Action Plan Research Articles

Multimorbidity and emergency hospitalisations during hot weather

BackgroundPeople with chronic diseases are a commonly listed heat-vulnerable group in heat-health action plans. While prior research identifies multiple health conditions that may increase vulnerability to ambient heat, there is minimal evidence regarding the implications of multimorbidity (two or more chronic diseases). MethodsFrom the statewide hospital registry of Queensland, Australia, we identified people aged ≥15 years who had emergency hospitalisation(s) between March 2004 and April 2016 and previously had 0, 1, 2, or ≥3 of five chronic diseases: cardiovascular disease, diabetes, mental disorders, asthma/COPD, and chronic kidney disease. We conducted time-stratified case-crossover analyses to estimate the odds ratio of hospitalisations associated with ambient heat exposure in people with different numbers, types, and combinations of chronic diseases. Ambient heat exposure was defined as a 5 °C increase in daily mean temperature above the median. FindingsThere were 2,263,427 emergency hospitalisations recorded (48.7% in males and 51.3% in females). When the mean temperature increased, hospitalisation odds increased with chronic disease number, particularly in older persons (≥65 years), males, and non-indigenous people. For instance, in older persons with 0, 1, 2, or ≥3 chronic diseases, the odds ratios associated with ambient heat exposure were 1.00 (95% confidence interval: 0.96, 1.04), 1.06 (1.02, 1.09), 1.08 (1.02, 1.14), and 1.13 (1.07, 1.19), respectively. Among the chronic diseases, chronic kidney disease, and asthma/COPD, either existing alone, together, or in combination with other diseases, were associated with the highest odds of hospitalisations under ambient heat exposure. InterpretationWhile individuals with multimorbidity are considered in heat-health action plans, this study suggests the need to consider specifically examining them as a distinct and vulnerable subgroup. FundingWellcome.

Investigating the Child Development of Learners with Special Educational Needs in Inclusive Education

Abstract: This study examined the development of 22 learners with special educational needs (LSENs) in inclusive education at Balamban SPED Center Elementary School in the Philippines. Surveys were used for data collection, and the analysis included descriptive statistics and comparative analysis. Most participants were 5-12-year-old females with three or four siblings. Their families had a monthly income of Php 10,000 or below. Autism was the most common particular need among successful learners, followed by hearing impairment and intellectual disability. According to parents, LSENs exhibited well-developed knowledge, attitude, skills, and behavior. Teachers, however, perceived that only knowledge and behavior were well-developed, while attitudes and skills showed moderate development. Perceptions of parents and teachers regarding child development did not differ significantly. The study concluded that inclusive education plays a crucial role in the success and development of LSENs. Successful learners demonstrated high levels of knowledge and behavior, as assessed by both parents and teachers. Teachers rated attitudes and skills as moderately developed. LSENs achieved functional literacy and adaptive behaviors necessary for daily life and prospects. Collaboration between parents and teachers was emphasized for enhancing child development and fostering holistic learners at home, school, and community. The study recommends that administrators use the findings to develop appropriate programs for LSENs, while teachers and parents utilize the results as an action plan to address educational gaps. The study can serve as a baseline for future research on the benefits of inclusive education for LSENs.

Elimination of mercury thermometers in health facilities: Review of achievement data as of January–October 2023

The Minamata Convention as a form of international agreement in the prevention and reduction of mercury emissions globally moves the world in support of eliminating mercury in the environment. Indonesia is one of the countries that contributed to making the “National Action Plan for Mercury Reduction and Elimination” particularly within its health sector, focusing on the elimination of mercury thermometers. This study aims to analyze the achievement of the elimination of mercury medical devices in the form of thermometers at Indonesian health facilities as an evaluation material for improving performance in achieving the program target by 100%. The research method utilized is descriptive qualitative analysis. In this study, primary data processing was carried out online to eliminate mercury medical devices in health facilities in Indonesia. From the research findings, it can be concluded that the achievement of mercury thermometer removal in Indonesia still has not reached the target of the “National Action Plan for Mercury Reduction and Elimination”

Key forecasts and prospects for green transition in the region of Central Asia beyond 2022

BackgroundThe transition to energy-sustainable systems is a globally accepted concept, but it is implemented with various degrees of success around the world. The aim of this paper is to determine the status of green transition in five Central Asian countries (Tajikistan, Turkmenistan, Uzbekistan, Kazakhstan, and the Kyrgyz Republic) that are among the highest energy consumers globally and the most vulnerable to climate change. Despite a notable improvement in living conditions across all countries over the past two decades, the region remains underdeveloped. Economic growth is based on the export of natural resources and remittance inflows, but the structure of the economy is monolithic.Main findingsUpon analysing transition indicators for the period 2000–2020, no evidence of significant changes towards a sustainable energy transition is found. All countries in the region (except Uzbekistan) have recorded an increase in carbon emissions, while the carbon intensity of the energy mix is almost the same. While there has been visible progress in reducing energy intensity, the countries in the region remain among the most energy-intensive economies. Despite the region’s substantial potential for renewable energy production, it remains underutilized.ConclusionsA multitude of varied problems accompanies the green transition in Central Asian countries. The energy market that has not yet been liberalised, along with significant subsidies and low energy tariffs, discourages investments in renewable energy sources and energy efficiency initiatives. A high level of corruption, rigid legislative and institutional infrastructure, and insufficient capital are additional factors that determine the speed, scope, and effectiveness of the green transition. Thus far, the primary focus in these countries has been on ensuring energy security. However, there has been a discernible surge in investments (particularly from China) in renewable energy projects. Although energy efficiency and climate change issues are formally defined, the energy transition goals are often declarative without an action plan that provides concrete steps in transition process. Strategic planing of economic development that includes all related sectors (not only the energy sector) and paying attention to socio-economic and environmental indicators of sustainable development are prerequisites for successfully implementating the energy transition in these countries.

Promoting healthy school food environments and nutrition in Canada: a systematic review of interventions, policies, and programs.

The school food environment is a critical interface for child and adolescent nutrition, and there is a need to understand existing literature on Canadian school food environments to identify equity gaps and opportunities, and empower decision-makers to plan for future action. Literature on Canadian school food and nutrition interventions, policies, programs, and their effects on diets and nutritional status are synthesized and appraised in this systematic review. A search strategy was developed for each database used (Medline, Embase, PsycINFO, ERIC, Cochrane Collaboration, Canadian Electronic Library, BiblioMap), with a combination of free text and controlled vocabulary, for articles published from 1990 to 2021. Unpublished data and grey literature were also searched. Quantitative and qualitative studies with an observational or intervention study design, reviews, or program evaluations conducted in Canadian schools with participants aged 5-19.9 years were included. Key study characteristics and risk of bias were extracted independently by 2 investigators using a standardized tool. A total of 298 articles were included (n = 192 peer reviewed and 106 from the grey literature), which were mostly conducted in Ontario (n = 52), British Columbia (n = 43), and Nova Scotia (n = 28). Twenty-four interventions, 5 nonevaluated programs, and 1 policy involved Indigenous populations. Overall, 86 articles measured and reported on effectiveness outcomes, including dietary intake; anthropometry; knowledge, attitudes, and practices; and physical activity. The literature remains largely heterogenous and primarily focused on nutrition education programs that use subjective assessments to infer changes in nutrition. A key facilitator to implementation and sustainability was community engagement, whereas key barriers were staff capacity, access to resources and funding, and consistent leadership. This review provides insight into Canadian school food and nutrition interventions, programs, and policies and uncovers important evidence gaps that require careful examination for future evaluations. Governments must create supportive environments that optimize nutrition for children and adolescents through equitable policies and programs. PROSPERO registration no. CRD42022303255.

Policy drivers and tools influencing the development of social enterprises in Taiwan

Purpose Taiwan promotes social enterprises with the Social Enterprise Action Plan and Social Innovation Action Plan, focusing on solving social problems and achieving sustainable development goals. This study aims to clarify the impetus for the above policies and determines whether the relevant policy tools can achieve the established policy goals. Design/methodology/approach This study adopts the in-depth interview method and uses the “social impact investment framework” constructed by OEDC and Dunn’s definition of public policy stakeholders to select 22 respondents, who were divided into three groups. Findings Taiwan’s decision-making in social enterprise policy is mainly driven by the pressure of youth unemployment and the 318-student movement. Intrinsic motivation strategies popularized the concept of social enterprise. Various strategies are used to break the limitations and diversify the organization, trigger more diverse social investments, broaden the goals of investment and complete the social enterprise ecosystem through these. Taiwan’s social enterprise policies are consistent with the global trend of “replacing subsidies with investment.” Originality/value This study shows that social enterprises generate mutual benefits between investors and social enterprises, that is, achieve free matching through external mechanisms. This study fills the gaps in Oliver’s “behavioral cube” framework of policy instruments. A “behavioral four-dimensional matrix” composed of nudge, shove, budge and reciprocity is proposed to complete the framework for social enterprise policy analysis tools.

Automatic Platform Bridge in Railways

The primary aim of the Automatic Railway Bridge System is to assist physically challenged passengers in moving from one platform to another. Crossing the railway track within the station premises poses significant challenges, especially for the handicapped and elderly individuals, who often require assistance from others. In this study, the agents utilize various resources such as train characteristics, driving regulations, and information pertaining to other trains to formulate their action plan. Many elderly individuals suffer from ailments such as leg cramps, walking difficulties, vein issues, and chronic foot pains, making it imperative to address this issue. To tackle this problem, we propose a project involving the implementation of a horizontally adjusted platform connecting both station platforms. This innovation eliminates the need for both adults and children to climb bridges, thereby saving time for passengers and ensuring smoother operations for all. Keywords- Railway Systems, Platform Bridge, IR SENSOR (E18-D80NK Infrared Proximity Sensor), DC Motor.

Regeneration niche of Cortaderia selloana in an invaded region: Flower predation, environmental stress, and transgenerational effects

Background and aimsBiological invasions are causing massive environmental, social, and economic impacts worldwide. Understanding the ecological factors that affect the regeneration of invasive plants is critical to develop action plans based on empirical biological evidence. In this study, we investigate ecological limits in the regeneration of Cortaderia selloana, an invasive species with a strong impact in temperate regions. MethodsWe sampled 22 sites invaded by C. selloana along an environmental gradient in northern Spain to evaluate the influence of flower predation, environmental stress, and transgenerational effects on the performance of C. selloana offspring. Key resultsWe found that over half of the sampled flowers per individual contained larvae of Spanolepis selloanae, a recently discovered predator of C. selloana. This finding suggests that the presence of this natural enemy extends over a larger area than previously thought, which might drastically reduce seed production. A common-garden experiment conducted with over 5,200 seeds revealed that seed germination is significantly enhanced with increasing temperatures (with an optimum temperature of 22/12 °C day/night temperatures), and that seedling survival and growth are highest under waterlogged soil conditions. Our experiments also suggest that the minimum temperature for germination of C. selloana is 10 °C, and that seedlings can survive up to one month without water. These findings can improve management programs by delineating which areas are at high risk of invasion and which ones are unsuitable for the regeneration of C. selloana. We also found that seed mass and maternal plant size are positively correlated with seed germination and early seedling growth. Progeny from dry maternal environments performed better under continuous drought conditions and the opposite was found under wet conditions. ConclusionsOverall, our results suggest that flower predators, environmental stress, and transgenerational effects have complex and profound effects on early demographic stages of C. selloana, influencing seed production, seed germination, seedling growth, and seedling survival.

A one health approach for monitoring antimicrobial resistance: developing a national freshwater pilot effort

Antimicrobial resistance (AMR) is a world-wide public health threat that is projected to lead to 10 million annual deaths globally by 2050. The AMR public health issue has led to the development of action plans to combat AMR, including improved antimicrobial stewardship, development of new antimicrobials, and advanced monitoring. The National Antimicrobial Resistance Monitoring System (NARMS) led by the United States (U.S) Food and Drug Administration along with the U.S. Centers for Disease Control and U.S. Department of Agriculture has monitored antimicrobial resistant bacteria in retail meats, humans, and food animals since the mid 1990’s. NARMS is currently exploring an integrated One Health monitoring model recognizing that human, animal, plant, and environmental systems are linked to public health. Since 2020, the U.S. Environmental Protection Agency has led an interagency NARMS environmental working group (EWG) to implement a surface water AMR monitoring program (SWAM) at watershed and national scales. The NARMS EWG divided the development of the environmental monitoring effort into five areas: (i) defining objectives and questions, (ii) designing study/sampling design, (iii) selecting AMR indicators, (iv) establishing analytical methods, and (v) developing data management/analytics/metadata plans. For each of these areas, the consensus among the scientific community and literature was reviewed and carefully considered prior to the development of this environmental monitoring program. The data produced from the SWAM effort will help develop robust surface water monitoring programs with the goal of assessing public health risks associated with AMR pathogens in surface water (e.g., recreational water exposures), provide a comprehensive picture of how resistant strains are related spatially and temporally within a watershed, and help assess how anthropogenic drivers and intervention strategies impact the transmission of AMR within human, animal, and environmental systems.

Mental Health Support Is an Unmet Need for Long-Term Burn Survivors: A Web-Based Survey.

A National Trauma Research Action Plan identified the involvement of burn survivors as critical informants to determine the direction of research. This study employed a web-based survey to identify care gaps in a sample of burn survivors. We surveyed burn survivors from around the United States through social media and email contact with the Phoenix Society for Burn Survivors. We elicited demographic info, burn history, and unmet needs. Statistical analysis was performed to test our hypothesis that lack of access to mental health support/professionals would be identified as an unmet need in long-term burn survivors. Of 178 survey respondents, most were at least ten years removed from the date of their burn injury (n=94, 53%). Compared to those less than 3 years from their burn injury, individuals greater than 10 years were at least 5 times more likely to note lack of access to mental health support [11-20 years OR 8.7, p< 0.001; >20 years OR5.7, p=0.001]. 60% of Spanish speakers reported lack of support group access was among their greatest unmet needs, compared to 37% of English speakers (p=0.184). This study highlights the need for ongoing access to mental health resources in burn survivors. Our findings emphasize that burn injury is not just an acute ailment, but a complex condition that evolves into a chronic disease. Additional studies should focus on the experiences of Spanish-speaking burn survivors, given small sample size leading to a likely clinically significant but not statistically different lack of access to support groups.

City health development planning – experiences from the Hungarian members of the WHO European Healthy Cities Network

ABSTRACT This study showcases the City Health Development Planning (CHDP) methodology developed and implemented in Hungarian designated cities of the World Health Organization European Healthy Cities Network. This methodology is based on those principles that the WHO-EHCN recommends for CHDP works. The methodology consists of two phases: creating a City Health Profile (CHP) with specific components such as content analysis of the city’s strategic policy documents, semi-structured interviews with local political decision-makers, adopting a decentralized and participatory planning approach, and gathering available health-related data from the city. Then, the City Health Development Plan is created based on the statement of the CHP using the CHDP. The effectiveness of CHDP efforts, relies on three crucial factors: local politicians’ commitment, the operation of a local multisectoral steering committee, and annual action plans approved by the local government. Kingdon’s multiple streams theory suggests that issues are addressed when the streams of problems, policy, and politics align. The CHDP methodology described in this paper can effectively support the alignment of the three streams and open a window of opportunity to contribute to creating a healthy urban environment, as demonstrated by the experiences of the Hungarian designated cities of the WHO-EHCN.

Leadership Development Interventions to Reduce Imposter Phenomenon in the STEM Fields in Minorities

Background: There is a significant lack of diversity in the Science, Technology, Engineering, and Mathematics (STEM) fields. Evidence shows that lack of representation can feed into feelings of imposter phenomenon which in turn influences leadership qualities. Objectives: An argument is made that by providing leadership development training to minorities in science, technology, engineering, and mathematics fields, confidence will be boosted, feelings of imposter phenomenon will be reduced, and thus these students will be retained. Approach: Theories explored to explain this challenge include the imposter phenomenon, servant leadership, and transformational leadership. Results: The goal of this article is to demonstrate the need for research into leadership development of minorities in the science, technology, engineering, and mathematics fields. Conclusions: A program proposal is also introduced as a suggested plan of action based on the findings.

Personalizing Students’ Digital Action Plans through Critical-Heutagogy Model for the Development of Critical Conscientization in Critical Reading

The advent of the digital age is unpredictably changing education and educational practices. With the wider availability of print and online materials, the language educator of the twenty-first century must expect her/his pupils to be more critical readers if they are to develop their critical consciousness in language acquisition. Consequently, the purpose of the study was to analyse the elements that impede students' capacity to increase their critical consciousness through critical reading, as well as the ways in which digital technology may alleviate the situation. In order to comprehend the reading practices of students, critical pedagogy and self-determined theory were applied. Utilizing a design-based research, design principles emerged that increased student engagement with texts, peers, and technology. As a result, a framework for enhancing students' proficiency and critical awareness in language teaching was developed.

Carbon Emission Analysis and Reporting in Urban Emissions: An Analysis of the Greenhouse Gas Inventories and Climate Action Plans in Sarıçam Municipality

The urban carbon footprint (UCF) is an important tool for assessing an organization’s ecological impacts and in guiding sustainability efforts. This calculation is usually measured in tons of carbon dioxide equivalent (CO2-eq). Calculations provide important data to determine strategies to reduce the carbon footprint and establish sustainability targets. Various standards and protocols guide UCF calculation, and many organizations aim to make these data transparent to their stakeholders and the public. This study aims to calculate the UCF of Sarıçam Municipality (SM) in the Adana Province of Türkiye. This study includes the greenhouse gas emission inventories resulting from all activities of the SM main service building, guest house, construction site service building, Cultural Center service building, and additional service buildings between 1 January 2022 and 31 December 2022. The calculations include generator fuel consumption, electricity consumption, the refrigerant gas leaks and refills resulting from these activities, the fuel consumed in vehicles owned by the company or whose fuel consumption is under company control, emissions originating from personal travel, emissions originating from customers and visitors, emissions originating from business travel, purchases, etc. Emissions from products purchased and emissions from waste transportation are included. The findings show that, in 2022, the total UCF of SM was equal to 10,862.46 tons of CO2-eq. The Paris Agreement aims to reduce the per capita emissions to approximately two tons of CO2-eq by 2030. The carbon footprint per employee within the municipality was calculated at 12.43 tons of CO2-eq, as derived from the analyzed data. The results reveal the importance of implementing sustainable practices and strategies within SM, such as energy efficiency measures, waste reduction, and the adoption of renewable energy sources, to mitigate its carbon footprint. This study plans to provide a basis for SM’s reduction efforts by keeping greenhouse gas emissions under control.

Hegemony, Europeanization, and Migration Diplomacy: Case of the EU-Turkey Statement and Action Plan

ABSTRACT This article analyzes the Turkey Statement and Action Plan concerning the concept of hegemony, Europeanization, and migration diplomacy. In contrast to the mainstream literature, which exclusively concentrates on the idea of the Europeanization process and balance politics in its analysis of the deal, this study explains the deal with the perspective of hegemony and hegemonic stability theory, along with mentioning discourses of Turkey and EU officials. In other words, the Europeanization process with the migration crisis in 2016 led to—especially economic—hegemony, which resulted by consent, not coercion, in the relationship between Turkey and the EU. Based on the deal, externalization, trade relations and rhetoric of Turkey and the EU, the article concludes that the migration crisis established a based hegemony between Turkey and the EU on the subject of the migration crisis.

Economic Vitality, Sustainability and Marketability of Mixed-Use Development Projects in the Leasing Industry

The study attempted to determine the economic vitality, sustainability, and marketability of mixed-use development projects in the leasing industry in the Philippines. The goal of this study is to identify the correlation among economic vitality, sustainability, and marketability. Additionally, develop a plan to enhance the economic vitality, sustainability, and marketability for stakeholders to use for future business ventures. The study employed the descriptive-correlational method of research with the help of a survey questionnaire. The population of the study came from 80 mixed-use development projects within the leasing industry in the second district of Laguna, Philippines. A sample of 67 was computed using the Slovin formula at 5% margin of error and 95% confidence interval. The actual selection of the respondents was done using a purposive random sampling technique. After thorough analysis, the following conclusions were made. The diversity of businesses and tenant types adds value to the overall development. The confidence in long-term development projects focuses on sustainability and future adaptation. Tenant satisfaction is crucial for marketability, suggesting a focus on both attracting and retaining tenants. The economic vitality has a direct relationship with the sustainability of mixed-use development projects in the leasing industry. Economic significantly affects the marketability of mixed-use development projects in the leasing industry. As the level of sustainability increases, the level of marketability of mixed-use development projects in the leasing industry also increases. Hence, an action plan that would improve the economic vitality, sustainability, and marketability of mixed-use development projects in the leasing industry was proposed.

Alcohol policy development in Sierra Leone: An assessment of the role of civil society

Objective: To assess the value addition of civil society collaboration with Government in the development of Sierra Leone’s National Alcohol Policy (NAP). Policy Development Process: We reviewed the entire process of lobby, advocacy, and support for the development of the NAP from 2015 when the Siera Leone Alcohol Policy Alliance (SLAPA) was formed to the launch of the NAP in 2023. It also assesses the level of collaboration between FoRUT, SLAPA and Ministry of Health of Health and Sanitation (MoHS). The MoHS coordinated the policy formulation process with substantive technical support from civil society. Results: The quality of the NAP was rated high as it reflected appropriate policy areas and interventions from the Global Strategy to Reduce the Harmful Use of Alcohol, the WHO SAFER initiative, and the Global Action Plan for Alcohol Control (202-2030). The NAP is a solid reference material for the development of a new alcohol bill. MoHS recognized FoRUT and SLAPA as the national champions for alcohol control in the country. FoRUT, directly and through SLAPA influenced the process of developing the NAP and its quality through advocacy, collaboration and technical and financial support. Conclusions: The development of the NAP in Sierra Leone truly reflects civil society-government collaboration, built on mutual trust and a common health and development agenda. Connecting national level lobby and advocacy with regional global advocacy actions to prioritize, influence, support, and monitor the alcohol control agenda is a critical catalyst for civil society to advancing the development of NAPs.

The role of Allee effect in cannibalistic species: An action plan to sustain the declining cod population

The role of Allee effect in cannibalistic species: An action plan to sustain the declining cod population

Evaluating a Trauma-Informed Care Training Program for Mental Health Clinicians

AbstractThe aim of this study was to evaluate the interRAI Trauma-Informed Care (TIC) training program based on evidence-informed Collaborative Action Plans. Focus groups and the Attitude Related Trauma-Informed Care (ARTIC) questionnaire addressed clinicians’ and mental health professionals’ attitudes toward the application of TIC with their child and youth clients. An explanatory sequential design was conducted. In total, 105 clinicians and mental health professionals who participated in a 4-hour, in-person or virtual TIC training, two comprehensive seminars, and 28 trauma-informed training web-based modules completed the ARTIC questionnaire. Researchers conducted seven focus groups with clinicians/participants (N = 23) to discuss the views and effectiveness of the interRAI TIC educational training modules. To quantitatively measure the change of attitudes towards TIC, descriptive statistical analysis was completed using the means and standard deviation of the ARTIC scores at the initial time point, the follow-up time point, and the difference between scores at both time points. Paired sample t-tests were conducted on both the overall score and each of the subscales in each of the three samples (total sample, online subsample, and hybrid subsample). A thematic analysis was conducted to generate qualitative findings from the focus groups. Findings from the quantitative and qualitative analyses suggest that the interRAI TIC training provided clinicians with an improved sense of knowledge and ability to apply trauma-informed care planning with their clients.

Addressing the challenges of dementia care in Nigeria: A call for a comprehensive national strategy

AbstractDespite the growing prevalence of dementia, driven by an ageing population and compounded by cultural misunderstandings and stigma, Nigeria lacks a coherent national plan to address this issue. The article points out that although Nigeria has enacted policies such as the National Aging Policy, which do not sufficiently address the specific needs of people living with dementia. It underscores the necessity of integrating a dementia strategy within the broader health and social care systems of Nigeria. The article draws on the World Health Organization's Global Dementia Action Plan to elaborates on several critical areas for action, including public health prioritization of dementia, awareness and stigma reduction, improved diagnosis, treatment, care, and support, alongside bolstering support for caregivers. It stresses the importance of a dementia‐friendly infrastructure, research and innovation, and leveraging community support to foster a more inclusive society. Furthermore, the article outlines current state of healthcare and social support systems in Nigeria, pointing to significant gaps in infrastructure, healthcare workforce, and financial mechanisms that hinder effective dementia care. Hence, elevating dementia care as a national health priority, and increasing access to quality care and support, Nigeria is well positioned to mitigate the impact of dementia on families and the person with dementia. The call to action is clear: a national dementia strategy, informed by global best practices and tailored to Nigeria's unique cultural and societal context, is essential for addressing the challenges of dementia care and improving the well‐being of affected individuals and their families in Nigeria.