Complementary Indicators Research Articles

Private protected areas and ecological connectivity in Chile

AbstractSpecies extinction rates have accelerated despite the global growth of the protected area estate, and maintaining or restoring ecological connectivity across landscapes is a major challenge in conservation. To address shortfalls in statutory protected areas, the designation of private protected areas (PPA) has been encouraged. Here we assess the level of ecological connectivity in the National System of Protected Areas in Chile (SNASPE) and measure the contribution of PPAs to the connectivity of the system, using novel indicators derived from landscape ecology. In so doing, we demonstrate how countries could report progress towards achieving connectivity among protected areas, using three complementary indicators. Our results show that while SNASPE currently has a high level of ecological connectivity, it varies substantially from region to region, with more protected and connected land needed to enhance connectivity. When PPAs are considered alongside statutory protected areas, connectivity is improved slightly, but still falls well short of meaningful levels. We therefore conclude that substantial expansion of the formal protected area network in Chile needs to happen, guided by a scientific and systematic process that enables the strategic designation of new PAs that enhance the performance of the current PA system and achieves international conservation goals. Additionally, new approaches and frameworks to recognize and manage land outside protected areas for connectivity and other ecosystem services are required.

Understanding the longitudinal trends (2005-2018) and multilevel risk factors of complementary feeding in Guinea.

This study aimed to define complementary feeding trends in Guinea from 2005 to 2018 and complementary feeding risk factors at the individual, household, and community levels. Data from 2005 to 2018 demographic health surveys (DHS) and Multiple Indicator Cluster Surveys were used to describe complementary feeding trends in Guinea. The most recent DHS was used to examine complementary feeding risk factors at the individual, household, and community levels. Complementary feeding indicators including introduction to complementary foods (INTRO), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) were calculated based on the 2010 World Health Organisation guidance. Multivariate logistic regressions were used to identify significant risk factors (p < 0.05). Since 2005, there has been a marginal increase in MDD and MAD, but a decrease in INTRO and MMF. The 2018 DHS survey revealed various complementary feeding risk factors. At the individual level, travelling 1-60 min to get water was associated with decreased odds of meeting INTRO, while iron supplementation and maternal education were associated with increased odds of meeting MMF and MDD, respectively. Routine vitamin A supplementation, fever in the past 2 weeks, and low birth weight were associated with increased odds of meeting MAD. At the household level, being in a lower wealth quintile was associated with decreased odds of meeting MDD and MAD. National and subnational programmes and policies designed to improve infant and young child diets may consider tailored approaches that address the specific indicators and risk factors associated with poorer diets in this Guinean context.

Evaluation of Complementary Feeding Indicators Among Children Aged 6–23 Months According to the Health Literacy Status of Their Mothers

Background/Objectives: Infant and young child feeding (IYCF) practices directly affect child health, development, and survival, especially under 2 years of age and ultimately affect adult life well-being. As the primary caregivers of the children, mothers with higher health literacy may better perceive the benefits of optimal complementary feeding practices, leading to improved health outcomes for their children. In this study, we aimed to assess complementary feeding practices among children aged 6–23 months in Turkey according to 2021 World Health Organization IYCF indicators [minimum dietary diversity (MDD); minimum meal frequency (MMF); minimum acceptable diet (MAD); egg and/or flesh food consumption (EFF); sweet beverage consumption (SwB); unhealthy food consumption (UFC); zero vegetable or fruit consumption (ZVF); and bottle feeding (BoF)] and investigate their associations with sociodemographic characteristics and mothers’ health literacy. Methods: With a descriptive study design, we reached 572 mothers of children aged 6–23 months from five regions of Turkey. We used the Turkey Health Literacy Scale-32 (TSOY-32) to assess mothers’ health literacy. Results: While maternal and child age are significantly associated with more complementary feeding practices, specifically MDD, MAD, and EFF, having multiple children has negative impacts on several complementary feeding indicators, including MDD, MMF, MAD, UFC, and ZVF. The only indicator associated with mothers’ TSOY-32 scores was zero fruit and vegetable consumption. Conclusion: Raising awareness among mothers about the importance of complementary feeding practices and identification of vulnerable groups will guide practitioners and policymakers to improve child health and nutrition.

La metodología del AuditeCT y su uso en la mejora continua de las contralorías territoriales de Colombia. Necesidades y posibilidades de ajuste

The AuditeCT methodology is an abbreviated name used in this article to refer to the process of measuring, evaluating and certifying the performance of Colombian territorial comptrollers’ offices. In this sense, it functions as a tool for monitoring and promoting the work of the comptrollers’ offices, with quarterly reports and an annual certification. Up to the year 2022, three periods were evaluated, starting in 2020, in which almost all the comptrollers’ offices were certified, despite the fact that a good part of them revealed management difficulties in missionary processes. Hence the need to consider the scope of the AuditeCT methodology. An exploratory descriptive review is then proposed to identify possible adjustments. Alternatives are suggested, such as establishing minimum performance thresholds by management process, broadening the scope of existing indicators or introducing new ones, and constructing and testing complementary indicators, such as the risk of corruption in public contracting.

Territorial Patterns of European Innovation in the Context of Different Innovation Output Proxies: A Spatial MGWR-SAR Approach

AbstractThe paper seeks to explore the drivers of European innovation represented by three innovation outputs (patent, trademark, and design applications), emphasizing spatial autocorrelation and heterogeneity. It includes data from 202 regions from 22 European Union (EU) Member States, along with 18 regions from Switzerland, Norway, and Serbia in 2019, providing a more comprehensive geographic scope. By considering multiple indicators of innovation output, including patents, trademarks, and design applications, the main objective is to examine spatial innovation spillovers and the heterogeneous responses of regional innovation output to innovation inputs in the context of European regions. To achieve this goal, the main instrument of the analysis is a newly proposed methodological framework called Mixed Geographically Weighted Regression-Spatial Autoregressive (MGWR-SAR) models. The analysis suggests that while all innovation inputs (most-cited publications, research and development expenditure in the business sector, human resources in science and technology, and population density) are justified in increasing all innovation outputs, the strength of particular determinants of innovation might vary across regions. Moreover, the analysis reveals valuable insights into how spatial spillovers influence regional innovation. The impact of spatial connections varies across the regions, with patents showing the strongest linkages, affecting about 92.27% of regions. Although trademarks and designs have fewer spatial connections (approximately 50% of regions), they still play a significant role in innovation. Although patents have traditionally dominated discussions of innovation, the findings reveal the importance of incorporating designs and trademarks as complementary indicators. Overall, the study highlights the need for multiple metrics to comprehensively evaluate innovations.

Random forest analysis of the relative importance of meteorological indicators for heatstroke cases in Japan based on the degree of severity and place of occurrence

Heatstroke is a serious health concern in Japan. To reduce heatstroke risk, the government of Japan implemented the “Heatstroke Alert” nationwide in 2021, employing the wet bulb globe temperature (WBGT) as a criterion. Although the WBGT is a useful meteorological indicator for assessing the risk of heatstroke, other important meteorological indicators must also be investigated. Therefore, using a random forest approach, this study analyzed the relative importance of several meteorological indicators, including those representing heat acclimatization, for each of the 47 Japanese prefectures. Using the generalized linear model, important meteorological indicators were employed as explanatory variables in the heatstroke prediction model to determine the predictive meteorological indicator. Heatstroke cases were evaluated separately by the degree of severity and the place of occurrence. The results showed that the relative temperature (RelTemp), which represents heat acclimatization and was calculated considering past temperature history, was the most predictive (i.e., provided the best goodness of fit) concerning the degree of severity, place of occurrence, and prefectures. RelTemp can be a complementary indicator of WBGT in countries and regions such as Japan, where seasonal differences in heat acclimatization must be considered. In addition, the findings of this study contribute to the development of a more accurate assessment of heatstroke risk.

Blunted reward-related activation to food scenes distinguishes individuals with alcohol use disorder in a pilot case-control fMRI pilot study.

Alcohol use disorder (AUD) is thought to bias the neurocircuitry underlying reward processing and motivation to preferentially attend to conditioned alcohol cues over natural rewards. The present case-control pilot study evaluated this hypothesis using novel natural reward paradigms. Twenty-eight participants (AUD, n = 14, light drinkers, n = 14) were recruited-AUD participants reported 44.0% heavy drinking days (%HDD) and 4.67 drinks/day over the preceding 90 days. Functional magnetic resonance imaging (fMRI) data were acquired during the administration of three separate picture-viewing paradigms of alcohol cues, food scenes, and social reward, respectively. Independent samples t-tests were performed to compare groups' fMRI data and exploratory correlation analyses were performed to examine associations with clinical characteristics of AUD. Food scenes elicited abnormally low reward-related activation, within the superior frontal gyrus and caudate bilaterally, among AUD participants. Lower activation to food scenes within the superior frontal gyrus was, in turn, associated with higher levels of past-month %HDD among AUD participants, specifically, along with craving and alcohol dependence severity when examined across the full sample. Contrasting reward types (e.g., alcohol cues vs. food scenes) did not reveal "preferential" activation to differentiate groups. Heavy drinking appears associated with reduced responsivity to natural rewards, specifically food rather than social cues. Neural mechanisms underlying the high prevalence of malnutrition among individuals with AUD may involve some combination of blunted approach-related affect and reduced craving-related motivation to eat when food is present, resulting in limited engagement of cortico-striato-thalamic motor circuitry supporting food acquisition. However, given the preliminary nature of this pilot study, such formulations remain tentative until larger follow-up studies can be conducted. From a potential translational standpoint, the ability of promising therapeutics to demonstrate increased responsivity to natural rewards, specifically nutritive reward may serve as a valuable complementary efficacy indicator for future clinical neuroimaging trials in AUD.

제주도의 경제 성장과 지속 가능성 - GRDP의 한계와 GPI를 통한 지속 가능성 평가

This study aims to evaluate the comprehensive development level of Jeju Island by analyzing the Genuine Progress Indicator (GPI) across economic, environmental, and social dimensions. To achieve this, the GPI for Jeju Island was calculated for the years 2000 to 2021, and the trends in GRDP and GPI were comparatively analyzed. The results showed that while GRDP generally increased, GPI exhibited periods of decline or stagnation at certain points. Notably, since 2019, the COVID-19 pandemic led to a decrease in tourism revenue, resulting in a decline in GRDP, whereas GPI showed an upward trend. This trend can be attributed to the reduction in environmental pressures and the recovery of natural resources due to the decrease in tourist numbers, and such effects may have a long-term impact on GPI. This study suggests that GPI, as a complementary indicator to GRDP, can be effectively utilized as a policy tool for promoting sustainable development.

Fertilizer dependency: a new indicator for assessing the sustainability of agrosystems beyond nitrogen use efficiency

Cropping systems depend on external nitrogen (N) to produce food. However, we lack metrics to account for society’s fertilizer dependency, although excessive increases in N application damage human and environmental health. The objective of this study is to propose a novel indicator, N fertilizer dependency, calculated as the ratio between human-controllable external inputs and total N inputs. Nitrogen fertilizer dependency has a solid mathematical base being derived from closing the nitrogen use efficiency (NUE) equation. This study also tests the value of the N fertilizer dependency concept at the cropping system (plant-soil) scale and at different spatial scales, from field to country, as a complementary indicator to promote sustainable production. The field experiments conducted with grain cereals as a main crop showed that when replacing the barley precedent crop with a legume, N fertilizer dependency accounted for soil legacy and was reduced by 15% in fertilized treatments. In a farm population, N fertilizer dependency ranged from 47 to 95% and accounted for the relevance of biological fixation and irrigation water N inputs, adding pertinent information to performance indicators (i.e., NUE). At the country scale, N fertilizer dependency showed different temporal patterns, depending mainly on the relevance of biological atmospheric N fixation. Nitrogen fertilizer dependency of global cropping systems has risen to ≈83% in the last five decades, even though the N exchange among regions has increased. Nitrogen fertilizer dependency has great potential to monitor the achievements of efforts aiming to boost system autonomy, and within similar agricultural systems, it can be used to identify practices that lead to a reduction of fertilizer needs. In summary, N fertilizer dependency is a new indicator to evaluate the agroenvironmental sustainability of cropping systems across the scales and provides a complementary dimension to the traditional indicators such as NUE, N output, and N surplus.

Optimal Coordinated Operation for Hydro–Wind Power System

The intermittent and stochastic characteristics of wind power pose a higher demand on the complementarity of hydropower. Studying the optimal coordinated operation of hydro–wind power systems has become an extremely effective way to create safe and efficient systems. This paper aims to study the optimal coordinated operation of a hybrid power system based on a newly established Simulink model. The analysis of the optimal coordinated operation undergoes two simulation steps, including the optimization of the complementary mode and the optimization of capacity allocation. The method of multiple complementary indicators is adopted to enable the optimization analysis. The results from the complementary analysis show that the hydraulic tracing effect obviously mitigates operational risks and reduces power losses under adverse wind speeds. The results from the analysis of capacity allocation also show that the marginal permeation of installed wind capacity will not exceed 250 MW for a 100 MW hydropower plant under random wind speeds. These simulation results are obtained based on the consideration of some real application scenarios, which help power plants to make the optimal operation plan with a high efficiency of wind energy and high hydro flexibility.

Inequality in breastfeeding and complementary feeding practices in Argentina by household income level in 2018-2019.

Introduction. Diet quality is a right related to survival, healthy growth, prevention of chronic diseases, and malnutrition in all its forms. The objective of this study was to analyze breastfeeding and feeding practices in children younger than 2 years from urban areas of Argentina in 2018-2019 according to their household income level. Population and methods. Secondary analysis of data of the Second National Survey on Nutrition and Health (ENNyS2) of 2018-2019. Breastfeeding and complementary feeding indicators proposed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) were analized. Data were stratified by household income level. Results. The analysis included 5763 children younger than 24 months old. Although 97% was ever breastfed, only 47% of infants younger than 6 months were exclusively breastfed the previous day and 48% continued with breastfeeding after 1 year old, with a higher prevalence in low-income children. The previous day, 23% of children aged 6 to 23 months did not eat any fruit or vegetable, 60% consumed unhealthy foods, and 50% consumed sweet beverages. The consumption of sweet beverages and the absence of fruit and vegetables were higher in low-income households. Conclusion. The quality of children's diet is far from the recommendations and is conditioned by income. Early initiation of breastfeeding, minimum dietary diversity, fruit and vegetable consumption are lower and sweet beverage consumption is greater in impoverished sectors.

Guideline Materials and Documentation for the Genetic Diversity Indicators of the Monitoring Framework for the Kunming-Montreal Global Biodiversity Framework

Genetic diversity is fundamental to biological diversity, vital for species’ health and adaptation to environmental change. Under the recently adopted Kunming-Montreal Global Biodiversity Framework (GBF), 196 Parties committed to report the status of genetic diversity for both wild and domesticated species. For this, three genetic diversity indicators were developed, two of which focus on processes contributing to genetic diversity conservation: ensuring that populations are large enough to maintain genetic diversity (effective population size Ne 500 indicator) and maintaining genetically distinct populations (populations maintained, PM indicator). A third indicator focuses on the number of species being monitored using DNA-based methods. Adopted by 196 CBD Parties in December 2022, GBF integrated Ne 500 and PM as headline and complementary indicators, respectively. To aid nations in quantifying these indicators, a detailed set of guideline materials was developed, encompassing species selection, data compilation, and indicator computation. These guidelines draw from the collaborative efforts of the first multinational assessment of genetic diversity indicators that was recently completed and that will be refined continually through a versioning system, as more experience is gained and shared. The materials aim to support the global monitoring framework established by the CBD and are accessible online for utilization and updates. The guidelines are available at this link.

Trends in Complementary Feeding Indicators in Children Aged 6-23 Months According to Participation in a Conditional Cash Transfer Program: Data from the Brazilian Food and Nutrition Surveillance System, 2015-2019.

Inadequate practices during complementary feeding are associated with malnutrition, especially in children experiencing vulnerable conditions and social inequality. The aim of this study was to evaluate the trends in complementary feeding indicators (CFIs) according to participation in a Brazilian cash transferu program-the Bolsa Família Program (BFP). This was a time-series study with secondary data from 600,138 children assisted from 2015 to 2019 and registered within the Brazilian Food and Nutrition Surveillance System. The CFIs assessed were food introduction, minimum meal frequency and appropriate consistency, minimum dietary diversity, iron-rich food, vitamin A-rich food, ultra-processed food consumption, and zero vegetable or fruit consumption. Prevalence and 95% confidence intervals were calculated for the CFIs according to BFP, the region of residence, and the child's age. The Prais-Winsten regression method was used to analyze the temporal trend. There was a steady trend for all CFIs of a healthy diet. A decrease in ultra-processed food consumption for both BFP (-10.02%) and non-BFP children (-9.34%) was observed over the years. Children residing in the North and Northeast regions and those enrolled in the BFP were more distant from the recommended feeding practices when compared to the other regions and non-BFP children. The results highlight the relevance of nutritional surveillance and the need to improve food and nutrition public policies for children aged 6-23 months, particularly for those experiencing greater social vulnerability.

Proposed complementary osteological indicators: Advancing the estimation of puberty stages in Bioarcheology.

The study of puberty is a well-established area of bioarcheological research, which greatly enhances our understanding of adolescence and growth in the past. Since the publications of Shapland and Lewis' works, which have become "standards" for estimating puberty in skeletal material, no additional osteological indicators of puberty have been proposed. Nevertheless, clinical practice constantly develops skeletal maturation markers that could be useful in bioarcheology. This study aims to assess the applicability and reliability of novel puberty indicators as a complementary tool to estimate puberty in skeletal remains. Four new maturation markers including spheno-occipital synchondrosis, humeral head ossification, calcaneal apophysis ossification, and mandibular premolar mineralization were selected and applied to a sample of 85 adolescents from pre-Roman southern Italy (Pontecagnano, 7th-4th BCE). Despite some limits in adapting the original clinical methods to osteoarcheological material, the use of these novel skeletal indicators had moderate to excellent scoring repeatability and an overall high agreement with the puberty and menarche status previously estimated with standard methods. These results encourage us to apply these markers in bioarcheology. In some cases, minor adaptations of the original scoring systems are suggested to enhance reliability. Including the proposed indicators in routine puberty data collection allows us to refine puberty estimation and improve the ability to identify key growth milestones in poorly preserved skeletons. Further application to osteological collections with diverse chronology and geographical differences is needed to assess how and to what extent the newly proposed maturation markers perform.

The Influence of Feeding Practice on the Risk of Stunting in Toddler: A Scoping Review

Child stunting is a serious case that is difficult to overcome because it is caused by poor food quality and the amount of food that does not meet the body's needs during the first two years of life. The purpose of this study is to review the influence of feeding practices and feeding methods on the risk of stunting in children under five. PRISMA-ScR reporting guidelines are used to identify key concepts and knowledge gaps. This scoping review used a five-step framework approach. The databases used were PubMed, Wiley Online Library, ScienceDirect, and EBSCO. Manual searches used the Research Rabbit search engine. Based on the search results of 979 articles, ten articles were found that matched the inclusion criteria. Out of the seven themes found, four were in line with WHO's complementary feeding indicators, namely Minimum Meal Frequency (MMF), Minimum Dietary Diversity (MDD), Minimum Acceptable Diet (MAD), and Introduction of Solid, Semi-Solid or Soft Foods (ISSSF). While the other three themes are a time of first feeding, breastfeeding practices, and feeding methods. Overall, inadequate feeding practices result in child malnutrition, including stunting. Improper nutrition and care during the first 1000 days of birth is detrimental to a child's life, both in the short and long term as malnutrition that occurs at this early stage of life has serious and irreversible consequences. Large-scale studies are recommended to explore the role of IYCF in reducing stunting and qualitative studies to determine barriers and drivers to improve infant and young child feeding practices.

Indicators to complement global monitoring of safely managed on-site sanitation to understand health risks

Halfway through the Sustainable Development Goal (SDG) period, there has been little research on the criteria for monitoring safely managed sanitation under SDG target 6.2. For reporting against SDGs, global indicators are necessarily limited and exclude many safety aspects from a public health perspective. Primary survey data from 31,784 households in seven countries in Asia and Africa were analysed, comparing estimates of safely managed on-site sanitation based on global indicators with five complementary indicators of safety: animal access to excreta, groundwater contamination, overdue emptying, entering containments to empty and inadequate protection during emptying. Application of additional criteria reduced the population with safely managed sanitation by 0.4–35% for specific indicators, with the largest impact due to the risk of groundwater contamination, animal access, and containments overdue for emptying. Combining these indicators across the service chain, excluding transport and treatment, found almost three-quarters of on-site systems currently assessed as safely managed with global indicators were considered unsafe based on complementary indicators. A more comprehensive assessment of safety of on-site sanitation can be achieved through these indicators, which could be integrated into national monitoring systems and used to inform sanitation investments that address local health-related risks.

Development of the Diet Quality Questionnaire for Measurement of Dietary Diversity and Other Diet Quality Indicators

BackgroundTo monitor trends toward healthy and sustainable diets, there is a need for feasible survey tools, with cross-cultural validity, low-cost, and low-expertise requirements. ObjectivesThe objective of this research was to develop a method to gather data suitable for monitoring diet quality in the general population (women and men of all ages) that is feasible within multitopic surveys, low burden for both enumerators and respondents, valid at population level, and that captures the information necessary for understanding diet quality at global and local levels. MethodsA literature review was conducted to identify constructs of diet quality with existing consensus, indicators with existing global demand, and methods that may be feasible and valid. Results were presented to a technical advisory group for debate, resulting in consensus on a set of constructs to be measured, desired indicators, viable data collection platforms, and an approach for testing and piloting. ResultsFood group-based indicators and 24-h recall period were selected as the most feasible and valid approach for population-level monitoring. A 29-item Diet Quality Questionnaire (DQQ) was developed, where each yes/no question asks about the consumption of a distinct food group on the previous day or night. The food groups were selected for the purpose of deriving indicators to capture the constructs for which there was consensus: nutrient adequacy, and protection against noncommunicable diseases, including both positive and negative risk factors. ConclusionsThe DQQ is low cost and feasible to administer in existing large-scale surveys, overcoming barriers to diet data collection that have precluded the routine monitoring of diet quality in the past. This novel approach has now been used across >85 countries in the Gallup World Poll and other surveys, generating the first nationally representative available datasets on Minimum Dietary Diversity for Women and complementary diet quality indicators.

The 1-min sit-to-stand test induces a significant and reliable level of neuromuscular fatigability: insights from a mobile app analysis.

The performance metric associated with the execution of the 1-min sit-to-stand (1STS) typically relies on the number repetitions completed in 1 min. This parameter presents certain limitations (e.g., ceiling effect, motivational factors) which can impede its interpretation. Introducing additional parameters, such as neuromuscular fatigability level, could enhance the informative value of the 1STS and facilitate its interpretation. This study aimed to assess (i) whether the 1STS induces fatigability and (ii) the reliability of the fatigability level. Forty young, healthy, and active participants underwent the 1STS twice during the same session. Isolated sit-to-stand maneuvers were performed before, immediately, and 1 min after completing the 1STS. A mobile app was utilized to obtain time (STST), velocity (STSV), and muscle power (STSP) from these sit-to-stand maneuvers. The pre-post change in these parameters served as the fatigability marker. Reliability was assessed using the intra-class correlation coefficient (ICC) and the coefficient of variation (CV). The mean number of repetitions during the 1STS was 63 ± 9. Significant decline in performance was observed for STST (13 ± 8%), STSV (-11.2 ± 6%), and STSP (-5.2 ± 3%), with more than 74% of participants exhibiting a decline beyond the minimal detectable change. Excellent between-session reliability (ICC ≥ 0.9; CV ≤ 5.3) was observed for the mobile app variables. The 1STS induces significant levels of fatigability. The fatigability indicators derived from the mobile app demonstrated remarkable reliability. Utilizing this user-friendly interface for computing fatigability may empower professionals to acquire insightful complementary indicators from the 1STS.

Acceptability and feasibility of tests for infection, serological testing, and photography to define need for interventions against trachoma.

Trachoma causes blindness due to repeated conjunctival infection by Chlamydia trachomatis (Ct). Transmission intensity is estimated, for programmatic decision-making, by prevalence of the clinical sign trachomatous inflammation-follicular (TF) in children aged 1-9 years. Research into complementary indicators to field-graded TF includes work on conjunctival photography, tests for ocular Ct infection, and serology. The perceived acceptability and feasibility of these indicators among a variety of stakeholders is unknown. Focus group discussions (FGDs) with community members and in-depth interviews (IDIs) with public health practitioners in Tanzania were conducted. FGDs explored themes including participants' experience with, and thoughts about, different diagnostic approaches. The framework method for content analysis was used. IDIs yielded lists of perceived strengths of, and barriers to, implementation for programmatic use of each indicator. These were used to form an online quantitative survey on complementary indicators distributed to global stakeholders via meetings, mailing lists, and social media posts. Sixteen FGDs and 11 IDIs were conducted in October-November 2022. In general, all proposed sample methods were deemed acceptable by community members. Common themes included not wanting undue discomfort and a preference for tests perceived as accurate. Health workers noted the importance of community education for some sample types. The online survey was conducted in April-May 2023 with 98 starting the questionnaire and 81 completing it. Regarding barriers to implementing diagnostics, the highest agreement items related to feasibility, rather than acceptability. No evidence of significant differences was found in responses pertaining to community acceptability based on participant characteristics. All of the indicators included were generally deemed acceptable by all stakeholders in Tanzania, although community education around the benefits and risks of different sample types, as well as addressing issues around feasibility, will be key to successful, sustainable integration of these indicators into trachoma programs.

Addressing the climate–finance interaction in a new light: From green to brown assets disclosure in the banking industry

AbstractThis paper explores the contribution of the banking industry to the decarbonization of the economy in the aftermath of the Paris Agreement. To this end, two complementary indicators are proposed: a carbon balance and a fossil fuel to equity ratio. The main novelty of these indicators is that, beyond traditional approaches in green finance, they take into account the parallel endeavor of banks in fossil fuel financing (so‐called “brown assets”). The results of the inquiry are presented in various maps and graphs. Both elements show that the bank‐induced process of decarbonization is lagging behind that of other industries, which creates a significant risk of financial instability. Changing this banking behavior necessarily involves a climate‐driven reform of the prudential rules on capital requirements; however, given the magnitude of the problem, this might not be enough. Nor is it the most urgent concern. Above all, what this paper makes clear is that the appropriate measurement and disclosure of financed emissions (both “green” and “brown”) is the first crucial step for the correct assessment of climate‐related risk and forms the basis for subsequent policy action.