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Background: Road traffic accidents are still serious, especially in developing countries. This paper takes China as a typical example of a developing country with rich characteristics related to road traffic safety for analysis. Methods: Temporal, spatial, road traffic accidents and economic information were gathered from the China Statistical Yearbook. Principal components analysis (PCA) was employed to establish a comprehensive indicator to represent road traffic safety based on different types of road traffic accidents information. Pearson correlation analysis and Eta coefficient test were performed to analyze whether time and space characteristics would affect the established indicator. Then the established indicator was introduced as dependent variable while year and regions as independent variables in the mixed linear model (MLM). At last, single-element regression model was built to study the impact of GDP per capita on road traffic safety. Results: In PCA, the variance explained by the established indicator was 93.993%. The results of Pearson correlation analysis and Eta coefficient test suggested that time and region were both related to the established indicator. MLM showed that the year, the regions and the interaction between them influenced road traffic safety in China significantly. The single-variable regression analysis indicated that, with the increase in GDP per capita, road traffic safety initially decreased and then increased. Conclusion: Road traffic safety in China was grim and changed greatly between different regions and years. This might be attributed to the yearly economic development and disparities among regions. .
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OBJECTIVE: Our purpose with this study is to examine the socioeconomic outcomes associated with chronic kidney disease not related to well-known risk factors (CKDnt) in four communities in Chichigalpa, Nicaragua that are home to a substantial number of sugarcane workers. METHODS: We employed a cluster-based systematic sampling design to identify differences in outcomes between those households affected directly by CKDnt and those that are not. RESULTS: Overall, we find that approximately one-third of households surveyed had a household member diagnosed with CKDnt. 86% of CKDnt households reported that the head of the household had been without work for the last 6 months or more, compared with 53% of non-CKDnt households. Non-CKDnt households took in more than double the earnings income on average than CKDnt households ($C52 835 and $C3120, respectively). Nonetheless, on average, CKDnt households' total income exceeded that of non-CKDnt households due to Nicaragua's national Instituto Nicaraguense de Seguridad Social Social Security payments to CKDnt households, suggestive of a substantial economic burden on the state resulting from the disease. Households headed by widows or widowers who are widowed as a result of CKDnt demonstrate distinct deficits in total income when compared with either non-widowed households or to households widowed by causes other than CKDnt. CONCLUSIONS: Despite strong similarities in terms of demographic characteristics and despite residing in the same communities with similar access to the available resources, households experiencing CKDnt exhibit distinct and statistically significant differences in important socioeconomic outcomes when compared to non-CKDnt households.
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Características da Família , Renda , Insuficiência Renal Crônica , Humanos , Nicarágua/epidemiologia , Renda/estatística & dados numéricos , Masculino , Insuficiência Renal Crônica/economia , Insuficiência Renal Crônica/etiologia , Insuficiência Renal Crônica/epidemiologia , Feminino , Adulto , Pessoa de Meia-Idade , Fatores Socioeconômicos , Fatores de Risco , Pobreza/estatística & dados numéricos , IdosoRESUMO
The factors influencing the adoption and implementation of CE in developing countries are not yet fully examined. By focusing on the Namibian mining sector, this study highlights the perspectives of local stakeholders on CE adoption in a developing country. The mine managers recognized that waste is problematic and that CE practices are beneficial for mining companies and Namibia at large. Our findings also indicated that stronger academic institutions providing CE training and helping develop CE solutions, public awareness campaigns, financial support for CE practices, cooperation among industry stakeholders, and clear CE policy would all help drive the implementation of CE.
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Países em Desenvolvimento , Mineração , Namíbia , HumanosRESUMO
Background Waterborne diseases are the most common form of infectious disease, spreading from contaminated water, especially in a developed country. These diseases are a major concern for the environment and public health. The living conditions in developing countries like India affect the water-handling practices, which make the population vulnerable to waterborne diseases. The inability to access safe drinking water also adds to this. Water safety for a community relies on water collection, treatment, storage, and handling in the household setting. Therefore, the burden of waterborne disease can be reduced by treating point-of-use drinking water, including improving handling and transport. Objectives The aim was to assess the safe drinking water handling practices in households. The objectives were to assess the safe drinking water-handling practices, namely, treatment, storage, lid status of the storage vessel, and water drawing technique, and to estimate the sources of safe drinking water. Methods This cross-sectional study was conducted in the Etawah district on a total of 312 eldest female family members actively working in the kitchen. Descriptive analysis and Chi-Square test were applied to the collected data and a p-value <0.05 at 95% confidence interval (CI) was taken as statistically significant. Results Overall, 135 (85.9%) households in urban areas relied on public supply. However, in rural areas mostly 130 (83%) households depended on private supply. In water-handling practices, 276 (88.4%) used some method to purify drinking water, a total of 209 (67%) households kept the lid of the storage container covered, and 249 (79.8%) households drew water either by pouring or scooping with a long handle. Conclusion The study concluded that both private and public sources were used for drinking water. Regarding water-handling practices, most households drank purified water, kept their containers covered, and drew water either by scooping or pouring from storage containers. Those who drank purified water mostly belonged to nuclear families and had private sources of drinking water.
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Objectives: Online educational platforms with open access have seen a growing adoption in the field of medical education. However, the extent of their global usage is still unclear. To fill this knowledge gap, our objective is to examine the usage patterns of two renowned open-access resources in Otolaryngology. This includes identifying the most sought-after topics and understanding the demographics of their users. Methods: Retrospective study of web analytics data between 2016 and 2021 extracted from the Headmirror.com and Mayo Clinic Otolaryngology YouTube channel platforms analyzing demographic and education topic trends via descriptive, geospatial, time-series, t-tests, and ANOVA analyses. Results: Viewership spanned 124 countries in 7 different geographic regions, with 72 countries comprising low- to middle-income countries, mostly represented ages of 25-34 years old, came from high-income countries rather than low-income (p < .001), and used mobile phones followed by computers for device access. Video-educational material comprised of subspecialty topics on Rhinology and Sinus Surgery (25%) at the highest end and Facial Trauma (1%) at the lowest. Controlling for the age of the video content, the most-accessed videos comprised of subspecialty topics on Head and Neck Surgery at the highest end and Laryngology at the lowest with significant differentiation across topics of interest (p < .044). Conclusions: This assessment of web-analytics platforms from two widely used otolaryngology free, online-access materials showed increasing global usage trends with significant differentiating factors along viewership demographics, as well as sought-after subspecialty topics of interest. In turn, our results not only lay the groundwork for characterizing the global otolaryngology audience but also for future development of targeted educational materials and accessibility initiatives aimed at ameliorating global educational disparities in the field.
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Forests boast essential resources and potential to mitigate climate change, meriting the development of conservation policies on all governmental scales. Ecosystem services provided by forests, including biodiversity, air quality, and food and fuel production, make forests valuable assets for climate-vulnerable communities that often lack the means to cope with ecosystem service degradation resulting from climate change. Historically, these vulnerable communities are previously marginalized and socio-economically limited, and climate change augments already-existing injustices. Policy discussions around managing forests and carbon, therefore, must consider environmental justice as well as diversity, equity, and inclusion to better meet the needs of all constituents. Using R, we perform a review of forest, climate, and policy peer-reviewed literature published between 2018 and 2021 for prevalence of topics related to diversity, equity, inclusion, and justice (DEIJ). We select DEIJ terms a priori and a posteriori based on our understanding of DEIJ and common considerations of the literature. Out of 2891 unique articles, 15.7% of literature mentioned at least one DEIJ term in the title, keyword list, or abstract. We identify which journals have published DEIJ literature more often in the context of forest, climate, and policy, and we perform a co-occurrence analysis of additional common themes. Concepts such as ecosystem services and economics appeared often in the literature, as well as REDD+ as a specifically mentioned policy. We call for increased consideration of DEIJ in forest, climate, and policy discussions and literature, as vulnerable communities historically have been excluded from and victimized by the conversations held among large, economically motivated entities.
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Mudança Climática , Conservação dos Recursos Naturais , Justiça Ambiental , Florestas , Biodiversidade , Ecossistema , Clima , Política AmbientalRESUMO
Objectives: With the increasing prevalence of dementia worldwide, there is a growing need for an integrated approach to dementia care. Little is known at present about the benefits of educational interventions for informal caregivers of people living with dementia (PLWD) in low- and middle-income countries (LMICs). This review aimed to identify and synthesise the current research on these interventions. Method: Four databases (PsycINFO, Medline, Web of Sciences and Scopus) were searched, alongside Google Scholar and reference lists. The Downs and Black checklist was used for quality assessment and data relating to intervention characteristics, outcomes, and educational component features were compared. Results: Eighteen papers detailing 17 studies were included. All studies presented found at least one significant outcome/effect. Study comparison was difficult due to diverse methodologies, intervention structures, and outcomes. Study quality was also variable. Four studies had education as the primary focus, and most interventions utilised multicomponent and group-based designs. Interventions that included group delivery tended to find more significant results than individual approaches. Intervention length did not appear to influence efficacy. Regular delivery and an average intervention dosage of around 12 h appeared most effective. Conclusions: Research into educational interventions for caregivers in LMICs appears to be promising and can help guide future interventions towards clinical implementation. A multicomponent group intervention trialled in Egypt provided particularly favourable findings. Future studies should focus on understanding the active mechanisms within such interventions to optimize their effectiveness. Collaboration between LMICs, high-income countries (HICs), and caregivers is crucial in developing interventions tailored to meet caregiver needs whilst accounting for feasibility and equity for dementia care worldwide.
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BACKGROUND AND PURPOSE: Radiotherapy (RT) is an essential treatment modality against cancer and becoming even more in demand due to the anticipated increase in cancer incidence. Due to the rapid development of RT technologies amid financial challenges, we aimed to assess the available RT facilities and the issues with achieving health equity based on current equipment compared to the previous reports from Iran. MATERIALS AND METHODS: A survey arranged by the Iran Cancer Institute's Radiation Oncology Research Center (RORC) was sent to all of the country's radiotherapy centers in 2022. Four components were retrieved: the reimbursement type, equipment, human resources, and patient load. To calculate the radiotherapy utilization rate (RUR), the Lancet Commission was used. The findings were compared with the previous national data. RESULTS: Seventy-six active radiotherapy centers with 123 Linear accelerators (LINACs) were identified. The centers have been directed in three ways. 10 (20 LINACs), 36 (50 LINACs), and 30 centers (53 LINACs) were charity-, private-, and public-based, respectively. Four provinces had no centers. There was no active intraoperative radiotherapy machine despite its availability in 4 centers. One orthovoltage X-ray machine was active and 14 brachytherapy devices were treating patients. There were 344, 252, and 419 active radiation oncologists, medical physicists, and radiation therapy technologists, respectively. The ratio of LINAC and radiation oncologists to one million populations was 1.68 and 4.10, respectively. Since 2017, 35±5 radiation oncology residents have been trained each year. CONCLUSION: There has been a notable growth in RT facilities since the previous reports and Iran's situation is currently acceptable among LMICs. However, there is an urgent need to improve the distribution of the RT infrastructure and provide more facilities that can deliver advanced techniques.
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Neoplasias , Radioterapia (Especialidade) , Humanos , Irã (Geográfico)/epidemiologia , Neoplasias/epidemiologia , Neoplasias/radioterapia , Aceleradores de Partículas , Inquéritos e Questionários , Radioterapia/métodosRESUMO
BACKGROUND: The Sendai Framework is the United Nations' most significant approach to reducing the risk of disasters from 2015 to 2030. This framework designed for all communities. However, communities should create operational and remedial strategies based on their unique circumstances. Considering the gaps in the implementation of Sendai framework strategies in Iran, as a developing country, the present study was designed. METHOD: This study was conducted by using a qualitative direct content analysis method to find out the expert's opinions on the implementation of the Sendai framework in Iran from 2021 to 2023. 35 experts in the focus group discussion and 9 experts in the interview were the participants of the study. RESULTS: Study findings were merged and reported as one main theme entitled Executive actions for implementing the Sendai Framework, four categories, and 37 codes. Eleven codes for the strategy of understanding disaster risk, 11 codes for the strategy of strengthening disaster risk governance to manage disaster risk, eight codes for the strategy of Investing in disaster risk reduction for resilience, and finally, seven codes for the strategy of enhancing disaster preparedness for effective response and to "Build Back Better" in recovery, rehabilitation, and reconstruction were identified as implementation solutions. CONCLUSION: The Sendai Framework has not provided any detailed implementation solutions because the countries' economic, social, level of development, etc., are different. The study's findings can be used as a guide for other developing countries.
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Planejamento em Desastres , Desastres , Humanos , Irã (Geográfico) , Desenvolvimento Sustentável , Comportamento de Redução do RiscoRESUMO
Due to fast industrial expansion and the increasing population in Vietnam, this country is confronting a mounting lack of energy. While this country has considerable renewable energy (RE) potentials, including wind, solar, biomass, and hydropower sources, it has yet to exploit them entirely because of a lack of proper planning. This research aimed to find and assess solutions for encouraging RE growth in Vietnam. RE development solutions were formulated through SWOT analysis and evaluated in terms of their social, economic, and environmental dimensions. The SWARA approach weighed the strategy evaluation criteria. The most influential sub-criteria were initial investment cost, reduction of adverse environmental impacts, and natural capacity of the region, with weights of 0.155, 0.127, and 0.114, respectively. Strategy evaluation was performed using the Gray ARAS, and the results were validated with the Gray COPRAS, the Gray TOPSIS-G, and the Gray MABAC. In the strategy ranking, the top strategy is to reduce the cost of renewable power generation. This can be achieved by using advanced technologies and promoting cooperation between domestic and foreign industries and companies. Increasing domestic and foreign investment in RE infrastructure by providing financial facilities for investors, developing domestic and international cooperation, and creating a competitive environment between different companies to reduce electricity production costs were the most suitable strategies.
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Energia Renovável , Vento , Meio Ambiente , Cooperação Internacional , Vietnã , Desenvolvimento EconômicoRESUMO
BACKGROUND: The study uncovers micro and macro socioeconomic disparities in terms of health behavior, disease perception, and reception of information. Furthermore, findings shed light on the possible role of health insurance on access to information, disease perception and the adoption of preventive behaviors in the context of a public health emergency such as the COVID-19 pandemic. METHODS: This study employed a cross-sectional design using the Philippine Demographic and Health Survey (DHS). With a total of 29,809 respondents, it evaluated the individual or household and systemwide socioeconomic determinants of four different outcomes: receipt of information, disease perception, uptake of free preventive services, and treatment-seeking behavior. In addition to logistic regression models with the socioeconomic variables as the independent variables, models for the evaluation of the moderating effect of insurance ownership were fitted. Predicted probabilities were reported for the analysis of moderating effects. RESULTS: Findings show that individual and householdsocioeconomic determinants affected health-behavior and access to or receipt of information pertinent to the COVID-19 pandemic. Both education and wealth affected the receipt of information such that individuals in more advantaged socioeconomic positions were at least 30% more likely to have received information on COVID-19. Wealth was also associated to treatment-seeking behavior. Regional differences were seen across all dependent variables. Moreover, the study provides evidence that ownership of insurance can close education-based gaps in the uptake of free vaccination and COVID-19 testing. CONCLUSION: It is imperative that targeted efforts be maximized by utilizing existing strategies and mechanisms to reach the marginalized and disadvantaged segments of the population. Health insurance may give off added benefits that increase proficiency in navigating through the healthcare system. Further research may focus on examining pathways by which health insurance or social policies may be used to leverage responses to public health or environmental emergencies.
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COVID-19 , Revelação , Humanos , Estudos Transversais , Filipinas , Teste para COVID-19 , Pandemias , Fatores Socioeconômicos , Seguro Saúde , Comportamentos Relacionados com a SaúdeRESUMO
Introduction: Intestinal parasitic infections pose a substantial threat to public health and are a huge burden to the economic development of a developing country. We aimed to identify the spectrum of intestinal parasitic infections with an emphasis on demographic and clinical characteristics observed among immunocompromised and immunocompetent patients. Materials and Methods: This observational study was performed in the Parasitology section of the Department of Microbiology from January 2022 to July 2022. A total of 2628 stool samples were obtained from patients presenting with chief complaints of abdominal pain, distension, vomiting, and foul-smelling feces. All the clinical and diagnostic data of the patients enrolled in the above-mentioned period were extracted from the ward files, hospital electronic records, and laboratory registers. Result: A total of 2628 stool samples were sent to the Parasitology section of the Department of Microbiology. Out of the above-mentioned samples, 70 (70/2628, 2.66%) samples yielded gastrointestinal parasites on microscopic examination. The mean age of the patients included in our cohort study was 32.53 ± 16.21 years with a male predominance of 72.86% (51/70, 72.86%). The most common gastrointestinal parasite identified from stool samples was Giardia lamblia (61/70, 87.14%). All cases of opportunistic gastrointestinal infection caused by Cryptosporidium spp. (4/70, 5.71%) in our study cohort were found to infest the immunocompromised patients. Conclusion: This study determines the spectrum of intestinal parasitic infections among the immunocompromised and immunocompetent individuals and guides physicians in starting appropriate anti-parasitic treatment along with the instillation of strict hand hygiene techniques.
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Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder associated with substantial impairment which considerably burdens healthcare systems worldwide. Research on IBS has largely been conducted in high-income countries posing barriers to the application of diagnostic strategies in low- and middle-income countries (LMICs) due to differences in disease characteristics, healthcare resources, and socioeconomic factors. This review discusses the diagnostic issues associated with LMICs. We present a concise overview of the relevant approaches and propose a diagnostic strategy based on the latest evidence. A positive diagnostic strategy that relies on appropriate symptom-based criteria is crucial within the diagnostic framework. A combination of complete blood count, fecal occult blood test, and complete stool test may reliably identify individuals with suspected IBS who are more likely to have organic diseases, thus justifying the necessity for a colonoscopy. Eventually, we developed a diagnostic algorithm based on a limited setting perspective that summarizes the available evidence and may be applied in LMICs.
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The COVID-19 pandemic exposed gaps in global health governance, catalyzing proposals for a new WHO pandemic treaty. This paper investigates China's stance on the treaty, recognizing it as reflective of many developing countries' concerns, through a qualitative analysis of its interventions during the treaty's drafting and negotiations and an examination of historical and geopolitical factors. Findings reveal China's emphasis on respecting state sovereignty, differentiated obligations for developing nations, preventing stigma, and concrete capacity building-concerns shared across the Global South. Its posture balances pragmatism and principle, reflecting differentiated responsibilities as a major power and developing country along with philosophical divergences from Western legal thinking. While endorsing global cooperation, China insists on voluntary terms without impinging on policy space. Implications suggest that accommodating China's concerns about invasive compliance mechanisms and inequitable burdens through flexible provisions can shape the treaty's acceptance and architecture. Creative solutions reconciling sovereignty and collective action combined with concrete equity measures and depoliticized cooperation will determine the treaty's success. China's major role indicates its endorsement, representative of the Global South's voice, is essential for an impactful pandemic treaty and reformed global health governance.
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Cooperação Internacional , Pandemias , Humanos , Saúde Global , Organização Mundial da Saúde , China/epidemiologiaRESUMO
Sub-Saharan African nations face multifaceted environmental problems, especially those associated with carbon discharges. Hence, this study calculates a composite carbon index in the context of 39 developing nations from this region and uses it as a proxy for the carbon emission-related environmental problems they have faced during the 2000-2020 period. This index is estimated by utilizing data regarding annual carbon dioxide discharges, output-based carbon productivity rates, and energy consumption-based carbon intensity levels in the concerned countries. Hence, policy takeaways from this study have critical relevance for the selected sub-Saharan African nations to help them achieve the objectives related to the Sustainable Development Goals agenda and the Paris Accord. Overall, the findings from the econometric analyses verify that more receipt of foreign direct investment initially raises but later on reduces environmental problems. Thus, the nexus concerning these variables depicts an inverse U-shape. Besides, the results endorse that greening the energy consumption structures of the sampled sub-Saharan African countries helps to abate their environmental problems in the long run while financial development aggravates the extent of environmental adversities that take place. Lastly, improving the quality of regulatory agencies enables the Sub-Saharan African nations to further mitigate their environmental problems. Moreover, these aforementioned findings are observed to be heterogeneous across low- and middle-income categories of the selected Sub-Saharan African countries. Furthermore, the heterogeneity of the findings is also confirmed by the outcomes derived from the country-specific analyses. Nevertheless, these nations should attract clean energy-embodying foreign direct investment, make their energy consumption structures greener by amplifying renewable energy adoption rates, introduce green funds to develop their financial sectors, and make their environmental regulatory agencies more transparent with their activities.
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Países em Desenvolvimento , Desenvolvimento Econômico , África Subsaariana , Energia Renovável , Internacionalidade , Investimentos em Saúde , Dióxido de Carbono/análiseRESUMO
INTRODUCTION: This study aims to quantitatively assess eligible patients and project the demand for particle therapy facilities in India from 2020 to 2040. In addition, an economic analysis evaluates the financial feasibility of implementing this technology. The study also examines the prospective benefits and challenges of adopting this technology in India. METHODOLOGY: Cancer incidence and projected trends were analyzed for pediatric patients using the Global Childhood Cancer microsimulation model and adult patients using the Globocan data. Economic cost evaluation is performed for large-scale combined particle (carbon and proton-three room fixed-beam), large-scale proton (one gantry and two fixed-beam), and small-scale proton (one gantry) facility. RESULTS: By 2040, the estimated number of eligible patients for particle therapy is projected to reach 161,000, including approximately 14,000 pediatric cases. The demand for particle therapy facilities is projected to rise from 81 to 97 in 2020 to 121 to 146 by 2040. The capital expenditure is estimated to be only 3.7 times that of a standard photon linear accelerator over a 30-year period. Notably, the treatment cost can be reduced to USD 400 to 800 per fraction, substantially lower than that in high-income countries (USD 1000 to 3000 per fraction). CONCLUSION: This study indicates that, in the Indian scenario, all particle therapy models are cost-beneficial and feasible, with large-scale proton therapy being the most suitable. Despite challenges such as limited resources, space, a skilled workforce, referral systems, and patient affordability, it offers substantial benefits. These include the potential to treat many patients and convenient construction and operational costs. An iterative phased implementation strategy can effectively overcome these challenges, paving the way for the successful adoption of particle therapy in India. PLAIN LANGUAGE SUMMARY: In India, the number of eligible patients benefiting from high-precision particle therapy technology is projected to rise till 2040. Despite high upfront costs, our study finds the long-term feasibility of all particle therapy models, potentially offering a substantial reduction in treatment cost compared to high-income countries. Despite challenges, India can succeed with an iterative phased approach.
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Neoplasias , Humanos , Índia/epidemiologia , Neoplasias/terapia , Neoplasias/economia , Neoplasias/radioterapia , Neoplasias/epidemiologia , Criança , Terapia com Prótons/economia , Adulto , Necessidades e Demandas de Serviços de Saúde/economia , Análise Custo-BenefícioRESUMO
Organic waste management is challenging in low-middle income countries. Environmental impacts and high management costs affect the sustainable development of cities, an issue that is exacerbated by the lack of social involvement. The research conducted in Iran aims to assess the benefits of organic waste home composting in Shiraz to improve solid waste management (SWM) sustainability. The introduction of a pilot project to assess home composting systems was described, together with an economic, social and environmental analysis. The current SWM system (S0) has been compared with the new strategy proposed (S1), where home composting is considered to be introduced to collect about 10% of the municipal solid waste generated in a 10-year horizon. An economic balance related to the capital costs and operational costs of both systems was introduced, in parallel with a life cycle assessment (LCA) of the SWM system, and a questionnaire survey of the local population. Results showed that S1 leads to around 5% economic savings for the municipality due to the avoidance of organic waste transportation and disposal. Environmental benefits include a lowering of CO2-Eq emissions of about 19,076 tonnes year-1. In addition, about 28% of the interviewed (n = 319) agreed to employ the home composting system at home (CI 5.5%, 95% of confidence level) supporting the theory that about 10% of the organic waste can be segregated and home-composted. The research underlines that home composting can contribute to improve the sustainability of SWM systems in developing countries.
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Introduction: Unintended pregnancy is associated with national socioeconomic development and gender inequality. In addition to contraception, educational interventions that promote family planning and address gender dynamics are considered important in preventing unintended pregnancy. While the importance of encouraging men's participation in family planning has been advocated, most studies have focused on the application of interventions to women or populations in high-income countries only. Therefore, we conducted a systematic review to evaluate the effects of educational interventions on men in low- and middle-income countries in terms of knowledge, attitudes, practices, and gender dynamics. Methods: Three electronic databases (CINAHL, Ovid MEDLINE, and Web of Science) were searched for studies published from January 1980 to October 2022. Keywords such as "men/husband," "family planning," "contraception," and "education" were combined to identify studies. Two independent reviewers conducted screening and data extraction, and the risk of bias was assessed using the Risk of Bias 2 tool. The quality of evidence was evaluated according to the GRADE Handbook. Results: The database search identified 16,086 articles, of which 4 cluster randomized controlled trials (RCTs) and 1 RCT were ultimately included. Each of them was conducted in four different countries: Malawi, Guatemala, Tanzania, and India. Changes in knowledge, attitude, family planning, and gender dynamics were the outcomes used to assess the effectiveness of interventions. The five selected articles exhibited an effect on ≥1 indicator for each outcome. However, the quality of evidence was determined to be low or very low owing to the risk of bias, heterogeneity, and imprecision. Conclusions: Determining the effectiveness of educational interventions in family planning for men in low- and middle-income countries requires additional high-quality intervention studies. As family planning is influenced by various background factors, it is important to develop appropriate interventions for each context and define relevant indicators that can be compared across contexts.
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Receiving international industrial transfer (mainly foreign direct investment, FDI) is extremely important for economic development but also brings negative environmental impacts for Southeast Asian developing countries (SEADCs). Due to relatively low labor costs and large market potential, SEADCs have become an attractive destination for industrial transfer after China, while studies were far from sufficient on the associated air pollutant emissions that would worsen air quality and threaten human health. We develop an exploratory framework to estimate the long-term trends of relevant air pollutant emissions in eight major SEADCs, including Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Thailand, and Vietnam. During 1990-2018, the emissions generally show a fluctuating upward trend and increased significantly in Cambodia, Laos, Philippines, and Vietnam. The total emissions of CO, NMVOC, SO2, NOX, PM2.5, and NH3 from the eight SEADCs increased from 19.0, 4.3, 3.6, 1.5, 0.5, and 0.4 kilotons (kt) to 391.6, 260.9, 271.1, 182.4, 48.4, and 12.2 kt, respectively. The emission growth in almost all SEADCs accelerated after 2008 and faster than FDI growth. The disparities in emissions among SEADCs basically grew first and then declined to a level lower than that of 1990, but generally exceeded the disparities in FDI. Productivity gain and emission intensity decrease primarily caused the emission growth and reduction, respectively. Relatively small reductions in emission intensity are found for NOX and SO2. In general, most SEADCs have utilized FDI for economic development without sufficient efforts on air pollutant emission controls. Our outcomes can inform the formulation and optimization of relevant policies reconciling economic development and air quality improvement in SEADCs.