Search Results (585)

This study estimates the prevalence of co-use of alcohol and cannabis, assesses the sociodemographic risk factors of co-use, and examines the associations between mental health and heavy episodic drinking (HED) and alcohol–cannabis co-use in Canada during the early years of the COVID-19 pandemic. Nine successive cross-sectional surveys, held from May 2020 to January 2022, of adults (aged ≥18 years) living in Canada were pooled for 9011 participants. The prevalence of co-use was calculated across sociodemographic groups. Logistic regressions were used to assess associations. Alcohol–cannabis co-use was associated with a greater likelihood of engaging in HED and experiencing symptoms of anxiety, depression, and loneliness. The prevalence of co-use of alcohol was different across sociodemographic groups. The highest prevalence was among TGD people (35.5%), followed by individuals aged 18–39 years (14.5%). Additionally, being TGD (aOR = 3.61, 95% CI 2.09–6.25), separated/divorced/widowed (aOR = 1.60, 95% CI 1.23–2.07), living in an urban area (aOR = 1.26, 95% CI 1.07–1.56), and having a high household income (aOR = 1.41, 95% CI 1.09–1.82) increased the likelihood of reporting alcohol–cannabis co-use. These findings underscore the fact that developing public health and clinical interventions for preventing and treating excessive alcohol or cannabis use must consider both alcohol and cannabis use patterns and should be tailored to the highest-risk TGD and young adults. Full article

Global policy narratives on livestock development increasingly emphasize environmental concerns, often overlooking the social dimensions of the sector. In the case of dairy, the world’s most valuable agricultural commodity, its role in social and economic development remains poorly quantified. Our study contributes to a more balanced vision of the UN SDGs thanks to the inclusion of a socio-economic dimension. Here we present a novel empirical approach to assess the socio-economic impacts of dairy development using a new global dataset and non-parametric modelling techniques (local polynomial regressions), with yield as a proxy for sectoral performance. We find that as dairy systems intensify, the number of farm households engaged in production declines, yet household incomes rise. On-farm labour productivity also increases, accompanied by a reduction in employment but higher wages. In dairy processing, employment initially grows, peaks, and then contracts, again with rising wages. The most substantial impact is observed among consumers: an increased milk supply leads to lower prices and improved affordability, expanding the access to dairy products. Additionally, dairy development is associated with greater agricultural value added, an expanding tax base, and the increased formalization of the economy. These findings suggest that dairy development, beyond its environmental footprint, plays a significant and largely positive role in social transformation, yet is having to adapt sustainably while tackling labour force relocation, and that dairy development’s social impacts mimic the general agricultural sector. These results might be of interest for the assessment of policies regarding dairy development. Full article

The sustainable management of Municipal Solid Waste (MSW) relies heavily on community participation in separating it at the source and delivering it to collection systems. These practices are crucial for reducing pollution, protecting ecosystems, and maximizing resource recovery. However, in the Global South context, with conditions of socioeconomic vulnerability, community participation in the sustainable management of MSW remains limited, highlighting the need to generate context-specific interventions. MSW includes items such as household appliances, batteries, and electronic devices, which require specialized handling due to their size, hazardous components, or material complexity. This study implemented a Community-Based Social Marketing approach during the research and design phases of an intervention focused on promoting source separation and management of hard-to-manage MSW in five municipalities within the administrative region of Norte de Santander (Colombia), which borders Venezuela. Using a mixed-methods approach, we collected data from 1775 individuals (63.83% women; M _age = 33.48 years; SD = 17.25), employing social mapping, focus groups, semi-structured interviews, participant observation, and a survey questionnaire. The results show that the source separation and delivery of hard-to-manage MSW to collection systems are limited by a set of psychosocial, structural, and institutional barriers that interact with each other, affecting communities’ willingness and capacity for action. Furthermore, a prediction model of willingness to engage in separation and delivery behaviors showed a good fit (R2 = 0.83). The strongest predictors were awareness of the negative consequences of non-participation and perceived environmental benefits, with subjective norms contributing to a lesser extent. Based on these results, we designed a context-specific intervention focused on reducing these barriers and promoting community engagement in the sustainable management of hard-to-manage MSW. Full article

The aim of this research is to identify policy and practice interventions that support a just transition towards resilient practices for resource-dependent communities. We focus on Thai Nguyen and Phu Tho, two provinces in the Northern Midlands and Mountains of Vietnam. The region is reliant on agriculture but is assessed as highly vulnerable to climate change. We surveyed 105 farming households. A Likert-type questionnaire asked respondents to self-assess their experiences of weather extremes and of changes they had made to their farming practices. Our results show that for both Thai Nguyen and Phu Tho, farmers see the effects of climate change on their crops. Respondents in Thai Nguyen were more likely to report technically driven adaptation and engagement with extension services. Respondents in Pho Tho were more likely to continue traditional practices. For both, use of traditional knowledge and practices was related to taking measures to adapt to climate change. Our main conclusion is that at least three actions could support a just transition to resilient livelihoods. First is incorporating natural science and traditional knowledge into decision-making for just transitions. Second is considering long-term implications of interventions that appear to support livelihoods in the short term. Third is tailoring messaging and engagement strategies to the requirements of the most vulnerable people. The main message of this study is that a just transition for resource-dependent communities will inevitably be context-specific. Even in centralized and authoritarian contexts, flexibility to adapt top-down policies to locals’ own experiences of changing climates is needed. Full article

Commitments to carbon neutrality at both international and national levels have spurred the development of market-based mechanisms that incentivize low-carbon technologies while penalizing emissions-intensive activities. These policies have wide ranging impacts for the Australian agricultural sector, and associated rural communities, where the majority of carbon credits and biodiversity credits are sourced in Australia. Undeniably, the introduction of carbon and environmental markets has created the opportunity for an expansion and diversification of local, rural economies beyond a traditional agricultural base. However, there is much complexity for the agricultural sector to navigate as environmental markets intersect and compete with food and fiber livelihoods, and entrenched ideologies of rural identity and purpose. As carbon and environmental markets focused on primary producers have expanded rapidly, there is little understanding of the associated situated and relational impacts for farming households and rural communities. Nor has there been much work to identify the barriers to engagement. This study explores these tensions through qualitative research in Stanthorpe and Roma, Queensland, offering insights into the barriers and benefits of market engagement. The findings inform policy development aimed at balancing climate goals with agricultural sustainability and rural community resilience. Full article

With the increasing integration of renewable energy and smart technologies in residential energy systems, proactive household energy management (HEM) have become critical for reducing costs, enhancing grid stability, and achieving sustainability goals. This study proposes a ultra-short-term forecasting-driven proactive energy consumption optimization strategy that integrates advanced forecasting models with multi-objective scheduling algorithms. By leveraging deep learning techniques like Graph Attention Network (GAT) architectures, the system predicts ultra-short-term household load profiles with high accuracy, addressing the volatility of residential energy use. Then, based on the predicted data, a comprehensive consideration of electricity costs, user comfort, carbon emission pricing, and grid load balance indicators is undertaken. This study proposes an enhanced mixed-integer optimization algorithm to collaboratively optimize multiple objective functions, thereby refining appliance scheduling, energy storage utilization, and grid interaction. Case studies demonstrate that integrating photovoltaic (PV) power generation forecasting and load forecasting models into a home energy management system, and adjusting the original power usage schedule based on predicted PV output and water heater demand, can effectively reduce electricity costs and carbon emissions without compromising user engagement in optimization. This approach helps promote energy-saving and low-carbon electricity consumption habits among users. 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

This study contributes to the broader sustainability discourse by evaluating public knowledge, awareness, and practices regarding air pollution among residents of Hanoi, Vietnam, focusing on its causes, health impacts, and mitigation strategies. A cross-sectional survey was conducted with 521 individuals in suburbs around Hanoi. A multistage sampling technique, combining cluster and simple random sampling, was used for participant recruitment. Three central and three suburban districts of Hanoi were randomly selected as clusters. One individual from each household was invited to participate and answer a structured survey, which assessed perceptions of air pollution, its human-induced causes, recognised health impacts, and individual and community-level mitigation behaviours. Nearly all participants (98.3%) were aware of air pollution, with 65.3% attributing it to human activities and 61.2% recognising specific air pollutants as primary contributors. The majority (93.9%) acknowledged health impacts, citing respiratory infections (55.1%) and sinus issues (51.2%) as prevalent concerns. Vulnerable groups, such as children under 5 (82.3%) and adults over 65 years old (77.4%), were identified as disproportionately affected. Social media (68.9%) and television (58.3%) were the dominant sources of information. Despite a recognition of air pollution’s importance (98.5%), there was limited engagement in systemic sustainability actions, such as supporting renewable energy initiatives. Most participants (84.3%) reported personal mitigation efforts, including energy-saving practices (35.5%) and walking instead of driving a car or bike (35.3%). While awareness of air pollution and its health impacts is high among Hanoi residents, proactive engagement in systemic solutions remains limited. Policymakers should prioritise community-based programs, public–private partnerships, sustainability education, and culturally tailored policy interventions to bridge gaps between awareness and action. Tailored interventions addressing demographic and cultural factors are essential to fostering socio-environmental sustainability in rapidly urbanising contexts. Full article

The growing global demand for energy has resulted in a demand for innovative strategies for residential energy management. This study explores a novel framework—MELISSA (Modern Energy LLM-IoE Smart Solution for Automation)—that integrates Internet of Things (IoT) sensor networks with Large Language Models (LLMs) to optimize household energy consumption through intelligent automation and personalized interactions. The system combines real-time monitoring, machine learning algorithms for behavioral analysis, and natural language processing to deliver personalized, actionable recommendations through a conversational interface. A 12-month randomized controlled trial was conducted with 100 households, which were stratified across four socioeconomic quintiles in metropolitan areas. The experimental design included the continuous collection of IoT data. Baseline energy consumption was measured and compared with post-intervention usage to assess system impact. Statistical analyses included k-means clustering, multiple linear regression, and paired t-tests. The system achieved its intended goal, with a statistically significant reduction of 5.66% in energy consumption (95% CI: 5.21–6.11%, $p<0.001$) relative to baseline, alongside high user satisfaction (mean = 7.81, SD = 1.24). Clustering analysis ($k=4$, silhouette = 0.68) revealed four distinct energy-consumption profiles. Multiple regression analysis ($R^2=0.68$, $p<0.001$) identified household size, ambient temperature, and frequency of user engagement as the principal determinants of consumption. This research advances the theoretical understanding of human–AI interaction in energy management and provides robust empirical evidence of the effectiveness of LLM-mediated behavioral interventions. The findings underscore the potential of conversational AI applications in smart homes and have practical implications for optimization of residential energy use. Full article

Grain production is crucial for national security and stability. Studying the impact of digital literacy on green production by grain farmers is of great significance for ensuring food security and achieving green agricultural development. This article utilizes data from the 2020 China Rural Revitalization Survey (CRRS), selecting a sample of 1811 farming households engaged in grain cultivation. Employing methods such as the ordered Probit model and mediating effect model, it analyzes the impact of digital literacy on green grain production from the perspectives of transformation drivers and pathways. The results show, first, that digital literacy significantly promotes farmers’ green production behaviors, and the findings remain valid after multiple robustness tests. Second, a mechanism analysis reveals that digital literacy drives farmers’ green production by reconstructing their benefit cognition and green cognition and promoting the application of green mechanization technologies. Third, a heterogeneity analysis indicates that the larger the farmers’ operation scale and the stronger their economic capacity, the more significant the promoting effect of digital literacy on their green production. Accordingly, it is necessary to accelerate the improvement of farmers’ digital literacy, reduce green production costs, popularize green mechanization technologies, and promote the green transformation of grain production. Full article

Objective: A self-management telehealth program to improve hand strength and function in systemic sclerosis (SSc) patients may improve their quality of life, so we investigated its efficacy. Methods: A 6-week prospective randomized controlled study was conducted in adults with SSc with a hand mobility in scleroderma (HAMIS) score > 1 or a limited range of motion in at least one hand joint. Participants were randomly allocated into three groups for six weeks of health education: (a) typical education, (b) watching video guides as needed, in addition to typical education, and (c) watching video guides and receiving weekly telephone notifications, in addition to typical education. The endpoints were the differences in self-management behavior, HAMIS scores, hand grip strength (HGS), and quality of life (QoL) using the European Quality of Life-5 Dimensions between groups, as well as the changes in these parameters compared to baseline. Results: A total of 24 patients per group were enrolled, with the majority diagnosed with diffuse cutaneous SSc (79.2%). Six weeks post-intervention, HGS improved significantly in both the video guide and telephone notification groups compared to typical education in both hands (p = 0.028, p = 0.044). Pincer grip differed between the groups in the non-dominant hand. Household modifications were more frequent in the video guide and telephone notification groups than in the typical education group (p = 0.023). All groups showed significant improvements in HGS and HAMIS scores in both hands, as well as in self-management behaviors, compared to baseline. QoL, as measured using a visual analog scale, improved significantly after the intervention in both the video guide and telephone notification groups, but not in the typical education group. Conclusions: Self-management telehealth programs effectively enhance hand strength, function, and self-management behaviors in patients with SSc with limited hand function. Weekly telephone notifications further reinforced continuity and engagement in these patients. Full article

In the context of emergency management, individual or household decisions to engage in risk mitigation behaviors are widely recognized to be influenced by a benefit–cost perception (perceived applied value (PAV) vs. perceived economic value (PEV), respectively). To better understand how such decisions are made, we conducted a mail survey (N = 211) of households living in the Red River of the North Basin, North Dakota, in 2018. The survey is aimed at understanding the overall experience of households with flooding and their behavior toward advanced protective strategies against future floods by analyzing household PEV—their willingness to pay for the National Aeronautics and Space Administration’s (NASA) Satellite Enhanced Snowmelt Flood Prediction system. This paper presents a mediation model in which various predictors (flood risk, experience, flood knowledge, flood risk perception, flood preparedness, flood mitigation, and flood insurance) are analyzed in relation to the PAV of the new Satellite Enhanced Snowmelt Flood Predictions in the Red River of the North Basin, which, in turn, may shape the PEV of this product. We discuss the potential implications for both the emergency management research community and professionals regarding the application of advanced risk mitigation technologies to help protect and sustain communities across the country from floods and other natural disasters. This paper provides a greater understanding of the economic and social aspects of sustainability in the context of emergency management and community development. Full article

Background/Objectives: Recruiting and retaining low-income participants in community-based diabetes interventions remains a persistent challenge, particularly in medically underserved areas. This study describes engagement strategies and lessons learned recruiting for a 12-month pilot of a community-based, medically tailored nutrition program for diabetes remission and weight loss. Methods: A descriptive, exploratory mixed-methods study was performed to assess the effectiveness of recruitment and engagement strategies in the HEAL Diabetes program and identify areas for improvement. Recruitment and enrollment data were tracked utilizing recruitment logs and field notes. Descriptive statistics were used to analyze recruitment activity and retention rates, while qualitative analysis of fieldnotes identified key barriers and facilitators. Results: Among 83 eligible participants, 63 (75.9%) completed the in-person screening and 35 (55.6% enrollment rate) enrolled. Retention was high, with 30 completing the study. Participants were largely African American (97.1%), female (70.6%), average age of 59.8 years, with a household income below USD 49,000 (74.3%). Recruitment cycles achieved 87.5% of the target before budget constraints halted enrollment. Recruitment was hindered by limited clinical integration, social barriers and life demands, while facilitators to recruiting included trust, flexibility, and tangible support for participation. Conclusions: Conventional recruitment methods, including registry-based approaches, were insufficient for engaging underserved populations. Participant-centric strategies, emphasizing trust, practical support, and structural and cultural relevance, can help enhance enrollment and retention. Effective engagement in community-based diabetes interventions requires multifaceted approaches that address clinical, social, and structural barriers to participation. Full article

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (U.S.) and a major contributor to several cancers, including cervical, anal, penile, and oropharyngeal cancers. Although a safe and effective vaccine is available, HPV vaccination rates remain suboptimal, particularly among racial, ethnic, and immigrant minority groups. This study explored multiple factors, such as cultural, social, and structural influences, influencing HPV vaccine decision-making among Cape Verdean immigrant parents in the U.S., a population currently underrepresented in HPV research. Methods: Qualitative study using individual, in-depth interviews with Cape Verdean immigrant parents of children aged 11 to 17 years living in the U.S. Interviews were transcribed verbatim and analyzed thematically using the social ecological model (SEM) to identify barriers and facilitators at the intrapersonal, interpersonal, organizational, community, and policy levels. Results: Forty-five Cape Verdean parents (27 mothers, 18 fathers) participated. Fathers were significantly older than mothers (50.0 vs. 41.1 years, p = 0.05). Most were married or partnered (60%), had at least a high school education (84.4%), and reported annual household incomes of US$50,000 or more (66.7%), with no significant gender differences. Nearly all spoke Creole at home (95.6%). Fathers had lower acculturation than mothers (p = 0.05), reflecting less adaptation to U.S. norms and language use. Most parents had limited knowledge of HPV and the vaccine, with gendered beliefs and misconceptions about risk. Only seven mothers (25.9%) reported receiving a provider recommendation; all indicated that their children had initiated vaccination (1 dose or more). Mothers were the primary decision-makers, though joint decision-making was common. Trust in providers was high, but poor communication and the lack of culturally and linguistically appropriate materials limited informed decision-making. Stigma, misinformation, and cultural taboos restricted open dialogue. Trusted sources of information included schools, churches, and Cape Verdean organizations. While parents valued the U.S. healthcare system, they noted gaps in public health messaging and provider engagement. Conclusions: Findings revealed that HPV vaccine uptake and hesitancy among Cape Verdean immigrant parents in the U.S. were influenced by individual beliefs, family dynamics, healthcare provider interactions, cultural norms, and structural barriers. These findings highlight the need for multilevel strategies such as culturally tailored education, community engagement, and improved provider communication to support informed vaccination decisions in this population. Full article

Agricultural green production (AGP) is a key strategy for ensuring stable and sustainable grain production in developing countries. However, from the perspective of technology acquisition, research on farmers’ willingness to adopt AGP remains limited. Based on this, a survey was conducted on 862 households in major grain-producing counties in the Huang Huai Hai Plain of China with a reliable and effective response rate of 97.44%. The aim was to employ Probit and mediation models to empirically analyze the direct impacts of green perception benefits and environmental regulation intensity on farmers’ AGP willingness, and further examine the intrinsic mechanisms of technology acquisition. The results demonstrated that both green perception benefits and environmental regulation intensity significantly enhanced farmers’ willingness to engage in AGP, with green perception benefits having a greater influence. Among the two-dimensional variables, economic benefits had a stronger promoting effect than identity benefits, with a difference of 0.044 units, while subjective regulation intensity outperformed objective regulation intensity by 0.173 units. This suggested the need to strengthen the subjective impact of AGP policies in practice. Further analysis revealed that technology acquisition mediated 5.87% of the effect of green perception benefits on farmers’ AGP willingness, with acquisition evaluation having the greatest mediating effect, followed by acquisition quality and acquisition channels. However, although the overall environmental regulation intensity did not significantly impact farmers’ willingness to engage in AGP, its two-dimensional indicators played a mediating role to varying degrees. The findings in this study provide valuable empirical evidence for promoting AGP among grain producers, contributing to grain production security and the sustainable development of developing countries. Thus, implementing environmental regulatory policies tailored to local conditions, enhancing farmers’ economic awareness and sense of responsibility, and expanding farmers’ channels for technology acquisition are reasonable policy choices. Full article