Socioeconomic Settings Research Articles

The impact of COVID-19 pandemic on fertility behaviour in Indian states: Evidence from the National Family Health Survey (2019/21).

The COVID-19 pandemic affected a broad spectrum of people's lives very quickly. Although the pandemic could influence people's fertility behaviours in several ways, there is little knowledge about such influence in diverse socioeconomic and cultural settings. This study investigated the impact of the COVID-19 pandemic on fertility behaviours and desires among women in a lower-middle-income country, India. Our study analyzed cross-sectional data from 13 states and union territories (UTs) in India that were surveyed in pre- and post-lockdown periods by the 2019/21 National Family Health Survey (NFHS). The data were analysed using the descriptive analysis technique and the multilevel logit model. All these analyses were performed using the technique developed for complex sample design. The poverty-stricken states of Uttar Pradesh and Jharkhand and the Odisha state with moderate socioeconomic status experienced a significant decrease in contraceptive use and non-significant changes in the desire for birth and sexual activities after the lockdown. Contraceptive use significantly increased after the lockdown in the rich states of Punjab, Delhi, and Tamil Nadu, as well as in the Arunachal Pradesh state with moderate socioeconomic status. The changes in fertility behaviours in Uttar Pradesh, Jharkhand, and Odisha may influence fertility positively, while those changes in Punjab, Delhi, Tamil Nadu, and Arunachal Pradesh may influence fertility negatively. At the aggregate level, there was a significant increase in desire for another child and a decrease in contraceptive use after the lockdown, which may influence fertility positively but can be compensated by reduced sexual activities. The influence of the fertility trends in the states with pro-natalist changes on India's recent fertility trend could be greater than those with anti-natalist changes, which can be better understood by analyzing reliable data from a couple of years following the 2019/21 NFHS.

How might the provision of smoking cessation services be adapted to improve uptake and success for people in low socioeconomic groups? A qualitative study (PROCESS Study)

BackgroundSmoking is a key driver of health inequalities and a leading cause of cancer incidence in the UK. Stop Smoking Services (SSS) offer a combination of behavioural and pharmacological support. Individuals who use SSS are three times more likely to successfully quit than those who try to quit unaided, but uptake of services is low, particularly amongst people from low socioeconomic backgrounds. The aim of this qualitative study was to understand the barriers and facilitators to accessing SSS in this population. MethodsQualitative interviews with SSS providers (pharmacists, SSS leads, and advisors; n=22) and potential or current service users from low socioeconomic backgrounds (n=115) across the UK. Interviews were coded thematically using NVivo and analysed using the COM-B model which cites Capability (C), Opportunity (O), and Motivation (M) as factors for changing behaviour (B). Informed consent was obtained verbally prior to interviews. FindingsFacilitators to accessing SSS included proximity of services, flexibility of service delivery, and free NRT provision. Barriers included waiting lists, staffing shortages, lack of service visibility and advertisement, and perceived stigma and lifestyle factors. The use of smart phones/apps in service provision was identified as both a barrier and facilitator. Recommendations for service enhancement included improved visibility and awareness of SSS (Capability), enhanced community links to embed services or support referral pathways (Opportunity) and person-centred approaches to SSS delivery (Motivation). InterpretationOur findings provide evidence on practical solutions for adapting SSS delivery, with potential to increase equitable uptake and improve outcomes. Removing structural barriers through tailored support and targeted promotion of local SSS is essential to maximise service uptake. The use of community outreach services/agencies was identified as an important way of maximising targeted work to improve access to SSS in low socioeconomic settings. FundingThis study was funded by Cancer Research UK.

Health dialogue intervention versus opportunistic screening in primary care for type 2 diabetes and cardiovascular disease prevention in settings with low socioeconomic status (DETECT): study protocol for a pragmatic cluster-randomized trial

BackgroundMeta-analyses of randomized trials suggest that health checks and health promotion interventions targeting behavior change in primary care do not prevent cardiovascular morbidity and mortality in the general population. However, whether such interventions are more effective in high-risk populations, such as people living in low socioeconomic settings, remains unclear, as they have been poorly represented in previous trials. Therefore, we aim to evaluate the effectiveness, cost-effectiveness, and implementation of systematic screening followed by an individually oriented, lifestyle-focused, health dialogue intervention for prevention of type 2 diabetes and cardiovascular disease, as compared to opportunistic screening, in primary care in socioeconomically disadvantaged areas.MethodsUsing an overall pragmatic approach and a cluster-randomized design with two arms, we aim to enroll 3000 participants aged 50–59 years from 30 primary care centers (PCCs) with an above-average level of Care Need Index in Stockholm Region, Sweden. PCCs will be randomized (1:1) either to a health dialogue intervention, which includes inviting enlisted patients to a systematic screening of risk factors followed by an individually oriented lifestyle-focused health dialogue, or to opportunistic screening, which includes screening patients for a smaller set of risk factors during an appointment at their PCC taking place for other reasons. The main outcome will be change in systolic blood pressure during 6- and 12-month follow-ups. Additional short-term outcomes will be changes in other biological risk factors, health-related quality-of-life, and lifestyle habits, as well as process and implementation outcomes, and unintended side effects. The long-term effect on type 2 diabetes and cardiovascular disease incidence and mortality will be examined using regional and nationwide registers. Changes in systolic blood pressure and other health outcomes will be analyzed using mixed-effect generalized linear modeling and mixed-effect Cox regression to capture variability between and within PCCs. A health economic evaluation will assess resource use and costs in the short- and long-term.DiscussionThis trial of lifestyle-focused health dialogues and opportunistic screening in primary care in socioeconomically disadvantaged areas in the largest region of Sweden has the potential to yield valuable insights that could support evidence-based policymaking.Trial registrationClinicalTrials.gov (NCT06067178). Prospectively registered September 27, 2023.

Measuring fidelity to manualised peer support for people with severe mental health conditions: development and psychometric evaluation of the UPSIDES fidelity scale

BackgroundPeer support workers provide support for people experiencing mental health conditions based on their own lived experience of mental health problems. Assessing fidelity to core ingredients of peer support is vital for successful implementation and intervention delivery. Modifications to its implementation are needed when scaling up to different socio-economic settings, raising further uncertainty about fidelity. As part of a large multi-centre study on peer support called Using Peer Support In Developing Empowering Mental Health Services (UPSIDES), we developed and evaluated the psychometric properties of the UPSIDES Fidelity Scale.MethodsWe constructed the fidelity scale based on an initial item pool developed through international expert consultation and iterative feedback. Scale refinement involved site-level expert consultation and translation, resulting in a service user-rated 28-item version and a peer support worker-rated 21-item version assessing receipt, engagement, enactment, competence, communication and peer support-specific components. Both versions are available in six languages: English, German, Luganda, Kiswahili, Hebrew and Gujarati. The scale was then evaluated at six study sites across five countries, with peer support workers and their clients completing their respective ratings four and eight months after initial peer support worker contact. Psychometric evaluation included analysis of internal consistency, construct validity and criterion validity.ResultsFor the 315 participants, item statistics showed a skewed distribution of fidelity values but no restriction of range. Internal consistency was adequate (range α = 0.675 to 0.969) for total scores and all subscales in both versions. Confirmatory factor analysis indicated acceptable fit of the proposed factor structure for the service user version (χ2/df = 2.746; RMSEA = 0.084) and moderate fit for the peer support worker version (χ2/df = 3.087; RMSEA = 0.093). Both versions showed significant correlations with external criteria: number of peer support sessions; perceived recovery orientation of the intervention; and severity of illness.ConclusionsThe scale demonstrates good reliability, construct and criterion validity, making it a pragmatic and psychometrically acceptable measure for assessing fidelity to a manualised peer support worker intervention. Recommendations for use, along with research and practical implications, are addressed. As validated, multi-lingual tool that adapts to diverse settings this scale is uniquely positioned for global application.Trial registrationISRCTN, ISRCTN26008944. Registered on 30 October 2019.

Nectar and pollen source of natural honey produced by Apis cerana skorikovi Engel (= himalaya): Palynological analysis from tropical to sub-tropical forests of eastern Himalaya

This study deals with the palynological analysis of natural “Himalayan cerana” honey collected from the tropical to sub-tropical forests of the eastern Himalaya (West Sikkim, Ziro valley of Arunachal Pradesh and sub-Himalayan region of West Bengal). A total of 12 honey samples were analysed. Among the six samples from Sikkim, one is found unifloral and remaining five samples are found to be multifloral. Similarly, the Kolakham (West Bengal) sample is found multifloral, whereas both the honey samples of Alipurduar (West Bengal) are found to be unifloral. All the three Arunachal Pradesh samples are found multifloral. Absolute pollen count (APC) reveals that the unifloral winter honeys are poor in APC compared to the multifloral ones. Significant occurrence of anemophilous pollen grains in honey samples points towards theirr entrapment either during long distance flight of the bees or on the sticky hive surfaces. The nectar calendars show that winter season is the honey dearth period in the study areas of the eastern Himalaya. Finally, the diversity and richness of the pollen grains in the honey samples also reflect the bee plant diversity of the surroundings. The study may further be useful to assess the potentiality for establishing a moderate to large-scale bee-keeping industry which may provide an alternate source of livelihood to improve the socio-economic set up of the local economically backward ethnic communities.

Outpatient Versus Inpatient Total Hip and Knee Arthroplasty in Morbidly Obese Patients

BackgroundMorbidly obese patients undergoing total joint arthroplasty (TJA) face increased postoperative complications, yet studies assessing the safety of this surgery in the outpatient setting for this population are lacking. This study aimed to fill this gap by assessing the safety and benefits of outpatient TJA in morbidly obese patients. MethodsThis study is a retrospective review of a commercial claims database. Based on the setting of the procedure, the patients were divided into four groups as follows: inpatient-TKA (total knee arthroplasty), outpatient-TKA, inpatient-THA (total hip arthroplasty), and outpatient-THA. The two TKA groups were matched based on age, sex, and the Charlson Comorbidity Index. The THA groups were matched similarly. The 30- and 90-day medical and surgical complications were compared between these groups. There were 5,500 patients included in each of the outpatient and inpatient TKA groups and 1,550 in each of the outpatient and inpatient THA groups. ResultsPatients undergoing inpatient TKA had higher rates of pulmonary embolism, urinary tract infection, transfusions, intensive care unit admissions, emergency department visits, readmissions at 30 days, surgical site infections, periprosthetic joint infection, prosthetic dislocations, and costs. As for the inpatient THA group, they had higher rates of pulmonary embolism, urinary tract infection, transfusions, intensive care unit admissions, emergency department visits, and costs. ConclusionsIt is well-established that morbidly obese patients undergoing TJA have higher complication rates than normal-weight patients, and patients should be counseled before arthroplasty. This study highlights the safety and benefits of outpatient TJA in morbidly obese patients. However, one should note that this was done using an insurance database, in which results may differ if it was done in a public and lower socioeconomic setting. Therefore, future prospective studies are needed to confirm the findings before implementing outpatient TJA in morbidly obese patients.

Anthropometric prediction models of body composition in 3 to 24month old infants: a multicenter international study

BackgroundAccurate assessment of body composition during infancy is an important marker of early growth. This study aimed to develop anthropometric models to predict body composition in 3–24-month-old infants from diverse socioeconomic settings and ethnic groups.MethodsAn observational, longitudinal, prospective, multi-country study of infants from 3 to 24 months with body composition assessed at three monthly intervals using deuterium dilution (DD) and anthropometry. Linear mixed modelling was utilized to generate sex-specific fat mass (FM) and fat-free mass (FFM) prediction equations, using length(m), weight-for-length (kg/m), triceps and subscapular skinfolds and South Asian ethnicity as variables. The study sample consisted of 1896 (942 measurements from 310 girls) training data sets, 941 (441 measurements from 154 girls) validation data sets of 3–24 months from Brazil, Pakistan, South Africa and Sri Lanka. The external validation group (test) comprised 349 measurements from 250 (185 from 124 girls) infants 3–6 months of age from South Africa, Australia and India.ResultsSex-specific equations for three age categories (3–9 months; 10–18 months; 19–24 months) were developed, validated on same population and externally validated. Root mean squared error (RMSE) was similar between training, validation and test data for assessment of FM and FFM in boys and in girls. RMSPE and mean absolute percentage error (MAPE) were higher in validation compared to test data for predicting FM, however, in the assessment of FFM, both measures were lower in validation data. RMSE for test data from South Africa (M/F−0.46/0.45 kg) showed good agreement with validation data for assessment of FFM compared to Australia (M/F−0.51/0.33 kg) and India(M/F−0.77/0.80 kg).ConclusionsAnthropometry-based FFM prediction equations provide acceptable results. Assessments based on equations developed on similar populations are more applicable than those developed from a different population.

Global Sex Disparities in Bystander Cardiopulmonary Resuscitation After Out-of-Hospital Cardiac Arrest: A Scoping Review.

This scoping review collates evidence for sex biases in the receipt of bystander cardiopulmonary resuscitation (BCPR) among patients with out-of-hospital cardiac arrest patients globally. The MEDLINE, PsycINFO, CENTRAL, and Embase databases were screened for relevant literature, dated from inception to March 9, 2022. Studies evaluating the association between BCPR and sex/gender in patients with out-of-hospital cardiac arrest, except for pediatric populations and cardiac arrest cases with traumatic cause, were included. The review included 80 articles on BCPR in men and women globally; 58 of these studies evaluated sex differences in BCPR outcomes. Fifty-nine percent of the relevant studies (34/58) indicated that women are less likely recipients of BCPR, 36% (21/58) observed no significant sex differences, and 5% (3/58) reported that women are more likely to receive BCPR. In other studies, women were found to be less likely to receive BCPR in public but equally or more likely to receive BCPR in residential settings. The general reluctance to perform BCPR on women in the Western countries was attributed to perceived frailty of women, chest exposure, pregnancy, gender stereotypes, oversexualization of women's bodies, and belief that women are unlikely to experience a cardiac arrest. Most studies worldwide indicated that women were less likely to receive BCPR than men. Further research from non-Western countries is needed to understand the impact of cultural and socioeconomic settings on such biases and design customized interventions accordingly.

Associations between risk factors, including approximal contact types and dental caries in children from low-income families. Pilot study.

The present cross-sectional study was conducted to evaluate various caries risk factors in children from low socio-economic groups and to assess if children with broad contacts between one or more primary molars (type I and S) should be categorized as at high caries risk. Clinical examinations were performed on 107, 3- to 10-year-old children from low socio-economic settings. Contact types along with other caries risk factors (insurance, diet, plaque, and fluoride use, and diet habits) were analyzed for effect on presence of caries lesions (prevalence) and caries experience (decayed, missing, filled teeth). 78% of the study population had dental caries lesions, with an average dmft of 5.6. Of the 277 evaluated contacts, 88% were categorized as broad contacts. Multivariate analyses failed to validate that broad contacts were a predictor of dental caries lesions. However, the analysis showed an association of insurance status, plaque index with dmft. In conclusion, the present study could not implicate broad contacts as a factor that increased caries risk in the studied population; however, it validates the importance of insurance status, plaque index, as well as diet frequency as predictors of dental caries lesions.

Evaluation of soil erosion rate using geospatial techniques for enhancing soil conservation efforts

According to reports, Ethiopia is one of the countries in sub-Saharan Africa with the worst affected by soil erosion. It has both on-site and off-site consequences on biophysical and socioeconomic settings in an area. The study area is heavily affected by soil erosion forming diverse erosion structures, particularly in the upper course of the watershed. Hence, this work seeks to estimate the geographically distributed annual soil loss rate and mapping of soil erosion hazard hotspot areas in the watershed using the Revised Universal Soil Loss Equation (RUSLE) adapted to Ethiopian conditions. The RUSLE parameters, such as rainfall erosion factor (R-factor), soil erodibility factor (K-factor), slope steepness and slope length factor (LS-factor), land cover factor (C-factor), and conservation practice factor (P-factor) were considered as data input for the analysis to quantify the soil loss rate in the study area. A digital elevation model (DEM) with a 12.5 × 12.5-meter resolution was employed for catchment delineation and determination of the LS factor.The mean yearly rainfall data from the surrounding rain gauge stations was used to analyze the R-factor. The results of the current conditions showed that the average typical soil loss rate from the entire watershed is 23.8 t ha-1 yr-1, and the quantity of soil loss from the study area ranged from 0 to 776.71tan /ha-1 yr-1. Nonetheless, Tiro Afeta experiences mean soil erosion at a rate of roughly 50.2 t ha-1 yr-1, exceeding the acceptable threshold of 11 t ha-1 yr-1. Determining the sustainability of soil production requires assessment, particularly in cases where significant yearly soil erosion occurs. Due to intensive agricultural activities in the Xiro Afeta watershed, significant soil erosion is predominantly occurring in thissteep upper region. Consequently, this area urgently requires appropriate soil protection measures.

Ensuring Sustainable Digital Inclusion among the Elderly: A Comprehensive Analysis

Advancements in digital technologies have transformed the world by providing more opportunities and possibilities. However, elderly persons have several challenges utilizing modern technology, leading to digital exclusion, which can negatively impact sustainable development. This research attempts to address the current digital exclusion by addressing the challenges older people face considering evolving digital technologies, focusing on economic, social, and environmental sustainability. Three distinct goals are pursued in this study: to perform a detailed literature review to identify gaps in the current understanding of digital exclusion among the elderly, to identify the primary factors affecting digital exclusion in the elderly, and to analyze the patterns and trends in different countries, with a focus on differentiating between High-Income Countries (HICs) and Lower Middle-Income Countries (LMICs). The research strategies used in this study involve a combination of a literature review and a quantitative analysis of the digital exclusion data from five cohorts. This study uses statistical analysis, such as PCA, chi-square test, one-way ANOVA, and two-way ANOVA, to present a complete assessment of the digital issues that older persons experience. The expected results include the identification of factors influencing the digital divide and an enhanced awareness of how digital exclusion varies among different socio-economic and cultural settings. The data used in this study were obtained from five separate cohorts over a five-year period from 2019 to 2023. These cohorts include ELSA (UK), SHARE (Austria, Germany, France, Estonia, Bulgaria, and Romania), LASI (India), MHAS (Mexico), and ELSI (Brazil). It was discovered that the digital exclusion rate differs significantly across HICs and LMICs, with the UK having the fewest (11%) and India having the most (91%) digitally excluded people. It was discovered that three primary factors, including socio-economic status, health-related issues, and age-related limitations, are causing digital exclusion among the elderly, irrespective of the income level of the country. Further analysis showed that the country type has a significant influence on the digital exclusion rates among the elderly, and age group plays an important role in digital exclusion. Additionally, significant variations were observed in the life satisfaction of digitally excluded people within HICs and LMICs. The interaction between country type and digital exclusion also showed a major influence on the health rating. This study has a broad impact since it not only contributes to what we know academically about digital exclusion but also has practical applications for communities. By investigating the barriers that prevent older people from adopting digital technologies, this study will assist in developing better policies and community activities to help them make use of the benefits of the digital era, making societies more equitable and connected. This paper provides detailed insight into intergenerational equity, which is vital for the embedding principles of sustainable development. Furthermore, it makes a strong case for digital inclusion to be part of broader efforts (and policies) for creating sustainable societies.

Global synthesis indicates widespread occurrence of shifting baseline syndrome.

As environmental degradation continues at local, regional, and global levels, people's accepted norms for natural environmental conditions are likely to decline. This phenomenon, known as shifting baseline syndrome (SBS), is increasingly recognized as a likely major obstacle to addressing global environmental challenges. However, the prevalence of SBS remains uncertain. We conducted an extensive systematic review, synthesizing existing research on people's perceived environmental baselines. Our analysis, based on 73 case studies, suggests that SBS is a widespread global phenomenon, occurring across diverse socioeconomic, environmental, and cultural settings. We observed that younger individuals tend to hold lower environmental baselines across various environmental contexts, including climate change, natural resource depletion, biodiversity loss, and pollution. An upward shift in perceived environmental baselines among younger generations was rarely observed. These results underscore the challenge that SBS poses when policy and management responses to environmental degradation are influenced by perceived natural environmental norms.

Identifying the Drivers Related to Animal Reservoirs, Environment, and Socio-Demography of Human Leptospirosis in Different Community Types of Southern Chile: An Application of Machine Learning Algorithm in One Health Perspective.

Leptospirosis is a zoonosis with global public health impact, particularly in poor socio-economic settings in tropical regions. Transmitted through urine-contaminated water or soil from rodents, dogs, and livestock, leptospirosis causes over a million clinical cases annually. Risk factors include outdoor activities, livestock production, and substandard housing that foster high densities of animal reservoirs. This One Health study in southern Chile examined Leptospira serological evidence of exposure in people from urban slums, semi-rural settings, and farm settings, using the Extreme Gradient Boosting algorithm to identify key influencing factors. In urban slums, age, shrub terrain, distance to Leptospira-positive households, and neighborhood housing density were contributing factors. Human exposure in semi-rural communities was linked to environmental factors (trees, shrubs, and lower vegetation terrain) and animal variables (Leptospira-positive dogs and rodents and proximity to Leptospira-positive households). On farms, dog counts, animal Leptospira prevalence, and proximity to Leptospira-contaminated water samples were significant drivers. The study underscores that disease dynamics vary across landscapes, with distinct drivers in each community setting. This case study demonstrates how the integration of machine learning with comprehensive cross-sectional epidemiological and geospatial data provides valuable insights into leptospirosis eco-epidemiology. These insights are crucial for informing targeted public health strategies and generating hypotheses for future research.

Intervention of Smallholder Homegarden Agroforestry Enhanced Soil Fertility Status and Soil Organic Carbon Stock in Tigray Lowlands, Northern Ethiopia

Justification: To reverse the challenges of land degradation, improve soil fertility and access to feed and wood, communities in the lowlands of northern Ethiopia started to establish homegarden agroforestry (HAF) decades ago. However, limited information is available and there was information gap on the effects of homegarden agroforestry systems (HAF) on soil properties and soil organic carbon stock enhancement in the Tigray lowlands, Northern Ethiopia. Aim: The objective of this was to explore the effect of conversion of mono-cropping systems (MCS) to HAF in Tselemti district, Tigray lowland, Northern Ethiopia. Materials, Methods and Statistical Methods Used: Two land use types, HAF and MCS fields replicated 15 times were considered. Thus, 30 fields, 15 from HAF & 15 from MCS were used. From each field, 1 composite soil sample for analysis of soil nutrients and 1 undisturbed soil sample for soil bulk density (BD) determination were collected from a depth of 0-30cm. All values were subjected to SPSS version 20 and analyzed using paired samples t-Test statistics at 5% level of significance. Results: The intervention of HAF resulted in significantly higher (p<0.05) and enhance SOC by 76% (1.66 +0.06 and 0.94 + 0.05 %); SOC stock by 82% (73+ 3 and 40+2); N by 75% (0.14 +0.02 and 0.08 + 0.01 %);avP by 37% (6.07 +0.58 and 4.42 + 0.21 ppm) and K by 26% (67.05+ 4.5 and 53.39+ 4.3 mg kg-1) (p<0.05) as compared to the MCS. Conclusion: This study elucidated that home gardening can help for maintaining soil nutrients and soil organic carbon stock. Hence, additional HAF have to be established in the area and in areas with similar bio-physical and socio-economic set up and the government should establish programs and campaigns to disseminate HAF systems and promote the importance of the land use.

Factors Influencing the Use of Tobacco Among Youth in Low-Income, Lower-Middle-Income, and Upper-Middle-Income Countries: A Systematic Review.

The use of tobacco is a significant global public health issue. According to the World Health Organization, tobacco use is a considerable risk factor for many diseases and causes more than 8 million deaths per year, with a disproportionate impact on low- and middle-income countries. Therefore, this systematic review was conducted to identify the factors influencing tobacco use among youth in low-income, lower-middle-income, and upper-middle-income countries. Study Design: A system review. The review followed the PRISMA guidelines, and the protocol was registered on PROSPERO (CRD42023430552). Several data sources were utilized, including PubMed, Scopus, ScienceDirect, MEDLINE, CINAHL, and ProQuest, and cross-sectional data from participants aged 15‒24 underwent investigation. Original full-text articles have been published between 2015 and 2023. Out of the 2892 studies, 20 were included in this review after two reviewers confirmed the eligibility criteria. The average age of the participants was (mean±standard deviation: 19.45±1.686). Most studies were conducted in lower-middle and upper-middle-income countries. Frequently reported influences were at the individual and social levels, including demographic, economic, and psychological parameters, attitude and knowledge, individual behavioral factors, parental education, family member tobacco use, stressful life events, and social networks. At the environmental level, factors included secondhand smoke exposure, community context, media channels, and access to tobacco. The findings demonstrated a significant association between youth tobacco use and individual-, social-, and environmental-level factors. Consequently, specific interventions targeting these factors should be deployed to mitigate youth tobacco use in various socioeconomic settings.

Prioritising older individuals for COVID-19 booster vaccination leads to optimal public health outcomes in a range of socio-economic settings.

The rapid development of vaccines against SARS-CoV-2 altered the course of the COVID-19 pandemic. In most countries, vaccinations were initially targeted at high-risk populations, including older individuals and healthcare workers. Now, despite substantial infection- and vaccine-induced immunity in host populations worldwide, waning immunity and the emergence of novel variants continue to cause significant waves of infection and disease. Policy makers must determine how to deploy booster vaccinations, particularly when constraints in vaccine supply, delivery and cost mean that booster vaccines cannot be administered to everyone. A key question is therefore whether older individuals should again be prioritised for vaccination, or whether alternative strategies (e.g. offering booster vaccines to the individuals who have most contacts with others and therefore drive infection) can instead offer indirect protection to older individuals. Here, we use mathematical modelling to address this question, considering SARS-CoV-2 transmission in a range of countries with different socio-economic backgrounds. We show that the population structures of different countries can have a pronounced effect on the impact of booster vaccination, even when identical booster vaccination targeting strategies are adopted. However, under the assumed transmission model, prioritising older individuals for booster vaccination consistently leads to the most favourable public health outcomes in every setting considered. This remains true for a range of assumptions about booster vaccine supply and timing, and for different assumed policy objectives of booster vaccination.

Co-designing in Tandem: Case study journeys to inspire and guide climate services

This study tests, empirically validates and refines the Tandem framework for co-designing climate services(Daniels et al., 2019; 2020), to enhance its applicability and effectiveness. Intended as an inspirational guide for ‘good practice’, Tandem is practical and non-prescriptive and is designed to be tailored to context. We apply Tandem in three different geographic and socioeconomic settings: 1) a rural community in Indonesia, where smallholder farmers are confronting climate impacts on agriculture; 2) two cities in Sweden, where planners are addressing climate-related flooding and heat stress; and 3) communities and institutions in a Colombian river basin, where climate change is leading to water scarcity, raising questions about equitable use. We find that Tandem was effective in these settings in: 1) moving from ‘useful’ to ‘usable’ information by building trust; 2) increasing institutional embedding through strengthened relationships and networks; 3) improving climate information uptake and use; 4) increasing capacity, confidence and a shared understanding of climate information by users, and the decision context by providers; and, 5) serving as a non-prescriptive guide for users, intermediaries and providers to co-design and structure an effective process for collaborative learning and action. We use insights from these case studies to enhance the original framework, enabling it to 1) scope and review climate and non-climate vulnerability and risks; 2) incorporate gender, social equity and power considerations; 3) acknowledge the value of local and traditional ecological knowledge; 4) co-explore horizontal and vertical governance at appropriate decision-making scales; and, 5) provide flexible starting points, with early identification of impact indicators.

УПРАВЛІННЯ ФІНАНСОВИМИ РЕСУРСАМИ ТЕРИТОРІАЛЬНИХ ГРОМАД У СИСТЕМІ ПУБЛІЧНИХ ФІНАНСІВ

The article examines the elements of managing the financial resources of territorial communities in the public finance system. The essence of the concept of public finance was analyzed, the classification of the sources of the formation of financial resources of territorial communities was considered, the level of effectiveness of local self-government bodies in the implementation of the functions and powers assigned to them and their role in managing the resource potential of socio-economic development of administrative-territorial units was investigated. It is established that local financial resources management is carried out using an integrated approach, which includes a combination of resources of the State and non-State sectors of the economy. This is done with a view to achieving the goals and indicators of socio-economic development set out in the planning process in the interests of the population of the administrative-territorial entity. In this context, it is important to apply the principles of financial support for the development of territorial communities in the activities of local public authorities. The analysis of the development of the local finance management system has led to the conclusion that it is advisable to determine a comprehensive indicator of the resource provision of local budgets. It should take into account the indicators of revenues per capita, the percentage of budget subsidies, the amount of funds raised through grant support project activities, the share of borrowing made to the local budget, the assessment of the communal property management indicators of the territorial community, etc. The generalised indicator will make it possible to compare the state of financial and resource provision of the territorial community in regions with different levels of economic, natural, recreational and social potential. At the same time, it should be clearly understood that the system of financial management of territorial communities is fundamentally determined by those who actually, not nominally, influence the development and implementation of management decisions and have actual levers of influence on it.

Typologies of informal adaptations of communal spaces:a comparative study between different socio-economic spatial settings in Amman

ABSTRACT This research reflects on various typologies of informal adaptations to communal spaces. Amman City has faced several humanitarian and economic crises that have played a significant role in its urban expansion. New patterns of communal space utilization have emerged, enabling the local community to develop and define its informal spaces and practices. To define these emerging typologies, the study uses comparative analysis in different socio-economic settings and mainly qualitative approaches. The study concludes with some reflections on how to learn from such practices and contribute to future resilient urban plans for the city and similar contexts.

Building climate-resilient value chains in arid and semi-arid regions: a VC-ARID approach for rangeland adaptation in Kenya

AbstractClimate change has adversely impacted nature-based value chains in the arid and semi-arid regions. The study investigates the impact of climate change on nature-based value chains in arid and semi-arid environments. With an emphasis on rangeland adaptation in Kenya, the study used the VC-ARID (Value Chains for Arid and Semi-Arid Regions) approach, designed to build climate-resilient value chains in arid and semi-arid regions. The findings reveal that climate change poses significant risks to nature-based value chains, including reduced water availability, increased temperature variability, and changes in precipitation patterns. The study identifies several challenges to value chain development, such as limited access to climate information, financial resources, and supportive policies. It underscores the urgent need to integrate climate resilience into value chain interventions to achieve poverty reduction and food security goals in arid and semi-arid regions. This calls for active collaboration and investment in climate information services, research, and extension services to enhance the adaptive capacity of value chain actors and promote sustainable development in vulnerable regions. Given that climate hazards and changes are context-specific, strategies for improving value chains' sustainability must be customized to the unique ecological and socioeconomic setting in which the nature-based value chain operates. Consequently, to build value chains that are climate resilient, each actor along the chain must assess climate risks and manage the activities that make up the value chain adaptively.