Global Recommendations Research Articles

Improving dietary diversity and food security among low-income families during financial crisis using cash transfers and mHealth: experience from two selected districts in Sri Lanka.

The economic crisis in Sri Lanka worsened food insecurity, with millions facing moderate-to-severe food shortages. This study evaluates the effectiveness of cash transfers combined with mobile health education in enhancing dietary diversity and food security among Sri Lankan households during the crisis. This quasi-experimental single-group pre-post study involved 1040 eligible individuals selected through stratified random sampling from eligible households of Samurdhi beneficiaries and smallholder farmers. The intervention included a cash transfer of LKR 22,500 and weekly nutrition awareness messages via WhatsApp and SMS complemented by a one-time awareness session. Dietary diversity and food security were assessed using standard validated tools such as the Diet Quality Questionnaire and Food Security Questionnaire. Food insecurity decreased significantly from 89.3% (n = 681) in the pre-test to 76.9% (n = 533) in the post-test, with a 12.4% reduction (95% CI, 8.57 to 16.24, p < 0.05). The Minimum Dietary Diversity for Women improved from 44.5 to 67.8% [23.3% increase (95% CI, 15.89 to 30.63; p < 0.05)]. The mean NCD-Protect and GDR scores increased significantly, indicating a higher adherence to global dietary recommendations, whereas the NCD-risk scores remained unchanged. This study demonstrated that cash transfers combined with mobile phone-based nutritional education significantly improved dietary diversity and food security among low-income families in Sri Lanka during the financial crisis. Not applicable.

Exploring the Effects of Greenhouse Gases and Particulate Emissions on Quality of Life: A Country-Level Empirical Study

This study explores the relationship between greenhouse gases (GHGs) and particulate emissions and quality of life. The aim is to understand how emissions affect quality of life globally—across countries, regions, and the global population. Statistical methods were used to examine the impact of various emissions’ indicators on different aspects of quality of life. The study highlights the urgent need for climate change action and encourages policymakers to take strategic steps. Climate change adversely affects numerous aspects of daily life, leading to significant consequences that must be addressed through policy changes and global governance recommendations. Key findings include that higher CO2 and methane emissions and air pollution negatively impact quality of life. CO2 emissions are positively associated with electricity while air pollution is positively associated with GDP and negatively with unemployment. Air pollution has an adverse effect on all three aspects of the children’s welfare dimension of quality of life. These results provide timely and convincing insights for policy- and decision-making aimed at mitigating the impact of emissions on quality of life.

Derivation of the Sagnac (Earth-rotation) correction and analysis of its accuracy for GNSS applications

AbstractGlobal Navigation Satellite Systems (GNSS) applications require computation of the geometric range between the satellite vehicle at the time-of-signal transmission and the receiver antenna location at the time-of-signal reception. This computation requires attention to the frames of reference due to the rotation of the Earth-Centered Earth-Fixed (ECEF) frame during the time-of-signal propagation. Three range computation approaches are commonplace and will be discussed herein. The first is the Global Positioning System Interface Control Document recommendation to rotate the ECEF frames to a common reference time. The other two are forms of the Sagnac correction. The Sagnac derivations already in the literature are either limited to stationary receivers or lack the connection between the Earth-centered inertial (ECI) and ECEF frames. Neither form of the Sagnac correction exactly reproduces the geometric range. They are approximations. The literature does not currently contain an analysis of the error involved in using either form of the Sagnac correction. This article makes two contributions: (1) it presents derivations for both forms of the Sagnac correction that are valid for moving receivers and that maintain the connection between the ECI and ECEF frames; and (2) it analyzes the error of the Sagnac correction for orbits of different radius. The analysis shows that Sagnac corrections introduce range errors less than $$7.57\times 10^{-4}$$ 7.57 × 10 - 4 meters for GNSS satellites at medium Earth orbit.

Federated Learning for Personalized Financial Recommendations

Abstract: Federated Learning (FL) has been the solution to one of those biggest contributors that have scared us from using Machine learning, i.e. Privacy [ for sensitive domains like finance ]. This survey focuses on leveraging Federated Learning in creating personalized recommendation systems for financial products such as loans, investment plans, credit cards and savings. For example, classical recommendation systems usually work in a centralized way to store a lot of sensitive financial data (or derivative structures), this setting presents other well-known privacy issues and security risks. FL provides a solution that enables multiple financial institutions to work together to train a global recommendation model without the need any of them to share their raw customer data. The paper reviews federated learning, and some key take ways are on differential privacy and secure aggregation to protect customer data while improving the quality of recommendations. We also talk about how to solve some problems like heterogeneity of the data, model convergence and regulatory constraints required in financial methods. The paper concludes by detailing future directions for federated learning in finance, with focus on how personalized financial recommendations can be dramatically transformed while preserving user privacy.

Preventing ischemic heart disease in women: a systematic review of global directives and policies

Cardiovascular disease is the leading cause of mortality in women worldwide. Yet cardiovascular disease in women remains underdiagnosed and undertreated, especially among vulnerable populations such as older women, low-income populations, and ethnic minorities. Resultantly, reduction in cardiovascular mortality among women has stagnated. To examine, consolidate current research findings and policies to identify gaps in women’s heart health practice, this review screened 21476 records and synthesized results from 124 English language publications worldwide. Using a life course approach, we assessed the connection between clinical recommendations and policy, and documented global recommendations and policies addressing prevention of cardiovascular disease in women. Key recommendations include fostering environments that encourage sustainable health behaviors for young women, advocating for national surveillance systems and guidelines for monitoring and increasing the understanding of cardiovascular health in high-risk pregnancy/postpartum groups, developing community prevention programs for midlife/menopause, and implementing direct population health management initiatives for elderly women, with an emphasis on higher risk groups. Inequalities still exist among women with varying socioeconomic status and race between countries, and even within countries.

Compliance of physical activity among adults with metabolic syndrome with the WHO recommendations

Abstract Introduction Low physical activity is a leading factor in 6% of deaths worldwide. In Bulgaria, it contributes to the deterioration of the health status of the population and determines 4.3% of the global burden of diseases. Over 70% of Bulgarian adults have insufficient physical activity during their free time. The aim of the study is to measure and assess the level of physical activity among adults with metabolic syndrome with the World Health Organization (WHO) Global recommendations. Methods A comparative study of the physical activity of a representative sample of 200 individuals with metabolic syndrome aged 54.7±10.5 from Pleven region was made with the WHO Global recommendations on physical activity for people living with chronic conditions. Modified Physical activity Questionnaire (PAQ) for adults was used for assessment of the physical activity. Data were processed with IBM SPSS v. 25. Results The weekly frequency of the vigorous-intensity physical activity (VIPA) was 1,61 days with a weekly duration of 215 minutes, which met the WHO recommendations on physical activity for people living with chronic conditions, but 64% of the respondents had none and only 26% had VIPA on 2 and more days a week. More than half of the respondents (55%) had none moderate-intensity aerobic PA. From the remaining, 34% had this type of PA on 3 and more days a week with duration of 225 minutes, which met the WHO recommendations. Walking more than 10 minutes a day on 5 and more days a week had 69% of the respondents (40 minutes/day). Only 12% had none walking. Only 2% stated that the physical inactivity is the most important cause for the rise of many non-communicable diseases. Conclusions More than half of the respondents had none vigorous- and moderate-intensity PA but the PA of the remaining met the WHO recommendations. Although physical inactivity is among the risk factors for the rise of many non-communicable diseases, contributing to death, it was not recognised by the respondents. Key messages • Walking is the most important physical activity for the adults with metabolic syndrome. • Increasing the duration of walking should be encouraged and supported to manage the metabolic syndrome.

Association between fitness levels and physical activity in apparently healthy Colombian men

Abstract Physical condition (PC) such as strength and endurance favor functional independence and disease prevention (Melo, 2014). Objective: To characterize the levels of Physical Activity (PA) and CP in apparently healthy men who practice PA in different settings in Bogotá-Colombia. This study is observational cross-sectional, 485 Men (M) participated, mean age 42±17.8 years. To measure the levels PA the IPAQ (International Physical Activity Questionnaires) was applied. The Confidence Interval (CI) and Standard Error (SE) were taken into account. For PA levels, data were analyzed with Rstudio v2022.12.0, with empirical distribution tests, Kolmogorov-Smirnov normality and independence with Chi-Square (χ²), in addition, mean (X¯), percentage (%) and standard deviation (±). 90.6% of the H met the overall PA recommendations (Leisure Time+Active Transportation) with 95% CI (88.0-93.0) and SE (0.012). The PC variables such as; Body Mass Index (BMI), Body Adiposity Index (BAI), Abdominal Circumference (AC), Grip Strength (GS) and Maximal Oxygen Consumption (Vo2max). The results showed that 35.6% (26.9±1.48) of H were Overweight (Ow) and 10.6% (32.7±2.39) were Obese (Ob), 39.7% (98.4±6.8) with Cardiovascular Risk (Rcv) by AC and 24.3% (29.7±3.45) with risk by BAI. As for GS 41.5% (27.1±6.39) is weak and 32.3% (33.3±6.3) is low Vo2max. According to independence tests with χ² there is association between the G and BMI (χ²=1452.1, df = 1427, p-value=0. 315), G and AC (χ²=394.9, df = 382, p-value=0. 313), G and Vo2max (χ²=155.5, df = 6, p-value&amp;lt;2.2e-16), G and BAI (χ²=2970.3, df = 1502, p-value&amp;lt;2.2e-16), G and GS (χ²=6015.5, df = 1502, p-value&amp;lt;2.2e-16). This project was approved by the bioethics committee. Conclusions 149 men corresponding to 30.7% of the sample present an increased possibility of Rcv, despite compliance with global PA recommendations. It is recommended that PA programs reinforce the improvement and promotion of PC to prevent possible Rcv. Key messages • The capacities that define physical fitness (FC) such as strength and endurance favor functional independence and disease prevention (Melo, 2014). • Apparently healthy men in Colombia present a higher possibility of Cardiovascular Risk due to low levels of physical fitness, despite compliance with global BP recommendations.

Action needed to address molecular HIV surveillance ethical concerns.

There have been growing ethical concerns about the widespread use of HIV-related molecular epidemiological public health surveillance and research-or what has come to be known as molecular HIV surveillance. The varied concerns of the practice originate due to lack of informed consent, lack of demonstrated benefit for communities, potential for eroded patient care relationships leading to poor health outcomes, and potential implications for information sharing and findings which could increase stigmatization and other negative impacts in contexts where HIV, drug use, sex work, migration, and poverty are criminalized. As people living with HIV, lawyers, clinicians, and social scientists, we are part of the growing movement calling for critical and ethical attention to the practice of molecular HIV surveillance and the public health logic which underwrites the practice. We urge Canadian public health actors and researchers working with molecular surveillance data to heed global guidance and recommendations for culturally informed ethical practices, to engage community members in HIV surveillance programs, and to ensure that people living with HIV are provided appropriate consent processes for uses of secondary data analysis. Furthermore, we urge researchers and Research Ethics Boards to interrogate assumptions of impracticality in seeking subsequent consent to use persons' health information held in data repositories and explore new methods of informed consent.

Evaluation of the feasibility, acceptability, and impact of Group Antenatal Care at the health post level on continuation in antenatal care and facility based delivery in Ethiopia using a cluster randomized stepped-wedge design: Study protocol

Background Adequate antenatal care (ANC) and facility-based delivery are linked to improved maternal and neonatal outcomes. Adequate antenatal care attendance and facility birth rates are increasing in Ethiopia but remain well below national goals and global recommendations. Group ANC (G-ANC), when implemented at higher level facilities, is associated with improved quality and experience of ANC, and increased ANC retention and facility-based delivery. The objectives of the study are to assess the feasibility, acceptability, and impact of G-ANC implemented at lower-level facilities (health posts) on ANC continuation and facility-based delivery. Methods G-ANC will first be piloted in five purposively selected health posts. The study will then use a stepped-wedge design in 36 health posts under six health centers, with randomization of the order of the start of the intervention done at the health center level (clusters). The design will include three time periods: first is a six-month control period with no G-ANC implementation, followed by another six months period where G-ANC will be introduced in half (n=18) of the study health posts, then final six months where G-ANC will be implemented in the remaining 18 health posts. Quantitative and qualitative data collection approaches will be used. The study has “pause and reflect” points designed to iterate on the intervention before rolling out to the next set of sites. Qualitative research will be conducted using in-depth interviews with pregnant women, health care workers, facility managers, and regional health managers. 770 women will be enrolled across all phases. Conclusions The study will inform decision makers locally and globally on whether G-ANC is a feasible service delivery model at the health post level. Effectiveness of G-ANC at increasing ANC retention and facility-based delivery will be reported, as well as its acceptability to pregnant women and Health Extension Workers. Registration NCT05054491, ClinicalTrials.gov (September 23rd 2021).

First insights into global permafrost-agroecosystems and recommendations for policymakers

First insights into global permafrost-agroecosystems and recommendations for policymakers Melissa Ward Jones discusses a recent paper published in Arctic, Antarctic, and Alpine Research of the first global study on permafrost-agroecosystems, published by members of the International Permafrost Association Permafrost-agroecosystem Action Group. When one thinks of high-latitude and mountainous regions, one usually thinks of cold and snow, not agriculture. But agriculture does occur in these areas. The climate of these regions limits the options for which crops to grow, and chosen animal species, such as yaks and reindeer, are adapted to cold. These regions also contain permafrost, or perennially frozen ground, a unique feature of these regions. The response to thawing permafrost, caused either by climate warming or land use change for cultivation, is varied (Ward Jones, 2024). These responses range from simple increases in ground temperatures to ground surface collapse when permafrost is ice-rich. The presence of permafrost and its response to thaw can add additional challenges to agricultural activities.

Cross-context equivalence and agreement of healthy diet metrics for national and global monitoring: a multicountry analysis of cross-sectional quantitative 24-hour dietary intake studies

BackgroundDespite national and global commitments to improve nutrition, there are no universally accepted indicators for at-scale monitoring of diets. Several metrics have been proposed and used, but they vary in their comprehensiveness and validity in capturing the properties of healthy diets and, potentially, their interpretability across contexts. ObjectiveThe objective of this study was to assess the cross-context equivalence and agreement of healthy diet metrics. DesignQuantitative 24-h dietary intake data from 57,456 nonpregnant females (15–49 y) in 21 countries were used to construct the food group diversity score (FGDS) and Minimum Dietary Diversity for Women indicator; the Global Diet Quality Score (GDQS) and its submetrics: GDQS+ and GDQS−; the Global Dietary Recommendations (GDR) score and its submetrics: noncommunicable disease (NCD)-Protect and NCD-Risk scores; and the All-5 indicator. Associations between (standardized) measures and indicators were quantified by fitting linear and logistic mixed-effect models across World Bank country income classifications, respectively. The levels of agreement between measures were assessed using Bland–Altman plots of z-scores, whereas rank correlations were assessed using Spearman’s ρ. ResultsThe consumption of healthy food groups was positively associated with concurrent intakes of unhealthy food groups, in particular in high-income countries. Hence, metrics constructed using both healthy and unhealthy food groups (i.e., GDR score and GDQS) showed relatively less discriminatory capacity across country income classifications than their respective submetrics or FGDS. Standardized metrics of healthy (e.g., FGDS and GDQS+) and unhealthy food group consumption (i.e., NCD-Risk and GDQS−) exhibited strong agreement and correlations. ConclusionComposite metrics weighting both healthy and unhealthy food groups have limited cross-context equivalence, because a wide range of diets can theoretically return similar scores. Healthy food group (sub)metrics performed comparably, likely indicating strong underlying construct validity (i.e., dietary diversity and nutrient adequacy). For national and global monitoring, refinement and validation of unhealthy food group metrics (i.e., moderation) is recommended to complement healthy food group metrics.

EMD-based ultraviolet radiation prediction for sport events recommendation with environmental constraint

With the rising awareness of health and wellness, accurate ultraviolet (UV) radiation forecasts have become crucial for planning and conducting outdoor activities safely, particularly in the context of global sporting events arrangement and recommendation with definite constraint on environmental conditions. The dynamic nature of UV exposure, influenced by factors such as solar zenith angles, cloud cover, and atmospheric conditions, makes accurate UV radiation data forecasting difficult and challenging. To cope with these challenges, we present an innovative approach for predicting the UV radiation levels of a certain region during a certain time period using Empirical Mode Decomposition (EMD), a robust method for analyzing non-linear and non-stationary data. Our model is specifically designed for urban areas, where outdoor events are common, and integrates meteorological data with historical UV radiation records from specific geographic regions and time periods. The EMD-based model offers precise predictions of UV levels, essential for event organizers and city planners to make informed decisions regarding the scheduling, relocation and recommendation of events to minimize health risks associated with UV exposure. At last, the effectiveness of this model is validated through various experiments across different spatial and temporal contexts based on the Urban-Air dataset (recording 2,891,393 Air Quality Index data that cover four major Chinese cities), demonstrating its adaptability and accuracy under diverse environmental conditions.

Pediatrics ACES and related life event screener (PEARLS): translation, transcultural adaptation, and validation to Brazilian Portuguese

ObjectiveAdverse Childhood Experiences (ACEs) have been associated with negative health outcomes. Screening for ACEs is crucial for improving health results, however, there is a shortage of standardized tools designed for children in Brazilian Portuguese. This study aimed to translate, culturally adapt, and validate the Pediatrics ACES and Related Life Event Screener (PEARLS) for use in Brazil. MethodThe study followed a methodological design for cross-cultural adaptation and psychometric evaluation. The PEARLS was translated and culturally adapted following a methodology that includes translation, synthesis, expert committee evaluation, target audience evaluation, and back-translation. After adaptation, a pilot cross-sectional study was conducted at a Multidisciplinary Health Care Clinical Center and a General Hospital-Reference Center for Child and Adolescent Care to assess the instrument's internal consistency, convergent validity, content validity and test-retest reliability. ResultsThe PEARLS-Br versions for Children, Teens, and Teen Self-Report were developed and subjected to pilot testing with 202 subjects. Participants demonstrated excellent comprehension, with Verbal Rating Scale median scores of 4 (IQR 4–5). Internal consistency was high, with Cronbach's alpha coefficients ranging from 0.78 to 0.81. Content validity, assessed by Kappa, indicated slight to almost perfect agreement across constructs. Test-retest reliability, assessed by Spearman's correlation coefficient, ranged from 0.89 to 0.94. ConclusionsPEARLS-BR (Child, teen, and teen self-report versions) were successfully translated, culturally adapted, and validated for assessing ACEs in Brazilian children and adolescents. This tool fills a crucial gap in ACE assessment in the Brazilian context, aligning with global recommendations for screening ACEs to improve overall health outcomes.

Borealpox Virus: a Comprehensive Review of its Emergence and Global Recommendations

The emergence of the Borealpox virus (BRPV), formerly known as the Alaskapox virus (AKPV), in 2015 poses an intriguing scientific challenge. Despite being first discovered in Alaska, BRPV is a potential global threat, and reports of instances have raised questions about how serious it can be; especially in those with impaired immune systems. The unique characteristics of BRPV have been clarified through genomic characterization, providing insight into its evolutionary lineage and transmission dynamics. A recent death linked to BRPV highlights the difficulties presented by newly developing infectious illnesses, particularly for individuals who are already at risk. The implications of BRPV for public health call for all-encompassing management approaches; such as creating efficient treatments and customized interventions for various clinical presentations. Research and surveillance initiatives are vital for comprehending ecological reservoirs and patterns of transmission. Additionally, biosafety regulations and immunization programs are critical for controlling outbreaks and reducing the worldwide effects of BRPV. Prioritizing vaccination drive approaches, implementing stringent infection control measures, and reinvigorating disease surveillance systems are imperative for preventing BRPV. In addition, enhancing the training of frontline healthcare professionals and implementing the One Health concept are crucial measures that foster robust cooperation and adaptability, while confronting new public health concerns. A comprehensive review of the emergence and consequences of the Borealpox virus is necessary to direct future investigations and global public health campaigns. By utilizing interdisciplinary approaches and promoting global collaboration, we may successfully alleviate the danger presented by BRPV and protect public health across borders.

Infectious diseases and global security: Analysis of global control and vaccination strategies

Introduction: Given the recent experience with the COVID-19 vaccine campaign, an optimal global policy to control future pandemics and ensure infectious security globally is highly relevant. Objective: The study aims to determine the optimal vaccination strategy to reduce COVID-19 morbidity and mortality during a pandemic.Methods: A systematic search of studies on infectious disease control and vaccination strategies for the period 2000-2023 in PubMed, Scopus, Web of Science and Google Scholar databases using keywords was conducted for the review. Relevant publications, data extraction and systematisation were selected.Results: The findings of the analysis highlight the importance of integrated interventions in global vaccination strategies, including health systems strengthening, innovative technologies for outbreak detection and international collaboration. Vaccination, as an effective preventive measure, significantly reduces the spread of infectious diseases. Vaccination with different types of vaccines has been shown to improve immune response compared to the use of the same type of vaccine. This approach, where the first and second vaccine doses are different, may increase the effectiveness of the immune response.Conclusions: Studies confirm that vaccination reduces the number of cases and deaths, reducing the economic burden. A variety of vaccines, including mRNA, vector, and inactivated vaccines, provide high efficacy in preventing COVID-19 infection and mortality, especially when a heterologous vaccination regimen is used. This review identifies the most effective infectious disease control strategies for the development of global health recommendations

Evaluation of freezing, ultra-cold freezing, and freeze-drying on the main components of human breast milk

Breastfeeding is the ideal food during the first two years, but only 31 % of children under six months of age receive exclusive breastfeeding, below the global recommendation. Alternative methods to direct breastfeeding have been used, including the creation of personal milk banks and the practice of deferred breastfeeding. This research aimed to evaluate the changes in human breast milk composition under freezing, ultra-cold freezing, and freeze-drying conditions in terms of: 1) carbohydrate profile as lactose and Human Milk Oligosaccharides; 2) protein quantity and characteristics (total crude protein, free amino nitrogen, in vitro digestibility, electrophoretic profile and secondary structure), and 3) functional and physicochemical components/ characteristics as pH, density and moisture, as well as pro- and anti-inflammatory cytokines and levels of secretory immunoglobulin A. With different preservation methods, no differences were detected in pH, density, moisture, total crude proteins, cytokines, four Oligosaccharides (3’-Sialyllactose, 6’-Sialyllactose, Lacto-N-Tetraose, and Lacto-N-neoTetraose), and secretory immunoglobulin A. The immunological components remain stable when frozen at –20 and −80°C and during freeze-drying, allowing women to prolong breastfeeding without changing the carbohydrate, protein, and functional or physicochemical main profile. Our results improve the understanding of human breast milk quality when alternative preservation methods are required beyond direct breastfeeding, aiming to extend the duration and rates of breastfeeding.

Healthy eating in globalized food environments: market access and consumer behavior in the Galápagos Islands of Ecuador

Abstract Food environments are the interface between food systems and consumers. Although market access contributes to diet intake, consumer behavior determines food acquisition practices yet is often neglected in food environment research. Implementing sustainable food system transformations in climate-vulnerable, trade-dependent settings requires effective integration of both geographic and experienced-based measures of access. This study in the Galápagos Islands (i) develops measures for geographic and experience-based food environments (EFEs) and (ii) links diet outcomes to these food environment measures independently and when interacted. Cross-sectional household data including diet recalls come from 388 participants in the Healthy Family Study from San Cristóbal Island, Galápagos in 2018. Geocoded market inventory and price data were obtained in 2018 using the Nutritional Environment Measurement Survey for Stores (n = 60). Geographic food environments were created from market scores and distribution. EFEs were based on factor analyzed consumer behavior strategies. Diet quality was defined using the global dietary recommendations score. Adjusted linear regressions tested the relationships between diet and food environment measures and included sociodemographic covariates. Interactions between geographic and EFEs were tested. This study showed that higher prioritization of convenience when food shopping was associated with lower healthy food intake. However, the relationship between food environment measures and diet is strongly modified by consumer behavior. For convenience-prioritizing households, the nearest market proved most associated with healthy diet outcomes. For households with a food-driven purchasing strategy, the preferred market was most associated with healthy diet outcomes. These findings show that market inventory can be healthful or deleterious to diets, depending on how individuals navigate their food environments. Empirical measures of food access that neglect to consider consumer behavior may fail to capture realistic representations of food environment and diet relationships. These findings underscore the importance of tailoring food system changes to incorporate context-specific consumer behavior.

Factors Influencing Physical Activity and Sports Practice among Young People by Gender: Challenges and Barriers

Young people aged 11 to 17 often fail to meet global recommendations for weekly physical activity and sports (PAS), despite its numerous benefits. In Spain, challenges such as excessive technology use and disinterest in PAS are prominent among youths. This study aimed to analyse the interest in PAS during leisure time and identify the factors influencing young people in a Spanish municipality towards this practice, as well as establish differences according to age and gender. Involving 891 adolescents (429 girls, 432 boys, and 30 other genders), this study found a significant association between gender and PAS participation. Boys are mainly motivated by fun and fitness, girls by health and fun, and other genders by perceived sports competence and health, with these motivations increasing with age. Deterring factors include fatigue, laziness, and lack of enthusiasm across all groups. Lack of free time is the most cited reason for quitting PAS, particularly for girls and other genders. For boys, disinterest, especially between ages 13 and 15, is a primary reason. These findings suggest that promoting PAS with a focus on health and leisure, and tailoring programmes to gender and age-specific needs, are essential to maintain motivation and ensure a healthier, more active population.

Global recommendations on adhesion prophylaxis in gynaecological laparoscopic surgery.

Adhesions are recognised as one of the most common complications of abdominal surgery; their diagnosis and prevention remains a significant unmet need in surgical therapy, affecting negatively a patient's quality of life and healthcare budgets. In addition, postoperative pelvic adhesions pose a high risk of reduced fertility in women of childbearing age. These 2023 Global Recommendations on Adhesion Prevention in Gynaecological Laparoscopic Surgery provide agreed-upon statements to guide clinical practice, with the ultimate goal of improving patient outcomes.

Forecasts for the Development of the Cruise Industry: Trends, Challenges and Opportunities

The article is devoted to the analysis of current trends affecting the global cruise tourism market. The paper examines the key growth factors of the industry, including technological innovations, changes in consumer preferences and the impact of environmental regulations. Special attention is paid to the analysis of the challenges faced by cruise line operators, such as global economic fluctuations, pandemic threats and increased competition. Potential opportunities for sustainable growth are also being discussed, including the development of new routes, infrastructure improvements and the introduction of environmentally friendly technologies. In conclusion, conclusions are drawn about the prospects of the cruise industry in a rapidly changing global landscape and recommendations are offered for stakeholders to adapt to future changes and optimize development strategies.