Implementation Of Strategies Research Articles

Alzheimer's disease and related dementia diagnoses among American Indian and Alaska Native adults aged ≥45 years, Indian Health Service System, 2016-2020.

Alzheimer's disease is the most common type of dementia and is responsible for up to 80% of dementia diagnoses and is the sixth leading cause of death in the United States. An estimated 38,000 American Indian/Alaska Native (AI/AN) people aged ≥65 years were living with Alzheimer's disease and related dementias (ADRD) in 2020, a number expected to double by 2030 and quadruple by 2050. Administrative healthcare data from the Indian Health Service (IHS) were used to estimate ADRD among AI/AN populations. Administrative IHS healthcare data from federal fiscal years 2016 to 2020 from the IHS National Data Warehouse were used to calculate the count and rate per 100,000 AI/AN adults aged ≥45 years with at least one ADRD diagnosis code on their medical record. This study identified 12,877 AI/AN adults aged ≥45 years with an ADRD diagnosis code, with an overall rate of 514 per 100,000. Of those, 1856 people were aged 45-64. Females were 1.2 times (95% confidence interval: 1.1-1.2) more likely than males to have a medical visit with an ADRD diagnosis code. Many AI/AN people with ADRD rely on IHS, tribal, and urban Indian health programs. The high burden of ADRD in AI/AN populations aged 45-64 utilizing IHS health services highlights the need for implementation of ADRD risk reduction strategies and assessment and diagnosis of ADRD in younger AI/AN populations. This study provides a baseline to assess future progress for efforts addressing ADRD in AI/AN communities.

New development: A resilient framework for optimizing the Republic of Kosovo's sustainable development

IMPACT This article offers critical insights for policy-makers, development strategists, environmental advocates, and academics engaged in the rigorous pursuit of sustainable development within the context of political uncertainties and evolving global challenges. It amplifies the discourse on integrating and reporting the United Nations Sustainable Development Goals (SDGs) into national development strategies, using Kosovo's endeavours as a pivotal case study. By emphasizing the role of resilience theory in enhancing adaptive governance and multi-sectoral collaboration for SDG achievement, this article substantiates the imperative for innovative, inclusive, and resilient approaches to SDG integration and reporting in national development planning. The findings and recommendations advocate for the strategic alignment of national development initiatives with global sustainability objectives, underscoring the importance of establishing environmental sustainability as a core pillar and the necessity for comprehensive stakeholder engagement in the policy-making process. As such, this work contributes to the broadening evidence base supporting the integration of resilience and sustainability principles into the governance and implementation of development strategies.

Non-pharmaceutical interventions for COVID-19 transiently reduced pneumococcal and Haemophilus influenzae carriage in a cross-sectional pediatric cohort in Southampton, UK.

The Southampton pneumococcal carriage study of children under 5 years old continued during the coronavirus disease 2019 (COVID-19) pandemic. Here, we present data from October 2018 to March 2023 describing prevalence of pneumococci and other pathobionts during the winter seasons before, during, and after the introduction of non-pharmaceutical interventions (NPIs) to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Nasopharyngeal swabs were collected from children attending outpatient clinics at a secondary care hospital and community healthcare sites. Pre-NPIs, in 2019/2020, the carriage prevalence of pneumococci at the hospital site was 32% (n = 161 positive/499 participants). During NPIs, this fell to 19% (n = 12/64), although based on fewer participants compared to previous years due to COVID-19 restrictions on health-care attendance. In 2021/2022, after NPIs had eased, prevalence rebounded to 33% (n = 15/46) [compared to NPIs period, χ2 (1, N = 110) =2.78, P = 0.09]. Carriage prevalence at community healthcare sites fell significantly from 27% (n = 127/470) in 2019/2020 to 19% during the NPI period (n = 44/228) in 2020/2021 [χ2 (1, N = 698) =4.95, P = 0.026]. No rebound was observed in 2021/2022 [19% (n = 56/288)]. However, in a multivariate logistic regression model, neither site had a significantly lower carriage prevalence during the NPI period compared to the post NPI period. A reduction in serotype diversity was observed in 2020/2021. Carriage of Haemophilus influenzae was particularly affected by NPIs with a significant reduction observed. In conclusion, among children under 5 years of age, transient, modest, and statistically non-significant alterations in carriage of both Streptococcus pneumoniae and H. influenzae were associated with SARS-CoV-2 NPIs.IMPORTANCEStreptococcus pneumoniae (the pneumococcus) continues to be a major contributor to global morbidity and mortality. Using our long-running pediatric study, we examined changes in pneumococcal carriage prevalence in nearly 3,000 children under the age of 5 years between the winters of 2018/2019 and 2022/2023. This period coincided with the severe acute respiratory syndrome coronavirus 2 pandemic and, in particular, the implementation of national strategies to limit disease transmission in the UK. We observed a transient reduction of both Streptococcus pneumoniae and Haemophilus influenzae in these populations during this period of non-pharmaceutical interventions. This aligned with the reduction in invasive pneumococcal disease seen in the UK and is therefore a likely contributor to this phenomenon.

Managing Risk Mitigation in Urban Expansion Areas of Argentina’s Drylands: The Gap between Perception and Environmental Behaviour

Accessibility to rigorous scientific information to promote risk mitigation measures by citizens is crucial, especially in the context of climate change and extreme weather events. This study focuses on the perception of flood risk and the implementation of mitigation strategies by residents in drylands urban sprawl areas. Risk perception, defined as the subjective assessment of the likelihood and potential consequences of flooding, is a key element of mitigation. While many studies have explored the link between risk perception and behaviour, this research addresses gaps in understanding how public information affects these perceptions and actions. In areas of rapid urban expansion, where regulation often overlooks environmental features, the lack of adequate information poses significant barriers to effective risk mitigation. This research reveals that although residents claim to understand flooding, their descriptions often indicate a lack of understanding of the phenomenon. This ‘passive optimism’ could be mitigated by providing rigorous information and specific technical recommendations. This study highlights the disconnect between residents’ awareness of flood risks and the inadequacy of preventive measures, underlining the importance of targeted information and collaboration between the scientific community, government sectors, and local populations.

Optimizing tracking and completion of follow-up colonoscopy after abnormal stool tests at health systems participating in the Centers for Disease Control and Prevention's Colorectal Cancer Control Program.

We present findings from an assessment of award recipients' partners from the Centers for Disease Control and Prevention's Colorectal Cancer Control Program (CRCCP). We describe partners' processes of identifying and tracking patients undergoing stool-based screening. We analyzed data from eight CRCCP award recipients purposively sampled and their partner health systems from 2019 to 2023. The data included number of stool-based tests distributed and returned; abnormal findings; referrals and completion of follow-up colonoscopies; and colonoscopy findings. We also report on strategies to improve tracking of stool-based tests and facilitation of follow-up colonoscopies. Five of eight CRCCP award recipients reported that all or some partner health systems were able to report stool test return rates. Six had health systems that were able to report abnormal stool test findings. Two reported that health systems could track time to follow-up colonoscopy completion from date of referral, while four could report colonoscopy completion but not the timeframe. Follow-up colonoscopy completion varied substantially from 24.2 to 75.5% (average of 47.9%). Strategies to improve identifying and tracking screening focused mainly on the use of electronic medical records; strategies to facilitate follow-up colonoscopy were multi-level. Health systems vary in their ability to track steps in the stool-based screening process and few health systems can track time to completion of follow-up colonoscopy. Longer time intervals can result in more advanced disease. CRCCP-associated health systems participating in this study could support the implementation of multicomponent strategies at the individual, provider, and health system levels to improve tracking and completion of follow-up colonoscopy.

Omitting the Escalating Dosage of Alpha-adrenergic Blockade before Pheochromocytoma Resection: Implementation of a Treatment Strategy in Discordance with Current Guidelines.

This study describes the effects of introducing a protocol omitting preoperative α-blockade dose-escalation (de-escalation) in a prospective patient group. The decline of mortality and morbidity associated with pheochromocytoma resection is frequently attributed to the introduction of preoperative α-blockade. Current protocols require preoperative α-blockade dose-escalation and multiple-day hospital admissions. However, correlating evidence is lacking. Moreover, recent data suggest equal perioperative safety regardless of preoperative α-blockade escalation. Single-institution evaluation of protocol implementation, including patients who underwent adrenalectomy for pheochromocytoma between 2015 and 2023. Intraoperative hemodynamic control was regulated by active adjustment of blood pressure using vasoactive agents. The primary outcome was intraoperative hypertension, defined as time-weighted average of systolic blood pressure (TWA-SBP) above 200mm Hg. Secondary outcomes included perioperative hypotension, postoperative blood pressure support requirement, hospital stay duration and complications. Of 102 pheochromocytoma patients, 82 were included; 44 in the de-escalated preoperative α-adrenergic protocol and 38 following the previous dose-escalation protocol. Median [IQR] TWA-SBP above 200mm Hg was 0.01 [0.0-0.4] mm Hg in the de-escalated group versus 0.0 [0.0-0.1] mm Hg in the dose-escalated group (P=0.073). Median duration of postoperative continuous norepinephrine administration was 0.3 hrs [0.0-5.5] versus 5.1 hrs [0.0-14.3], respectively (P=0.003). Postoperative symptomatic hypotension occurred in 34.2% versus 9.1% of patients (P=0.005). Median hospital stay was 2.5 days [1.9-3.6] versus 7.1 days [6.0-11.9] (P<0.001). No significant differences in complication rates were observed. Our data suggest that adrenalectomy for pheochromocytoma employing a de-escalated preoperative α-blockade protocol is safe and results in a shorter hospital stay.

A contact-based constitutive model for the numerical analysis of masonry structures using the distinct element method

This study presents a robust contact constitutive model in the distinct element method (DEM) framework for simulating the mechanical behavior of masonry structures. The model is developed within the block-based modeling strategy, where the masonry unit is modeled as deformable blocks with potential crack surfaces in the middle of the bricks, while the mortar joints are defined as zero-thickness interfaces. The modeling strategy implements multi-surface plasticity with damage mechanics, including a tension cut-off, Coulomb failure criterion, and an elliptical compressive cap for the damage in tension, shear, and compression, respectively. Two new features are introduced in this contact model: a piecewise linear softening function for strength degradation in tension and shear and a hardening/softening function to phenomenologically define the compressive damage of masonry composite into the unit-mortar interface. The constitutive model is implemented in commercial DEM software using the small displacement configuration and validated against material and experimental tests on masonry walls subjected to constant pre-compression and monotonically increasing in-plane load. The experimental and numerical results regarding the force-displacement relationship and damage pattern produced by the proposed constitutive model are compared and critically discussed, demonstrating the capability of DEM coupled with the suitable constitutive law in simulating the behavior of masonry structures.

A Review on Mastitis in Dairy Cows Research: Current Status and Future Perspectives

One of the most serious diseases affecting dairy cattle, causing significant losses both in breeding and economy, is mastitis, an inflammation of the mammary gland. Due to the economic importance of this issue, many research teams are striving to develop an easy-to-apply and, most importantly, effective method to prevent mastitis. The use of traditional methods for mastitis detecting and treating, as well as improvement in hygienic conditions, have not yielded the expected results in combating this disease combating. Currently, the main task is to find the tools that would allow for the rapid detection of mastitis and the improvement of udder health in cows while maintaining high milk production, which is essential for the profitability of dairy cattle farming. Accurate and rapid diagnostic tools, with the simultaneous capability of identifying pathogens, may help to reduce losses. Sufficient sensitivity and specificity for tests are required to minimize the number of false-positive and false-negative cases. Efforts are also being made to determine the optimal threshold value for detecting the disease at its earliest possible stage. The estimation of somatic cell count (SCC) as a phenotypic indicator of mastitis is widely used. A more precise parameter for accurately describing udder health is the differential somatic cell count (DSCC). The well-known California Mastitis Test (CMT) is an inexpensive, easy, and rapid method for mastitis detection useful on farms. The latest diagnostic methods for mastitis utilize tests based on the activity of N-acetyl-β-d-glucosaminidase (NAGase) or lactate dehydrogenase (LDH) as well as the determination of acute phase proteins (APPs) in blood serum and milk (such as haptoglobin, serum amyloid A, fibrinogen, and ceruloplasmin). Research also focuses on the genomic improvement of mastitis resistance in successive generations, and for this purpose, many quantitative trait loci (QTLs) and single nucleotide polymorphisms (SNPs) have been identified. In recent years, immunotherapy has become an increasingly common area of research, including vaccinations, T/B cell immunotherapy, RNA immunotherapy, epigenetic immunotherapy, stem cell therapy, and native secretory factors. An important aspect of the control of mastitis is the implementation of strategies that focus primarily on preventing the disease through appropriate breeding and farm management practices. In the forthcoming years, a significant challenge will be the development of universal diagnostic and therapeutic strategies that can be effectively implemented as alternatives to antibiotic therapy. Future research should prioritize the advancement of preventive and therapeutic techniques, such as immunotherapies, bacteriocins, herbal therapy, and nanoparticle technology.

Neural-Targeted Rehabilitation Strategies to Restore Typical Activation after Joint Injury.

In patients with musculoskeletal injury, changes have been observed within the central nervous system that contribute to altered movement planning. This maladaptive neuroplasticity potentially explains the clinical disconnect where residual neuromuscular dysfunction and high rates of reinjury that are often observed even after individuals clear return-to-activity functional testing. An improved understanding of these neural changes could therefore serve as a guide for facilitating a more complete recovery and minimizing risk of re-injury. Therefore, we propose a paradigm of neural-targeted rehabilitation to augment commonly used therapeutic techniques targeting sensorimotor function in order to better address maladaptive plasticity. While most treatments have the capability to modify neural function, optimizing these treatments and combining them with integrative therapies (e.g. implementation of motor learning strategies, transcranial direct current stimulation) may enhance neural efficiency and facilitate return-to activity in patients with musculoskeletal injury. To complete this model, consideration of affective aspects of movement and associated interventions must also be considered to improve the durability of these changes.

Reduce PAPR in Filtered-CPOFDM using Hybrid Method System

5G multicarrier waveform Filtered Cyclic Prefix Orthogonal Frequency Division Multiplexing (F-CPOFDM) allows for high data speeds and increases in spectrum efficiency. The main drawback of F-CPOFDM is its high peak-to-average power ratio (PAPR), a common element of all multicarrier modulation schemes. In this research is investigate the implementation of a Hybrid strategy to reduce the peak to average power ratio (PAPR) in a F-CPOFDM system and evaluated the impact of employing a Hybrid Technique with Group Codeword Shift (GCS), Median Codeword Shift, Selective Codeword Shift (SCS), and Conventional F-CPOFDM on the reduction of peak to average power ratio (PAPR) in CP-OFDM. The novelty of this research is GCS method integration with WHT Precoding technique for reduce PAPR. Simulation results show that compared to traditional Filtered-CPOFDM, the GCS-WHT method reduces peak PAPR by 59.46 %, while the SCS- method reduces it by 32.43 % and the MCS-WHT method reduces it by 31.53%. Compare to the non-hybrid technique, the GCS only reduce 45.95%, while for SCS and MCS reduce 19.82% and 23.42% respectively. From the results, shows that Hybrid method is better performance compare with non-hybrid method.

Toward precision medical education: Characterizing individual residents' clinical experiences throughout training.

Despite the central role of experiential learning in residency training, the actual clinical experiences residents participate in are not well characterized. A better understanding of the type, volume, and variation in residents' clinical experiences is essential to support precision medical education strategies. We sought to characterize the entirety of the clinical experiences had by individual internal medicine residents throughout their time in training. We evaluated the clinical experiences of medicine residents (n = 51) who completed training at NYU Grossman School of Medicine's Brooklyn campus between 2020 and 2023. Residents' inpatient and outpatient experiences were identified using notes written, orders placed, and care team sign-ins; principal ICD-10 codes for each encounter were converted into medical content categories using a previously described crosswalk tool. Of 152,426 clinical encounters with available ICD-10 codes, 132,284 were mapped to medical content categories (94.5% capture). Residents' clinical experiences were particularly enriched in infectious and cardiovascular disease; most had very little exposure to allergy, dermatology, oncology, or rheumatology. Some trainees saw twice as many cases in a given content area as did others. There was little concordance between actual frequency of clinical experience and expected content frequency on the ABIM certification exam. Individual residents' clinical experiences in training vary widely, both in number and in type. Characterizing these experiences paves the way for exploration of the relationships between clinical exposure and educational outcomes, and for the implementation of precision education strategies that could fill residents' experiential gaps and complement strengths with targeted educational interventions.

Solution for crop classification in regions with limited labeled samples: deep learning and transfer learning

ABSTRACT Reliable classification results are crucial for guiding agricultural production, forecasting crop yield, and ensuring food security. Generating reliable classification results is relatively simple in regions with sufficient labeled samples, but regions with limited labeled samples remain a significant challenge. In this study, we propose two new solutions that leverage the feature representation capabilities of deep learning and the sample reuse potential of transfer learning to solve the limited label problem. Specifically, we develop a Variable-dimensional Symmetric Network with Position Encoding (VPSNet) to improve the efficiency of labeled sample utilization. Additionally, we introduce a transfer strategy based on the Inter-Regional Discrepancies in Crop Time Series (IRDCTS) to expand the labeled sample reuse region. We evaluated the proposed model in three regions with limited labels between 2017 and 2018. Experimental results show that our model has superior discriminative feature extraction capabilities compared to other existing models. The feasibility of the proposed transfer strategy is tested in three pair regions, showing that IRDCTS can enhance the model adaptability by reducing inter-domain discrepancies. This study provides a comprehensive solution to the classification problem of the limited labeled samples, involving both the development of classification models and the implementation of transfer strategies.

Методология управления проектами в условиях цифровой трансформации предприятия

The article examines the Agile methodology, presents its advantages and disadvantages. A new way of interaction between project work participants at the enterprise is proposed. This approach to organizing project work takes into account new challenges of digital transformation and digital solutions aimed at implementing tasks in order to optimize the use of enterprise resources. The considered methodology of project management in the context of digital transformation of the enterprise includes the overall organization of work, effective interaction of participants, the formation of cross-functional working groups in the development of digital transformation projects, the implementation of the digital transformation strategy, and the development of digital culture. The proposed approach made it possible to form a theoretical and methodological basis for understanding the need to create and use cross-functional working groups in the implementation of digital transformation projects.

Empowering Societal Digital Transformation at the Local Level

Digital transformation has revolutionised the way businesses operate through the utilisation of technology. Digital tools enable citizens to access government services quickly and at their own convenience, whilst also facilitating more efficient and effective administrative processes. While many national governments have embraced digital tools, the same cannot be said for local governments, particularly in developing nations as they have not yet taken advantage of the benefits of digitalisation. Whereas some experiences of digital transformation have a top-down approach, this paper shares the experience of a collaborative and participatory process of design and development of a Digital Strategy for Pemba Town Council, in rural Zambia. The aim was to enhance service delivery to its citizens by harnessing the potential of digital tools for a five-year period (2022-2026). Pemba Council faced challenges due to a lack of basic Information and Communication Technology (ICT) infrastructure and ICT-enabled systems. Guided by Andrew’s (1971) model of strategy formulation and implementation, and employing an action research methodology, the study engaged the local community and the council through focused group discussions and key informant interviews to understand their challenges, explore solutions to improve service delivery, and finally to develop a digital strategy for the council, the first of its kind. The study noted that while digitalisation for the council could be hampered by challenges such as the digital divide, digital literacy, infrastructure challenges, lack of human resources, among others, both the council and community stakeholders displayed enthusiasm for the process. The study underscores the crucial role citizens play in shaping local decisions, and therefore the need for their engagement in such processes that affect how they engage with local authorities. The paper also presents a guide on how to engage citizens and government officials to develop a participatory digital strategy that is adapted to local needs, infrastructure and context. The study not only contributes to scholarship on digitalisation and its potential to improve service delivery, but is also useful for local governments operating in similar contexts as Pemba Town Council and seeking digitalisation.

Revitalizing Rural Landscapes: Applying Cultural Landscape Gene Theory for Sustainable Spatial Planning in Linpu Village

In the context of rapid urbanization, it is imperative to address the preservation and sustainable development of rural landscapes. This study introduces a novel framework using cultural landscape gene theory to enhance the landscape spatial pattern of Linpu Village, China. Employing a multi-method approach, including data collection and historical data analysis, GIS analysis, and field surveys, we analyze the village’s landscape features and identify a well-preserved “one core, two wings” spatial configuration with diminishing accessibility from the center to the periphery. The study uncovers significant challenges to landscape coherence and legibility, including landscape element discontinuity, inadequate maintenance, and fragmented information. To address these issues, we propose optimization strategies aimed at revitalizing weakened cultural landscape genes, repairing disrupted elements, ensuring corridor integrity, and improving spatial organization. The extraction–construction–analysis–preservation model established in this research not only delivers a comprehensive analysis of Linpu’s cultural landscape but also offers a scalable framework for preserving the ecological and cultural integrity of traditional villages. This study contributes to the practical implementation of sustainable landscape strategies, enhancing the ecological adaptability and resilience of rural environments in the face of urban encroachment.

Drug administration errors among anaesthesia providers in South Africa: a cross-sectional descriptive study

BackgroundDrug administration errors (DAEs) in anaesthesia are common, the aetiology multifactorial and though mostly inconsequential, some lead to substantial harm. The extend of DAEs remain poorly quantified and effective implementation of prevention strategies sparse.MethodA cross-sectional descriptive study was conducted using a peer-reviewed survey questionnaire, circulated to 2217 anaesthetists via a national communication platform. The aim was to determine the self-reported frequency, nature, contributing factors and reporting patterns of DAEs among anaesthesia providers in South Africa.ResultsOur cohort had a response rate was 18.9%, with 420 individuals populating the questionnaire. 92.5% of surveyed participants have made a DAE and 89.2% a near-miss. Incorrect route of administration, potentially resulting in serious harm, accounted for 8.2% (n = 23/N = 279) of these errors. DAEs mostly reported in cases involving adult patients (80.5%, n = 243/N = 302), receiving a general anaesthetic (71.8%, n = 216/N = 301), where the drug-administrator prepared the drugs themselves (78.7%, n = 218/N = 277), during normal daytime hours (69.9%, n = 202/N = 289) with good lightning conditions (93.0%, n = 265/N = 285). 26% (n = 80/N = 305) of DAEs involved ampoule misidentification, whilst syringe identification error reported in 51.6% (n = 150/N = 291) of cases. DAEs are often not reported (40.3%, n = 114/N = 283), with knowledge of correct reporting procedures lacking. 70.5% (n = 198/N = 281) of DAEs were never discussed with the patient.ConclusionsDAEs in anaesthesia remain prevalent. Known error traps continue to drive these incidents. Implementation of system based preventative strategies are paramount to guard against human error. Efforts should be made to encourage scrupulous reporting and training of anaesthesia providers, with the aim of rendering them proficient and resilient to handle these events.

Volt/Var Strategy Implementation in the Three-Phase Current Injection Power Flow Employed for Microgrid Studies in a Global Power Flow Environment

Volt/Var Strategy Implementation in the Three-Phase Current Injection Power Flow Employed for Microgrid Studies in a Global Power Flow Environment

Role of Bacillus coagulans (Heyndrickxia coagulans)BCP92 in managing irritable bowel syndrome: A randomized, double-blind, multicenter, placebo-controlled clinical trial.

Irritable bowel syndrome (IBS) is a major global healthcare burden that requires effective and well-tolerated intervention. This study aimed to investigate the effectiveness and safety of Bacillus coagulans BCP92, a probiotic, in managing IBS symptoms. This randomized controlled trial included 100 participants who strictly adhered to the protocol. Various parameters such as IBS severity, digestive symptom frequency, gastrointestinal symptom frequency, stool consistency, interleukin-6 levels, stress relief, and anxiety levels were evaluated over 12 weeks. B. coagulans BCP92 significantly improved IBS severity (P < .001), and gastrointestinal symptom frequency (P < .001) compared with that in the control group. The stool consistency significantly improved (P < .001). Mental stress relief was remarkable (P = .001), differentiating the test and control groups. No significant change in interleukin-6 levels was observed; however, the safety assessment revealed an excellent profile with no reported severe adverse events. B. coagulans BCP92 is one of the most promising therapeutic options for the management of IBS because it has shown significant efficacy in alleviating symptoms among patients suffering from this condition, resulting in improved stool consistency changes in addition to improving overall mental well-being for its users, thereby foreseeing the elimination of any potential side effects experienced during the implementation of this approach strategy within our health care system, thereby improving patient outcomes and leading to individualization of treatment plans among all individuals diagnosed with this disease entity who may have symptoms, including abdominal pain or discomfort associated with changes in bowel habits.

A study of the driving factors of the intention and behavioral deviations of rural residents in waste classification

Introduction: The deviation between the stated intentions and actual actions of rural residents regarding waste classification constitutes a significant impediment to the effective implementation of environmental management strategies in rural areas. It is therefore recommended that steps be taken to reduce the deviation between the stated intentions and actual behaviors of rural residents. Doing so will help to reinforce environmental governance in rural communities and provide the necessary support for rural revitalization.Methods: This study establishes an analytical framework for examining the deviation between the internal perceived efficacy and external environmental policies among rural residents. The relationship between intention and behavior can be classified into three distinct scenarios: “intention with behavior,” “intention without behavior,” and “no intention with behavior.” Furthermore, an empirical analysis is conducted using survey data collected by Nanjing Agricultural University in the China Land Economic Survey in June and July 2021.Result: The results show that 1) the perceived efficacy has a significant positive influence on the deviation between the intention and behavior of rural residents in domestic waste classification, while the environmental policy has a significant negative effect on it; 2) the guiding policy has a significant negative moderating effect on the influence of perceived efficacy on the deviation between the intention and behavior of rural residents and the situation of “with intention and without behavior,” while the reward–punishment policy has a significant positive moderating effect on the influence of perceived efficacy on “without intention and behavior;” 3) the perceived efficacy has a masking effect on the impact of environmental policies on the deviation between the intention and behavior or “with intention and without behavior” of rural residents and a partial mediating effect on the impact of the environmental policy on “with intention and behavior” or “without intention and behavior.”Discussion: In consideration of these findings, the study proposes policy recommendations that emphasize the interconnectivity of the government, village collective organizations, and rural residents. The recommendations include the implementation of environmental policies and initiatives designed to enhance rural residents’ awareness of waste classification.

Climate change adaptation attributes across scales and inter-institutional networks: insights from national and state level water management institutions in India

Effective climate change adaptation requires cohesive inter-institutional networks across different scales, facilitating the sharing of data, information, knowledge, and practices. However, the impact of adaptation attributes across scales is poorly understood due to limited focus on these networks. Based on interviews with 26 institutions operating at the national level (ION) in India and 26 institutions operating within a state (Himachal Pradesh) (IOS), this study analysed adaptation attributes and the inter-institutional networks across the two scales to understand its implications at different scales. IONs have a greater capacity (compared to IOS) to frame guidelines, standards and regulations for practitioners along with better accessibility to resources and information. When coupled with bridging institutions, this can enhance adaptive capacities at other scales. Conversely, learnings from low regret adaptive measures being implemented by IOS are opportunities for informing national policy strategies. While national adaptation strategies and goals can inspire adaptation at lower scales, the currently fragmented inter-institutional network in India reduces the passage and accessibility of data and information, creating a bottleneck for the smooth devolution of adaptation attributes. Recruitment and deployment practices for water officials further entrench silo attitudes, impeding essential data accessibility. Adaptation needs comprehensive networks across vertical, horizontal, and diagonal institutional connections to improve climate risk perception and strategy implementation. Policy measures should consider socio-institutional factors beyond legislative prescriptions.