Search Results (223)

Agrarian women are at the forefront of rural livelihoods increasingly affected by the frequency and severity of climate change impacts. However, their household livelihood resilience (HLR) remains limited due to gender-blind policies, scarce sex-disaggregated data, and inadequate consideration of gender-specific needs in resilience-building efforts. Grounded in participatory feminist research, this study employed a multi-method qualitative approach, including semi-structured interviews and oral history narratives, with 60 women in two climate-vulnerable provinces. Data were analyzed through thematic coding, CATWOE (Customers, Actors, Transformation, Worldview, Owners, Environmental Constraints) analysis, and descriptive statistics. The findings identify nine major climate-related events disrupting livelihoods and reveal a limited understanding of HLR as a long-term, transformative concept. Adaptation strategies remain short-term and focused on immediate survival. Barriers to HLR include financial constraints, limited access to agricultural resources and technology, and entrenched gender norms restricting women’s leadership and decision-making. While local governments, women’s associations, and community networks provide some support, gaps in accessibility and adequacy persist. Participants expressed the need for financial assistance, vocational training, agricultural technologies, and stronger peer networks. Strengthening HLR among agrarian women requires gender-sensitive policies, investment in local support systems, and community-led initiatives. Empowering agrarian women as agents of change is critical for fostering resilient rural livelihoods and achieving inclusive, sustainable development. Full article

The present research deals with forecasting the potential content of humic acids (HA) in Ukrainian lignite based on the coal’s physicochemical characteristics. The focus is on developing an experimental–statistical model that considers moisture content, volatile matter yield, and calorific value of lignite. The development of the humic acid yield’s dependence on some lignite parameters is based on both original research data and literature sources. Humic acids were extracted using alkaline solutions, and HA content was calculated for various lignite deposits in Ukraine. The adequacy check of the model showed a relative prediction error of up to 12%, indicating good agreement between the model and experimental data. The highest potential yield of humic acids was recorded for lignite from the Dnipropetrovsk region (Dnieper-Donets Basin), amounting to 53–56 wt.%. The presented results demonstrate the feasibility of using mathematical forecasting to assess the industrial potential of humic acid production from lignite. Full article

Water scarcity, exacerbated by climate change, population growth, and competing sectoral demands, poses a major threat to agricultural sustainability, particularly in irrigated regions such as the Nile Delta in Egypt. Addressing this challenge requires innovative approaches to evaluate irrigation performance despite the limitations in ground data availability. Traditional assessment methods are often costly, labor-intensive, and reliant on field data, limiting their scalability, especially in data-scarce regions. This paper addresses this gap by presenting a comprehensive and scalable framework that employs publicly accessible satellite data to map crop types and subsequently assess irrigation performance without the need for ground truthing. The framework consists of two parts: First, crop mapping, which was conducted seasonally between 2015 and 2020 for the four primary crops in the Nile Delta (rice, maize, wheat, and clover). The WaPOR v2 Land Cover Classification layer was used as a substitute for ground truth data to label the Landsat-8 images for training the random forest algorithm. The crop maps generated at 30 m resolution had moderate to high accuracy, with overall accuracy ranging from 0.77 to 0.80 in summer and 0.87–0.95 in winter. The estimated crop areas aligned well with national agricultural statistics. Second, based on the mapped crops, three irrigation performance indicators—adequacy, reliability, and equity—were calculated and compared with their established standards. The results reveal a good level of equity, with values consistently below 10%, and a relatively reliable water supply, as indicated by the reliability indicator (0.02–0.08). Average summer adequacy ranged from 0.4 to 0.63, indicating insufficient supply, whereas winter values (1.3 to 1.7) reflected a surplus. A noticeable improvement gradient was observed for all indicators toward the north of the delta, while areas located in the delta’s new lands consistently displayed unfavorable conditions in all indicators. This approach facilitates the identification of regions where agricultural performance falls short of its potential, thereby offering valuable insights into where and how irrigation systems can be strategically improved to enhance overall performance sustainably. Full article

Healthcare-associated infections (HAIs), also referred to as nosocomial or hospital-acquired infections, are a significant cause of death worldwide, with hand hygiene being the most powerful means to tackle them. The present study had a twofold aim: first, to assess the level of knowledge and the degree of compliance with hand hygiene practices based on healthcare workers’ self-reports; second, to evaluate whether behavioral economics techniques, specifically a poster combining an image and an informational message, designed according to the published literature, can increase the level of healthcare workers’ compliance with hand hygiene. Factors that potentially affect compliance were also examined. This study involved distributing a questionnaire to healthcare workers in Greek public hospitals, from which 314 completed responses were collected during the last quarter of 2023. Participants were randomly and evenly assigned to an intervention group that received a nudging poster or to a control group, which did not. Self-reported compliance with hand hygiene practices was high, based on two latent variables derived through exploratory factor analysis, although knowledge of germ transmission was moderate, as reflected in the relevant knowledge question scores. However, nudging had no statistically significant effect on hand hygiene behavior. Compliance was associated with several factors, including gender, age, work experience, profession, perceived adequacy of available hygiene-related resources, and perceived consequences of nosocomial infections on patient outcomes. Full article

A prior history of falls remains the strongest predictor of future falls in individuals with Parkinson’s disease (PD). There are limited biomarkers available to identify falls risk before falls begin to occur. The aim of this review is to investigate if features associated with falls risk may be detected by wearable sensors in patients with PD. A systematic search of the MEDLINE, EMBASE, Cochrane, and Cinahl databases was performed. Key quality criteria include sample size adequacy, data collection procedures, and the clarity of statistical analyses. The data from each included study were extracted into defined data extraction spreadsheets. Results were synthesized in a narrative manner. Twenty-four articles met the inclusion criteria. Of these, twelve measured falls prospectively, while the remaining relied on retrospective history. The definition of a “faller” varied across studies. Most assessments were conducted in a clinical setting (18/24). There was considerable variability in sensor placement and mobility tasks assessed. The most common sensor-derived measures that significantly differentiated “fallers” from “non-fallers” in Parkinson’s disease included gait variability, stride variability, trunk motion, walking speed, and stride length. Full article

Background/Objectives: Adolescents in Latin America are experiencing rising rates of overweight/obesity and non-communicable diseases, while public health nutrition efforts targeting this group remain limited. This study explores adherence to the EAT-Lancet diet and its relationship with micronutrient adequacy and ultra-processed food (UPF) consumption. Methods: Cross-sectional data from national nutrition surveys of 19,601 adolescents across six Latin American countries were analyzed. Data on sociodemographics, anthropometrics, and dietary habits were collected using standardized questionnaires and 24 h dietary recalls or food records. Nutrient intake was estimated via statistical modeling, and nutrient adequacy ratios were based on age- and sex-specific requirements. UPF intake was classified using the NOVA system, and adherence to the EAT-Lancet diet was assessed with the Planetary Health Diet Index. Results: Overall adherence to the EAT-Lancet diet was low (mean score: 28.3%). Rural adolescents had higher adherence than urban adolescents, and those aged 10–13 and 17–19 showed better adherence compared to adolescents aged 14–16. Adolescents from lower socioeconomic backgrounds adhered more than those from higher socioeconomic backgrounds. Adherence varied from 20.2% in Argentina to 30.2% in Brazil and Chile. Higher adherence was associated with lower UPF intake. Among urban adolescents, greater adherence was linked to a higher risk of inadequate riboflavin, niacin, and cobalamin intake, a trend not observed in rural adolescents. Conclusions: Adherence to the EAT-Lancet diet is low among Latin American adolescents, particularly in urban areas. Public health efforts should prioritize reducing UPF consumption, improving access to nutrient-dense, culturally appropriate foods, and supporting fortified staple foods. Full article

Background: Medical photography is widely used in dermatology referrals to secondary healthcare, yet concerns exist regarding image quality and data security. This study aimed to evaluate the quality of clinical photographs used in dermatology referrals, to identify discrepancies between specialties’ perceptions, and to determine the general awareness of proper storage and security of clinical photographs. Methods: A 43-question survey, based on previously validated questionnaires, was administered to general and family medicine (GFM) doctors and to dermatologists at an academic referral hospital in Porto, Portugal. The survey assessed demographics, photo-taking habits, perceived photo quality, adequacy of clinical information, and opinions on the role of photography in the referral process. Quantitative statistical methods were used to analyze questionnaire responses. Results: A total of 65 physicians participated (18 dermatologists and 47 GFM doctors). Significant differences were observed between the two groups. While 36.2% of GFMs rated their submitted photos as high- or very-high-quality, none of the dermatologists rated the received photos as high-quality, with 83.3% rating them as average (p = 0.012). Regarding clinical information, 46.8% of GFMs reported consistently sending enough information, while no dermatologists reported always receiving sufficient information (p < 0.001). Most respondents (76.9%) agreed that the quality of photographs is important in diagnosis and treatment. Conclusions: The findings reveal a discrepancy between GFM doctors’ and dermatologists’ perceptions of photograph quality and information sufficiency in dermatology referrals. Standardized guidelines and educational interventions are necessary to improve the quality and consistency of clinical photographs, thereby enhancing communication between healthcare providers and ensuring patient data privacy and security. Full article

Background: Transcutaneous CO₂ (TcCO₂) measurement is widely used in the diagnosis and monitoring of ventilatory failure. Robust data on the success rates of measurement is scant. We aimed to discern the factors affecting the success rate of TcCO₂ measurement in a regional LTV service. Methods: Patients undergoing TcCO₂ measurement between October 2019 and January 2022 were identified retrospectively. Notes were analysed for basic demographics, indications for TcCO₂ measurement, measurement outcome, device used (Radiometer TCM5 or Sentec, based on availability), setup (self, carer, or clinician), inpatient or domiciliary study, and number of TcCO₂ measurement attempts occurred. Statistical comparisons were made by Fisher’s exact test. Results: We identified 435 recording events on 288 patients, mean age of 53, and 56% were males. A total of 189 (66%) had a neuromuscular disorder (NMD). The commonest indications for TcCO₂ measurement were ‘assessing ventilatory failure’ (43%) in treatment-naïve patients and ‘adequacy of ventilation therapy due to persistent symptoms’ (26%) in those established on LTV. Over 80% of our recording events were applied by patients or their carers. Overall, TCM5 devices had statistically higher successful recording rates (197/268, 73.5%) than Sentec (100/165, 60.6%) [p = 0.0056]. In domiciliary studies, TCM5’s success rate of 187/253 (73.9%) versus Sentec’s 94/154 (61.0%) was significantly better [p = 0.0079]. The success rate of each measurement attempt ranged between 62.9 and 67.0%, with up to three attempts on each subject. Conclusions: Home TcCO₂ is helpful in managing those with respiratory failure. Repeating tests after initial failure of recording is worthwhile. There may be differences in performance across devices which warrants further study. Full article

The current replication crisis relating to the non-replicability and the untrustworthiness of published empirical evidence is often viewed through the lens of the Positive Predictive Value (PPV) in the context of the Medical Diagnostic Screening (MDS) model. The PPV is misconstrued as a measure that evaluates ‘the probability of rejecting $H_0$ when false’, after being metamorphosed by replacing its false positive/negative probabilities with the type I/II error probabilities. This perspective gave rise to a widely accepted diagnosis that the untrustworthiness of published empirical evidence stems primarily from abuses of frequentist testing, including p-hacking, data-dredging, and cherry-picking. It is argued that the metamorphosed PPV misrepresents frequentist testing and misdiagnoses the replication crisis, promoting ill-chosen reforms. The primary source of untrustworthiness is statistical misspecification: invalid probabilistic assumptions imposed on one’s data. This is symptomatic of the much broader problem of the uninformed and recipe-like implementation of frequentist statistics without proper understanding of (a) the invoked probabilistic assumptions and their validity for the data used, (b) the reasoned implementation and interpretation of the inference procedures and their error probabilities, and (c) warranted evidential interpretations of inference results. A case is made that Fisher’s model-based statistics offers a more pertinent and incisive diagnosis of the replication crisis, and provides a well-grounded framework for addressing the issues (a)–(c), which would unriddle the non-replicability/untrustworthiness problems. Full article

Continuous transformations, which have been observed more and more in recent years, require an increase in the effectiveness of measures in the state regulation of the labour market, which is possible only with a clear understanding and realistic assessment of its condition and existing trends of changes. For this purpose, guided by the data of the Bureau of National Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan, the country’s labour market was monitored, and the key factors that played a significant role in its formation were identified. Using these factors as a basis, vector autoregression (VAR) models were built to analyse dynamic relationships between economic variables. The choice of stationary variables ensured the adequacy of the model, which was confirmed by diagnostic tests such as the ADF test, Jarque–Bera test, and Ljung–Box test. Impulse response functions (IRFs) were used to assess the effect of shocks on each variable and other system variables. All results were visualised as graphs illustrating the dynamics of the impact over ten times. The modelling results showed that the changes are interrelated: shocks to youth unemployment (YUR) have the most significant impact on the total unemployment (UR) and the unemployed population (U), while outward migration (NM) has a short-run effect mainly on the economically active population (EA). The model confirmed that the labour market is indifferent to changes in youth unemployment, a key indicator for forming an effective employment policy. The study’s practical significance lies in its potential to inform the government, international organisations, and business communities about the state of the labour market and the necessary vectors of social policy. This will ensure economic growth and improve citizens’ quality of life in light of the changing nature of the labour market. Full article

Background: Tennessee has one of the worst rankings for older adults’ oral health in the United States. This study aims to evaluate the oral health-related quality of life (OHRQoL) among older individuals (aged 60 and above) in Tennessee using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Methods: The data were collected from the 233 Tennessee Smile-on program participants in the early phase of the COVID-19 pandemic, between December 2019 and August 2021. The frequency and percentage for each subgroup were calculated. Cronbach’s alpha was used to measure the internal consistency or reliability of OHIP in this study. Factor Analysis (FA) with oblique rotation was conducted to explore the underlying factor structure of the OHIP questionnaire set. A p < 0.05 was considered statistically significant. Results: The majority of participants were retired (59.66%), and there was a significant difference in OHIP_sum scores among different employment statuses (p = 0.018). Cronbach’s alpha showed the domains of psychological discomfort, physical disability, and psychological disability were highly correlated with the total score (alpha = 0.8). Factor analysis identified three main dimensions: physical discomfort, psychological distress, and functional disability, and they can explain over 90% of the total variance. Individuals measure of sampling adequacy (MSA) and overall MSA are greater than 0.9, indicating excellent sampling adequacy. Conclusions: The study suggested that oral health can be assessed not only through examinations by dental professionals but also by considering emotional and social well-being. However, a limitation of the study is that it was conducted during the COVID-19 outbreak, which restricted participant involvement. Full article

Therapeutic management during the acute phase of traumatic brain injury (TBI) relies on continuous multimodal cerebral physiologic monitoring to detect and prevent secondary injury. These high-resolution data streams come from various invasive/non-invasive sensor technologies and challenge clinicians, as they are difficult to integrate into management algorithms and prognostic models. Data reduction techniques, like moving average filters, simplify data but may fail to address statistical autocorrelation and could introduce new properties, affecting model utility and interpretation. This study uses the CAnadian High-Resolution TBI (CAHR-TBI) dataset to examine the impact of temporal resolution changes (1 min to 24 h) on autoregressive integrated moving average (ARIMA) modeling for raw and derived cerebral physiologic signals. Stationarity tests indicated that the majority of the signals required first-order differencing to address persistent trends. A grid search identified optimal ARIMA parameters (p,d,q) for each signal and resolution. Subgroup analyses revealed population-specific differences in temporal structure, and small-scale forecasting using optimal parameters confirmed model adequacy. Variations in optimal structures across signals and patients highlight the importance of tailoring ARIMA models for precise interpretation and performance. Findings show that both raw and derived indices exhibit intrinsic ARIMA components regardless of resolution. Ignoring these features risks compromising the significance of models developed from such data. This underscores the need for careful resolution considerations in temporal modeling for TBI care. Full article

With the Republic of Türkiye signing the “Convention on Intangible Cultural Heritage” in 2006, awareness and sensitivity towards the safeguarding of cultural heritage has also begun to develop in the Turkish Republic of Northern Cyprus (TRNC), which has close relations with the Republic of Türkiye. However, the intangible cultural heritage convention could not be signed in the TRNC due to political reasons, and this has led to a lack of sufficient change and awareness about it on the island. Regrettably, the limited number of academic studies carried out in universities in this field has proven to be inadequate in terms of creating general public awareness about the subject. However, the knowledge and experience of both the community and individuals working in this field are crucial for the safeguarding and sustainability of cultural heritage elements. In this context, this study collected the knowledge and opinions of personnel affiliated with the TRNC Ministry of Culture on the subject of intangible cultural heritage (ICH), and it investigated whether the adequacy of the personnel’s knowledge and opinions around cultural heritage had a direct impact on its safeguarding and sustainability. This research used a type of mixed method called “Convergent Mixed-Methods Design”. The sample of this research consisted of 30 personnel working in different units affiliated with the Ministry of Culture in Northern Cyprus. This study included personnel working in different units and positions affiliated with the ministry. An interview form was used to obtain the data that formed the basis of this research. The interview form consisted of 10 structured and 3 semi-structured questions prepared by the researchers. Descriptive statistics were used in the analysis of the quantitative data, and content analysis was used in the analysis of the qualitative data. This study, which aimed to determine the knowledge and opinions of Ministry of Culture officials working in the TRNC regarding the safeguarding and transfer of intangible cultural heritage elements, revealed that the employees were not fully informed about the scope, objectives, and protection of ICH. Full article

Concrete median barriers are prone to damage from low-velocity impacts. However, there is a limited understanding of how damage from initial impacts affects barriers’ long-term performance and whether they maintain safe continued service or must be replaced. Therefore, this paper evaluates the performance of the concrete barriers under sequential low-velocity impact using finite-element analysis. Crash test simulations were performed by impacting the concrete barrier twice with an 80,000 lb (36-ton) tractor-trailer at a target impact velocity and angle. The first impact’s velocities varied between 30 mph (48 kmph) and 54 mph (87 kmph) at 10°, 15°, and 20° crash angles, and the damaged barrier was subsequently subjected to the second impact conforming to the American Association of State Highway and Transportation Officials’ (AASHTO) Manual for Assessing Safety Hardware (MASH) for Test Level 5 criteria (i.e., representative velocity of 52.7 mph (85 kmph) at 15°). Therefore, a total of 78 impact simulations were conducted, and statistical analysis was performed to investigate the relationship between the peak impact forces of the first and second impacts and the crash angle and velocity across distinct phases of the crash simulation and over the entire crash history. The results show that while the peak impact force of the first impact was linearly related to both velocity and angle, the maximum impact force at the second impact did not follow the same trend. However, when considering the localized peak forces in each phase of the crash, the peak forces from the later stages of the second impact (i.e., rebound and final interaction phases) were highly correlated with the initial impact’s velocity and angle, substantially reducing the barrier’s capability to resist vehicular impact loads. In particular, for initial velocities above 46 mph (74 kmph) at angles of 15° and 20°, barriers formed shear cracks traversing across their cross-section, which resulted in excessive fragmentation during the second impact and consequent failure to meet the MASH criteria in terms of structural adequacy. Full article

The concept of positive mental health (PMH) and therefore mental well-being (MWB) have taken center stage over the last few decades. The Mental Health Continuum—Short Form (MHC-SF) is one of the most important tools for assessing MWB. This study aims to assess the psychometric properties and dimensionality of the Portuguese version of the MHC-SF by comparing three competing models. Methods: Between January and March of 2021, a survey was conducted with a convenience sample of 495 Portuguese adolescents aged 12 to 18 years, enrolled in grades 7 to 12. Descriptive statistics and bivariate statistical tests and measures associated with confirmatory factor analysis (CFA) were calculated. Results: The results of the CFA support the idea that the bifactor model fits the data better than the other competing models. The indices support unidimensionality, namely the explained common variance (ECV = 0.81), the Percentage of Uncontaminated Correlations (PUC = 0.69), and the omega hierarchical (ωH = 0.89), and point to the existence of a general MHC-SF factor. The scale showed high reliability (ω = 0.95) in the general factor. The MHC-SF has concurrent validity, correlating with other scales that assess aspects related to mental health and well-being. Conclusion: The results point to the adequacy of the bifactor model and suggest the existence of a general factor of PMH, confirming that the total score of the scale can be used. Full article