Disadvantaged Communities Research Articles

Conservation Humanities and Multispecies Justice

This article argues that biodiversity conservation is primarily a social and cultural issue and only secondarily a scientific one. It explains the proxy logic of narratives about endangered species, which typically serve as proxies for community identities and the changes communities have undergone through processes of modernization and colonization. Polar bears, whose endangerment is interpreted differently by North American and European audiences, on the one hand, and by Inuit communities, on the other, serve as an example of how endangered species narratives not only involve culture but also, more specifically, issues of multispecies justice. Conservation humanities needs to engage with the two central problems that multispecies justice has identified and grappled with: conflicts between the interests of disadvantaged human communities and nonhuman species and conflicts and trade-offs between the interests of different nonhuman species. The essay argues that adopting the framework of “multispecies justice” rather than “conservation” will help to overcome some of the impasses of interdisciplinary collaboration in environmental studies in the past.

A Building Blocks Approach to Implementing a Telehealth Clinic Model to Improve Primary Care Access in the Philippines: A Large-scale Pilot Project

A limited number of healthcare workers and cost constraints limit primary care access in the Philippines. To test telehealth as a low-cost and effective solution, a large-scale digital health clinic was implemented in the selected urban and rural communities. In collaboration with local authorities, our pilot telemedicine clinic was implemented for 3 days in January 2023. Patients were registered and their vitals were assessed before they were seen by a remote United States-based licensed physician who provided recommendations for treatment. Medical devices with real-time streaming capabilities, such as electronic stethoscopes, were utilized to enhance remote examinations. A total of 322 patients were treated at the telehealth clinic, of which 218 completed a population health survey. A large proportion of patients had a doctor visit more than 12 months prior (39.2%) and had not received a dental examination (86.3%) or an eye examination within the past year (84.4%). Most patients had access to a smartphone (69.7%). A lower proportion had access to an internet connection that was sufficient for video calls (57.9%) or a laptop (8.5%). Our clinic demonstrated that telehealth is a feasible solution to improve primary care access for disadvantaged communities in the Philippines.

Transformative Horizons in Education: Navigating Challenges, Embracing Innovations, and Shaping Global Landscapes

The global education landscape stands at a crossroads, grappling with multifaceted challenges that demand transformative solutions. The inertia within traditional educational systems, financial constraints, stakeholder resistance, reliance on standardized testing, digital inequalities, and a gap between education and needs of the workforce collectively hinder the necessary evolution. Bringing change in education requires a concerted, collaborative effort to embrace disruptive innovations. Reshaping curricular frameworks, bridging digital divides, and fostering a culture that values adaptability and inclusivity are priority. As we navigate this transformative journey, the solutions to educational challenges can be achieved by recognizing the interconnected nature of these challenges and addressing them collectively. That will also ensure that the pursuit of innovation in education becomes a global priority. Through sustained commitment, collaboration, and strategic planning we can equip learners to be ready to face the complexities of the 21st century. In closing, we welcome the readers of the 'International Journal of Change in Education.' The journal envisions itself as a catalyst for positive change, providing a space for cutting-edge research and innovative ideas that address the critical issues facing education globally. By fostering a community of scholars, educators, and policymakers, this journal aspires to generate insights and solutions that will shape the future of education. As contributors and readers, your support is pivotal. We encourage you to share your expertise, experiences, and groundbreaking studies that delve into the heart of educational transformation. Thank you for joining us on this transformative journey.

Systematic surveillance tools to reduce rodent pests in disadvantaged urban areas can empower communities and improve public health

Rodents are notorious pests, known for transmitting major public health diseases and causing agricultural and economic losses. The lack of site-specific and national standardised rodent surveillance in several disadvantaged communities has rendered interventions targeted towards rodent control as often ineffective. Here, by using the example from a pilot case-study in the Bahamas, we present a unique experience wherein, through multidisciplinary and community engagement, we simultaneously developed a standardised national surveillance protocol, and performed two parallel but integrated activities: (1) eight days of theoretical and practical training of selected participants; and (2) a three-month post-training pilot rodent surveillance in the urban community of Over-the-Hill, Nassau, The Bahamas. To account for social and environmental conditions influencing rodent proliferation in the Bahamas, we engaged selected influential community members through a semi-structured interview and gathered additional site-specific information using a modified Centers for Diseases Control and Prevention (CDC) exterior and interior rodent evaluation form, along with other validated instruments such as tracking plates and snap trapping, to test and establish a standardised site-specific rodent surveillance protocol tailored for the Bahamas. Our engagement with community members highlighted poor disposal of animal and human food, irregular garbage collection, unapproved refuse storage, lack of accessible dumpsters, poor bulk waste management, ownership problems and structural deficiencies as major factors fuelling rodent proliferation in the study areas. Accordingly, results from our pilot survey using active rodent signs (that is, the presence of rodent runs, burrows, faecal material or gnawed material) as a proxy of rodent infestation in a generalized linear model confirmed that the variables earlier identified during the community engagement program as significantly correlated with rodent activities (and capturing) across the study areas. The successful implementation of the novel site-specific protocol by trained participants, along with the correlation of their findings with those recorded during the community engagement program, underscores its suitability and applicability in disadvantaged urban settings. This experience should serve as a reference for promoting a standardised protocol for monitoring rodent activities in many disadvantaged urban settings of the Global South, while also fostering a holistic understanding of rodent proliferation. Through this pilot case-study, we advocate for the feasibility of developing sustainable rodent control interventions that are acceptable to both local communities and public authorities, particularly through the involvement of a multidisciplinary team of professionals and community members.

Implementing active surveillance for TB: A descriptive survey of healthcare workers in the Eastern Cape, South Africa.

South Africa is a tuberculosis (TB) high-burden country. In the Eastern Cape (EC), community health worker (CHW) teams implement active surveillance for TB to curb spread in disadvantaged communities. However, achieving the goals of the End-TB strategy require coordinated efforts that implement policy and strengthen health systems. This survey described views of healthcare workers (HCWs) in primary care facilities on factors that influence implementation of active surveillance for TB. This survey was conducted across two districts, among healthcare workers working in TB rooms at primary health facilities. A cross-sectional survey of HCW in the EC. The survey included 37 clinics in the OR Tambo Health District (ORTHD) and 44 clinics in the Nelson Mandela Bay Health District (NMBHD). Routine screening at primary care facilities (88.2%) and contact tracing initiatives (80.8%) were the common modes of TB screening. Tuberculosis screening services in the community were only provided by CHWs in 67.3% of instances. Although CHWs were adequately trained and motivated; the lack of transport, limited availability of outreach team leaders (OTLs) and poor security limited implementation of TB screening services in the community. Comparison between both districts revealed TB screening was limited by lack of transport in the rural district and poor security in the urban context. Community engagement provided a platform for improving acceptability. Community-based TB screening was limited. Inadequate coordination of services between stakeholders in the community has limited reach. Further research should describe that coordinating resource allocation and community empowerment could improve the implementation of active surveillance for TB.Contribution:This study highlights the views of TB room HCWs who believe the opportunity for community-level TB screening is improved with effective leadership and community engagement for acceptability of these services.

Addressing building related energy burden, air pollution, and carbon emissions of a low-income community in Southern California

This study examines the impact of low-income assistance and electrification programs on a disadvantaged community in Southern California. An urban building energy model is paired with an AC power flow and electric distribution system degradation model to evaluate how the cost of energy, carbon emissions, and pollutant emissions change after applying building weatherization, energy efficiency, and electrification measures to the community. Results show that traditional weatherization and energy efficiency measures (upgrading lighting and appliances, improving insulation to current building code standards) are the most cost-effective, reducing the cost of energy and carbon emissions by 10–20 % for the current community. Heat pump water heaters offer a 40 % average reduction in carbon emissions and almost 50 % decrease in criteria pollutant emissions, but at a cost increase of 17–22 %. Appliance electrification also reduces carbon emissions 5–10 % but increases cost by 7 % to 25 %. For reducing carbon, government programs that support building electrification are most cost-effective when they combine switching from natural gas to electricity with high efficiency system. Electrifying hot water and appliances effectively reduces emissions but must be paired with improved low-income assistance programs to prevent increased energy burden for low-income families. The urban building energy model and electrical distribution simulations used in this study can be replicated in other low-income communities.

Architecture, Design and Community in Colombia. More Urban, More Rural, More Social: The Workshop Experience

This contribution reflects on two challenges: the first focuses on analysing how architects-designers, teachers-students, should apply post-pandemic projective thinking from the academy. On the other hand, to make a critical reflection on how specifically from the PUJCali, under the methodologies of service-learning, co-design and placemaking, work has been done and can continue to be done in favor of small disadvantaged communities with the intention of producing significant changes for them. Especially after the pandemic, we wonder how it would be possible to orient these experiences towards a more collaborative, inclusive, transdisciplinary, collective and transcommunity learning system, moving away from hegemonic positions. How these workshops have a direct impact on the communities of school-age children and increase their well-being in multiple aspects, as well as improving their coexistence and behaviours. Valuing research work in conjunction with the community highlights the importance of appropriation by those directly involved when they feel part of the work process.

Differences in rehabilitation evaluation access for rural and socially disadvantaged stroke survivors

ABSTRACT Background Most stroke survivors have ongoing deficits and report unmet needs. Despite evidence that rehabilitation improves stroke survivors’ function, access to occupational and physical therapy is limited. Describing access to care for disadvantaged communities for different levels of stroke severity will provide proportions used to create Markov economic models to demonstrate the value of rehabilitation. Objectives The objective of this study was to explore differences in the frequency of rehabilitation evaluations via outpatient therapy and home health for Medicare Part B ischemic stroke survivors in rural and socially disadvantaged locations. Methods We completed a retrospective, descriptive cohort analysis using the 2018 and 2019 5% Medicare Limited Data Sets (LDS) from the Centers for Medicare and Medicaid Services using STROBE guidelines for observational studies. We extracted rehabilitation Current Procedural Terminology (CPT) codes for those who received occupational or physical therapy to examine differences in therapy evaluations for rural and socially disadvantaged populations. Results Of the 9,076 stroke survivors in this cohort, 44.2% did not receive any home health or outpatient therapy. Of these, 64.7% had a moderate or severe stroke, indicating an unmet need for therapy. Only 2.0% of stroke survivors received outpatient occupational therapy within the first year Rural and socially disadvantaged communities accessed rehabilitation evaluations at lower rates than general stroke survivors. Conclusions These findings describe the poor access to home health and outpatient rehabilitation for stroke survivors, particularly in traditionally underserved populations. These results will influence future economic evaluations of interventions aimed at improving access to care.

Community Health Workers: Improving Home Visiting Engagement of High-Risk Birthing People in Segregated Neighborhoods.

Racial and ethnic disparities in perinatal health remain a public health crisis. Despite improved outcomes from home visiting (HV) participation during pregnancy, most eligible individuals of color do not engage. Neighborhood segregation, a manifestation of structural racism, may impose constraints on engaging eligible individuals in HV. To examine whether race, ethnicity, and/or language-concordant community health workers (CHWs) increased HV engagement for birthing people in segregated neighborhoods. Program evaluation using administrative linked data from birth records, Medicaid claims, and HV program participation. Strong Beginnings (SB), a program with HV provided by CHWs working with nurses and social workers, was compared with the Maternal Infant Health Program (MIHP), a state Medicaid-sponsored HV program without CHW involvement. Data were analyzed using χ 2 tests and Poisson regressions. A total of 4560 individuals with a Medicaid-eligible birth between 2016 and 2019, including 1172 from SB and 3388 from the MIHP. Penetration (percentage of participants in HV among all Medicaid-eligible individuals across quintiles of neighborhood segregation) and dosage (the total number of home visits from both CHWs and nurses/social workers, and then restricted to those from nurses/social workers). SB penetrated more segregated neighborhoods than the MIHP (58.4% vs 48.3%; P < .001). SB participants received a higher dosage of home visits (mean [SD]: 11.9 [6.1]) than MIHP participants (mean [SD]: 4.4 [2.8], P < .001). Importantly, CHWs did not replace but moderately increased home visits from nurses and social workers (51.1% vs 35.2% with ≥5 intervention visits, P < .001), especially in more segregated neighborhoods. Community-informed HV models intentionally designed for people facing disparities may help facilitate program outreach to segregated neighborhoods with concentrated deprivation and reduce racial and ethnic disparities. An HV program provided by CHWs working with nurses and social workers was associated with an increase in penetration and dosage in segregated neighborhoods, compared with HV without CHW involvement. This underscores the value of CHWs partnering with licensed professional workers in improving HV engagement in disadvantaged communities.

Renal-specific loss of ferroportin disrupts iron homeostasis and attenuates recovery from acute kidney injury.

Chronic kidney disease is increasing at an alarming rate and correlates with the increase in diabetes, obesity, and hypertension that disproportionately impact socioeconomically disadvantaged communities. Iron plays essential roles in many biological processes including oxygen transport, mitochondrial function, cell proliferation, and regeneration. However, excess iron induces the generation and propagation of reactive oxygen species, which lead to oxidative stress, cellular damage, and ferroptosis. Iron homeostasis is regulated in part by the kidney through iron resorption from the glomerular filtrate and exports into the plasma by ferroportin (FPN). Yet, the impact of iron overload in the kidney has not been addressed. To test more directly whether excess iron accumulation is toxic to kidneys, we generated a kidney proximal tubule-specific knockout of FPN. Despite significant intracellular iron accumulation in FPN mutant tubules, basal kidney function was not measurably different from wild type kidneys. However, upon induction of acute kidney injury (AKI), FPN mutant kidneys exhibited significantly more damage and failed recovery, evidence for ferroptosis, and increased fibrosis. Thus, disruption of iron export in proximal tubules, leading to iron overload, can significantly impair recovery from AKI and can contribute to progressive renal damage indicative of chronic kidney disease. Understanding the mechanisms that regulate iron homeostasis in the kidney may provide new therapeutic strategies for progressive kidney disease and other ferroptosis-associated disorders.NEW & NOTEWORTHY Physiological iron homeostasis depends in part on renal resorption and export into the plasma. We show that specific deletion of iron exporters in the proximal tubules sensitizes cells to injury and inhibits recovery. This can promote a chronic kidney disease phenotype. Our paper demonstrates the need for iron balance in the proximal tubules to maintain and promote healthy recovery after acute kidney injury.

Lipid Management in Primary Care for Socioeconomically Disadvantaged Populations in Northern England: A Qualitative Study.

People in low socioeconomic circumstances are more susceptible to dyslipidemia and cardiovascular disease than those living in more affluent populations. Limited healthcare access and low preventive care uptake widen health inequalities. Understanding how primary care can better serve socioeconomically disadvantaged communities is urgently needed. To explore lipid management delivery in socioeconomically disadvantaged areas and identify barriers and enablers for lipid optimization for socioeconomically disadvantaged populations. Individual semi-structured remote interviews with clinicians, purposively recruited from primary care practices serving extremely socioeconomically disadvantaged communities in Northern England, UK, who were involved in the delivery and organization of lipid management. Interviews were recorded, transcribed, and analyzed thematically following framework analysis. Fifteen interviews were undertaken. Five themes emerged: complex and multimorbid patients with competing priorities, limited access and follow-up to supporting services, being flexible and working beyond guidelines, high workload with inadequate staff support, and the need for care integrity and sustainable support. The findings of this study have been fed back to the delivery of the national program to improve cardiovascular health. Socioeconomically disadvantaged communities have complex health needs posing risks of multimorbidity but living with low health literacy, competing demands upon time, and financial constraints. Clinicians are willing to adapt services but a lack of guidance for care and funded services remains a significant barrier to targeted service delivery. Research is needed to inform the effectiveness and acceptability of interventions for lipid management tailored for those experiencing low socioeconomic disadvantage.

ROLE OF COTTAGE INDUSTRIES IN RURAL LIVELIHOODS

Agriculture and traditional handicrafts are deeply ingrained in Indias rural terrain, and cottage businesses have emerged as a key component in maintaining rural livelihoods. This abstract explores the complex aspects of the function that cottage industries play in rural Indias socio-economic structure. Cottage industries, which are sometimes confused with small-scale businesses, cover a broad range of pursuits, from contemporary pursuits like small-scale manufacturing and internet businesses to traditional handicrafts, handloom weaving, ceramics, and agro-processing. These sectors, which have their roots in rural Indias rich cultural legacy, provide major contributions to job creation, income production, and skill development-all of which are critical for reducing poverty. Cottage industries promote inclusive growth by giving people in disadvantaged communities of society more possibilities to find work. For example, women in rural regions frequently use cottage enterprises to achieve financial independence and self-empowerment. The case studies and success stories in this abstract demonstrate how cottage enterprises have a transforming effect on gender dynamics in rural areas. The role of cottage industries in rural livelihoods in India is a dynamic and evolving narrative. This abstract provides insights into the economic, social, and environmental dimensions of cottage industries, emphasizing their potential as catalysts for inclusive and sustainable rural development. Understanding and nurturing these industries is crucial for unlocking the full potential of rural economies and fostering a more resilient and empowered rural India.

Explainable artificial intelligence for decarbonization: Alternative fuel vehicle adoption in disadvantaged communities

This article explores the adoption of alternative fuel vehicles (AFVs), leading to decarbonization, in disadvantaged communities (DACs) by applying statistical and explainable artificial intelligence (XAI) techniques to understand the factors associated with AFV adoption in these communities. The study harnesses a unique and comprehensive database of surveys and public databases for the Puget Sound region in the United States. The XAI techniques, specifically the Extreme Gradient Boosting algorithm with Shapely Additive Explanations, provide interpretable and understandable explanations of factors associated with AFV adoption in DACs. The study findings provide an understanding of the social and economic factors and challenges of DACs. The results suggest several key factors, especially a lack of access to charging infrastructure, consumer attitudes, and income, play a substantial role in adopting AFVs. As expected, AFV adoption in DACs (12.96%) is lower than non-DACs (15.30%). More public charging stations strongly correlate with AFV adoption in DACs. Tech-oriented households in DACs are more likely to adopt AFVs compared with non-DACs. The findings also point to the significant effects of home charging facilities while adopting AFVs in DACs. The XAI results emphasize the importance of socio-economic factors in AFV adoption programs and provide insights into decision-making in DACs. This research contributes to the literature on AFV adoption and suggests opportunities for improvements in DACs transitioning to AFVs. The study findings can be used to assess the planning-level impacts of refueling or charging infrastructure in DACs while enabling DACs to benefit from infrastructure investments.

Stakeholder perspectives of a co-produced intervention to integrate mental health for children and youth within the community sub-system in South Africa

PurposeThis study evaluated the process of integrating child and youth mental health to existing psychosocial support in disadvantaged South African communities. MethodsFour child practitioners of the host organization attended a Train-of-Trainer programme. They subsequently co-produced an intervention informed by a service transformation framework along five service domains. Implementation involved 368 community participants. A sub-sample of 43 participants were engaged in focus groups on their experiences. Data were analysed through thematic analysis. ResultsEstablished themes were inter-linked and transcended the five intervention domains. Engagement and conceptualization of mental health through awareness were viewed as pre-requisites to application of new knowledge. This should be supported by systemic changes, predominantly community mobilization and integrated care. Knowledge transfer involving collaboration between services and communities would enable sustainability of impact. The findings led to the formulation of a Theory of Change. ConclusionsIntegration of child and youth mental health through a cascade approach that actively involves communities in co-production and delivery can enhance service provision in resource-constrained Majority World contexts.

Advancing equitable stormwater management: A decision support tool integrating best practices for nutrient removal and environmental justice

Stormwater runoff is a significant contributor to nutrient pollution, leading to water quality degradation and ecological imbalances. The management of stormwater runoff and nutrient pollution faces significant challenges due to inadequate assessment tools for evaluating nutrient loads across multiple watersheds at the state level and the absence of an open-source tool that can comprehensively assess the effectiveness of stormwater Best Management Practices (BMPs) in nutrient removal while incorporating environmental justice (EJ) considerations. To address these challenges, we developed an innovative online statewide tool that identifies areas where BMP planning needs to be prioritized to address environmental disparities resulting from high pollutant loads intersecting with disadvantaged communities, alongside tracking pollutant loads after various BMP implementations. In doing so, we estimated pollutant loads including total phosphorus (TP), total nitrogen (TN), biochemical oxygen demand (BOD), and total suspended solids (TSS) from urban land use in 1378 HUC-12 watersheds across Florida using EPA's pollutant load estimate tools (PLET), which calculates loads based on factors such as land use, septic systems and wastewater discharge, soil characteristics, and precipitation. To integrate BMP implementation with EJ considerations, a social vulnerability index was developed to identify tiers of sociodemographic disparities using racial/ethnicity metrics (e.g., % black, % Hispanic, etc.) and socioeconomic metrics (e.g., median household income, educational attainment, etc.). We then investigated the effectiveness of 28 urban stormwater BMPs in reducing pollutant loads and estimated post-BMP loads for each watershed. Hotspots of nutrient pollution were primarily identified in coastal areas, with residential land use as the main contributor. Miami-Dade, Broward, and Hillsborough counties had the highest sociodemographic disparities. In addition, central and southern Florida exhibited a disproportionate exposure of disadvantaged communities to pollutant loads. The developed online tool contributes significantly to holistic watershed management by features including visualizing the distribution of nutrient pollution loads across state watersheds, identifying areas with high pollutant loads intersecting with disadvantaged communities, and quantifying pollution load reductions post-BMP implementation. This research promotes equitable outcomes and empowers stakeholders in Florida to adopt sustainable and inclusive practices for water quality improvement.

Dynamic Traffic Data in Machine-Learning Air Quality Mapping Improves Environmental Justice Assessment.

Air pollution poses a critical public health threat around many megacities but in an uneven manner. Conventional models are limited to depict the highly spatial- and time-varying patterns of ambient pollutant exposures at the community scale for megacities. Here, we developed a machine-learning approach that leverages the dynamic traffic profiles to continuously estimate community-level year-long air pollutant concentrations in Los Angeles, U.S. We found the introduction of real-world dynamic traffic data significantly improved the spatial fidelity of nitrogen dioxide (NO2), maximum daily 8-h average ozone (MDA8 O3), and fine particulate matter (PM2.5) simulations by 47%, 4%, and 15%, respectively. We successfully captured PM2.5 levels exceeding limits due to heavy traffic activities and providing an "out-of-limit map" tool to identify exposure disparities within highly polluted communities. In contrast, the model without real-world dynamic traffic data lacks the ability to capture the traffic-induced exposure disparities and significantly underestimate residents' exposure to PM2.5. The underestimations are more severe for disadvantaged communities such as black and low-income groups, showing the significance of incorporating real-time traffic data in exposure disparity assessment.

CLIMATE CHANGE AND INDUCED MARGINALIZATION: PERSPECTIVES

The global arena of international relations is placing increasing importance on the subject of climate change. The disruptions in natural weather patterns are giving rise to a wide array of challenges in ecological, sociopolitical, and economic systems. This piece of writing investigates the concept of marginalization brought about by the effects of climate change. The analysis adopts a multi-faceted approach, utilizing the framework of climate justice. The primary focus lies in understanding how climate-induced marginalization impacts a nation’s social structure, especially affecting disadvantaged communities. Following that, the conversation delves into making a comparison among different countries, examining their contributions to climate change and the subsequent difficulties they encounter. The article also underscores the insufficiencies in international frameworks aimed at mitigating climate change, underscoring the lack of accountability during their development. Additionally, the problem of climate-induced marginalization is evaluated in the context of the Sustainable Development Goals, and suggestions are put forth to effectively tackle this issue.

DO MUNICIPALITIES HAVE THE POWER TO REGULATE THE KEEPING OF “DANGEROUS” DOGS?

Dog attacks and resultant deaths are frequent occurrences in South Africa. Pit bulls are responsible in many of these cases and there are calls for them to be banned. Dogs, however, are the property of their owners, and forcing people to give them up will amount to a deprivation of property and an infringement of a dog owner’s right to property, which is protected by section 25 of the Constitution. Dogfighting is rife in South Africa and the conduct of dog owners contributes to dogs being aggressive and leads to dog attacks. In terms of the Constitution, animal control is a functional area of concurrent national and provincial legislative competence; on a strict interpretation, this means that municipalities do not have the power to legislate on the function. However, everyone is guaranteed the right to freedom and security of the person, which includes the right to be free from all forms of violence from either public or private sources. As such, the municipality (as part of the State) must respect, protect, promote and fulfil the right. Municipalities also have a duty to promote a safe and healthy environment, and the power to make by-laws on matters they may administer. They may also exercise powers that are reasonable and incidental to the effective performance of municipal functions, which is supported by the principle of subsidiarity, the fulfilment of the duties arising from section 12 of the Constitution, and the objective to promote a safe and healthy environment. A municipality that has the necessary resources can legislate and enforce by-laws on matters listed in Schedule 4A and 5A of the Constitution, provided that such action seeks to further the objectives of Chapter 2 of the Constitution and is not in conflict with measures adopted by the national and provincial spheres. The National Society for the Prevention of Cruelty to Animals (NSPCA) is responsible for animal welfare, but the responsibilities of animal welfare organisations are becoming greater as urbanisation in South Africa accelerates and animals in many disadvantaged communities are in dire need of basic animal care. The suite of local government law is geared towards the social and economic upliftment of communities, and there is legislative justification for interventions by municipalities to address matters such as the control of public nuisances, dog licensing, the operation of pounds, and the conduct of community members that can alleviate the pressure on those organisations tasked with animal care. There are a number of legislative instruments that apply to animals. A consolidation of the provisions of the various pieces of legislation into a single by-law aimed at regulating the keeping and treatment of dogs, may result in increased law enforcement and (it is hoped) increased sentences as a result of amplified enforcement, as well as improved deterrence.

The Limitations and Potentials of Evaluating Economic Aspects of Community-Based Health Promotion: A Critical Review.

Community-based health promotion (CBHP) interventions are promising approaches to address public health problems; however, their economic evaluation presents unique challenges. This review aims to explore the opportunities and limitations of evaluating economic aspects of CBHP, focusing on the assessment of intervention costs and outcomes, and the consideration of political-level changes and health equity. A systematic search of the PubMed, Web of Science and PsycInfo databases identified 24 CBHP interventions, the majority of which targeted disadvantaged communities. Only five interventions included a detailed cost/resource assessment. Outcomes at the operational level were mainly quantitative, related to sociodemographics and environment or health status, while outcomes at the political level were often qualitative, related to public policy, capacity building or networks/collaboration. The study highlights the limitations of traditional health economic evaluation methods in capturing the complexity of CBHP interventions. It proposes the use of cost-consequence analysis (CCA) as a more comprehensive approach, offering a flexible and multifaceted assessment of costs and outcomes. However, challenges remain in the measurement and valuation of outcomes, equity considerations, intersectoral costs and attribution of effects. While CCA is a promising starting point, further research and methodological advancements are needed to refine its application and improve decision making in CBHP.

Research Review: Grandparental care and child mental health - a systematic review and meta-analysis.

The number of children residing in grandfamilies is growing worldwide, leading to more research attention on grandparental care over the past decades. Grandparental care can influence child well-being in various forms and the effects vary across contexts. In this systematic review and meta-analysis, we synthesize the evidence on the relation between grandparental care and children's mental health status. We identified 5,745 records from seven databases, among which 38 articles were included for review. Random effects meta-analyses were used to synthesize evidence from eligible studies. We also examined the variability across study and participant characteristics, including study design, recruitment method, child age, child gender, study region, family type, comparison group, and outcome rater. The meta-analysis consisted of 344,860 children from the included studies, whose average age was 10.29, and of which 51.39% were female. Compared with their counterparts, children being cared for by their grandparents had worse mental health status, including more internalizing problems (d = -0.20, 95% CI [-0.31, -0.09], p = .001), externalizing problems (d = -0.11, 95% CI [-0.21, -0.01], p = .03), overall mental problems (d = -0.37, 95% CI [-0.70, -0.04], p = .03), and poorer socioemotional well-being (d = -0.26, 95% CI [-0.49, -0.03], p = .03). The effects varied by study design and child gender. The findings highlight that grandparental care is negatively associated with child mental health outcomes with trivial-to-small effect sizes. More supportive programs and interventions should be delivered to grandfamilies, especially in disadvantaged communities.