State Of Vulnerability Research Articles

Refugees as Entrepreneurs? A Challenge to HDP Programmes

ABSTRACT Protracted refugee situations in territories of war or natural hazards challenge the logic of the humanitarian-development-peace (HDP) nexus that inspires liberal humanitarianism. The organised expression of that nexus is the so-called ‘integrated approach’ in which humanitarian aid, development aid and peacebuilding are intertwined in missions aimed at promoting a durable peace. The experiences of camps for Palestinian and Syrian refugees in Jordan and of South Sudanese and Congolese refugees in Uganda question some basic assumptions of the HDP programmes. In the last two decades, the policies adopted in these locations show a two-fold reconfiguration of the HDP liberal programme: first, the aim of containing humanitarian crises locally, in the peripheries, thereby preventing their adverse effects spreading to the core of the international system; second, a focus on refugees’ capacity to become more resilient and entrepreneurial in order to overcome their vulnerable condition. Overall, this so-called neoliberal approach to humanitarianism with its focus on containment and individual entrepreneurship-inspired resilience has moved away from its liberal configuration as part of a systemic reconfiguration of local social fabric.

Implementing the information system for older adult patients post-discharge self-management: a qualitative study.

Discharging older adult patients from the hospital poses risks due to their vulnerable conditions, complex instructions and limited health literacy. Insufficient information about medication side effects adds to patient concerns. To address this, a post-discharge information summary system was developed. While it has shown positive impacts, concerns exist regarding implementation fidelity. This study employed a theory-driven approach to understand health providers' perspectives on effective implementation. Individual semi-structured interviews were conducted via telephone with nurses, doctors and pharmacists from local public hospitals. All interviews were audio-recorded and transcribed verbatim. Theoretical Domains Framework (TDF) was applied for direct content analysis. Belief statements were generated by thematic synthesis under each of the TDF domains. A total of 98 participants were interviewed. Out of the 49 belief statements covering eight TDF domains, 19 were determined to be highly relevant to the implementation of the post-discharge information summary system. These TDF domains include knowledge, skills, social/professional role and identity, beliefs about consequences, intentions, memory, attention and decision processes, environmental context and resources and social influences. Our study contributes to the understanding of determinants in implementing discharge interventions for older adult patients' self-care. Our findings can inform tailored strategies for frontline staff, including aligning programme rationale with stakeholders, promoting staff engagement through co-creation, reinforcing positive programme outcomes and creating default settings. Future research should employ rigorous quantitative designs to examine the actual impact and relationships among these determinants.

Measuring climate vulnerability of tourism-dependent livelihoods: The case of Lamgtang National Park

Climate change poses significant challenges to tourism-dependent communities in mountain regions, threatening their livelihoods and well-being. However, there is a lack of comprehensive assessments that consider the multidimensional nature of vulnerability and the specific socio-cultural contexts of these communities. This study assesses the livelihood vulnerability of tourism-dependent communities in Lamtang National Park exposed to climate change using the Livelihood Vulnerability Index (LVI) and the Livelihood Vulnerability Index -Intergovernmental Panel on Climate Change (LVI-IPCC) framework. A mixed-methods approach was employed, including household surveys (n=119), vulnerability index calculations, and analysis of weather data. The purposive stratified sampling based on ecological gradient and proximity to trekking trails ensured the representativeness of the sample. One hundred nineteen households were surveyed, with respondents from the Hill Janajati ethnic group. Results showed that the majority of households (63%) were tourism-dominant, followed by agriculture-dominant (17%) and mixed livelihood (13%). The LVI results revealed a moderate vulnerability (0.365), with financial and natural capitals being the most vulnerable. The LVI-IPCC analysis showed that the community's adaptive capacity (0.537) is slightly lower than its exposure (0.564), and sensitivity is comparatively low (0.296), resulting in a low LVI-IPCC index (0.01). Weather data analysis, including the Mann-Kendall trend test, Sen's slope analysis, and multi-model ensemble projections, indicated increasing precipitation trends and a warmer, wetter future for the region. The triangulation of LVI, LVI-IPCC, forecast data, and weather station data strengthens the findings and highlights the need for targeted interventions. The projected changes in temperature and precipitation patterns for Rasuwa district and vulnerability status of tourism-dependent communities highlight the urgency of implementing climate change adaptation measures, which may include diversifying livelihoods, improving access to education and training, strengthening social support systems, and promoting sustainable land and water management practices.

Challenges Faced by Cancer Patients during the COVID-19 Pandemic, a Vision for the Future: A Qualitative Study.

Cancer is a disease that affects various aspects of patients' lives. The COVID-19 pandemic has presented numerous challenges and difficulties for cancer patients, exacerbating their already vulnerable conditions. Identifying the challenges these patients face can be a practical step toward improving their quality of care in future pandemics. This qualitative study aims to identify the challenges cancer patients encounter during the COVID-19 pandemic. This is a qualitative study with a content analysis approach. Participants included 16 cancer patients hospitalized at Tabriz Shahid Ghazi Hospital in 2020. Sampling was conducted purposefully, and interviews were continued until data saturation was achieved. All interviews were recorded and transcribed at the earliest opportunity. The data were analyzed using content analysis based on the Lundman and Graneheim method. Data analysis led to the identification of four categories of challenges faced by cancer patients during the pandemic: Mental derangement and fear (fear of premature death, fear of contracting COVID-19, fear of disease recurrence), ineffective nurse-patient communication (personal protective equipment and distant care from nursing stations), economic instability (difficulties in providing for the family's livelihood and increased medical expenses), and reduced access to services (Contracting of infection among doctors and nurses and redirection of resources and services to COVID-19 patients). Participants expressed that these challenges were additional to their pre-existing difficulties and were intensified by the COVID-19 pandemic. Team support and interdisciplinary collaboration can be beneficial in addressing mental derangement and severe fears and solving problems comprehensively. Using various methods to facilitate safe and continuous communication between nurses and patients aside from their beds can give patients a greater sense of calmness. Financial facilitations can alleviate pressure on patients, and planning and communication strategies for accessing care and treatment services during a pandemic should be organized in advance.

Assessing socio-economic vulnerability to riverbank erosion in the Middle Brahmaputra floodplains of Assam, India

Riverbank erosion is a catastrophic phenomenon that has rendered floodplains worldwide vulnerable and has significantly impacted millions of people. This article aims to examine the relative status of socio-economic vulnerability to riverbank erosion at the village level in the Middle Brahmaputra floodplains of Assam, India, by constructing a socio-economic vulnerability index (SeVI). The index was constructed based on the Intergovernmental Panel for Climate Change (IPCC) approach by integrating the three components of exposure, sensitivity and adaptive capacity. Data on the site-specific indicators of these components were collected through a field survey of 508 households from 18 villages. A multiple regression analysis was conducted to assess the relationship between vulnerability and its components. The SeVI analysis revealed that eight villages were highly vulnerable to bank erosion while seven and three villages experienced moderate and low vulnerability respectively. High vulnerability is attributed to displacement of erosion-affected people, soil degradation, land use land cover (LULC) changes and poor performance in the fields of health, education, economy, infrastructure and agriculture. The regression analysis indicated that the degree of vulnerability was mostly impacted by exposure followed by sensitivity. The study calls for infrastructural upgradation, improvements in education and healthcare facilities, construction of erosion control structures, use of geotextiles, application of bioengineering techniques and adoption of traditional knowledge to reduce the level of vulnerability. The SeVI as a planning tool has not only identified the vulnerable villages but also helped in setting priorities for socio-economic development. Thus, the methodological framework adopted in this study may be utilized by other geographical regions for assessing vulnerability and safeguarding the communities from the risk of bank erosion.

COVID-19 and influenza vaccine uptake in women with criminal-legal system involvement

Objective: Given their vulnerable health status and resource constraints, the perspectives of women with criminal-legal involvement (WCLI) are important but not usually represented in the literature on vaccine interest and vaccine hesitancy. This study aims to examine how the COVID-19 pandemic and vaccine affected the influenza vaccine uptake among WCLI. Methods: A cross-sectional secondary analysis was conducted using data collected from the Tri-City study, which followed WCLI in three U.S. cities from 2019 to 2023. We mapped the distribution of influenza vaccine uptake in 2019–2023 and developed a composite outcome that reflected participants' patterns of Y/N to influenza vaccine, which were categorized into four groups: Influenza Vaccine Supportive, Influenza Vaccine Adaptive, Influenza Vaccine Discontinued, and Influenza Vaccine Resistant. Results: Out of 507 people: 23.7% were Supportive, 8.5% Adaptive, 15.2% Discontinued and 38.3% Resistant. People who received the COVID vaccine had significantly lower odds of being identified as Discontinued (OR = 0.42, 95%CI = 0.20–0.87, p = .020) and Resistant (OR = 0.23, 95%CI = 0.13–0.43, p < .001), compared to the Supportive group. Mistrust toward COVID-19-related information was a significant independent predictor of being Adaptive (OR = 1.59, 95%CI = 1.08–2.35, p = .019), Discontinued (OR = 1.61, 95%CI = 1.15–2.25, p = .006), and Resistant (OR = 1.54, 95%CI = 1.19–2.00, p < .001) relative to Supportive. Conclusions: Vaccine hesitancy poses significant challenges to public health efforts, with apparent dampening effect across vaccines. Public health messaging and clinical interactions informed by best practices in communication tailored to the lived experience of all people, including women with criminal-legal system involvement, will be necessary to inform future interventions aimed at increasing vaccine uptake.

Diving into broad-scale and high-resolution population genomics to decipher drivers of structure and climatic vulnerability in a marine invertebrate.

Species with widespread distributions play a crucial role in our understanding of climate change impacts on population structure. In marine species, population structure is often governed by both high connectivity potential and selection across strong environmental gradients. Despite the complexity of factors influencing marine populations, studying species with broad distribution can provide valuable insights into the relative importance of these factors and the consequences of climate-induced alterations across environmental gradients. We used the northern shrimp Pandalus borealis and its wide latitudinal distribution to identify current drivers of population structure and predict the species' vulnerability to climate change. A total of 1514 individuals sampled across 24° latitude were genotyped at high geographic (54 stations) and genetic (14,331 SNPs) resolutions to assess genetic variation and environmental correlations. Four populations were identified in addition to finer substructure associated with local adaptation. Geographic patterns of neutral population structure reflected predominant oceanographic currents, while a significant proportion of the genetic variation was associated with gradients in salinity and temperature. Adaptive landscapes generated using climate projections suggest a larger genomic offset in the southern extent of the P. borealis range, where shrimp had the largest adaptive standing genetic variation. Our genomic results combined with recent observations point to further deterioration in southern regions and an impending vulnerable status in the regions at higher latitudes for P. borealis. They also provide rare insights into the drivers of population structure and climatic vulnerability of a widespread meroplanktonic species, which is crucial to understanding future challenges associated with invertebrates essential to ecosystem functioning.

DAM DEVELOPMENT AND FOOD SECURITY OF DIRECTLY AFFECTED HOUSEHOLDS: A CASE STUDY IN JATIGEDE DAM, SUMEDANG, WEST JAVA

The Jatigede Dam construction project has caused many residents in the inundation area of the Jatigede reservoir to move to new areas. The affected households by the Jatigede Dam in new places must adapt to obtain sources of income for food and other necessities. This research aims to elucidate the agroecosystem production, off-farm jobs, and food adequacy and food security of the affected people of Jatigede Dam in Jatimekar Hamlet, Jemah Village. The research method used was a combination of qualitative and quantitative. The results revealed that the affected households of the Jatigede Dam Development Project who live in Jatimekar Hamlet, Jemaah Village, have less agricultural land ownership such as rice fields, mixed gardens and home gardens than before the Jatigede Dam existed. Consequently, some of the affected households of Jatigede Dam, they are also involved in various off-farm jobs. Based on food security, it shows that the affected people of Jatigede Dam in Jatimekar Hamlet, Jemah Village are in a vulnerable condition, due to low family income, and farming also faces various problems, such as water scarcity in the dry season and agricultural inputs, such as inorganic fertilizers, pesticides, and plant seeds have high price.

Uma visão de mundo emergente devido à Covid-19

Introduction. In the current article, it is intended to draw attention to the conservation of rigid or inserious positions in the face of environmental facts associated with the pandemic, and motivate a change in the way of understanding the world. Events have occurred in stages prior to the pandemic, there have been events during the pandemic and events that have occurred after the pandemic (if this plague ever ends). Objective. This exercise of intellectual production in confinement, from confinement, or because of confinement, is a novel or atypical experience that seeks that as social and thinking human beings, we spend time reflecting on deficit and vulnerable conditions. Reflection. It is necessary to seek adequate solutions and contribute them to the community to which one belongs, in the context of a possible emerging worldview. Conclusion. The Covid-19 pandemic has shaken the foundations of life for human beings, throughout the world, without qualms or predilections. It is convenient to slow down the pace of life of individuals and societies, in search of times and spaces for reflection regarding new thoughts that help to have another vision of the world.

An examination of Water-Energy-Food nexus: From theory to application

The significance of adopting a nexus approach in gauging the sustainable development of the water-energy-food nexus is usually overlooked since global governance legislations and policies have often focused on a silo-growth agenda of each sector independently. While theoretical sustainability frameworks provide a conceptual vision of the yardsticks that will monitor and assess the achievement of sustainability goals, they have not been used to examine and establish tangible mechanisms for translating sustainability visions into action plans. Against this background, a review of sustainability assessment frameworks and assessment of the socio-environmental system levers of the water-energy-food nexus in the United Arab Emirates is first conducted, following which Masdar City in the United Arab Emirates is used to exemplify the application and translation of sustainability frameworks into practice. The study also presents a new perspective on the convolutions of the water-energy-food nexus by examining time-horizon and planetary factors to address prevailing challenges in the water-energy-food trilemmas. Inspired by the United Arab Emirates’ relentless efforts in driving the sustainability journey toward net-zero and building a balanced circular economy, a sustainability framework of key nexus projects is therefore sculpted to highlight the important role of adaptive management governance in managing socio-environmental systems such as water-energy-food. The Masdar case study demonstrated the importance of sustainability assessment framework as a tool to systematically and robustly monitor the interactions between the nexus components as it can highlight areas of vulnerability, resilience and other states of system characteristics.

Salutogenic approach paradigm of comprehensive and integrated health care

The health care approach denoted as salutogénesis was reviewed based on the historical, which conceives actions from integrality - integration precepts that enhance technical quality and enhance perceived quality (warmth) in order to achieve well-being and promote the building of a subject, family and community with a style of coping with the health situation that is paid by a professional with a way of thinking - acting proactively, not reactively, which favorably affects the quality of individual and collective life. In this sense, various current flat and electronic scientific publications have been valued, as well as recognized national and international texts, which supports the novelty of the model that is exposed, its usefulness and competitiveness and the relevance of applying it in the context of the Cuban health system. that has the person versus the community as the center, since such an approach always reorients - revitalizes, the promotion of health and prevents lifestyles that favor successfully facing various risks and conditions the reasonable effectiveness of avoiding a given disease and, of course, generating a qualitative enhancement - quantitative regarding, abort - restore, sequelae of damage to health in a given case, then power, from the state of apparent health, a Danger, Vulnerability and Risks type approach, for which it enhances Strengths and reverses Weaknesses and , turns Threats - Opportunities into its target and confronts them-boldly transforms, so that it enhances the well-being of the person, the family and the community.

Modifiable Lifestyle Risk Factors in Adult Survivors of Childhood Cancer: A Nationally Representative Study.

Given the vulnerable health condition of adult childhood cancer survivors, it is essential that they develop positive health behaviors to minimize controllable health risks. Therefore, we evaluated if adult survivors of non-childhood cancer and childhood cancer differ in the odds of each modifiable risk factor compared with each other and compared with the general population. This nationally representative study leveraged the National Health Interview Survey (NHIS) sample from 2000 to 2018 and the Behavioral Risk Factor Surveillance System (BRFSS) sample from 2016 to 2021. Our study population included adults diagnosed with cancer when they were ≤14 years of age. Outcomes included physical activity, body mass index (BMI), current smoking, ever-smoking, alcohol use, and binge drinking. Insufficient physical activity was not statistically significant in the BRFSS, but in the NHIS, childhood cancer survivors had significantly more insufficient physical activity compared with non-childhood cancer survivors (aOR 1.29, P =0.038) and the general population (aOR 1.40, P =0.006). Childhood cancer survivors also had a higher likelihood of being significantly underweight (aOR 1.84, P =0.018) and having ever-smoked (aOR 1.42, P =0.001) compared with the general population in the NHIS. There was a significantly higher likelihood of smoking among childhood cancer survivors in the BRFSS (aOR 2.02, P =0.004). The likelihoods of many risky behaviors between adult childhood cancer survivors and general population controls were comparable, although rates of physical activity may be decreased, and rates of smoking may be increased among childhood cancer survivors. Targeted interventions are needed to promote healthy behaviors in this vulnerable population.

The process of declaring information security profiles

The article discusses the process of declaring information security profiles, which is an important aspect of ensuring information security in modern organizations. The main purpose of the declaration is to establish clear requirements and control measures to ensure an appropriate level of protection of information assets against potential threats and vulnerabilities. The authors of the article analyze the basic and target information security profiles, emphasizing their features, advantages and disadvantages. In particular, the basic security profile is considered as a minimum set of requirements that can be quickly implemented to ensure an initial level of protection. At the same time, the target security profile is aimed at more detailed adaptation of security measures to the specific needs and risks of the organization, which provides a higher level of protection. The process of declaring security profiles includes several stages, such as assessing the current state of security, identifying threats and vulnerabilities, defining security requirements, developing and implementing security profiles, and regularly monitoring and updating security measures. The article also discusses the current standards and regulations that govern the process of declaring security profiles, in particular, NIST SP 800-53 rev. 5, ISO/IEC 27001, and ND TZI 3.6-006-21. The article analyzes how these standards can be used to create effective security profiles that meet the specific requirements of organizations of various sizes and industries. The authors conclude that the process of declaring information security profiles is critical to ensuring an adequate level of protection of information assets. Implementation of clearly defined security profiles allows organizations to take a systematic approach to risk management, reduce the likelihood of security incidents and increase the overall level of information security.

Just-in-Time Adaptive Intervention for Stabilizing Sleep Hours of Japanese Workers: Microrandomized Trial.

Sleep disturbance is a major contributor to future health and occupational issues. Mobile health can provide interventions that address adverse health behaviors for individuals in a vulnerable health state in real-world settings (just-in-time adaptive intervention). This study aims to identify a subpopulation with vulnerable sleep state in daily life (study 1) and, immediately afterward, to test whether providing mobile health intervention improved habitual sleep behaviors and psychological wellness in real-world settings by conducting a microrandomized trial (study 2). Japanese workers (n=182) were instructed to collect data on their habitual sleep behaviors and momentary symptoms (including depressive mood, anxiety, and subjective sleep quality) using digital devices in a real-world setting. In study 1, we calculated intraindividual mean and variability of sleep hours, midpoint of sleep, and sleep efficiency to characterize their habitual sleep behaviors. In study 2, we designed and conducted a sleep just-in-time adaptive intervention, which delivered objective push-type sleep feedback messages to improve their sleep hours for a subset of participants in study 1 (n=81). The feedback messages were generated based on their sleep data measured on previous nights and were randomly sent to participants with a 50% chance for each day (microrandomization). In study 1, we applied hierarchical clustering to dichotomize the population into 2 clusters (group A and group B) and found that group B was characterized by unstable habitual sleep behaviors (large intraindividual variabilities). In addition, linear mixed-effect models showed that the interindividual variability of sleep hours was significantly associated with depressive mood (β=3.83; P=.004), anxiety (β=5.70; P=.03), and subjective sleep quality (β=-3.37; P=.03). In study 2, we found that providing sleep feedback prolonged subsequent sleep hours (increasing up to 40 min; P=.01), and this effect lasted for up to 7 days. Overall, the stability of sleep hours in study 2 was significantly improved among participants in group B compared with the participants in study 1 (P=.001). This is the first study to demonstrate that providing sleep feedback can benefit the modification of habitual sleep behaviors in a microrandomized trial. The findings of this study encourage the use of digitalized health intervention that uses real-time health monitoring and personalized feedback.

Investigating the effects of spatial scales on social vulnerability index: A hybrid uncertainty and sensitivity analysis approach combined with remote sensing land cover data.

Investigating the effects of spatial scales on the uncertainty and sensitivity analysis of the social vulnerability index (SoVI) model output is critical, especially for spatial scales finer than the census block group or census block. This study applied the intelligent dasymetric mapping approach to spatially disaggregate the census tract scale SoVI model into a 300-m grids resolution SoVI map in Davidson County, Nashville. Then, uncertainty analysis and variance-based global sensitivity analysis were conducted on two scales of SoVI models: (a) census tract scale; (b) 300-m grids scale. Uncertainty analysis results indicate that the SoVI model has better confidence in identifying places with a higher socially vulnerable status, no matter the spatial scales in which the SoVI is constructed. However, the spatial scale of SoVI does affect the sensitivity analysis results. The sensitivity analysis suggests that for census tract scale SoVI, the indicator transformation and weighting scheme are the two major uncertainty contributors in the SoVI index modeling stages. While for finer spatial scales like the 300-m grid's resolution, the weighting scheme becomes the uttermost dominant uncertainty contributor, absorbing uncertainty contributions from indicator transformation.

ENHANCEMENT IN-GROUP COHESIVENESS – NEW ASPECT IN THE TAXONOMY OF IDENTITY MANAGEMENT STRATEGIES (THE CASE OF PEOPLE LIVING IN POVERTY)

The main aim of the current study is to present the negative social identity management strategies used by the poor group of people living in Georgia. The qualitative and quantitative research was conducted with the participation of socially vulnerable citizens in order to explore the social identity theory in the targeted group. As a result of the research, the negative social identity management strategies, such as social creativity, individual/social mobility and enhancement in-group cohesiveness were identified. There was also adapted the scale of measuring negative social identity management strategies, which is related to Social Vulnerability Status. A novelty of the study is considering the enhancement in-group cohesiveness as a negative social identity management strategy. The study gives interesting potential to other researchers to continue studying new taxonomy of negative social identity management strategies withing other vulnerable groups. In addition, our findings help us understand identity management strategies better, revealing important insights for efforts to reduce poverty and support community development.

The association of a frailty index derived from laboratory tests and vital signs with clinical outcomes in critical care patients with septic shock: a retrospective study based on the MIMIC-IV database

PurposeFrailty is a vulnerable state to stressors due to the loss of physiological reserve as a result of multisystem dysfunction. The physiological and laboratory-based frailty index (FI-Lab), depending on laboratory values and vital signs, is a powerful tool to capture frailty status. The aim of this study was to assess the relationship between FI-Lab and in-hospital mortality in patients with septic shock.MethodsBaseline data for patients with sepsis in the intensive care unit were retrieved from the Critical Care Medicine Database (MIMIC-IV, v2.2). The primary outcome was mortality during hospitalization. The propensity score matching (PSM) method was used to analyze the basic conditions during hospitalization between groups.The FI-Lab was analysed for its relationship with in-hospital mortality using logistic regression according to continuous and categorical variables, respectively, and described using the restricted cubic spline (RCS). Survival was compared between groups using Kaplan-Meier (KM) curves. Subgroup analyses were used to improve the stability of the results.ResultsA total of 9219 patients were included. A cohort score of 1803 matched patients was generated after PSM. The analyses showed that non-surviving patients with septic shock in the ICU had a high FI-Lab index (P<0.001). FI-Lab, whether used as a continuous or categorical variable, increased with increasing FI-Lab and increased in-hospital mortality (P<0.001).Subgroup analyses showed similar results. RCS depicts this non-linear relationship. KM analysis shows the cumulative survival time during hospitalisation was significantly lower as FI-Lab increased (log-rank test, P<0.001).ConclusionElevated FI-Lab is associated with increased in-hospital mortality in patients with septic shock.

Mind the gap: knowledge, attitudes and perceptions on antimicrobial resistance, antimicrobial stewardship and infection prevention and control in long-term care facilities for people with disabilities in the Netherlands

BackgroundAntimicrobial resistance (AMR) has become one of the major public health threats worldwide, emphasizing the necessity of preventing the development and transmission of drug resistant microorganisms. This is particularly important for people with vulnerable health conditions, such as people with intellectual disabilities (ID) and long-term care residents. This study aimed to assess the current status of AMR, antimicrobial stewardship (AMS) and infection prevention and control (IPC) in Dutch long-term care facilities for people with intellectual disabilities (ID-LTCFs).MethodsA web-based cross-sectional survey distributed between July and November 2023, targeting (both nonmedically and medically trained) healthcare professionals working in ID-LTCFs in The Netherlands, to study knowledge, attitudes and perceptions regarding AMR, AMS and IPC.ResultsIn total, 109 participants working in 37 long-term care organizations for people with intellectual disabilities throughout the Netherlands completed the questionnaire. The knowledge levels of AMR and IPC among nonmedically trained professionals (e.g., social care professionals) were lower than those among medically trained professionals (p = 0.026). In particular regarding the perceived protective value of glove use, insufficient knowledge levels were found. Furthermore, there was a lack of easy-read resources and useful information regarding IPC and AMR, for both healthcare professionals as well as people with disabilities. The majority of the participants (> 90%) reported that AMR and IPC need more attention within the disability care sector, but paradoxically, only 38.5% mentioned that they would like to receive additional information and training about IPC, and 72.5% would like to receive additional information and training about AMR.ConclusionAlthough the importance of AMR and IPC is acknowledged by professionals working in ID-LTCFs, there is room for improvement in regards to appropriate glove use and setting-specific IPC and hygiene policies. As nonmedically trained professionals comprise most of the workforce within ID-LTCFs, it is also important to evaluate their needs. This can have a substantial impact on developing and implementing AMR, AMS and/or IPC guidelines and policies in ID-LTCFs.

The empowered family: New narratives to rethink dengue prevention and control in Córdoba, Colombia.

Dengue is a disease that constitutes a public health problem difficult to control due to the multidimensionality of associated factors and the particularities of the territories. This article analyzes the notion of family empowerment related to the prevention and control of dengue in Córdoba, Colombia. From July to October 2023, using a qualitative approach, semi-structured interviews were conducted with 30 family groups located in the municipalities of San Andrés de Sotavento, San Bernardo del Viento, Pueblo Nuevo, and Montería, selected for being indigenous, Afro-descendant, or rural and urban populations in vulnerable conditions. The results show that families, beyond their particular arrangements in terms of structure and dynamics, are aware of their role in the prevention and control of diseases, identifying the capacities required to face dengue. However, they reproduce narratives of conceptual and power dominance that assign a greater commitment on the part of educational and health agents to promote alternatives that contribute to reducing the risks of dengue. The challenges that must be faced for effective family empowerment are discussed, so that prevention practices gain greater strength.

Drivers of municipal water security and vulnerability in Pakistan: A case study of Mardan, Khyber Pakhtunkhwa

Tehsil Mardan has experienced enormous shifts in land use and cover (LULC), growth in population, climate variance, and a drop in the groundwater table. This study sought to evaluate and quantify the vulnerability status of municipal water security in Tehsil Mardan, by incorporating LULC, population, and climate indicators using remote sensing and statistical techniques. LULC changes were quantified from Landsat imageries using Envi from 1990 to 2021. Field and questionnaire surveys were conducted to estimate groundwater depletion and municipal water demand. The Mann-Kendall trend test was applied to temperature and precipitation data. Analysis of correlation was performed to measure the relationship among all the variables. To get a deeper understanding of the vulnerability of municipal water security caused by physical, climatic, and social factors, the analytical hierarchy process (AHP) was utilized. LULC results showed a fivefold rise in built-up class from 37 km2 to 188 km2 and a substantial decline in bare land from 437 km2 to 252 km2 from 1990 to 2021. The average groundwater table depletion was one foot per year and showed a significant positive correlation with the number of tube wells, water supply and demand, and population growth. An increase of 0.008 °C per year in average temperature while a declining trend is observed in mean precipitation during the last 30 years. The results showed that municipal water security vulnerability changed from “invulnerable relatively” to “very vulnerable” stage during the last three decades. The study contributed valuable insights to facilitate policymakers, and urban planners for management of the current and future municipal water works, land use planning, and associated environmental opportunities and threats.