Income Nations Research Articles

Healthcare workers' knowledge, attitudes, and practices towards cardiovascular disease prevention: a multi-national cross-sectional study

Abstract Introduction Prior studies have shown that improved primordial prevention of cardiovascular disease (CVD) may significantly delay its onset. Healthcare workers (HCWs) are well-placed to influence healthy lifestyle habits for CVD prevention. However, it is unclear how well HCWs fare in this role given the multiple demands on their time in clinical practice. Purpose We sought to understand the CVD prevention knowledge, attitudes and practices (KAPs) of HCWs across 25 nations. Insights gained could help inform efforts to optimise CVD prevention by HCWs. Methodology: Data was collected via an anonymous, online questionnaire which consisted of pre-validated CVD prevention and smoking cessation subscales adapted from the Preventive Medicine Attitudes and Activities Questionnaire (PMAAQ). The subscales have been previously validated in a study population of primary care residents in the US, demonstrating validity and reliability. Results 668 HCWs (60% doctors, 28% nurses, 12% medical students) from 25 nations responded to the survey. Overall, 74.86% of HCWs routinely assessed patients’ cardiovascular (CV) risk profiles in clinical practice. 65.65% of HCWs counselled patients who were asymptomatic for CVD on tangible lifestyle changes to improve their CV risk profiles, while 68.22% of HCWs did so when patients were overweight. Of note, only 51.26% of HCWs implemented comprehensive smoking cessation interventions for their patients. Practising HCWs demonstrated higher levels of CVD prevention promotion than medical students in all aspects (Fig 1b), except for self-reported importance of CVD risk factor counselling in primary prevention (Tukey HSD diff: 0.31, p-value: 0.051). Among practising HCWs, there were no significant differences in their promotion of CVD prevention across varying lengths of clinical practice. HCWs from higher income nations[1] tended to fare worse than their lower income counterparts in the promotion of CVD prevention (Fig 1a). Conclusion A large multi-national survey reveals significant gaps in the promotion of CVD prevention by HCWs, highlighting key differences in CVD prevention practices based on national income status. The results also demonstrate significant differences between medical students and practising HCWs’ CVD prevention behaviours, highlighting the role of continuing education for the promotion of long-term positive CVD prevention clinical practices amongst HCWs. Further efforts may target the medical education of early-career HCWs, especially in higher income nations. [1] National income level is defined as per the World Bank's classification, with the exception of Taiwan which is not classified as an independent nation under the World Bank. However, Taiwan is still labelled as a high income nation as her GNI (US$33,565) fits the criterion of the World Bank's definition of a high income nation (GNI per capita of >US$13,846).Table 1:Participant demographicsFigure 1a and 1b

A Study to Assess the Effectiveness of Educational Package in Terms of Knowledge Regarding Essential New Born Care among Mother in the Postnatal Wards of Selected Hospital, Nadiad

BACKGROUND: The neonatal period, covering the first 28 days of life is a vital stage marked by significant physiological changes and the new borns adjustment to the crucial for the baby’s survival and long term health. Proper new born care is essential in decreasing neonatal illness and death promoting healthy growth and development. Worldwide neonatal mortality is a major public issue, especially in low and middle income nations. The World Health Organization (WHO) reports that nearly 2.4 million children die within their first month of life annually, with most of these deaths happening within the first week. Infection are a leading cause of neonatal mortality, responsible for about one-third all neonatal deaths. New born are practically vulnerable to infection due to their underdeveloped immune system. Education on essential new-born care, covering aspects like infection prevention, breastfeeding thermal care, and immunization, plays a critical role in decreasing these fatalities. Postnatal wards offer a special chances to educate mothers about essential new-born care. During this period mothers are typically more open to learning and incorporating new practice that can benefit their infants. Tailored educational programs designed for postnatal mothers of essential new-born care practice and encourage their adoption. AIM This study assess the effectiveness of an educational package design to enhance mothers' knowledge regarding essential new born care in selected hospital in Nadiad. OBJECTIVE: To evaluate the impact of an educational package on mothers' knowledge about essential new born care in post natal wards. METHODS A quasi experimental study design was employed. The study include 40 mothers in post natal wards from selected hospital in Nadiad. Participants were divided into two groups: An experimental group receiving the educational package and a control group receiving standard care. Pre-test and post- test knowledge assessments were conducted using a structured questionnaire. INTERVENTION: The educational package comprised informative flip book interactive session focus on essential new born care such as breast feeding, hygiene, immunization and recognizing dangerous sign.RESULTS: The pre-test knowledge scores of both groups were comparable. Post intervention, the group showed a significant increase on knowledge scores compared to the pre- test. Statistical analysis using paired T test revealed that the educational package effectively improved mother’s knowledge of essential new born care (p< 0.05). The educational package significantly enhanced mother’s knowledge regarding essential new born care in post natal wards. Implementing such educational interventions can improve new born health outcomes by empowering mothers which crucial care. Further studies are recommended to assess long term retention of knowledge and its impact on new born health.

Assessment of Knowledge, Attitude, and Practice Toward Physical Activity and It’s Associated Factor Among Women Attending Antenatal Care at Public Health Institutions in Debre Berhan Town, North Eastern Ethiopia

Physical inactivity is linked to pregnancy-related complications. Exercise participation during pregnancy is restricted in low-middle income nations, including Ethiopia. Therefore, this study aimed to assess factors associated with physical activity practice among pregnant women attending antenatal care at public health institutions in Debre Berhan Town Northeastern Ethiopia. Institutional based cross-sectional study was conducted from March 22, 2021 to May 22, 2021 in Debre Berhan Town. The systematic random sampling technique was used to obtain the 418 participants. Data were collected by using standardized questionnaires. Data were entered, cleaned by Epi data version 3.1 and analyzed by SPSS version 25. The variables which had p-value < .05 and with 95% confidence interval were declared as determine factors of antenatal physical exercise. According to this study, 222 (53.1%, CI [48.3, 57.7]), 220 (52.6% [47.8, 57.2]), and 218 (52.2% [CI 47.6, 56.7]) of respondents had good knowledge, favorable attitude, and good practice of physical exercise respectively. Age group of 30 to 34 years (AOR: 2.15, 95% CI [1.08, 4.29]), housewife (AOR: 7.81, 95% CI [1.48, 41.21]), cultural recommendation (AOR: 2.16, 95% CI [1.37, 3.39]), exercise before pregnancy (AOR: 2.69, 95% CI [1.72, 4.19]), and gestational age >24 weeks (AOR: 2.538, 95% CI [1.02, 6.29]) were factors associated with practice of physical exercise during pregnancy. Physical activity during pregnancy was more common in the current study than in the national average. During an ANC visit, health care providers should improve and strengthen physical activity counseling sessions.

ANALYTICAL STUDY ON FACTORS AFFECTING THE ATTITUDE AND PERSPECTIVES OF FEMALE PATIENTS ON THE USE OF ARTIFICIAL INTELLIGENCE IN THE ASSESSMENT OF SCREENING MAMMOGRAMS

Background: Breast cancer is one of the most common cancers among Indian women, with an incidence of 25.8 per 100,000 women according to the Ministry of Health and Family Welfare. Late detection is responsible for poor quality of life (QOL), and it is the leading cause of death. Studies have shown that people are positive towards AI performing assessment tasks in healthcare in general and in mammography screening. Moreover, it is challenging to implement strategies based on self-breast inspection or do mammography in rural regions or low and middle income nations for a variety of reasons. Objective: This study was conducted to assess the perception and attitude of various female patients reporting to the radiology unit of a tertiary care centre regarding the use of Artificial Intelligence in routine mammogram screening. Study Design: A cross sectional questionnaire based study was conducted female patients attending the radiology unit of a tertiary Care Centre in Central Kerala. Methods: After obtaining, informed written consent was taken from the study participants. A predesigned, pretested, validated checklist was used to collect the required data. The Knowledge, attitude and practice was ascertained through Likerts scale and scoring done accordingly. Statistical tests of significance was employed to assess the possible associations between various variables with the knowledge, attitude and perceptions regarding Artifical Intelligence based Mammogram Results: Among the 170 study subjects analysed, 68.6% had a satisfactory knowledge about Artificial intelligence. Among the 170 study subjects analysed, 86% had a good attitude about being screened through AI enabled mammogram techniques. 92% of the total study subjects registered for mammogram had done it based on self choice. The association between age and willingness to get screened was found to be statistically significant. It was also seen that there was a statistically very high significance between Knowledge regarding AI and the independent decision to get screened. There was also a statistically significant association between age and scores >60% regarding knowledge and attitude regarding the vaccination among the study subjects. Conclusions: Majority of the study population was having a satisfactory knowledge regarding AI usage in healthcare.

Environmentally Related Taxes and Forest Loss

Abstract In recent years, environmental state theory has argued that nations have implemented laws and regulations along with spending money on conservation to address environmental problems. However, questions remain about the effectiveness of such policies. The authors draw on environmental state theory to frame this study in which they examine if higher levels of environmentally related forestry taxes correspond with lower levels of forest loss in low- and middle- income nations. The authors test this hypothesis by using use two-stage least squares regression models for a sample of 81 low- and middle- income nations. The results indicate support for the hypothesis that higher levels of environmentally related taxes are associated with less forest loss in low- and middle-income nations.

The Indian Perspective on Existing Human Rights Violations Against People with Cognitive Psychosocial Disability

Regardless of economic status, violations of human rights are committed worldwide against those suffering from mental and psychological disorders. Rather than coming from scientific research, the evidence from low- and middle-income nations comes from reports from non-governmental organizations (NGOs), UN documents, official publications, and the media. Additionally, a wide consultation with individuals from low and middle income nations who have people with mental and psychosocial disabilities has been conducted. The WHO Quality Rights Assessment Tool, which evaluates the mental health institutions in compliance with the CRPD and their suitability for human rights, served as the basis for this qualitative consultation.

Role of blood-brain barrier dysfunction in the development of poststroke epilepsy.

Stroke is a major contributor to mortality and morbidity worldwide and the most common cause of epilepsy in the elderly in high income nations. In recent years, it has become increasingly evident that both ischemic and hemorrhagic strokes induce dysfunction of the blood-brain barrier (BBB), and that this impairment can contribute to epileptogenesis. Nevertheless, studies directly comparing BBB dysfunction and poststroke epilepsy (PSE) are largely absent. Therefore, this review summarizes the role of BBB dysfunction in the development of PSE in animal models and clinical studies. There are multiple mechanisms whereby stroke induces BBB dysfunction, including increased transcytosis, tight junction dysfunction, spreading depolarizations, astrocyte and pericyte loss, reactive astrocytosis, angiogenesis, matrix metalloproteinase activation, neuroinflammation, adenosine triphosphate depletion, oxidative stress, and finally cell death. The degree to which these effects occur is dependent on the severity of the ischemia, whereby cell death is a more prominent mechanism of BBB disruption in regions of critical ischemia. BBB dysfunction can contribute to epileptogenesis by increasing the risk of hemorrhagic transformation, increasing stroke size and the amount of cerebral vasogenic edema, extravasation of excitatory compounds, and increasing neuroinflammation. Furthermore, albumin extravasation after BBB dysfunction contributes to epileptogenesis primarily via increased transforming growth factor β signaling. Finally, seizures themselves induce BBB dysfunction, thereby contributing to epileptogenesis in a cyclical manner. In repairing this BBB dysfunction, pericyte migration via platelet-derived growth factor β signaling is indispensable and required for reconstruction of the BBB, whereby astrocytes also play a role. Although animal stroke models have their limitations, they provide valuable insights into the development of potential therapeutics designed to restore the BBB after stroke, with the ultimate goal of improving outcomes and minimizing the occurrence of PSE. In pursuit of this goal, rapamycin, statins, losartan, semaglutide, and metformin show promise, whereby modulation of pericyte migration could also be beneficial.

‘It was horrible to watch, horrible to be a part of’: Midwives’ perspectives of obstetric violence

BackgroundObstetric violence, including unconsented interventions, coercion and disrespect, violates human rights; impacting the physical and psychosocial health of women. The perspective and experience of midwives related to obstetric violence have been explored in low and middle-income countries, with limited research into the experience of midwives in high income nations. AimTo explore Australian midwives’ perspectives of obstetric violence. MethodsThematic analysis of qualitative in-depth interviews with 15 midwives experienced in supporting women during birth. Critical feminist theory underpinned each stage of the research. FindingsInterviews with 15 Australian midwives from diverse care settings were analysed thematically. Four key themes were developed from the data: ‘the operationalisation of obstetric violence’, ‘the impact of obstetric violence’ ‘the historical and situational context’ and ‘hope for the future’. Midwives considered entrenched patriarchal structures and gender inequity as fundamental to the occurrence of obstetric violence. This societal scaffold is intensified within health care systems where power imbalances facilitate maternal mistreatment through coercion and grooming women for compliance in the antenatal period. Fragmented care models expose women to mistreatment with continuity models being protective only to a point. Midwives experience their own trauma, as a result of what they have witnessed, and due to the lack of support they receive when advocating for women. ConclusionsObstetric violence occurs in Australian maternity systems with unconsented interventions, overmedicalisation, coercion, and disrespect observed by midwives. Care-related trauma impacts on the mental health of midwives, raising workforce concerns for policy makers, consumer advocates and professional bodies.

#598 Successful application of allo-hemodialysis in a porcine model of embolization-induced acute kidney injury

Abstract Background and Aims Annually, millions of kidney patients, primarily in low- and low-middle income nations, die prematurely due to the lack of affordable kidney replacement therapy. We propose a novel, low-cost alternative dialysis modality called allo-hemodialysis (alloHD), where blood of a patient with kidney failure flows counter-current to the blood of a healthy subject (“buddy”) through the dialyzer [1]. Uremic solutes and excess fluid are then excreted by the buddy's healthy kidneys. We have already demonstrated the technical feasibility of alloHD in pigs with acute kidney injury (AKI) induced by renal artery ligation [2]. In this study, we explored alloHD in a less invasive porcine model of AKI induced by renal artery embolization. Method The protocol was approved by the Committee for the Purpose of Control and Supervision of Experiments on Animals (CPCSEA), New Delhi, India. We studied two female Yorkshire pigs (weight 80-90 kg) with central venous catheter as vascular access. AKI was induced by embolization of both kidneys by transcatheter deployment of Contour™ Poly Vinyl Alcohol particles (Boston Scientific, Marlborough, MA, USA). The AKI pig and the buddy pig were connected to the dialysate and blood compartments, respectively, of a Nipro Cellentia 17H dialyzer. The AKI pig was then dialyzed for 4 hours against the healthy buddy pig. During alloHD, both pigs were anticoagulated with heparin (5,000 IU/h) and the buddy pig was sedated with 1-2% isoflurane gas. Blood samples were collected before, during, and after alloHD for measurements of blood urea nitrogen (BUN) and creatinine. Results We performed nine alternate day alloHD sessions with the same pair of pigs. During alloHD, BUN and Creatinine levels declined in the AKI pig (Fig. 1) and increased—as expected—transiently above baseline in the buddy pig and then trended towards baseline post-dialysis (Fig. 1). We found no indication of hemolysis or coagulation of the extracorporeal circuit in any of the nine alloHD sessions. The animals were sacrificed after the 9th session. Conclusion We demonstrated the feasibility of alloHD in a porcine embolization AKI model. This study corroborates and complements our previous experience with alloHD in a porcine model of AKI induced by renal artery ligation. Given these promising results, we are investigating the potential for advancing to a clinical trial.

Children dually involved with statutory child protection and juvenile justice in Australia: A developmental cascade framework

Children who experience dual involvement by child protection and juvenile justice statutory systems have poorer life outcomes attributable to higher levels of disadvantage and more complex needs compared to single system involved children. Literature regarding dual involved children in high income, western, and democratic nations are largely based on US studies. Whilst child protection and juvenile justice systems across the United States, United Kingdom, Canada, New Zealand, and Australia have somewhat similar legislative systems, cohort outcomes and relationships between risk factors and offending trajectories for dual involved children are influenced by differing legislative, geographic, and demographic contexts. Compared to international literature, significant gaps exist regarding the Australian context. Further, within Australia, there are no evaluated specific responses and/or strategies directed towards supporting this highly vulnerable cohort towards increased long-term positive outcomes. This is the first comprehensive review of Australian studies that examines the characteristics of children who have had dual involvement with juvenile justice and child protection agencies within Australia. Using a thematic analysis twenty-five studies with dual involved samples were analysed, examining the individual, familial, environmental, and systemic factors that contribute to the likelihood of children becoming involved in both child protection and juvenile justice systems within Australia. Six thematic factors emerged that characterised the trajectories of dual involved children: cumulative and destabilising adversity; maltreatment timing and type; offending onset and context; educational disadvantage and disengagement; co-occurring challenges; and First Nations overrepresentation. Our findings are applied to Developmental Systems Theory, extending on previous literature to depict an Australian first developmental cascade framework illustrating the context specific pathways of dual involved children and opportunities for intervention in Australia. The discussion highlights and compares differences between Australian and international contexts with the intention of emphasising key areas for future research, and policy and practice reform. This is important because of the nuanced differences between dual involved characteristics across different legislative and geographic contexts, with particular relevance to the experiences of First Nations children and families. Future research, policy and practice would benefit from continued reforms that focus resources on co-ordinated system responses and cohort specific services; namely, culturally appropriate diversion strategies that promote behavioural de-escalation and educational engagement.

IJCM_53A: Association between women’s autonomy and unintended pregnancy in India using NFHS- 5

Background: Numerous research studies conducted in low- and middle- income nations have suggested that women’s autonomy can be a major factor in lowering the rate of unwanted pregnancies. In the Indian setting, where patriarchy is prevalent and women’s participation in crucial choices is restricted by sociocultural norms, there is limited data on women’s autonomy. The National Family Health Survey 2019-2021 (NFHS-5) provides information on population, health, and nutrition for India and each state/union territory (UT). Data of 4,00606 women aged 15-49 years who reported their reproductive intentions were extracted and analysed in which 3,70,691 had a birth in the last five years and were not pregnant, and 29,915 women were pregnant at the time of the survey. Objective: To determine the association between women’s autonomy and unintended pregnancy in India. Methodology: The National Family Health Survey-5 conducted in 2019-21 was used for the analysis. Information on ever-married women was extracted from women aged 15-49 years. Bivariate logistic regression was used to examine the association of unintended pregnancy with women’s autonomy, demographic, socio-economic, and social context variables. Results: The highest proportion of unintended pregnancies 12.82% were found in the women with low autonomy. A significant difference was seen between the pregnancy intention of respondents and their demographic, economic and social covariates. The prevalence of unintended pregnancy was higher among women who were in the age group 15-24 years, in the poorest wealth quintile, lived in rural areas, had more than three children, and who married before the age of 18 years. Conclusion: Improvement in women’s autonomy can reduce unintended pregnancy in India. Women with higher autonomy will be able to regulate their fertility and can appropriately limit their family size.

Earth at risk: An urgent call to end the age of destruction and forge a just and sustainable future.

Human development has ushered in an era of converging crises: climate change, ecological destruction, disease, pollution, and socioeconomic inequality. This review synthesizes the breadth of these interwoven emergencies and underscores the urgent need for comprehensive, integrated action. Propelled by imperialism, extractive capitalism, and a surging population, we are speeding past Earth's material limits, destroying critical ecosystems, and triggering irreversible changes in biophysical systems that underpin the Holocene climatic stability which fostered human civilization. The consequences of these actions are disproportionately borne by vulnerable populations, further entrenching global inequities. Marine and terrestrial biomes face critical tipping points, while escalating challenges to food and water access foreshadow a bleak outlook for global security. Against this backdrop of Earth at risk, we call for a global response centered on urgent decarbonization, fostering reciprocity with nature, and implementing regenerative practices in natural resource management. We call for the elimination of detrimental subsidies, promotion of equitable human development, and transformative financial support for lower income nations. A critical paradigm shift must occur that replaces exploitative, wealth-oriented capitalism with an economic model that prioritizes sustainability, resilience, and justice. We advocate a global cultural shift that elevates kinship with nature and communal well-being, underpinned by the recognition of Earth's finite resources and the interconnectedness of its inhabitants. The imperative is clear: to navigate away from this precipice, we must collectively harness political will, economic resources, and societal values to steer toward a future where human progress does not come at the cost of ecological integrity and social equity.

Prevalence of Malnutrition and Related Factors in Elderly Population

Malnutrition in the elderly is caused by various complicated interaction of several factors and also it is a common issue among them. Studies from low- and middle-income countries reported a substantially greater prevalence of malnutrition than research from high income nations. According to the studies conducted in India overall occurrence of malnutrition in Indian elderly is 17.93%. Additionally, the prevalence of malnutrition was significantly influenced by geography and the tool used to detect it. The prevalence of malnutrition was higher among female 16.67%, hospital settings 28.87%, urban areas 19.29%, and northern region 27.37% of India. Malnutrition in the elderly is linked to decreased mobility, weakened immunity, and cognitive impairment, all of which lower their overall functional capacity. So, elderlies are specifically susceptible to malnutrition; thus, it is important to identify nutritional issues in them and take appropriate action. Keywords: Malnutrition, Nutritional status, Elderly aged above 60, Mini nutritional assessment tool, Prevalence of malnutrition, Risk factors.

One-third of global population at cancer risk due to elevated volatile organic compounds levels

Outdoor air pollution, particularly volatile organic compounds (VOCs), significantly contributes to the global health burden. Previous analyses of VOC exposure have typically focused on regional and national scales, thereby limiting global health burden assessments. In this study, we utilized a global chemistry-climate model to simulate VOC distributions and estimate related cancer risks from 2000 to 2019. Our findings indicated a 10.2% rise in global VOC emissions during this period, with substantial increases in Sub-Saharan Africa, the Rest of Asia, and China, but decreases in the U.S. and Europe due to reductions in the transportation and residential sectors. Carcinogenic VOCs such as benzene, formaldehyde, and acetaldehyde contributed to a lifetime cancer burden affecting 0.60 [95% confidence interval (95CI): 0.40–0.81] to 0.85 [95CI: 0.56–1.14] million individuals globally. We projected that between 36.4% and 39.7% of the global population was exposed to harmful VOC levels, with the highest exposure rates found in China (82.8–84.3%) and considerably lower exposure in Europe (1.7–5.8%). Open agricultural burning in less-developed regions amplified VOC-induced cancer burdens. Significant disparities in cancer burdens between high-income and low-to-middle-income countries were identified throughout the study period, primarily due to unequal population growth and VOC emissions. These findings underscore health disparities among different income nations and emphasize the persistent need to address the environmental injustice related to air pollution exposure.

Industrial and textile waste trade: Multilayer network and environmental policy effects

Waste management is an international enterprise, and it is important to understand global flows of recyclable materials. The Pollution Haven Hypothesis (PHH) suggests that waste moves from high income nations with stringent environmental policy to low income nations with less environmentally stringent policy, by exploiting low labor and regulatory costs. This paper assesses the PHH thesis for slag/dross and textiles (SDT) wastes in PHH through novel integration of the multilayer network and gravity models. The multilayer network model generates network effect that quantifies interlayer connections of multiple waste trade networks. Instead of North-South movement of waste, North-North, South-South, and even South-North are shown. Results from the gravity model indicate that stringent waste management policies reduce both waste exports and imports. PHH is not found for slags/dross where high income countries are importing the waste, contradicting PHH. On the other hand, PHH is more evident between highly connected hubs and havens in SDT waste trade networks.

Residents’ Attitudes, Behaviour, and Willingness to Recycle E-waste in Brunei Darussalam

Today, the electronics industry is the largest and fastest-growing manufacturing sector in the world. The rapid expansion of this industry coupled with the brief product lifespan generates an enormous amount of e-waste. Increasing amounts of waste from the electronics industry pose a significant problem for many lower-middle income nations today. For proper disposal and routing of e-waste, consumer cognizance plays a crucial role in directing e-waste to its authorised collection centres and authorised recyclers. Financial constraints, inadequate storage facilities and information on e-waste, lack of awareness on the impacts of e-waste, the absence of rules and regulations, and the lack of an appropriate description of roles and responsibilities pertaining to e-waste management, among other factors, may be impeding e-waste management. In this research, a primary survey is conducted to determine consumers’ awareness and preferences regarding the disposal of electronic waste. The survey was conducted in Brunei Darussalam with 351 consumers using a structured questionnaire. This survey questionnaire’s demographic profile includes gender, age group, employment status, household size, and income range. Knowledge of e-waste, awareness of e-waste, willingness to recycle, and consumer preference regarding the appropriate disposal and management of e-waste were identified using exploratory factor analysis. The study reveals that 57.3% of respondents comprehend the definition of e-waste, with 89.9% of respondents using a mobile phone daily and 86.6% using a computer daily. 58.1% of respondents do not know what to do with their e-waste, so the majority retain it at home. The primary concern regarding e-waste disposal is a lack of knowledge about recycling facilities. Approximately 66% of respondents are willing to pay between BND $ 1 - 10 for the disposal or recycling of e-waste, and 38% are willing to travel between 1 and 5 kilometers for disposal or recycling. 76% of respondents concurred that the government should subsidise e-waste disposal. By comprehending attitudes, behaviour, and willingness to recycle e-waste, a comprehensive e-waste management policy can be formulated.

Facility Factors Affecting the Uptake and Utilization of Antenatal Care Services By Pregnant Adolescents in Rongai Sub County, Nakuru County.Kenya

Purpose: Antenatal care plays a crucial role in fostering a sense of trust and rapport between the expectant woman and her healthcare practitioner. It serves as a platform for tailoring health promotion messages to the specific needs of the person, while also facilitating the identification and appropriate management of any maternal problems or risk factors that may arise. Complications arising from pregnancy and childbirth constitute the primary cause of mortality among women aged 15-19 years in poor and middle income nations. The objective of this study was to examine the extent to which adolescent mothers in Rongai Sub County, Nakuru County, Kenya utilize antenatal care services. The researchers obtained ethical permission from the GLUK Ethics committee, NACOSTI, and the Nakuru County Government. In addition, the researchers sought consent from the participants and ensured confidentiality by refraining from utilizing any form of identifying.
 Methodology: The research employed a descriptive cross-sectional study design, utilizing purposeful sampling and single population proportion approaches. The target population comprised of adolescent moms between the ages of 15 and 19 within the geographical area of Rongai Sub County. The data collection instruments employed in this study consisted of researcher-administered questionnaires. The survey was distributed to adolescent mothers who satisfied the specified criteria for inclusion. The acquired data underwent coding and was thereafter fed into the computer system for analysis utilizing SPSS version 25.
 Findings: The findings of the research were succinctly presented through the utilization of percentages, tables, and charts. There was a significant correlation between adolescents' negative attitudes toward ANC utilization and the results of the study (χ2 =26.306, p =.002). it was also noted that the relationship between hours of operation and adolescents’ uptake of ANC was also significant (χ2 =25.865, p =.000). Similarly long waiting hours (χ2 =12.391, p =.054), lack of trust among ANC service providers (χ2 =127.847, p =.000), and high transport cost (χ2 =15.169, p =.019), significantly affected adolescents’ uptake of ANC services.
 Unique Contribution to Theory, Practice and Policy: The findings of this research demonstrate that the utilization of ANC services by adolescent and adult expectant women can offer significant contributions to the understanding of disparities, identification of barriers, and development of appropriate interventions to increase ANC service utilization. It is suggested by this study that tailored services be implemented with the aim of increasing ANC utilization among adolescent mothers in Rongai Sub County.

Facility Factors Affecting the Uptake and Utilization of Antenatal Care Services By Pregnant Adolescents in Rongai Sub County, Nakuru County.Kenya

Purpose: Antenatal care plays a crucial role in fostering a sense of trust and rapport between the expectant woman and her healthcare practitioner. It serves as a platform for tailoring health promotion messages to the specific needs of the person, while also facilitating the identification and appropriate management of any maternal problems or risk factors that may arise. Complications arising from pregnancy and childbirth constitute the primary cause of mortality among women aged 15-19 years in poor and middle income nations. The objective of this study was to examine the extent to which adolescent mothers in Rongai Sub County, Nakuru County, Kenya utilize antenatal care services. The researchers obtained ethical permission from the GLUK Ethics committee, NACOSTI, and the Nakuru County Government. In addition, the researchers sought consent from the participants and ensured confidentiality by refraining from utilizing any form of identifying.
 Methodology: The research employed a descriptive cross-sectional study design, utilizing purposeful sampling and single population proportion approaches. The target population comprised of adolescent moms between the ages of 15 and 19 within the geographical area of Rongai Sub County. The data collection instruments employed in this study consisted of researcher-administered questionnaires. The survey was distributed to adolescent mothers who satisfied the specified criteria for inclusion. The acquired data underwent coding and was thereafter fed into the computer system for analysis utilizing SPSS version 25.
 Findings: The findings of the research were succinctly presented through the utilization of percentages, tables, and charts. There was a significant correlation between adolescents' negative attitudes toward ANC utilization and the results of the study (χ2 =26.306, p =.002). it was also noted that the relationship between hours of operation and adolescents’ uptake of ANC was also significant (χ2 =25.865, p =.000). Similarly long waiting hours (χ2 =12.391, p =.054), lack of trust among ANC service providers (χ2 =127.847, p =.000), and high transport cost (χ2 =15.169, p =.019), significantly affected adolescents’ uptake of ANC services.
 Unique Contribution to Theory, Practice and Policy: The findings of this research demonstrate that the utilization of ANC services by adolescent and adult expectant women can offer significant contributions to the understanding of disparities, identification of barriers, and development of appropriate interventions to increase ANC service utilization. It is suggested by this study that tailored services be implemented with the aim of increasing ANC utilization among adolescent mothers in Rongai Sub County.

Does ESG performance bring to enterprises’ green innovation? Yes, evidence from 118 countries

Research background: The sustainable development and innovation economics theory and related literature place a lot of emphasis on the relationship between environment, society, and governance (ESG) and green innovation. Purpose of the article: The purpose of this paper is to understand what the factors are that influence green innovation and why there is a big disparity in green innovation capabilities between nations. In addition, this paper aims to investigate the impact of ESG performance of green innovation by using unbalanced panel data covering 118 sample countries during the period of 1999–2019. Methods: Panel fixed effect model; Instrumental variable (IV) method; First-differencing (FD) method; Kinky least-squares (KLS) approach. Findings & value added: ESG performance provides evidence for its positive and significant impact on such innovation. Among the ESG factors, governance seems to have the most important influence on green innovation. Moreover, the positive influence of ESG performance is more evident in higher income and wealthy nations. Furthermore, we also conclude that ESG performance can affect green innovation through FDI, human capital, financial development and trade openness. These conclusions hold up after a number of robustness tests and taking into account any potential endogenous issues. Overall, policymakers should pay close attention to the findings.

Retrospective investigation of the 2019 African swine fever epidemic within smallholder pig farms in Oudomxay province, Lao PDR.

The 2019 African swine fever (ASF) outbreak in the Lao People's Democratic Republic (Lao PDR or Laos) represented a major epidemiologic event where a transitioning lower-middle income nation (LMIC) experienced a viral epidemic in a naïve pig population. The diversity of pig management styles creates challenges for local and regional policymakers when formulating recommendations to control an ASF outbreak. The aim of this study were to investigate the management of pigs in villages of Oudomxay province that were affected by ASF in 2019, as a case study in a smallholder pig-rasing system in northern Laos. The frequencies of well known risk factors were measured in the affected villages and the timelines and household level stock losses due to the outbreak were investigated. These findings were compared to data available from a similar outbreak in the southern province of Savannakhet. Disease control implications of these findings are discussed. Mean losses were 3.0-23.3 pigs per household, with a mean lost herd value of USD 349, 95% CI (294-415). These pig losses reflect those estimated in Savannakhet (6.7 pigs per household). However, the financial loss estimated per household was higher, USD 349 versus USD 215, possibly due to higher pig values and a higher input/output management approach in Oudomxay. The investigation revealed the presence of numerous ASF risk factors, such as swill-feeding and free-ranging. In addition, poor biosecurity practices - such as inappropriate garbage disposal and slaughtering - that could contaminate the environment were present. ASF cases occurred across all villages between June and December 2019, with outbreak periods ranging from 22-103 days. These values are consistent with the outbreak in Savannakhet; however, notable differences in management styles were observed. These findings demonstrate the need for more disease control resources from the village to the Governmental level. Villages need support in enacting context appropriate biosecurity measures, whilst the ongoing surveillance and investigation of ASF require investment in logistical and veterinary resources at the Governmental level.