Search Results (2,766)

The right to development, an inherent human right for all, emphasizes that all individuals and communities have the right to participate in, contribute to, and benefit from development that ensures the full realization of human rights. In Kenya, where a significant portion of the population faces poverty and vulnerability to climate change, access to rights-based needs such as clean water, healthcare, and education still remains a critical challenge. This study explored the implementation of a Human Rights-Based approach to community development through a Public–Private Development Partnership model (PPDP), with a focus on alleviating poverty and improving access to rights-based services at the community level in Narok and Nakuru counties. The research aimed to identify critical success factors for scaling the PPDP model and explore its effects on socio-economic empowerment. The study employed a mixed-methods approach for data collection, using questionnaires to obtain quantitative data, focus group discussions, and key informant interviews with community members, local leaders, and stakeholders to gather qualitative data. We cleaned and analyzed all our data in R (version 4.4.3) and used the chi-square to establish the significance of differences between areas where the PPDP model was implemented and control areas where it was not. Results reveal that communities with the PPDP model experienced statistically significant improvements in employment, income levels, and access to rights-based services compared to control areas. The outcomes underscore the potential of the PPDP model to address inclusive and sustainable development. This study therefore proposes a scalable pathway beginning with access to rights-based needs, followed by improved service delivery, and culminating in economic empowerment. These findings offer valuable insights for governments, development practitioners, investment agencies, and researchers seeking community-driven developments in similar socio-economic contexts across Africa. For the first time, it can be adopted in the design and implementation of development projects in rural and local communities across Africa bringing into focus the need to integrate rights-based needs at the core of the project. Full article

Background: Thailand is rapidly transitioning into an aging society, creating an intergenerational caregiving gap that strains existing support systems. Objective: This study evaluated the effectiveness of “Young Care,” a community-based intervention designed to enhance youth knowledge, attitudes, and caregiving practices (KAP) toward older adults. Methods: A two-day structured training was conducted in Maha Sarakham Province in 2023 using a pre-post mixed-methods design. Middle and high school students participated in lectures, multimedia sessions, and experiential learning activities related to caregiving. Quantitative data were collected using validated KAP questionnaires, while qualitative insights were obtained from focus group discussions involving students, older persons, caregivers, and local leaders. Results: Post-intervention analysis revealed significant improvements in knowledge and attitudes (p < 0.001), accompanied by increased empathy, caregiving initiative, and a sense of moral responsibility among participants. Conclusions: The initiative fostered formal partnerships among schools, local governments, healthcare providers, and universities through memoranda of understanding. These collaborations enabled budgetary support and outreach to out-of-school youth, positioning “Young Care” as a scalable, youth-centered strategy to address Thailand’s long-term care challenges. Full article

Persons with disabilities face barriers to accessing sexuality education. For those who identify as queer, these challenges are compounded by stigma, ableism, and heteronormativity, resulting in distinct and overlooked experiences. This study explored the sexuality education needs of persons with disabilities who identify as queer in Kenya—a neglected demographic—using a phenomenological approach. Data were collected through a focus group discussion with six participants and analyzed thematically. Three themes emerged: invisibility and erasure; unprepared institutions and constrained support networks; and agency and everyday resistance. Educational institutions often overlook the intersectional needs of persons with disabilities who identify as queer, leaving them without adequate tools to navigate relationships, sexuality, and rights. Support systems are often unprepared or unwilling to address these needs. Societal attitudes that desexualize disability and marginalize queerness intersect to produce compounded exclusion. Despite these challenges, participants demonstrated agency by using digital spaces and informal networks to resist exclusion. This calls for policy reforms that move beyond tokenism to address the lived realities of multiply marginalized groups. Policy reform means not only a legal or governmental shift but also a broader cultural and institutional process that creates space for recognition, protection, and participation. Full article

Deliberative approaches to governance systems analysis and improvement are rare. Australia’s Great Barrier Reef (GBR) provides the context to describe an innovative approach that combines reflexive and interactive engagement processes to (a) develop and design a framework to assess the GBR’s complex governance system health; and (b) undertake a benchmark assessment of governance system health. We drew upon appreciative inquiry and used multiple lines of evidence, including an extensive literature review, governance system mapping, focus group discussions and personal interviews. Together, these approaches allowed us to effectively engage key actors in value judgements about twenty key characteristic attributes of the governance system. These attributes were organised into four clusters which enabled us to broadly describe and benchmark the system. These included the following: (i) system coherence; (ii) connectivity and capacity; (iii) knowledge application; (iv) operational aspects of governance. This process facilitated deliberative discussion and consensus-building around attribute health and priorities for transformative action. This was achieved through the inclusion of diverse perspectives from across the governance system, analysis of rich datasets, and the provision of guidance from the project’s Steering Committee and Technical Working Group. Our inclusive, collaborative and deliberative approach, its analytical depth, and the framework’s repeatability enable continuous monitoring and adaptive improvement of the GBR governance system and can be readily applied to complex governance systems elsewhere. Full article

Background: Emotional safety is increasingly recognized as crucial for high-quality patient care, encompassing a patient’s sense of security, courteous treatment, being heard, and a peaceful environment. Purpose: The purpose of this study was to explore the perceptions of patients and providers (doctors and nurses) regarding emotional harm and safety in relation to hospitalized patients. Methods: We conducted a qualitative study in public-sector teaching hospitals in Peshawar, Pakistan. Data were collected after we obtained informed consent using individual interviews with 15 providers, namely, doctors (n = 7) and nurses (n = 8), and five focus group discussions (FGDs) with 25 hospitalized patients. Data from both the interviews and FGDs were analyzed using Braun and Clarke’s six-phase approach to thematic analysis. Results: The key themes revealed by the providers’ perspectives were factors contributing to emotional harm, staff-related factors, coping mechanisms and solutions, and the impact of prior experiences and involvement. The main themes that emerged from the patients’ perspectives were anxiety upon admission, the impact of communication, emotional stress due to treatment delays, systemic/bureaucratic challenges, financial burden, a lack of emotional support, and post-hospitalization concerns. The consistent perspectives shared by both patients and providers included the impact of systemic factors, communication issues, the role of staff attitude/behavior, financial concerns, and the influence of prior experiences. Conclusions: This study highlights the complex interplay of systemic, staff-related, and patient-specific factors. It suggests a need to improve communication, staff support, administrative processes, financial counseling, emotional support integration, and discharge planning to minimize harm and create a patient-centered environment. Full article

This paper proposes a multi-hop peer-to-peer (P2P) video streaming architecture designed to support dynamic, conversation-aware communication. The primary contribution is a decentralized system built on WebRTC that eliminates reliance on a central media server by employing super node aggregation. In this architecture, video streams from multiple peer nodes are dynamically routed through a group of super nodes, enabling real-time reconfiguration of the network topology in response to conversational changes. To support this dynamic behavior, the system leverages WebRTC data channels for control signaling and overlay restructuring, allowing efficient dissemination of topology updates and coordination messages among peers. A key focus of this study is the rapid and efficient reallocation of network resources immediately following conversational events, ensuring that the streaming overlay remains aligned with ongoing interaction patterns. While the automatic detection of such events is beyond the scope of this work, we assume that external triggers are available to initiate topology updates. To validate the effectiveness of the proposed system, we construct a simulation environment using Docker containers and evaluate its streaming performance under dynamic network conditions. The results demonstrate the system’s applicability to adaptive, naturalistic communication scenarios. Finally, we discuss future directions, including the seamless integration of external trigger sources and enhanced support for flexible, context-sensitive interaction frameworks. Full article

This study explores the interplay of climate vulnerability and social capital in two rural communities: Brajaballavpur, a high-climate-prone village in the Indian Sundarbans characterized by high ecological fragility, recurrent cyclones, and saline water intrusion affecting water access, livelihoods, and infrastructure; and Jemua, a low-climate-prone village in the land-locked district of Paschim Bardhaman, West Bengal, India, with no extreme climate events. A total of 85 participants (44 in Brajaballavpur, 41 in Jemua) were selected through purposive sampling. Using a comparative qualitative research design grounded in ethnographic fieldwork, data were collected through household interviews, Participatory Rural Appraisals (PRAs), Focus Group Discussions (FGDs), and Key Informant Interviews (KIIs), and analyzed manually using inductive thematic analysis. Findings reveal that bonding and bridging social capital were more prominent in Brajaballavpur, where dense horizontal ties supported collective action during extreme weather events. Conversely, linking social capital was more visible in Jemua, where participants more frequently accessed formal institutions such as the Gram Panchayat, local NGOs, and government functionaries that facilitated grievance redressal and information access, but these networks were concentrated among more politically connected individuals. The study concludes that climate vulnerability shapes the type, strength, and strategic use of social capital in village communities. While bonding and bridging ties are crucial in high-risk contexts, linking capital plays a critical role in enabling long-term social structures in lower-risk settings. The study contributes to both academic literature and policy design by offering a relational and place-based understanding of climate vulnerability and social capital. Full article

Despite increasing interest in including indigenous and local people in forest restoration initiatives, their views on which species are most useful, or reasons behind not planting native tree species are often ignored. Focused on south-western Rwanda, this study addressed these knowledge gaps. We carried out 12 focus group discussions with village elders to determine the following: main benefits provided by native forests, the native species they prefer for different uses, and the main barriers to species’ cultivation. Then, considering other key information from the literature, we performed a ranking exercise to determine which native species had the greatest potential for large-scale tree planting initiatives. Our results show that native forests provide 17 benefits to local communities, some of which cannot be replaced by plantations with exotic species. Among the 26 tree species identified as most useful for timber, firewood, medicine and fodder, ten were ranked as with the greatest potential for restoration initiatives. Of these, two had not been included in recent experimental plantations using native species in Rwanda, and none were considered among the priority species for domestication in Africa. Overall, our study highlights the need to better connect the ecological and social dimension of forest reforestation initiatives in multiple contexts. Full article

Myelodysplastic syndromes/neoplasms (MDS) represent a biologically and clinically diverse group of myeloid malignancies marked by cytopenias, morphological dysplasia, and an inherent risk of progression to acute myeloid leukemia. Over the past two decades, the field has made significant advances in characterizing the molecular landscape of MDS, leading to refined classification systems to reflect the underlying genetic and biological diversity. In 2025, the treatment of MDS is increasingly individualized, guided by integrated clinical, cytogenetic, and molecular risk stratification tools. For lower-risk MDS, the treatment paradigm has evolved beyond erythropoiesis-stimulating agents (ESAs) with the introduction of novel effective agents such as luspatercept and imetelstat, as well as shortened schedules of hypomethylating agents (HMAs). For higher-risk disease, monotherapy with HMAs continue to be the standard of care as combination therapies of HMAs with novel agents have, to date, failed to redefine treatment paradigms. The recognition of precursor states like clonal hematopoiesis of indeterminate potential (CHIP) and the increasing use of molecular monitoring will hopefully enable earlier intervention/prevention strategies. This review provides a comprehensive overview of the current treatment approach for MDS, highlighting new classifications, prognostic tools, evolving therapeutic options, and ongoing challenges. We discuss evidence-based recommendations, treatment sequencing, and emerging clinical trials, with a focus on translating biological insights into improved outcomes for patients with MDS. Full article

Background/Objectives: There is a need for randomized clinical trials with higher quality, especially for older people at high risk of falls, with interventions that consider individual needs, comprehensiveness of care, and connection with primary health care. We designed a randomized controlled trial to examine the effects of a case management intervention combined with a physical exercise protocol on risk factors for falls, falls data, adherence, satisfaction, costs, and implementation in community-dwelling older adults with high risk of falls. Methods: A minimum of 60 community-dwelling older people with high falls risk will participate in the randomized controlled assessor-blinded trial (MAGIC—v. 2). The trial will be conducted in a regional health department of São Paulo state (Brazil), which includes 6 cities. Participants will be randomized to the Intervention Group (case management intervention based on all individual risk factors for falls identified by a multidimensional assessment, over 16 weeks, once a week, by telephone calls). Both groups will perform a physical exercise protocol based on falls prevention for 16 weeks (twice a week) in Health Units. The assessment will be performed at baseline, after 16 weeks of intervention, after 6-month follow-up, and after 12-month follow-up. Primary outcome measures include falls data and potentially modifiable risk factors for falls. Discussion: This study has the potential to facilitate the future implementation of the intervention based on case management with a focus on fall prevention in the health sectors. Trial registration: Brazilian Registry of Clinical Trials (ReBEC). Full article

COVID-19 vaccine hesitancy in Pakistan is a barrier to optimal vaccine uptake and has been situated within a context of hesitancy towards other vaccines. A mixed-methods study was conducted during the initial COVID-19 vaccine roll-out in 2021 in four union councils in Peshawar, consisting of a cross-sectional survey, eight focus group discussions (FGDs) with community members and eight in-depth interviews with healthcare workers (HCWs) to assess perceptions toward vaccines. Multivariable logistic regression was used to assess factors associated with COVID-19 vaccine hesitancy. Of 400 survey participants, 57.3% were vaccine acceptant and 42.8% vaccine hesitant. Just over half (56.8%) perceived COVID-19 vaccines to be safe. Most (88%) reported trust in HCWs to provide accurate vaccine information. FGDs revealed that women received less information about the vaccine compared to men and cultural restrictions were barriers even for those willing to be vaccinated. Correlates of vaccine acceptance included male sex (aOR 2.25; 95% CI 1.29–3.91), age 50 years or greater (aOR 1.74; 95% CI 1.19–6.31), social network support (e.g., vaccine acceptance among an individual’s social network) in receiving COVID-19 vaccines (aOR 2.38; 95% CI 1.45–3.89), community concern about COVID-19 spread (aOR 2.84; 95% CI 1.73–4.66), and trust in HCWs to provide vaccine information (aOR 3.47; 95% CI 1.62–7.42). Future vaccine promotion should prioritize engaging community leaders, sharing transparent information, combatting misinformation and rumors, and implementing household-based interventions especially targeting the importance of vaccination among women and young people to increase uptake. Full article

The confluence of financial constraints, climate change mitigation efforts, and evolving user expectations has significantly transformed the concept of facility management (FM). Traditional FM has now evolved to enhance sustainability in the built environment. Sustainable facility management (SFM) can add value to companies, organizations, and governments by balancing the financial, environmental, and social outcomes of the FM processes. The systematic literature review revealed a limited number of studies developing a performance measurement framework for SFM in office buildings and/or other building types in the literature. Given that the lack of this theoretical basis inhibits the effective deployment of SFM practices, this study aims to fill this gap by developing a performance measurement framework for SFM in office buildings. Accordingly, an in-depth literature review was initially conducted to synthesize sustainable performance measurement factors. Next, a series of focus group discussion (FGD) sessions were organized to refine and verify the factors and develop a novel performance measurement framework for SFM. Lastly, consistency analysis, the Bayesian best worst method (BBWM), and sensitivity analysis were implemented to determine the priorities of the factors. What the proposed framework introduces is the combined use of two performance measurement mechanisms, such as continuous performance measurement and comprehensive performance measurement. The continuous performance measurement is conducted using high-priority factors. On the other hand, the comprehensive performance measurement is conducted with all the factors proposed in this study. Also, the BBWM results showed that “Energy-efficient material usage”, “Percentage of energy generated from renewable energy resources to total energy consumption”, and “Promoting hybrid or remote work conditions” are the top three factors, with scores of 0.0741, 0.0598, and 0.0555, respectively. Moreover, experts should also pay the utmost attention to factors related to waste management, indoor air quality, thermal comfort, and H&S measures. In addition to its theoretical contributions, the paper makes practical contributions by enabling decision makers to measure the SFM performance of office buildings and test the outcomes of their managerial processes in terms of performance. Full article

This paper discusses the role of energy and movement in facilitating experiences of well-being from an anthropological perspective that considers energy as a situated form of knowledge. Drawing on fieldwork among Core Energetics (CE) and 5Rhythms (5R) groups, I examine how the circulation of energy is achieved through bodily movements and dances, attention to the senses, somatic self-cultivation, and deep experiences of consciousness. Focus is hold on the ritual elements, including a specific spacetime framework and intersubjective exercises that facilitate energetical experiences that renew the subjective and intersubjective relationship to the self in a restorative way. I argue that mind–body–energy groups conflate two Western sources: on the one hand, the legacy of early Western medical offshoots that have been marginalized by mainstream biomedicine, and on the other, discursive references to contemporary interpretations of quantum physics. Full article

In recent decades, flexible electronics have witnessed remarkable advancements in multiple fields, encompassing wearable electronics, human–machine interfaces (HMI), clinical diagnosis, and treatment, etc. Nevertheless, conventional rigid electronic devices are fundamentally constrained by their inherent non-stretchability and poor conformability, limitations that substantially impede their practical applications. In contrast, conductive hydrogels (CHs) for electronic skin (E-skin) and healthcare monitoring have attracted substantial interest owing to outstanding features, including adjustable mechanical properties, intrinsic flexibility, stretchability, transparency, and diverse functional and structural designs. Considerable efforts focus on developing CHs incorporating various conductive materials to enable multifunctional wearable sensors and flexible electrodes, such as metals, carbon, ionic liquids (ILs), MXene, etc. This review presents a comprehensive summary of the recent advancements in CHs, focusing on their classifications and practical applications. Firstly, CHs are categorized into five groups based on the nature of the conductive materials employed. These categories include polymer-based, carbon-based, metal-based, MXene-based, and ionic CHs. Secondly, the promising applications of CHs for electrophysiological signals and healthcare monitoring are discussed in detail, including electroencephalogram (EEG), electrocardiogram (ECG), electromyogram (EMG), respiratory monitoring, and motion monitoring. Finally, this review concludes with a comprehensive summary of current research progress and prospects regarding CHs in the fields of electronic skin and health monitoring applications. Full article

The present study was conducted in Dacope Upazila, a sub-district located within the Khulna District of the coastal region in Bangladesh. The research methods employed included the implementation of 350 household questionnaire surveys (HQSs), 12 focus group discussions (FGDs), and 20 key informant interviews (KIIs) to assess economic security status in disaster-vulnerable areas. The findings indicate that the economic well-being of the region is precarious due to a paucity of revenue sources and the occurrence of various calamitous events, induced risks, and vulnerabilities. To achieve long-term economic security for households, a considerable proportion of the population (approximately 22%) in the study areas is dependent on agricultural activities for their livelihoods. The study also revealed that approximately 22% of households in the study areas reported experiencing salinity intrusion. Furthermore, most of the households, around 68%, reported cyclones as their primary obstacle to building disaster-resilient communities. Consequently, the prevailing local and institutional strategies to ensure economic security were found to be inadequate and unsustainable in the study upazila. Therefore, the study resulted in the formulation of a conceptual framework intended to measure the contribution of economic security to the adaptability and sustainability of disaster-resilient communities in vulnerable coastal areas of Bangladesh. Full article