Coordination Of Efforts Research Articles

From Concrete to Nature: Navigating Paradigm Shifts in River Management Through a Sustainability Lens

ABSTRACT“Sustainable river management” (SRM) and “paradigm shifts in river management” (PSRM) are frequently employed in the field of river management, widely recognized by both researchers and policymakers. However, past studies often present these concepts as implicitly understood, typically addressing one in isolation without exploring the interrelationship between the two or their combined potential as a comprehensive analytical tool for practical river management. This paper aims to elucidate the connection between SRM and PSRM, proposing an integrated framework to enhance the analysis of river management practices. Using Taiwan's Keelung River as a case study, the findings reveal that the river's management history can be divided into four paradigms: “structural emergency measures,” “dominant structural measures,” “integrated water management,” and ultimately, SRM. Each paradigm reflects the negotiations, compromises, and coordination efforts of stakeholders at that time, with enduring influence on the Keelung River today. While historically effective, the long‐standing preference for flood control through levee construction now struggles to address the challenges posed by short‐duration extreme rainfall and emerging environmental and ecological management needs, testing the adaptive capacities of both central and local governments.

How do you do it?: Gynecologic Brachytherapy Best Practices at High Volume Institutions within the United States and Canada

Definitive treatment including chemoradiation and brachytherapy for patients diagnosed with locally advanced cervical cancer requires significant multidisciplinary coordination. Our goal was to assess and share gynecologic brachytherapy best practices from high volume brachytherapy centers. A survey was sent to 42 centers within the United States and Canada that perform a high volume of complex gynecologic brachytherapy. Responses were collected from 32/42 (76%) institutions. 41% of responding institutions perform > 100 complex brachytherapy procedures per year. Most departments have >1 brachytherapist and 85% of respondents complete 1-2 complex brachytherapy procedures per day. 91% of surveyed departments have support staff specifically devoted to brachytherapy. Approximately 50% of intracavitary/hybrid procedures are performed in departmental brachytherapy suites. Institutions use MRI (35%), CT (24%) or a combination (24%) for treatment planning. 88% of respondents use sedation for tandem based procedures. Respondents cite high complexity of care, insufficient reimbursement, untimely referrals, shared operative and clinical duties, expensive applicator acquisition and complex scheduling as challenging aspects of providing brachytherapy services. Conversely, respondents cite a dedicated team, departmental brachytherapy suite, well organized coordination of procedures and personnel, anesthesia support, a full range of applicators, image-based planning near the department and supportive administration as integral components in providing brachytherapy. Most surveyed institutions have >1 brachytherapist who perform 1-2 procedures per day in a dedicated brachytherapy space with a team that assists with coordination and scheduling efforts. A well supported multidisciplinary team is vital to ensure state of the art brachytherapy which is essential in curing these challenging malignancies.

Zero-dose children in Latin America: analysis of the problem and possible solutions

Introduction Zero-dose children (ZDC) are defined as those that have never been reached by routine immunization services. In Latin America, almost 2.7 million infants younger than 1 year of age, have incomplete vaccination schedules, and vaccine preventable diseases such as measles or polio have increase worldwide. ZDC are reported to reside in high risk and fragile settings, including remote-rural areas, urban slums, and conflict-affected areas. Identifying the problem and settings in each country is mandatory to propose possible solutions to the immunization coverage situation. Areas covered In November 2023, a group of experts of the Latin America Society of Pediatric Infectious Diseases (SLIPE) analyzed the global and regional reality of ZDC, and present in this document an updated reality of the Latin American region and the weight of the possible interventions to overcome this problem. Expert commentary Communication is a key element to improve vaccination coverage, as it is quality and use of vaccination data. Campaigns that deliver targeted and effective messages to communities and families, provide education about vaccination, avoid missed vaccination opportunities, and coordinate efforts across different sectors and communities, among other strategies, could improve the current immunization situation.

Implementation of integrated services of intelligent supply chains by leading Chinese logistics companies.

The article examines the restructuring of global supply chains within the framework of the active development of China’s logistics services market. It is established that with the continuous improvement of the country’s digital economy, these services can become one of the important directions for the development of large Chinese companies operating in this industry. The purpose of the work is to study the implementation of integrated intelligent supply chain services, analyze the practice of their application, and their impact on the growth of turnover and income of leading logistics enterprises in the country — Xiamen C&D Group Corp. Ltd., SF Express Holding, YTO Express — in 2021–2023. The paper describes the step-by-step mechanism of the intelligent supply chains of Chinese companies and its innovative component. It is determined that the studied organizations adhere to the principle of digital excellence, promote digital industrialization, jointly create a common logistics big data platform (the country’s digital logistics ecosystem), and apply new business formats and a modern logistics model to facilitate the industrial transformation and modernization of China’s economy. To achieve the goals of the study and analyze the restructuring of global supply chains within the framework of the active development of China’s logistics services market, methods of scientific analysis of scientific literature and economic analysis of reports of leading logistics companies in China, comparative analysis, content analysis, and case studies were used to study examples of the implementation of intelligent supply chains in Xiamen C&D Group Corp. Ltd., SF Express Holding, YTO Express. The results of the research can be useful for international organizations and partners of China engaged in joint logistics projects and initiatives to enhance cooperation and coordination efforts.

SNOMED-CT and learning health systems for NHS dentistry - a dream needing to become reality.

There has been discussion and confusion about SNOMED-CT (systematised nomenclature of medicine clinical terminology), learning health systems (LHSs) and their relevance in dentistry. This article aims to provide an overview of SNOMED-CT, LHSs and the all-too-often omitted patient and service benefits from their use. LHSs are delivering impactful benefits to patients and services globally in medicine. There are some examples in dentistry, but these are few and lack the nationalised co-ordinated efforts supporting general medical practice (GP) electronic health record (EHR) databases. These impacts require research and insights from large-scale, linked EHR databases, for which SNOMED-CT will greatly facilitate. This opinion piece discusses SNOMED-CT, LHSs and the current state of EHR databases in dentistry with comparison to medical practice. Impactful examples of GP EHR database research are presented, as well as the potential benefits and disadvantages of EHR-based approaches in dentistry. Barriers to creating large dental EHR databases in the UK are discussed and potential solutions offered. Lastly, there is a call to action for multiple stakeholders, including dental clinicians, patients, academics, public health professionals, software suppliers, commissioners, and the government to co-ordinate efforts, including that of SNOMED-CT implementation, so that dentistry does not get excluded from the benefits of integrated LHSs.

Policy Coordination on Transportation Infrastructure Development in Palembang City

On a national level, Palembang is positioned to support various spatial and developmental needs of Jakarta, the capital city. Hosting the Asian Games 2018 was one such initiative, which necessitated accelerated transportation infrastructure development in Palembang. This required innovative approaches to policy coordination in infrastructure development. This study aims to examine the mechanisms and challenges of policy coordination in transportation infrastructure development. The research highlights that coordination efforts have faced delays due to institutional constraints, as agencies and institutions are tied to their own regulations, budgets, and programs while striving to meet their individual targets. Adopting a post-positivist approach, this study employs qualitative methods, including in-depth interviews with stakeholders, and applies qualitative data analysis techniques. The findings reveal that coordination challenges have been mitigated to some extent through the national strategic development project framework, with the entire coordination process being directed by a top-down approach led by the Committee for the Acceleration of Infrastructure Provision (KKPPI).

An exploratory study of the mandate and functions of national pharmaceutical services units: global trends and the cases of Côte d'Ivoire, Kenya, and Nepal.

National pharmaceutical services units (NPSUs) - organisational units within the central government usually responsible for pharmaceutical services and management - have an increasingly narrow mandate. Anecdotal evidence points to an increasing focus, almost exclusively, on logistics management, while pharmaceutical care and policy oversight have become fragmented. This study examined NPSUs' current functions and mandates, and proposed what should be the critical functions and roles of these units going forward. Using case studies of Côte d'Ivoire, Kenya and Nepal, the study relied on a literature review and in-depth interviews. We triangulated and synthesised the findings to identify NPSUs by level in the health ministry's hierarchy and reporting line, mandate, and function. We identified medicine regulation, procurement and supply chain management, selection and rational use of medicines, and pharmacy practice regulation as four broad sets of functions that NPSUs commonly have as their mandate. A clear position in the Ministry of Health's hierarchical structure, the legal or administrative framework that mandates an NPSU's functions, and national pharmaceutical policies and regulations to guide the pharmaceutical sector are three critical factors for effective functioning. It is essential to have a legislative framework that at a minimum identifies one NPSU as responsible for pharmaceutical policy and governance, serving as the steward for the pharmaceutical system. This role encompasses pharmaceutical system coordination and administrative functions, formulating and implementing policies for organising, managing, financing, regulating, monitoring, and evaluating the pharmaceutical system. As such, we recommend that NPSUs should at a minimum have four broad sets of functions: pharmaceutical policy and governance, medicine regulation, pharmacy practice regulation and procurement and supply chain management. The study substantiates the need for a pharmaceutical policy and governance unit that stewards the pharmaceutical system and is empowered to monitor and evaluate system performance and coordinate efforts for system strengthening.

Self-other distinction modulates the sense of self-agency during joint actions

In daily life interactions, we achieve goals with partners through tight temporal coordination or sequential joint efforts. Is our individual sense of control over shared outcomes (sense of self-agency) the same as the one experienced when we act alone? Do we explicitly and implicitly feel like we are fully in control of the motor act even if the goal is finally achieved by our partner? To address these questions, we measured explicit and implicit sense of self-agency in individual and (coordinated or sequential) interactive contexts. We studied 42 healthy adult participants during active/passive button presses aimed at turning on a light bulb. This goal could be achieved individually (Solo condition) or by interacting with a partner (Joint condition) synchronously (joint Coordination task) or sequentially (joint Sequential task). We collected trial-by-trial explicit judgments of self-agency. To quantify the intentional binding phenomenon, an index of implicit sense of agency, we also measured the perceived compression of the time interval between the active or passive movements and their outcomes. Explicit sense of agency: we observed decreased judgments of self-agency in Joint trials compared with the Solo ones in both the Coordination and Sequential tasks. Implicit sense of agency: in the Coordination task, we found a significant intentional binding effect only in Solo trials but not in Joint ones. For the Sequential task, however, a significant intentional binding was also present in the Joint condition. Our results indicate that the individual sense of agency is reduced during joint actions, yet this can be restored at an implicit level when the format of the motor interaction makes the individual contribution to goal achievement more obvious. We discuss these results considering current cognitive theories on motor awareness and interactions.

From Individual Observations to Global Assessments: Tracing the Marine Carbon Knowledge Value Chain

Marine carbon observations (MCOs) provide essential data to trace historical and current changes in marine carbon storage and fluxes that ultimately feed into the Global Carbon Budget and the Intergovernmental Panel on Climate Change report. Therefore, MCOs play a key role in informing global climate policy as well as ocean governance. However, they only achieve this potential if multiple sources of observations are combined and analyzed jointly. This implies an immense coordination effort by the international MCO community which developed, e.g., joint standards for the collection of (meta‐)data, quality control processes, data platforms, etc. This article traces the value chain of MCOs, concretely for CO2, from data collection to the Intergovernmental Panel on Climate Change report. Based on an interdisciplinary research project, the study illuminates which structures and practices the marine carbon community has developed to integrate different observations and measurement technologies, starting from German research institutes and agencies and expanding to the European and international networks to which they contribute. Combining a social network analysis with qualitative insights from in‐depth interviews, the article identifies key information providers and brokers and pinpoints systemic vulnerabilities, e.g., where connections between observation networks or data platforms are maintained based on personal relationships or ad‐hoc interactions rather than automated data submissions, or where temporally limited third party funding threatens the continued existence of the observation network.

The European Union in its pursuit of being a global leader in climate neutrality

ABSTRACTThis contribution examines the most important actions taken by the European Union (EU) to improve the global climate. Positioning itself as a leader in climate action, the EU has adopted the European Green Deal (EGD) strategy, in which it has defined the long‐term goal of achieving climate neutrality by 2050. Moreover, one of the aims of EU climate leadership is to influence external partners, which takes various forms (e.g., participation in conferences under the auspices of the United Nations, financial support for partner countries, and political dialog). However, the soft power instruments used by the EU to combat climate change are encountering a number of challenges conditioned by events both within the EU (e.g., farmers' protests) and outside its borders (e.g., Russian aggression against Ukraine). They require greater coordination and preventive efforts to reduce the impact of potential new crises and to strengthen the EU's strategic autonomy.

Politics of HIV Vaccine Research from International to Global Health

Paradoxically, the absence of HIV vaccine has been very structuring for global vaccine logics, and, more broadly, “global health” research. HIV vaccine research has oscillated between optimism and pessimism and has been central to the humanist justification for research in the South. From the attempt by the World Health Organization’s Vaccine Development Unit (VAD) on AIDS to become the centre of an “international” coordination effort to the diplomatic work involved with Thailand’s HIV research, I describe political contexts, and postcolonial power relations connected to HIV vaccine research. I argue that the failure of “international” coordination has paved the way for another politicization of global HIV vaccine research which led to a shift away from inter-state diplomacy to a “stateless” situation where the global vaccine logics contribute to the development of an experimental regime that relies on the capture of public resources and the availability of depoliticized biological subjects for the purposes of private valorization.

PSYCHOSOCIAL FACTORS AND CURRENT PRACTICES IN THE PSYCHOLOGICAL ASSESSMENT PROCESS FOR BARIATRIC SURGERY: A literature review

The psychological evaluation for bariatric surgery is mandatory, and its conduction by the psychologist must adhere to professional principles and guidelines, as well as specific legislation. Therefore, the study aimed to investigate the process of psychological evaluation for bariatric surgery and, additionally, to identify the psychological factors assessed and the instruments used in the process. This is a bibliographic research with data collection conducted between September and October 2023, in electronic databases such as Lilacs, Scielo, PubMed, and Pepsic, including full-text, open-access scientific articles published from 2018 to 2023. A total of 119 articles were found, of which 14 were selected for analysis. As a result, four categories were identified regarding psychological evaluation in bariatric surgery: 1) Importance of evaluation: involves expectations, support network, stress, and mental health; 2) Relevant psychosocial factors: such as social support and lifestyle; 3) Resources used: tools like BDI–II, BAI, ECAP, BAROS, EFS, IDATE, and LIS-A to assess emotional and cognitive aspects; 4) Challenges: highlight the complexity and the need for a multidisciplinary approach. Difficulties faced by psychologists in conducting these evaluations were also identified, requiring well-structured strategies and practices. Based on these findings, it is crucial that the responsible bodies—such as the Federal Council of Psychology—coordinate efforts, as the implementation of specific documents benefits psychologists and candidates for bariatric surgery by providing clear guidelines and standardizing procedures, making the professional practice more precise, safe, and accessible.

Adult cardiac transplantation utilizing donors after circulatory death.

Donation after circulatory death (DCD) presents both opportunities and challenges in the realm of heart transplantation. Its emergence holds promise for narrowing the gap between patients in need of organs and the available donor pool. The rapid emergence of DCD use has allowed heart transplant volume to increase worldwide. Long-term outcomes and best practices remain to be defined and are important considerations in the wider use of these techniques in a broad selection of patients to understand best use and practice moving forward. Expanding DCD donation entails substantial resource allocation, coordination efforts, and training initiatives. Moving forward, standardization is imperative, particularly in aspects such as "stand-off" time, warm ischemic time (WIT), and perfusate composition.

Streaming disasters on TikTok: Examining social mediated crisis communication, public engagement, and emotional responses during the 2023 Maui wildfire

Short video-sharing platforms, such as TikTok, play a significant role in allowing the public to experience natural disasters vicariously, share information, and coordinate peer-led disaster relief efforts. With emerging platforms like TikTok providing experientially immersive content, the role of digital storytelling in stimulating public engagement and emotions remains underexplored. Drawing from narrative persuasion theory and visual storytelling literature, the current study proposes an integrated framework to examine the storyteller, visual frame, and digital presentation characteristics of TikTok videos in predicting social-mediated public engagement and emotional reactions surrounding a recent natural disaster, the 2023 Maui Wildfire. Using visual content analysis and computational methods, the study analyzed 526 TikTok videos and 59,950 associated comments. Results showed that audiovisual vividness consistently predicted all three types of disaster engagement. In contrast, storyteller type, storytelling frame, and other presentation characteristics inconsistently predicted information consumption intention, information sharing intention, and emotional reactions on TikTok.

Tourism-generated energy use characteristics and sustainability transitions

Mountain tourism destinations are characterized as significantly impacted by their remoteness, seasonal climatic variations, and fragile ecosystems. These factors greatly influence the development, distribution, and consumption of energy sources in the tourism sector. With the increasing popularity of mountain parks and protected areas as tourism destinations, it is critical to understand the interplay between tourism development (e.g. expansion of tourism facilities), patterns of energy sources (diversity and consumption levels) in the tourism sector, and overall sustainability of resources use at the destination level. Current literature reveals a dearth of research on energy issues in mountain protected areas, which is somewhat surprising as energy and resource consumption issues are becoming more important from a climate change perspective. This paper examines contemporary energy use patterns in the Sagarmatha (Mount Everest) National Park of Nepal. A mixed methods is applied to analyze development trends and transitions in energy use. Data were collected based on questionnaire surveys of tourism facilities, complemented by semi-structured interviews. The findings indicate that energy sources used in the facilities have gone through a significant change, from a firewood-dependent tourism center to increasing use of alternative sources including liquified petroleum gas (LPG) and hydroelectricity. About one-third of the facilities did not use firewood. The heterogeneous geographic distribution of the facilities affects the spatial use of energy sources. Furthermore, we argue that the coordination efforts between the national park administration and local communities, the growth of tourism, the construction of hydropower plants, and the advancement of transportation are the leading causes of the changes in energy use patterns. Knowledge of the energy use characteristics and drivers influencing the energy transitions can inform future policies that promote a low-carbon economy in mountain destinations.

Determinants of access to primary healthcare for formerly incarcerated women transitioning into the community: a systematic review of the literature

BackgroundWomen with a history of incarceration experience significantly poorer health outcomes and encounter barriers to accessing healthcare, both during incarceration and after release. These challenges are more pronounced compared with...

Climate change and non-native species in the Spanish Network of National Parks

The Iberian Peninsula is a primary entry point for non-native species (NNS) into Europe via maritime routes, and is a significant tourist destination. This positions the highly diverse Spanish National Parks at high risk from invasive species, necessitating proactive adaptation and mitigation strategies. We present a comprehensive analysis of the risks posed by NNS to the network of 15 continental and marine National Parks in Spain under climate change, aiming to align management strategies with international Global Biodiversity Framework (GBF) targets. We identified 200 NNS across the network of National Parks, including 78 listed in national NNS regulations. Park managers helped identify 22 priority NNS, including the water hyacinth, American mink, Cape fig and wakame, among others. Over half of the 22 priority NNS (55%) were classified as having a “Major” impact on native biodiversity according to EICAT standards, with another 23% considered “Massive”. Distribution models suggest that rising minimum temperatures could enable NNS to expand in altitude within the parks, particularly in high-mountain parks. Species like the barbary sheep, water hyacinth and largemouth bass may particularly benefit from global warming. Our findings prioritize national parks most vulnerable to the double threat posed by climate change and invasive species, such as Islas Atlánticas, Doñana and Archipelago de Cabrera. We conclude that, in order to progress towards achieving GBF goals, it is essential to: (i) coordinate NNS management efforts across administrations (national and regional), (ii) integrate resources and expertise in a unified strategy against invasion across the network and (iii) enhance public awareness about the risks of introduction and impact of NNS.

How does fatigue affect handstand balance? a non-linear approach to study fatigue influence in handstand performance

BackgroundThe handstand is an essential skill in acrobatic sports. This skill requires the athlete to maintain an inverted upright stance with only the hands supported, which requires a great effort of muscular coordination and motor control. Several factors influence the ability to control the posture, including fatigue, which is a bit studied constraint of handstand performance.Research questionWith the aim to find out whether variability in movement control can be an indicator of fatigue, the present study was carried out.MethodFourteen male acrobatic gymnasts were required to perform handstands. The time series for analyzing variability were capturing using Force Platforms, which is a traditional laboratory instrument, and Inertial Measurement Units (IMU), which is a more recent and less widely used, but more accessible tool. For this purpose, an analysis of the amount of variability was carried out, using the standard deviation. And analysis of the structure of variability (or complexity), using Detrended Fluctuation Analysis (DFA) and Fuzzy Entropy (FuEn).ResultsOur results reveal that fatigue causes significant increases in the amount of variability in the medio-lateral axis on the force platform, and in the IMU located in the area of the L5 vertebra. These changes are accompanied by increased auto-correlation in the medio-lateral axis of the force platform, and more unpredictable behavior in the L5 IMU.

Does COVID-19 lockdown matter for air pollution in the short and long run in China? A machine learning approach to policy evaluation

This paper leverages a data-driven two-step approach to effectively evaluate the effects of COVID-19 lockdown on air pollution in both the short and long-term in China. Using air pollution, meteorological conditions, and air mass clusters from 34 air quality monitoring stations in Beijing from 2015 to 2022, this study first employs a deweathering machine learning technique to decouple the confounding effects of meteorological on the air pollution. Furthermore, a detrending percentage change indictor is applied to remove the influence of seasonal variations on air pollution. The findings reveal that: (1) Human interventions are the primary drivers of changes in air pollution concentrations, whereas meteorological factors have a relatively minor impact. (2) During the COVID-19 lockdown, significant variations in air pollution levels are observed, with the effects of city lockdown ranging from a decrease of 40.11% ± 14.81% to an increase of 20.28% ± 14.36%. Notably, there is a decline in concentrations of NO2, PM2.5, CO, and PM10, while the levels of O3 and SO2 increase even during the strictest lockdown period. (3) In the year following the COVID-19 lockdown, there is a rebound in overall air pollution levels. However, by the second year, a general decline in air pollution is observed, except for O3. Therefore, it is imperative to integrate the confounding effects of meteorological factors into air quality management policies under various future scenarios: adopt high-intensity control measures for sudden air quality deteriorations, advance green recovery initiatives for long-term emission reductions, and coordinate efforts to reduce composite atmospheric pollution.

Zero-dose children in Latin America: analysis of the problem and possible solutions

Introduction Zero-dose children (ZDC) are defined as those that have never been reached by routine immunization services. In Latin America, almost 2.7 million infants younger than 1 year of age, have incomplete vaccination schedules, and vaccine preventable diseases such as measles or polio have increase worldwide. ZDC are reported to reside in high risk and fragile settings, including remote-rural areas, urban slums, and conflict-affected areas. Identifying the problem and settings in each country is mandatory to propose possible solutions to the immunization coverage situation. Areas covered In November 2023, a group of experts of the Latin America Society of Pediatric Infectious Diseases (SLIPE) analyzed the global and regional reality of ZDC, and present in this document an updated reality of the Latin American region and the weight of the possible interventions to overcome this problem. Expert commentary Communication is a key element to improve vaccination coverage, as it is quality and use of vaccination data. Campaigns that deliver targeted and effective messages to communities and families, provide education about vaccination, avoid missed vaccination opportunities, and coordinate efforts across different sectors and communities, among other strategies, could improve the current immunization situation.