Search Results (3,611)

Background/Objectives: Older adults (65+) are the fastest growing age group in Canada, comprising 18.8% of the country’s population. During the COVID-19 pandemic, use of virtual care, including telehealth and tele-medicine, increased dramatically among older adults in Canada who often face higher health risks, mobility limitations, and many barriers to accessing healthcare. Despite the rapid expansion in virtual care, no systematic review has focused specifically on virtual care among older adults in Canada. This review aims to explore the factors influencing virtual care adoption and the experiences of older Canadians during the pandemic through a systematic review. Methods: Conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, the review involved a comprehensive search of PubMed, Scopus, ESCBOHost, and Web of Science on 2 May 2025, yielding 281 unique citations. After screening and applying eligibility criteria, 15 studies employing quantitative, qualitative, or mixed-methods designs, with sample sizes ranging from 15 to 2,282,798, were included and appraised using the Mixed Methods Appraisal Tool (MMAT). Results: The review identified three domains of factors and the ways in which each factor shapes older adults’ virtual care experiences: (1) personal factors influencing virtual care use and demand (e.g., age, education, language, income, immigration status, community sizes), (2) resource factors impacting virtual care adoption (e.g., technology access, support), and (3) varying virtual care experiences among older adults (e.g., in assessment and communication efficacy, privacy, care quality, convenience, safety, and costs). Conclusions: This review highlights the complexities of virtual care engagement among older adults and underscores the need for inclusive, tailored strategies to improve the accessibility and effectiveness of virtual care delivery in both pandemic and post-pandemic contexts. Full article

Background: Concerns over women’s mental health have intensified globally, especially among mothers managing dual careers and family responsibilities. Positive Psychology Interventions (PPIs), such as gratitude journaling and well-being workshops, have demonstrated promise in enhancing mental health; however, their applicability in Arab contexts remains underexplored. This study aims to investigate the effectiveness of PPIs on mothers’ well-being, gratitude, depression, anxiety, and stress in Saudi Arabia. Methods: This quasi-experimental, one-group pretest–posttest study assessed the effects of a four-week PPI on 37 Saudi working mothers (aged 21–50 years) employed at a private school in Riyadh. The intervention included guided gratitude journaling thrice weekly and two workshops on positive psychology and gratitude. Pre- and post-intervention assessments used validated Arabic versions of the Depression Anxiety Stress Scale (DASS-21), WHO-5 Well-being Index, and Gratitude Questionnaire (GQ-6). Results: Significant improvements were found post-intervention: depression, anxiety, and stress scores decreased (p < 0.001), while well-being and gratitude increased (p = 0.001). However, participants with lower household income (<50,000 SAR) showed less improvement, indicating a potential moderating effect of socioeconomic status. Conclusions: The intervention demonstrated promising short-term improvements in mental health and well-being among Saudi mothers. The findings underscore the importance of culturally appropriate PPIs and highlight the need for further research using controlled, long-term designs. Limitations include the small, non-random sample, absence of a control group, and restriction to a single geographic region. Full article

Ruminant livestock production plays a crucial role in the agricultural systems of Sub-Saharan Africa, significantly supporting rural livelihoods through income generation, improved nutrition, and employment opportunities. Despite its importance, the sector continues to face substantial challenges, such as low feed quality, seasonal feed shortages, and climate-related stresses, all of which limit productivity and sustainability. Considering these challenges, the adoption of natural feed additives has emerged as a promising strategy to enhance animal performance, optimise nutrient utilisation, and mitigate environmental impacts, including the reduction of enteric methane emissions. This review underscores the significant potential of natural feed additives such as plant extracts, essential oils, probiotics, and mineral-based supplements such as fossil shell flour as sustainable alternatives to conventional growth promoters in ruminant production systems across the region. All available documented evidence on the topic from 2000 to 2024 was collated and synthesised through standardised methods of systematic review protocol—PRISMA. Out of 319 research papers downloaded, six were included and analysed directly or indirectly in this study. The results show that the addition of feed additives to ruminant diets in all the studies reviewed significantly (p < 0.05) improved growth parameters such as average daily growth (ADG), feed intake, and feed conversion ratio (FCR) compared to the control group. However, no significant (p > 0.05) effect was found on cold carcass weight (CCW), meat percentage, fat percentage, bone percentage, or intramuscular fat (IMF%) compared to the control. The available evidence indicates that these additives can provide tangible benefits, including improved growth performance, better feed efficiency, enhanced immune responses, and superior meat quality, while also supporting environmental sustainability by reducing nitrogen excretion and decreasing dependence on antimicrobial agents. Full article

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

Background/Objectives: Family caregivers of individuals with schizophrenia often face considerable psychological and physical strain due to the complexity of caregiving. Although psychoeducation has demonstrated benefits in alleviating this burden, its provision via telenursing remains underexplored in Saudi Arabia. This study evaluated the effect of a psychoeducational program delivered via telenursing on reducing caregiver burden. Methods: A quasi-experimental design was used with 60 caregivers from a tertiary mental health hospital in northern Saudi Arabia, who were divided equally into intervention and control groups. The intervention group participated in a structured four-week psychoeducational program via Zoom, while the control group received routine care. Caregiver burden was assessed using the Family Burden Interview Schedule (FBIS), a validated tool designed to measure the objective and subjective burden experienced by family members caring for individuals with mental illness. The FBIS was administered before and three months after the intervention. The statistical analysis included independent and paired t-tests and ANOVA. Results: The pre-intervention scores showed no significant differences, confirming baseline equivalence. The post-intervention scores showed a significant reduction in burden among the intervention group (p < 0.001), while no meaningful change occurred in the control group. Additionally, a lower burden was associated with higher education, sufficient income (i.e., the caregiver’s perception of being able to meet essential household expenses without financial strain), strong family support, and absence of caregiver illness. Conclusions: These findings suggest that psychoeducation through telenursing is an effective strategy for reducing caregiver burden and improving support accessibility, particularly for those in remote areas. Full article

The work presents a comprehensive analysis and costing of sugar beet cultivation in 2020–2022, for individual farms of the Lublin region. About 120 farms were analyzed. Based on this analysis, the criteria for a model farm were determined and adopted for the calculation of sugar beet production costs. ARIMA process modeling was performed, based on which forecasts were determined for several selected parameters. Customs tariffs introduced by the USA have a drastic impact on the economy. The effects of the COVID19 pandemic may also have a significant impact on the current market situation. Forecasting in the current geopolitical situation is very difficult because of the lack of stationarity of parameters. The financial result obtained by growers is mainly influenced by indirect costs absorbing 61.31% of total costs in 2020. In 2021 and 2022, indirect costs were 61.16% and 59.61% of production income, respectively. Among this group of costs, the largest share is accounted for by the costs of sowing services, sugar beet harvesting, and soil liming amounting from 14.27% to 15.92%. During the analyzed period, sugar beet cultivation remained profitable, with a production profitability index of 1.31 in 2020 and 2021, and 1.10 in 2022. The unit cost of production increased every year. In 2020, it was 14.27% and in 2021, it increased to 15.19%. The unit cost of production in 2022 was the highest, at 23.41%. Sugar beet cultivation is one of the profitable activities in agricultural production, but it is characterized by high production costs, which increased during the years analyzed (2020 to 2022), topping out at 90.87% of total revenue. The information and data presented in this study will be used in the development of a farmer-oriented application and will support the creation of an expert system for sugar beet growers. Cost forecasting will enable farmers to plan their production more effectively. Full article

Compared to commuting, grocery shopping trips, despite their profound implications for mixed land use and transportation planning, have received limited attention in travel behavior research. Drawing upon a travel diary survey conducted in a fast-growing metropolitan region of the United States, i.e., Salt Lake County, UT, this research investigated a variety of influential factors affecting mode choices associated with grocery shopping. We analyze how built environment (BE) characteristics, measured at seven spatial scales or different ways of aggregating spatial data—including straight-line buffers, network buffers, and census units—affect travel mode decisions. Key predictors of choosing walking, biking, or transit over driving include age, household size, vehicle ownership, income, land use mix, street density, and distance to the central business district (CBD). Notably, the influence of BE factors on mode choice is sensitive to different spatial aggregation methods and locations of origins and destinations. The straight-line buffer was a good indicator for the influence of store sales amount on mode choices; the network buffer was more suitable for the household built environment factors, whereas the measurement at the census block and block group levels was more effective for store-area characteristics. These findings underscore the importance of considering both the spatial analysis method and the location (home vs. store) when modeling non-work travel. A multi-scalar approach can enhance the accuracy of travel demand models and inform more effective land use and transportation planning strategies. Full article

Although organizational resilience is well established, refining the systematic quantitative evaluation of health systems resilience (HSR) remains an ongoing opportunity for advancement. Research either focuses on individual HSR indicators, such as social welfare policy, public expenditure, health insurance, healthcare quality, and technology, or broadly examines socio-economic factors, highlighting the need for a more comprehensive methodological approach. This study employed the Slacks-Based Measure (SBM) within Data Envelopment Analysis (DEA) to analyze efficiency by maximizing outputs. It systematically examined key HSR factors across countries, providing insights for improved policymaking and resource allocation. Taking a five-year (2016–2020) dataset that covered 55 to 56 countries and evaluating 17 indicators across governance, health systems, and economic aspects, the paper presents that all sixteen top-ranked countries with a perfect efficiency score of 1 belonged to the high-income group, with ten in Europe, highlighting regional HSR differences. This paper concludes that adequate economic resources form the foundation of HSR and ensure stability and sustained progress. A properly supported healthcare workforce is essential for significantly enhancing health systems and delivering quality care. Last, effective governance and the equitable allocation of resources are crucial for fostering sustainable development and strengthening HSR. Full article

Background/Objectives: Dietary patterns have changed over time, characterising a process of nutritional transition that reflects socioeconomic and demographic inequalities among different populations. This study assessed changes in dietary consumption patterns and the associated social determinants, comparing two time periods in a sample of individuals from a state in the Northeast Region of Brazil. Methods: Data from the 2008–2009 and 2017–2018 Household Budget Survey for the state of Paraíba were analysed, totalling 951 and 1456 individuals, respectively. Foods were categorised according to the NOVA classification and compared based on sociodemographic and economic variables. To determine the factors that most strongly explain the contribution of each NOVA food group to the diet, beta regression analysis was conducted. Results: Differences were observed between the two periods regarding the dietary contribution of the NOVA food groups, with a decrease in consumption of unprocessed foods and an increase in ultra-processed foods. Living in urban areas, being an adolescent, and having an income above the minimum wage were associated with reduced intake of unprocessed foods in both periods. Additionally, being an adolescent and having more than eight years of schooling were associated with higher consumption of ultra-processed foods. Conclusions: The population under study showed changes in food consumption, reflecting a transition process that is occurring unevenly across socioeconomic and demographic groups, thereby reinforcing social inequalities. These findings can guide priorities in food and nutrition policies, highlighting the need for intervention studies to evaluate the effectiveness of such actions. Full article

Objective: This study aimed to develop a performance evaluation index system for a district-level public hospital in Chongqing, China, based on Diagnosis-Related Groups (DRGs), to provide a benchmark for performance assessment in similar hospitals. The system was constructed using a literature analysis, the Delphi method, and the Analytic Hierarchy Process (AHP) to identify and weight relevant indicators. Results: The evaluation system consists of three primary indicators and eighteen secondary indicators. Key secondary indicators include the Case Mix Index (CMI), cost consumption index, low-risk group mortality rate, the proportion of patients with three- or four-level surgeries at discharge, and the proportion of medical service revenue to medical income. In 2020, significant improvements were observed in several indicators, such as a decrease in the low-risk group mortality rate to 0% and increases in the proportion of patients with three- or four-level surgeries and CMI by nearly 10% and 13%, respectively. Conclusions: This study successfully developed a comprehensive and scientifically sound performance evaluation index system for a district-level public hospital in Chongqing. The system has proven effective in objectively assessing inpatient medical care performance and providing valuable guidance for improving healthcare services in similar settings. Full article

By 2050, it is estimated that approximately 200 million people will be displaced due to the impacts of climate change. Vulnerability to climate change is shaped not only by environmental factors but fundamentally by systemic power relations and structural conditions present at both the places of origin and destination. In Latin America, climate-displaced persons predominantly settle in marginalised neighbourhoods, where widely accepted informality facilitates their rapid arrival but obstructs genuine progress and full integration as urban citizens. This paper critically examines the prevailing myths that justify the persistence of informality, revealing the socioeconomic challenges faced by climate migrants in the region. These four dominant myths are (1) Latin America’s inherently low productivity levels; (2) concessions by the ruling class enabling excluded groups to merely survive; (3) the perceived privilege of marginalised neighbourhoods to generate income outside formal legal frameworks, which supports their social capital; and (4) the limited benefits associated with formalisation. Debunking these myths is essential for developing effective public policies aimed at reducing informality and promoting inclusive urban integration, ultimately benefiting both climate migrants and host communities. Full article

Tunisia faces significant challenges related to climate change, which deeply affect its natural and agricultural resources. This reality threatens not only food security but also the economic stability of rural communities and mainly rural women. This research aims to assess the impact of climate change on rural women in the agricultural development group in Sidi Bouzid, focusing on the strategies adopted and the support provided by various stakeholders to mitigate this impact. To achieve this, we developed a rigorous methodology that includes structured questionnaires, focus group discussions, and topological analysis through Multiple Correspondence Analysis (MCA). The results revealed that rural women were categorized into three groups based on their vulnerability to climate change: severely vulnerable, vulnerable, and adaptive. The findings highlighted the significant impact of climate change on water resources, which has increased family tensions and reduced agricultural incomes, making daily life more challenging for rural women. Furthermore, a deeper analysis of interactions with external stakeholders emphasized the important role of civil society, public organizations, and research institutions in strengthening the climate resilience of rural women. Given these findings, strategic recommendations aim to enhance stakeholder coordination, expand partnerships, and improve access to essential technologies and resources for women in agricultural development groups. Full article

Enhancing farmers’ digital literacy is both an inevitable requirement for adapting to the digital age and an important measure for promoting the sustainable development of livestock and poultry manure resource utilization. This study surveyed and obtained data from 1047 farm households in Ningxia and Gansu, two provinces in China that have long implemented livestock manure resource utilization policies, from December 2023 to January 2024, and employed the binary probit model to analyze how digital literacy influences farmers’ willingness to adopt two livestock manure resource utilization modes, as well as to analyze the moderating role of three policy regulations. This paper also explores the heterogeneous results in different village forms and income groups. The results are as follows: (1) Digital literacy significantly and positively impacts farmers’ willingness to adopt both the “household collection” mode and the “livestock community” mode. For every one-unit increase in a farmer’s digital literacy, the probability of farmers’ willingness to adopt the “household collection” mode rises by 22 percentage points, and the probability of farmers’ willingness to adopt the “livestock community” mode rises by 19.8 percentage points. After endogeneity tests and robustness checks, the conclusion still holds. (2) Mechanism analysis results indicate that guiding policy and incentive policy have a positive moderation effect on the link between digital literacy and the willingness to adopt the “household collection” mode. Meanwhile, incentive policy also positively moderates the relationship between digital literacy and the willingness to adopt the “livestock community” mode. (3) Heterogeneity analysis results show that the positive effect of digital literacy on farmers’ willingness to adopt two livestock manure resource utilization modes is stronger in “tight-knit society” rural areas and in low-income households. (4) In further discussion, we find that digital literacy removes the information barriers for farmers, facilitating the conversion of willingness into behavior. The value of this study is as follows: this paper provides new insights for the promotion of livestock and poultry manure resource utilization policies in countries and regions similar to the development process of northwest China. Therefore, enhancing farmers’ digital literacy in a targeted way, strengthening the promotion of grassroots policies on livestock manure resource utilization, formulating diversified ecological compensation schemes, and establishing limited supervision and penalty rules can boost farmers’ willingness to adopt manure resource utilization models. Full article

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

Introduction: Low medication adherence and low hypertension control are a public health challenge, particularly in low- and middle-income countries (LMICs). Healthcare system- and patient-related barriers hinder the successful management of hypertension. This study aimed to identify the perceptions of barriers and facilitators to hypertension management among health system stakeholders in Santander, Colombia. Materials and Methods: We conducted a qualitative, phenomenological, and interpretative study, comprising five focus groups, to explore the barriers and facilitators to managing people with hypertension. Each focus group was formed by stakeholders from territorial entities, healthcare insurers, or healthcare providers. Meetings were held between December 2022 and February 2023. The sessions were recorded and transcribed using NVivo Transcription and analyzed using NVivo version 1.6.1. Results: Seven categories of barriers and facilitators were identified: strategies, resources, access, risk assessment, cross-sector collaboration, articulation, and stewardship. Of these categories, articulation and stewardship emerged as the main barriers, as revealed through axial coding and cluster analysis, which highlighted deficiencies in stewardship practices, a lack of clear objectives, and misalignment with public policy frameworks. Conclusions: Multisectoral actions extending beyond healthcare providers and aimed at improving coordination and intersectoral collaboration are essential for enhancing hypertension control in LMICs, such as Colombia. Addressing social determinants and strengthening primary healthcare through community-based strategies are critical, making stewardship and improved access key priorities. Full article