full article

Antimicrobial resistance (AMR) among Escherichia coli from food animals is a rising problem, and heavy antimicrobial use in poultry is a contributing factor. In Zambia, studies linking poultry-associated AMR and antibiotic use (AMU) are rare. This study aimed to investigate commercial and medium-/small-scale poultry farmers’ usage of antimicrobials based on a questionnaire survey in ten districts of Zambia. In addition, the study characterized extended-spectrum β-lactamase (ESBL)-producing E. coli isolates obtained from poultry in the same districts. Data regarding knowledge and usage of antimicrobials were collected from commercial and medium-/small-scale poultry farmers using a pre-tested structured questionnaire. At the same time, cloacal samples were collected and analyzed. One hundred and fifty E. coli isolates were tested for antimicrobial susceptibility using eight antibiotic classes. The isolates were further screened for ESBL production by streaking them on cefotaxime (CTX)-supplemented MacConkey agar, then subjecting them to sequencing on a NextSeq. The questionnaire survey showed that more medium-/small-scale than commercial poultry farmers used antimicrobials (OR = 7.70, 95% CI = 2.88–20.61) but less prescriptions (OR = 0.02, 95% CI = 0.00–0.08). Susceptibility testing revealed that resistance was highest to ampicillin (128/148, 86.5%) and tetracycline (101/136, 74.3%) and that the prevalence of multidrug resistance (MDR) (28/30, 93.3%) was high. Whole-genome sequencing (WGS) of eight (8/30, 26.7%) isolates with CTX Minimum Inhibitory Concentration (MIC) ≥ 4 µg/mL revealed the presence of ESBL-encoding genes bla_CTX-M-14, bla_CTX-M-55, and bla_TEM. WGS also detected other AMR genes for quinolones, aminoglycosides, phenicols, tetracycline, macrolides, and folate-pathway antagonists. Altogether, the questionnaire survey results showed a higher proportion of AMU and lower prescription usage among medium-/small-scale farmers. In addition, our results emphasize the circulation of ESBL-producing E. coli strains with associated MDR. It is critical to educate farmers about AMR risks and to encourage responsible usage of antimicrobials. Furthermore, there is a need to strengthen regulations limiting access to antimicrobials. Finally, there is a need to establish a one health system to guide public health response. Full article

The global food trade network (FTN) is a critical infrastructure for achieving the Sustainable Development Goals (SDGs). The FTN’s vulnerability to geopolitical conflicts, public health crises, and climate change events directly impacts food security and the ability to meet the SDGs. This study aims to analyze the dynamic evolution of the vulnerability of FTN, focusing on the period from 2000 to 2022, to aim for strategies for enhancing the resilience and sustainability of the global food system. Based on complex network analysis, we examine the structural characteristics and evolution of FTN for four major crops: soybeans, wheat, rice, and maize. We identify a trend towards increased network density and regionalization, with a decline in average shortest path length (ASPL) and an increase in the average clustering coefficient (ACC). These changes indicate a shift towards a more interconnected and resilient FTN in response to various shocks, including the COVID-19 pandemic and the Russia–Ukraine conflict. The findings suggest that the global FTN has adapted to increase resilience, which is essential for achieving the SDGs related to food security and sustainable development. The study’s insights can guide policy interventions to further strengthen the network against future shocks and promote global food security. Full article