National System Research Articles

Sustainable Logistic Management Plan as an alternative to minimize budget difficulties of Higher Education Institutions

Brazil has increased its scientific production in the past four decades, with public universities playing a major role in scientific and technological research in the country. Recent cuts in governmental budgets to these institutions put them at risk of closing down, impacting not only education, but also research and development in the country, thus threatening the future of the national science and technology system. Sustainable actions may help universities to overcome this crisis. The aim of this study was to evaluate the results of the implementation, in 2008, of a Sustainable Logistic Management Plan (SLP) at the Federal University of Health Sciences of Porto Alegre (UFCSPA). Indicators were collected by UFCSPA Environmental Management Commission (EMC) and were publicly available. The study analyzed indicators such as water and energy consumption and special waste production to assess trends in environmental aspects and their respective impacts. The number of graduate and undergraduate courses at UFCSPA increased during the period, therefore most indicators showed an increase in resource consumption in absolute values. However, a decrease was observed when consumption was analyzed per capita. Accordingly, overall consumption of electricity increased 143% from 2008 to 2020, whereas a reduction per capita was observed. Special waste production increased 46% from 2013 to 2020, but per capita production remained stable and water consumption, despite having an average annual increase of 8%, also had a per capita reduction. This study shows how sustainable actions implemented by UFCSPA affected the use of resources, reducing the consumption of water, electricity, disposable materials, and waste per capita. Therefore, we can conclude that the actions implemented by the university in 2008 and monitored by the EMC in the SLP contributed significantly to achieving financial balance in the institution.

INITIAL ANALYSIS OF THE IMPLEMENTATION OF THE CREDIT-MODULE SYSTEM OF EDUCATIONAL PROCESS ORGANIZATION AND ATTITUDE OF MEDICAL COLLEGE STUDENTS TO IT

The training of a mid-level healthcare professional involves studying a significant number of different subjects and assimilating a large amount of information in a short period of time. The credit-modular system of educational process organization according to the standards of the European Credit Transfer System (ECTS) of education provides good prospects for the implementation of this task, ensuring the acquisition of relevant knowledge and competencies, which is necessary in the context of competition on the global labour market and innovative development of society.
 The purpose of the study was to find out and analyse the opinions of students, academic and teaching staff of Physiology department, their attitude and suggestions regarding the implementation of ECTS at the Professional Medical College of IFNMU, where this system started working since 2021.
 Materials and methods. An anonymous survey was carried to achieve the set objectives. Separate questionnaires were drawn up for students and teachers, which included questions about their attitude to teaching disciplines (including Physiology) in accordance with the ECTS principles, its positive and negative aspects, wishes and suggestions for improving the educational process organization and other items. In total, the questionnaires contained eight questions for teachers and sixteen for students.
 Results. The analysis of the survey results gives grounds to assert that not all students of the Medical College are fully ready to the study based on ECTS at the moment, transition from passive to active forms of it, where individual and creative work is preferred. Actually, in our opinion one of the key problematic issues of the credit transfer system of education is that students are not entirely focused on the priority of independent learning of the curriculum material and a significant part of extracurricular learning in it. Also most students consider that the amount of material assigned for independent study is too much. On the other hand, our teaching experience shows that they do not always work through the topics properly, although there are consultation hours during extracurricular time, where students can discuss unclear questions with the teacher. The attitude to test control as an integral part of the educational process and one of the methods of students’ knowledge evaluation is ambiguous. Among the positive aspects of ECTS education the most often are noted the following: constant and versatile preparation for classes, a better evaluation system, the possibility of retaking unsatisfactory marks, which is an important additional motivation to improve the level of knowledge from the subject and improve academic performance.
 Conclusions. As a result, the following conclusions can be drawn: a) as of today, the perception of the IFNMU Medical College students the credit-modular system of education, their readiness and attitude to it are quite ambiguous with the corresponding positive and negative aspects; b) there is an evidently need for further work to improve the training of both students and teachers, optimisation of their collaboration and creation a closer relationship between them; c) it is necessary, in our opinion, on the one hand, to preserve maximally the positive achievements of the national education system, on the other hand – to use effectively the experience of European countries. This will create the basis for training a qualified, mobile, creative specialist of mid-level healthcare.

Research alignment in the U.S. national park system: Impact of transformative science policy on the supply and demand for scientific knowledge for protected area management

The US National Park System encompasses diverse environmental and tourism management regimes, together governed by the 1916 Organic Act and its dual mandate of conservation and provision of public enjoyment. However, with the introduction of transformative science policy in the 2000's, the mission scope has since expanded to promote overarching science-based objectives. Yet despite this paradigm shift instituting “science for parks, parks for science”, there is scant research exploring the impact of the National Park Science Policy on the provision of knowledge. We address this gap by developing a spatiotemporal framework for evaluating research alignment, here operationalized via quantifiable measures of supply and demand for scientific knowledge. Specifically, we apply a machine learning algorithm (Latent Dirichlet analysis) to a comprehensive park-specific text corpus (combining official needs statements -i.e. demand- and scientific research metadata -i.e. supply-) to define a joint topic space, which thereby facilitates quantifying the direction and degree of alignment at multiple levels. Results indicate an overall robust degree of research alignment, with misaligned topics tending to be over-researched (as opposed to over-demanded), which may be favorable to many parks, but is inefficient from the park system perspective. Results further indicate that the transformative science policy exacerbated the misalignment in mandated research domains. In light of these results, we argue for improved decision support mechanisms to achieve more timely alignment of research efforts towards distinctive park needs, thereby fostering convergent knowledge co-production and leveraging the full value of National Parks as living laboratories.

Topical Issues of Counteracting the Threats to National Security

Introduction. One of the primary important objects for ensuring the national security of any state, as an independent and self-sustained subject of the system of global policy coordinates, is its sovereignty. The sovereignty is the fundamental category in formulating the principles of the national constitutional and international law. Ensuring the sovereignty is one of the most important functions and tasks of the modern Russian state. The article analyses the state policy and its legal basis for ensuring the national security, it focuses on the threats and crises in both the international and national security systems. The research is relevant due to studying the selective approach of some states to fulfilling their obligations to adhere to the commonly recognised principles of the international relations. It is emphasised, that although formally observed, the principle of national sovereignty of the states is constantly violated when referred to the weaker states according to the medieval “right of the strong”. The topical issues of counteracting the threats to national security are investigated. Attention is focused on the need to develop the measures aimed at timely and efficient prevention thereof. The aim of the study is to analyse the concept of “sovereignty”, identify the external and internal threats to the sovereignty of Russia and develop recommendations on the strategic national priorities. Materials and Methods. The research was conducted using the general and specific methods of scientific cognition, in particular, the dialectical method, content analysis of the normative legal acts, juridical comparativistics, as well as systemic, structural-functional, logical and other methods. Results. Within the research such concepts as “sovereignty”, “national interests of the Russian Federation and strategic national priorities” have been analysed. The assessment of the current state of the world order is given, as well as the directions and trends of its reform are studied. The external and internal threats to the sovereignty of Russia have been identified and strategic goals in the field of ensuring the national security have been outlined. Discussion and Conclusion. Based on the results of the conducted research, it was proved that the qualitative change of the methodological and conceptual foundations of the national and international security is required. To counteract the different national security threats, it is necessary to adhere to the national priorities, goals and the developed strategy. The present paper deems to be important for the Russian juridical science, as well as for the subjects of lawmaking and law enforcement.

Adherence to GLP1-RA and SGLT2-I affects clinical outcomes and costs in patients with type 2 diabetes.

To evaluate the impact of adherence to glucagon like peptide-1 receptor agonists (GLP1-RA) and sodium-glucose transporter two inhibitors (SGLT2-I) on clinical outcomes and costs in patients with type 2 diabetes mellitus (T2DM). The 121,115 residents of the Lombardy Region (Italy) aged ≥40years newly treated with metformin during 2007-2015 were followed to identify those who started therapy with GLP1-RA or SGLT2-I. Adherence to drug therapy over the first year was defined as the proportion of days covered >80%. Within each drug class, for each adherent patient, one non-adherent patient was matched for age, sex, duration, adherence to metformin treatment and propensity score. The primary clinical outcome was a composite of insulin initiation, hospitalisation for micro- and macrovascular complications and all-cause mortality after the first year of drug treatment. Costs were evaluated based on reimbursements from the national healthcare system. After matching, 1182 pairs of adherent and non-adherent GLP1-RA users and 1126 pairs of adherent and non-adherent SGLT2-I users were included. In both groups, adherent patients experienced a significantly lower incidence of the primary outcome (HR: 0.85, 95% CI 0.72-0.98 for GLP1-RA and HR: 0.69, 95% CI 0.55-0.87 for SGLT2-I). A significant reduction in hospitalizations was found for adherent patients in the GLP1-RA group but not for the SGLT2-I group. Results were consistent when analyses were stratified by age and sex. While higher drug-related costs in the adherent group were counterbalanced by decreased hospitalisation costs in SGLT2-I treated patients, this was not the case for GLP1-RA. Higher adherence to drug treatment with GLP1-RA and SGLT2-I during the first year of the drug intake is associated with a lower incidence of adverse clinical outcomes in a real-world setting.

Стратегии мирового сообщества по разрешению экологических проблем: опыт криминологического анализа

The article presents a criminological analysis of the UN’s environmental protection activities. The rele-vance of the author’s appeal to these problems is emphasized by the fact that the state of the environment is most directly related to all spheres of human activity, without exception, starting from the prices of goods and ending with the state of his health in all countries of the world. It is noted that the development of significant UN documents on environmental protection and the intensification of the international community’s activities in the environmental field are inextricably linked with the convening of international conferences, among which were of particular importance: the UN Conference on the Human Environment in 1972 (Stockholm Conference), Conferences in Rio de Janeiro in 1992, 2012, the UN Conference on Climate Change in Kyoto in 1997, the UN Climate Conference in 2021. The author concludes that the UN is called to play a leading role in environmental protection. However, it does not have sufficient resources and competence to solve all global environmental problems. It is emphasized that despite some efforts of the world community, the global environmental crisis is getting worse, and the current national and international systems are not able to reduce the growing burden of humanity on the natural environment, including threats to environmental safety, environmental crime.

Data Sharing in a Decentralized Public Health System: Lessons From COVID-19 Syndromic Surveillance.

The COVID-19 pandemic revealed that data sharing challenges persist across public health information systems. We examine the specific challenges in sharing syndromic surveillance data between state, local, and federal partners. These challenges are complicated by US federalism, which decentralizes public health response and creates friction between different government units. The current policies restrict federal access to state and local syndromic surveillance data without each jurisdiction's consent. These policies frustrate legitimate federal governmental interests and are contrary to ethical guidelines for public health data sharing. Nevertheless, state and local public health agencies must continue to play a central role as there are important risks in interpreting syndromic surveillance data without understanding local contexts. Policies establishing a collaborative framework will be needed to support data sharing between federal, state, and local partners. A collaborative framework would be enhanced by a governance group with robust state and local involvement and policy guardrails to ensure the use of data is appropriate. These policy and relational challenges must be addressed to actualize a truly national public health information system.

The Impact of Carbon Emissions Trading on the Total Factor Productivity of China’s Electric Power Enterprises—An Empirical Analysis Based on the Differences-in-Differences Model

Based on the panel data of China’s listed electric power enterprises, this paper adopts the differences-in-differences model to empirically analyze the pilot policy of carbon emissions trading’s impact on the total factor productivity of power enterprises in 2013. The study finds that the carbon trading pilot policy has a significant positive effect on the total factor productivity of power companies, and the two possible impact mechanisms are external cost compensation and additional income, and internal low-carbon technology innovation and resource allocation optimization. The conclusions above have been further confirmed by the parallel trend test and robustness test. The heterogeneity analysis demonstrates that there are differences in the regression results between state-owned enterprises and nonstate-owned enterprises. The possible reason is that state-owned enterprises are more likely to be affected by the carbon emissions trading system, and their asset-heavy model puts greater pressure on carbon emission reduction. Therefore, their demand for low-carbon technology innovation is more urgent; areas with stricter carbon emission verification are more sensitive to the implementation of carbon trading, and a reasonable increase in carbon verification can make the carbon trading market more effective. Based on the research results, this paper proposes to speed up the improvement of the national carbon trading market system, enhance the diversity and richness of the main market, improve the liquidity of the carbon trading market, broaden financing channels for electric power enterprises, and improve the carbon market supervision mechanism.

Adaptive change: Emerging economy enterprises respond to the international business environment challenge

The technological and market containment of emerging economy enterprises (EEEs) from developed countries is becoming a great challenge for EEE development. In this context, how do EEEs respond to international business challenges and achieve continuous organizational innovation? This study proposes a process model of EEEs’ organizational adaptive change to achieve innovation using the case of Hikvision, a leading Chinese artificial intelligence (AI) enterprise. The results show that the adaptive change in EEEs is a dynamic process. The negative impact of international business environment challenges on enterprise development is the starting point for enterprises to adopt change behaviors. Through adaptive change in innovation strategy, innovation architecture and innovation systems, EEEs can break through technology blockades, overcome market crises and further weaken the negative impact of such challenges. This study constructs an adaptive change process model for EEEs and proposes strategic initiatives for EEEs with the help of a national innovation system (NIS), which has policy implications for EEE strategies and industrial policy design in emerging economies.

National Museum Wales and the scalar bureaucracies of institutional memory work

Museums form a core institutional foundation to the formation of national identities. They reflect, obfuscate, perform, and shape national narrative and discourse, particularly when operated at the national scale. In Wales, the national museum system is public and composed of seven museums. These national museums negotiate scale in complex, but perhaps not necessarily unique, ways as they root themselves into local communities and regions, operationalize themselves alongside other regional, national, and state heritage institutions, and increasingly inform, support, and draw upon inter- and transnational heritage. How do collective memories or national narratives translate or articulate across scales and landscapes into and from a central bureaucracy, particularly one which came under limited control of democratically-elected Welsh governing bodies in 1997? While geographers have historically included museums within our broader purview, particularly in historical and cultural contexts, few studies have asked how a transcalar, multi-thematic, and dispersed public museum system could be approached via a bureaucratic political geography. This paper aims to address the place for geography at the intersection of nation, state, memory, and museum within the context of National Museum Wales and argues for greater consideration of institutional and bureaucratic memory work within nation-building.

Programs of study and earnings dynamics

University programs differ in the subsequent earnings processes of their enrollees, including many features that students might care about to differing degrees such as the level of average earnings, earnings growth, and volatility. Do the earnings features of a university program’s enrollees reflect the causal effect of enrolling in that program or the self-selection of students into that program? Would students experience a different earnings process if they enrolled in a different program of study? To estimate the causal impact of enrolling in a program of study on the enrollees’ future earnings process, we exploit a discontinuity built into the Danish national university admissions system, which provides quasi-random assignment of similar applicants to different programs. We leverage the rich cross-program variation in the enrollees’ future earnings processes to measure the impact of entering a program whose enrollees experience high earnings levels, growth, and volatility on their own subsequent earnings level, growth, and volatility. We find that a student’s subsequent earnings levels and volatility – but not their earnings growth – are caused by entering programs of study whose enrollees have those features.

Spiritual parenting for the community of Tanjung Dayang Selatan Village, Ogan Ilir Regency

The laws on child protection and the national education system outline the roles and responsibilities of parents towards their children. However, the reality in Indonesia, particularly in rural areas, reveals that many parents still neglect their children's education and spiritual development, leading to high rates of school dropout and moral decline among children. The objective of community service program is to impart an understanding of Islamic spiritual parenting concepts to the target audience, enabling its application within the community. This community service initiative comprises three main agendas: pre-test, socialization or counseling sessions on family sociology and spiritual parenting, and post-test evaluations. The results of the activity demonstrated a 33% increase in participants' knowledge after engaging in spiritual parenting discussions.

Exploring hospital resilience protective or risk factors: lessons for future disaster response efforts.

Hospital resilience is essential in responding to disasters, but current research focuses mainly on frameworks and models rather than the protection of resilience and analysis of risk factors during public health emergencies. This study aims to examine the development of resilience in Chinese frontline hospitals during the initial COVID-19 outbreak in 2020, providing insights for future disaster response efforts. We conducted interviews with 26 hospital staff members who were involved in the initial response to the COVID-19 outbreak in China. We used a semi-structured interview approach and employed purposive sampling and snowball sampling techniques. The interview outline was guided by the 'Action Framework' proposed by the World Health Organization (WHO) for responding to infectious disease emergencies. This framework includes dimensions such as command, surveillance, risk communication, medical response, and public health response. We analyzed the collected data using Colaizzi's seven-step data analysis method and the template analysis method. WHO's 'action framework' effectively highlights the factors that contribute to hospital resilience. While medical response, including the availability of materials and facilities, the use of information technology, and the capacity for infectious disease diagnosis and treatment, remains crucial, other important aspects include awareness and beliefs about infections, treatment experience, interdisciplinary collaboration, and more. Additionally, it is essential to establish an intelligent command system, foster trusting partnerships between teams, improve monitoring capabilities for infectious disease agents, enhance risk communication through information synchronization and transparency, strengthen infection control planning, and improve environmental disinfection capabilities for effective public health emergency response. These contradictions significantly impact the enhancement of hospital resilience in dealing with major infectious disease outbreaks. In responding to sudden major infectious diseases, hospitals play a vital role within the healthcare system. Enhancing hospital resilience involves more than just improving treatment capabilities. It also requires effective command coordination at the hospital level, infection control planning, and the deployment of intelligent equipment. Additionally, planning for effective communication and coordination between hospitals, communities, and the national healthcare system can further enhance hospital resilience.

Corporate training is a mechanism for the reproduction of labor resources

The availability of professional skills adequate to the modern economic and technological paradigm among citizens forming the country’s labor resources is an important task for the sustainability of national economic and production systems. Corporate universities established in companies contribute to solving this problem in many ways. Organizations use the corporate university model to promote their learning initiative in order to effectively manage their large investments in professional development and staff development. Thus, corporate training has expanded its influence, and not limited to the functions of reproducing professional competencies within individual companies, it is currently a mechanism for implementing government programs and concepts for the formation and development of skills of the population, which corresponds to the policy of workforce development as one of the significant factors of state sustainability in the context of economic transformation and global challenges.

Assessing the Nationwide Benefits of Vehicle–Grid Integration during Distribution Network Planning and Power System Dispatching

The diffusion of electric vehicles is fundamental for transport sector decarbonization. However, a major concern about electric vehicles is their compatibility with power grids. Adopting a whole-power-system approach, this work presents a comprehensive analysis of the impacts and benefits of electric vehicles’ diffusion on a national power system, i.e., Italy. Demand and flexibility profiles are estimated with a detailed review of the literature on the topic, allowing us to put forward reliable charging profiles and the resulting flexibility, compatible with the Italian regulatory framework. Distribution network planning and power system dispatching are handled with dedicated models, while the uncertainty associated with EV charging behavior is managed with a Monte Carlo approach. The novelty of this study is considering a nationwide context, considering both transmission and distribution systems, and proposing a set of policies suitable for enabling flexibility provision. The results show that the power and energy demand created by the spread of EVs will have localized impacts on power and voltage limits of the distribution network, while the consequences for transmission grids and dispatching will be negligible. In 2030 scenarios, smart charging reduces grid elements’ violations (−23%, −100%), dispatching costs (−43%), and RES curtailment (−50%).

Recent changes in growth trajectories: a population-based cohort study of over 5 million Brazilian children born between 2001 and 2014

There is limited evidence on recent trends in childhood growth trajectories in Low-/middle-income countries. We investigated how age-trajectories for height and Body Mass Index (BMI) have changed among Brazilian children born in two different time periods after2000. We used a population-based cohort (part of the "Cohort of 100-Million Brazilians") created by the linkage of three Brazilian administrative databases: the Cadastro Único of the Federal Government, the National System of Live Births and the National Nutritional and Food Surveillance System. We included longitudinal data on 5,750,214 children who were 3 to <10 years of age and born between 2001 and 2014 (20,209,133 observations). We applied fractional polynomial models with random-effects to estimate mean height and BMI trajectories for children. Compared to children born in 2001-2007, the cohort born in 2008-2014 were on average taller, by a z-score of 0.15 in boys and 0.12 in girls. Their height trajectories shifted upwards, by approximately 1cm in both sexes. Levels of BMI increased little, by a z-score of 0.06 (boys) and 0.04 (girls). Mean BMI trajectories also changed little. However, the prevalence of overweight/obesity increased between cohorts, e.g., from 26.8% to 30% in boys and 23.9%-26.6% in girls aged between 5 and <10 years. An increase of 1cm in mean height of Brazilian children during a short period indicates the improvement in maternal and child health, especially those from low-income families due to the new health and welfare policies in Brazil. Although mean BMI changed little, the prevalence of child overweight/obesity slightly increased and remained high. This work was supported by National Council for Scientific and Technological Development - CNPq; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES; National Institute for Health Research (NIHR) Great Ormond Street Hospital Biomedical Research Centre; Society for the Study of Human Biology; Fundação de Amparo à Pesquisa do Estado de Minas Gerais - FAPEMIG; Departamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia, Inovação e Complexo da Saúde do Ministério da Saúde - Decit/SECTICS/MS. The study also used resources from the Centre for Data and Knowledge Integration for Health (CIDACS), which receives funding from the Bill & Melinda Gates Foundation, the Wellcome Trust, the Health Surveillance Secretariat of the Ministry of Health and the Secretariat of Science and Technology of the State of Bahia (SECTI-BA).

Defining urban boundaries through DBSCAN and Shannon's entropy: The case of the Mexican National Urban System

A novel method is proposed to define cities' boundaries within a given national urban system. Point Volunteered Geographic Information, such as the OpenStreetMap road network nodes, together with national geospatial information, like economic units, are recursively clustered using DBSCAN at different distance thresholds; clusters smaller than a threshold reflecting the rural settlements pattern are filtered, and then Shannon's entropy for the entire system is calculated. The system of percolated nodes obtained when this entropy reaches its maximum is compared against the current definition of what is officially urban. It is found to be very similar to the actual urban-nonurban classification, and also to have a very high correspondence with the current classification of the Mexican National Urban System (SUN). An additional finding is that the percolated system at the maximum entropy value has a very high correspondence with Zipf's law, while the current Mexican SUN does not.

Hypertension in Pregnancy: Current Challenges and Future Opportunities for Surveillance and Research.

Hypertension in pregnancy (HP) includes eclampsia/preeclampsia, chronic hypertension, superimposed preeclampsia, and gestational hypertension. In the United States, HP prevalence doubled over the last three decades, based on birth certificate data. In 2019, the estimated percent of births with a history of HP varied from 10.1% to 15.9% for birth certificate data and hospital discharge records, respectively. The use of electronic medical records may result in identifying an additional third to half of undiagnosed cases of HP. Individuals with gestational hypertension or preeclampsia are at 3.5 times higher risk of progressing to chronic hypertension and from 1.7 to 2.8 times higher risk of developing cardiovascular disease (CVD) after childbirth compared with individuals without these conditions. Interventions to identify and address CVD risk factors among individuals with HP are most effective if started during the first 6 weeks postpartum and implemented during the first year after childbirth. Providing access to affordable health care during the first 12 months after delivery may ensure healthy longevity for individuals with HP. Average attendance rates for postpartum visits in the United States are 72.1%, but the rates vary significantly (from 24.9% to 96.5%). Moreover, even among individuals with CVD risk factors who attend postpartum visits, approximately 40% do not receive counseling on a healthy lifestyle. In the United States, as of the end of September 2023, 38 states and the District of Columbia have extended Medicaid coverage eligibility, eight states plan to implement it, and two states proposed a limited coverage extension from 2 to 12 months after childbirth. Currently, data gaps exist in national health surveillance and health systems to identify and monitor HP. Using multiple data sources, incorporating electronic medical record data algorithms, and standardizing data definitions can improve surveillance, provide opportunities to better track progress, and may help in developing targeted policy recommendations.

Profile and burden of the family caregiver: the caring experience in multiple sclerosis. An observational study

BackgroundThe broad implications of caring for a family member with a chronic medical condition, such as MS, can lead caregivers to experience a high burden of care. The aim of the study was to describe profile of MS caregivers and their burden and to explore potential factors influencing this burden.Methods200 family caregivers of a person with MS completed survey questionnaires across a cross-sectional study. Many information were collected: caregiver socio-demographic and health-related data, caregiving activities, knowledge of MS, coping strategies, mood, social support received and care recipient information. Caregiving burden was measured by the ZBI (Zarit Burden Interview). The extent to which the variables explained caregiver burden was analyzed using a hierarchical approach.Results68% of the caregivers reported a perceived burden of care (ZBI score > 20). Our results show that physical and mental related-health variables are important predictive factors of the care burden, explaining much of the observed variance (40.9%).ConclusionFamily caregivers in MS continue to make up the shortfall produce by national health and welfare systems. We highlighted the importance of good physical and mental health in decreasing perceived burden. Working to alleviate psychological distress through mechanisms focus on reducing worries and perceived burden may be a valid approach.

Analysis of Sorghum Local Food Development Analysis Community-Based For Food Security and Nutrition in Lembata and East Flores, East Nusa Tenggara Province

This study analyzed local food development with community-based sorghum in two villages in the Lamaholot region, Lembata Regency and East Flores, East Nusa Tenggara. Research how sorghum development is related to the national food system by Food Law No. 18 of 2012 and according to the Sustainable Food System of FAO, as well as analyze how the food system is related to SDGs (2) without hunger. The research design is a mixed method, combining qualitative and quantitative analysis. The research resource persons were farmers, village heads, traditional leaders, religious leaders, cultural leaders, and local governments. Research findings show that the development of local food in both villages of the Lamaholot Tribe is in harmony with nature, respects all living things as a unit, and is by local wisdom. Community practices strongly support sustainable food systems. The practices carried out impact social, environmental, and economic sustainability. The above findings are reinforced by the results of quantitative analysis, which shows that: 1) The development of local food based on sorghum meets the expectations of farmer group members and is by local wisdom. 2). There is a linkage between the local food system of sorghum and the national food system and sustainable food system for environmental, social, and economic sustainability. Judging from the linkage of the national food system, it is obtained that the development of local food meets the elements of food availability, access, and utilization. 3) Development of local food sorghum as an alternative to overcome food security and nutrition.