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We examined the interactions between stream water and subsurface sediment to quantify how these interactions influenced organic C respiration and dissolved inorganic C (DIC) production in the hyporheic zone of a high-gradient headwater mountain stream draining a forested catchment at the H. J. Andrews Experimental Forest, Oregon, USA. We compared measurements from a well network with those from six 2-m-long hyporheic mesocosms. The patterns in hyporheic metabolism were similar in wells and mesocosms: O2 declined and DIC increased with travel time. However, the dissolved organic C (DOC) showed little net change in concentration. The mesocosms showed that net losses of DOC could account for 7% of O2 consumed during summer and autumn and 24% of O2 consumed in the winter and spring. Previous research at our study site suggested that large volumes of hyporheic exchange are likely to result in continual processing of streamwater DOC through the hyporheic zone, which would limit the accumulation of bioavailable DOC. Consequently, hyporheic respiration in this forested headwater stream appears to rely primarily on organic C ultimately derived from sediment-bound or buried particulate organic matter (POC). We modeled the consumption of O2 (k O2) and the production of DIC (k DIC) as zero-order kinetic reactions. In the mesocosms, k O2 and k DIC were correlated to temperature and were 2× higher in the summer and autumn than in the winter and spring. In the well network, however, neither k O2 nor k DIC showed seasonal differences. The k DIC was also correlated to initial DOC concentrations in both the mesocosms and the wells. Further, the k DIC was correlated to the time since the mesocosms were packed, which suggests that sediment disturbance or incorporation of relatively fresh organic matter from packing the mesocosms increased the bioavailability of the POC. Further, changes in concentrations of O2, DOC, and DIC were approximately linear when plotted against travel time for both the mesocosms and the well field. These data suggest that the processes that release bioavailable DOC from POC are relatively constant along hyporheic flow paths and govern the rate of hyporheic metabolism in the hyporheic zone of this forested headwater stream. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion and Conclusions We retrospectively studied the societal value of lost health due to alcohol use and compared it with excise taxes on alcohol sales for India in 2019.We estimated the overall alcohol‐attributable disease burden using disability‐adjusted life‐years (DALY) for India and its 30 states for all causes with alcohol use as a risk factor from the GBD 2019 Study. The societal value of lost health was calculated using value of life‐year (VLY) approach by multiplying region‐specific factors from ‘Global Health 2035’, 2019–2020 GDP per capita and DALYs. We acquired the national and state‐level (top 10 states) alcohol sales excise taxes from the Reserve Bank of India. Net losses were assessed by subtracting the revenue collected from excise taxes from VLY. All values are in Indian rupees (INR).The societal value of health lost due to alcohol use in India was 6.2 (95% uncertainty interval 4.8, 7.8) trillion INR in 2019. The absolute state‐level values varied from 7.3 (4.7, 10.4) billion INR in Mizoram to 1.1 (0.8, 1.4) trillion INR in Maharashtra. The per capita values ranged from 950.2 (642.9, 1285.3) INR for Bihar to 61,332 (39,273.7, 87,288.5) INR for Mizoram. Nationally, excise tax collection from alcohol sales was 1.8 trillion INR depicting a net loss of 4.4 (3.1, 6.0) trillion. Maharashtra had the largest absolute and per capita net loss.These are novel estimates depicting the net losses due to alcohol use in India with direct policy implications to disincentivise sales and adequately raise taxes. [ABSTRACT FROM AUTHOR]

Aim Materials and Methods Results Conclusions To highlight oversimplified quality‐adjusted life year (QALY) calculations and incremental cost‐effectiveness ratios (ICERs) regarding lifestyle metformin and placebo as flaws in the trial‐based (Diabetes Prevention Program) cost‐effectiveness analysis.We revised the QALY calculations to conform to convention and calculated appropriate ICERs using both original and revised QALYs results. We used several additional health economics tools to present results, showing the consistency of each method and the added value of each. We presented net monetary benefits, assessed decision uncertainty and calculated net losses. We also used graphics, making correct interpretation clearer and allowing illustration and calculation of technical and economic inefficiencies of treatments that were not cost‐effective.ICERs with either QALY calculation indicated that metformin was technically and economically inefficient and not cost‐effective. There was virtually no decision uncertainty. All methods employed pointed to an identical conclusion.In contrast to original claims, although lifestyle was cost‐effective in diabetes prevention, metformin was not, and acting otherwise imposes significant monetary and health costs. Various available tools of economic evaluation would probably have prevented the original misinterpretation by the authors had they been used. The varied tools implemented here illustrate with a common example their consistency and value to the field, showing how to depict the results in various ways. [ABSTRACT FROM AUTHOR]

The Amazon forest contains globally important carbon stocks, but in recent years, atmospheric measurements suggest that it has been releasing more carbon than it has absorbed because of deforestation and forest degradation. Accurately attributing the sources of carbon loss to forest degradation and natural disturbances remains a challenge because of the difficulty of classifying disturbances and simultaneously estimating carbon changes. We used a unique, randomized, repeated, very high-resolution airborne laser scanning survey to provide a direct, detailed, and high-resolution partitioning of aboveground carbon gains and losses in the Brazilian Arc of Deforestation. Our analysis revealed that disturbances directly attributed to human activity impacted 4.2% of the survey area while windthrows and other disturbances affected 2.7% and 14.7%, respectively. Extrapolating the lidar-based statistics to the study area (544,300 km²), we found that 24.1, 24.2, and 14.5 Tg C y-1 were lost through clearing, fires, and logging, respectively. The losses due to large windthrows (21.5 Tg C y-1) and other disturbances (50.3 Tg C y-1) were partially counterbalanced by forest growth (44.1 Tg C y-1). Our high-resolution estimates demonstrated a greater loss of carbon through forest degradation than through deforestation and a net loss of carbon of 90.5 ± 16.6 Tg C y-1 for the study region attributable to both anthropogenic and natural processes. This study highlights the role of forest degradation in the carbon balance for this critical region in the Earth system. [ABSTRACT FROM AUTHOR]

This study aims to explore the financial status of Medicaid Home Care Aides (HCAs) working in Washington State (WA). This study importantly covers both economic and psychological components of financial insecurity, a comprehensive approach that may help advance policy development for HCAs' financial security. An online survey was conducted from April to May 2019 among employed WA HCAs. The descriptive analyses were conducted using Stata. About two-thirds earned less than $30,000 annually (62%) from all their jobs combined, including non-caregiving work. Over 1 in 4 reported having over $40 k in long-term debt (28%). More than 3 in 4 reported they could only cover housing and basic living expenses using savings for less than 2 months (76%), showing likely unreadiness for sudden financial shocks (financial vulnerability). Nearly 3 in 4 HCAs (73%) experienced at least one material hardship that include housing hardship, utilities hardship, medical hardship, and food insecurity. One in 4 expressed their financial stress was severe. More WA HCAs experienced material hardships (73%) than U.S. low-income families (64.2%). In 2021, the median annual wage for WA HCAs was about 20% higher than the national one; however, their wages still remain below the living wage. In conclusion, although WA HCAs' wages are comparable to national averages, they still experience financial vulnerability and material hardships. Therefore, achieving living wages is necessary for WA HCAs. [ABSTRACT FROM AUTHOR]

Aim: The inclusion of production losses in health care priority setting is extensively debated. However, few studies allow for a comparison of these losses across relevant clinical and demographic categories. Our objective was to provide comprehensive estimates of Norwegian production losses from morbidity and mortality by age, sex and disease category. Methods: National registries, tax records, labour force surveys, household and population statistics and data from the Global Burden of Disease were combined to estimate production losses for 12 disease categories, 38 age and sex groups and four causes of production loss. The production losses were estimated via lost wages in accordance with a human capital approach for 2019. Results: The main causes of production losses in 2019 were mental and substance use disorders, totalling NOK121.6bn (32.7% of total production losses). This was followed by musculoskeletal disorders, neurological disorders, injuries, and neoplasms, which accounted for 25.2%, 7.4%, 7.4% and 6.5% of total production losses, respectively. Production losses due to sick leave, disability insurance and work assessment allowance were higher for females than for males, whereas production losses due to premature mortality were higher for males. The latter was related to neoplasms, cardiovascular disease and injuries. Across age categories, non-fatal conditions with a high prevalence among working populations caused the largest production losses. Conclusions: The inclusion of production losses in health care priority debates in Norway could result in an emphasis on chronic diseases that occur among younger populations at the expense of fatal diseases among older age groups. [ABSTRACT FROM AUTHOR]

This paper explores the relationship among education, knowledge, perception and disaster experience to investigate whether household disaster preparedness behaviour mitigates income losses. We employ instrumental variables approach and generate indigenous knowledge from a large‐scale dataset to examine responsiveness of disaster preparedness via unemployment and production. We identify disaster and climate knowledge perception as new determinant towards disaster risk reduction. Our findings suggest Disaster Preparedness Index (DPI) is almost 64% effective in mitigating household per capita net income loss in comparison with the mean via unemployment channel. We argue that informal education and community‐based training could bring more efficacies in this loss mitigation mechanism. [ABSTRACT FROM AUTHOR]

The article discusses how the Medical Library Association (MLA) is adapting and navigating to changes and innovations. Topics discussed include the role of the board of directors in leading the direction of MLA, the strategies of MLA to grow the organization, address its financial challenges and achieve long-term sustainability, and its strategic goals from 2015 to 2024.

Motivated by debates about California's net migration loss, we employ valued exponential-family random graph models to analyze the inter-county migration flow network in the United States. We introduce a protocol that visualizes the complex effects of potential underlying mechanisms and perform in silico knockout experiments to quantify their contribution to the California Exodus. We find that racial dynamics contribute to the California Exodus, urbanization ameliorates it, and political climate and housing costs have little impact. Moreover, the severity of the California Exodus depends on how one measures it, and California is not the state with the most substantial population loss. This paper demonstrates how generative statistical models can provide mechanistic insights beyond simple hypothesis-testing. [ABSTRACT FROM AUTHOR]

Objectives Contextually driven decision making is multidimensional, as individuals need to contend with prioritizing both competing and complementary demands. However, data is limited as to whether temporal discounting rates vary as a function of framing (gains vs loss) and domain (monetary vs social) in middle-to-older aged adults. It is also unclear whether socioaffective characteristics like social isolation and loneliness are associated with temporal discounting. Methods Temporal discounting rates were examined across monetary gain, monetary loss, social gain, and social loss conditions in 140 adults aged 50–90 during the Omicron stage of the pandemic. Self-report measures assessed loneliness and social isolation levels. Results Results found evidence of steeper temporal discounting rates for gains as compared to losses in both domains. Social outcomes were also more steeply discounted than monetary outcomes, without evidence of an interaction with the framing condition. Socioeconomic and socioaffective factors were unexpectedly not associated with temporal discounting rates. Discussion Community-dwelling middle-to-older aged adults showed a preference for immediate rewards and devalued social outcomes more than monetary outcomes. These findings have implications for tailoring social and financial incentive programs for middle to later adulthood. [ABSTRACT FROM AUTHOR]

Net global losses of seagrasses have accelerated efforts to understand recovery from disturbances. Stressors causing disturbances (e.g., storms, heatwaves, boating) vary temporally and spatially within meadows potentially affecting recovery. To test differential recovery, we conducted a removal experiment at sites that differed in thermal stress for a temperate seagrass (Zostera marina). We also synthesized prior studies of seagrass recovery to assess general patterns. Seagrass shoots were removed from 28.3 m2 plots at edge and central sites of a meadow in South Bay, Virginia, USA. We hypothesized faster recovery for edge plots where greater oceanic exchange reduces thermal stress. Contrary to our hypothesis recovery was most rapid in the central meadow matching control site shoot density in 24 months. Recovery was incomplete at the meadow edge and estimated to require 158 months. Differences in recovery were likely due to storm‐driven sediment erosion at the edge sites. Based on data from prior recovery studies, which were primarily on monospecific meadows of Zostera, seagrasses recover across a broad range of conditions with a positive, nonlinear relationship between disturbance area and recovery time. Our experiment indicates position within a seagrass meadow affects disturbance susceptibility and length of recovery. Linking this finding to our literature synthesis suggests increased attention to spatial context will contribute to better understanding variation in recovery rates. [ABSTRACT FROM AUTHOR]

Despite the data demonstrating an increased utilization of hepatitis C virus (HCV)-viremic kidneys, the acceptance and incorporation of HCV-viremic kidneys are not universal. We aimed to identify regional differences and their temporal changes in the utilization of HCV-viremic kidneys. Using the Organ Procurement and Transplantation Network database, HCV-viremic kidneys utilized in kidney transplants from March 15, 2019, to March 14, 2023, were included. The utilization of HCV-viremic kidneys across the United States and center-level clustering of HCV-viremic donor kidney transplants into HCV NAT-negative recipients (HCV D+/R− transplants) using Gini coefficients were examined. Significant regional variations were observed, with regions 3, 10, and 11 accounting for 51% of all HCV-viremic kidney utilization. Region 9 benefited the most from HCV-viremic kidney transplants with a high influx of kidney imports from other regions (284.9% gain). Region 8 and region 6 encountered the most substantial losses, with net losses of −44.2% and −41.1%, respectively. HCV D+/R− transplants were concentrated in specific high-volume centers, but trends indicated a gradual increase in a more equitable distribution across centers over time. Significant variations can be observed in the utilization of HCV-viremic kidneys throughout the United States. These variations highlight opportunities for kidney transplant centers in specific regions to adopt policies for HCV-viremic kidney transplants, thereby expanding their donor pool. Encouragingly, an increasing number of kidney transplant centers are adopting HCV D+/R− kidney transplants, indicating positive progress. These trends suggest a more balanced access to HCV-viremic kidneys ahead. [ABSTRACT FROM AUTHOR]

Background: Rural hospitals are increasingly at risk of closure. Closure reduces the availability of hospital care in rural areas, resulting in a disparity in health between rural and urban citizens, and it has broader economic impacts on rural communities as rural hospitals are often large employers and are vital to recruiting new businesses to a community. To combat the risk of closure, rural hospitals have sought partnerships to bolster financial performance, which often results in a closure of services valuable to the community, such as obstetrics and certain diagnostic services, which are viewed as unprofitable. This can lead to poor health outcomes as community members are unable to access care in these areas. Purpose: In this article, we explore rural hospital service offerings and financial performance, with an aim to illuminate if specific service offerings are associated with positive financial performance in a rural setting. Methods: Our study used hospital organization data, as well as county-level demographics with periods of analysis from 2015 and 2019. We employed a pooled cross-sectional regression analysis with robust standard errors examining the association between total margin and service lines among rural hospitals in the United States. Results: The findings suggest that some services deemed unprofitable in urban and suburban hospital settings--such as obstetrics and drug/alcohol rehabilitation--are associated with higher margins in rural hospitals. Other unprofitable service lines--such as psychiatry and long-term care--are associated with lower margins in rural hospitals. Conclusion: Our results suggest the need of rural hospitals to choose services that align with environmental circumstances to maximize financial performance. Practice Implication: Hospital administrators in rural settings need to take a nuanced look at their environmental and organizational specifics when deciding upon the service mix. Generalizations regarding profitability should be avoided to maximize financial performance. [ABSTRACT FROM AUTHOR]

Purpose: Falls are a significant financial burden and health hazard for residents in assisted living facilities (ALFs). However, limited capacity to observe residents has hindered understanding of resident–staff interactions within rooms. The current study aimed to describe nurse–resident interactions using data from a remote technology combining computer vision and staff location tracking. Method: Eighty-three staff working at an urban ALF with 215 residents were trained at the initiation of the study. Remote surveillance devices were installed in 32 residences and staff and resident interactions were tracked over 170 days. Results: Staff visited residents an average of 20.7 times per day for short durations (mean = 1.08 minutes). Urgent alert response times averaged 3.0 minutes, with faster response times through the mobile application (mean = 2.7 minutes) compared to in-person (mean = 3.3 minutes) response. Conclusion: By better understanding staff activity patterns in ALFs, this study has the potential to improve fall prevention and care for residents in ALFs. [Journal of Gerontological Nursing, 50(7), 7–11.] [ABSTRACT FROM AUTHOR]

Hospitals that are considered non-profit take into consideration not to make any losses other than seeking profit. A model that ensures that hospital price policies are variable due to hospital revenues depending on patients with appointments is presented in this study. A dynamic pricing approach is presented to prevent patients who have an appointment but do not show up to the hospital from causing financial loss to the hospital. The research leverages three distinct machine learning (ML) algorithms, namely Random Forest (RF), Gradient Boosting (GB), and AdaBoost (AB), to analyze the appointment status of 1073 patients across nine different departments in a hospital. A mathematical formula has been developed to apply the penalty fee to evaluate the reappointment situations of the same patients in the first 100 days and the gaps in the appointment system, considering the estimated patient appointment statuses. Average penalty cost rates were calculated based on the ML algorithms used to determine the penalty costs patients will face if they do not show up, such as 22.87% for RF, 19.47% for GB, and 14.28% for AB. As a result, this study provides essential criteria that can help hospital management better understand the potential financial impact of patients missing appointments and can be considered when choosing between these algorithms. [ABSTRACT FROM AUTHOR]

The establishment and management of protected areas (PAs) often involve modifying traditional land use rights and changing the production and living activities of locals, which can lead to changes in the factors that drive land use transitions. Our understanding of the spatiotemporal patterns of land use transition and the contributions of social-ecological drivers remains incomplete. In this study, we focused on the Yarlung Zangbu Grand Canyon National Park and examined how social-ecological factors influence land use transitions by developing a theoretical model of land use transitions within PAs. Our findings revealed that cropland, shrubland, grassland, and wetland experienced net losses in area, while forestland, water, ice/snow, barren land, and impervious land exhibited fluctuating growth patterns from 1985 to 2020. The net decrease in grassland was 157425.60 ha, while the net increase in forest was 140709.20 ha. The quality of land habitat increased from 0.5158 to 0.6656. Land use dominant and recessive transitions displayed varying spatial characteristics and scales across different time periods. In particular, the degree of influence of policy factors on land use dominant transition declined from 0.0800 in 1985–1990 to –0.0432 in 2010–2020, while its influence on land use recessive transition declined from 0.00058 in 1985–1990 to 0 in 2010–2020. The results show that social-ecological factors intricately influenced different types of land use transitions, leading to a shift from a balanced state to a new equilibrium. These results enhance our understanding of the spatiotemporal patterns and complex dynamics of land use transitions within PAs, providing insights and practical implications for effective land management in PAs by considering the land-human relationships. [ABSTRACT FROM AUTHOR]

The rising costs of cancer care and subsequent medical financial hardship for cancer survivors and families are well documented in the United States. Less attention has been paid to employment disruptions and loss of household income after a cancer diagnosis and during treatment, potentially resulting in lasting financial hardship, particularly for working‐age adults not yet age‐eligible for Medicare coverage and their families. In this article, the authors use a composite patient case to illustrate the adverse consequences of cancer diagnosis and treatment for employment, health insurance coverage, household income, and other aspects of financial hardship. They summarize existing research and provide nationally representative estimates of multiple aspects of financial hardship and health insurance coverage, benefit design, and employee benefits, such as paid sick leave, among working‐age adults with a history of cancer and compare them with estimates among working‐age adults without a history of cancer from the most recently available years of the National Health Interview Survey (2019–2021). Then, the authors identify opportunities for addressing employment and health insurance coverage challenges at multiple levels, including federal, state, and local policies; employers; cancer care delivery organizations; and nonprofit organizations. These efforts, when informed by research to identify best practices, can potentially help mitigate the financial hardship associated with cancer. [ABSTRACT FROM AUTHOR]

This article examines the human toll of the 1944–1945 famine in Java, Indonesia's main island. It estimates birth and death rates for the Indonesian population in Java during 1941–1951. Using the net population loss method, the article approximates a net loss of 3.3 million people during the 1942–1945 Japanese occupation period. This includes 1.8 million excess deaths; 0.7 million during 1944 and 1.1 million during 1945. The remainder are 1.4 million missing births in 1944 and 1945, associated with the malnutrition of women of childbearing ages and physical separation of wives from husbands recruited by Japanese authorities for forced labour. [ABSTRACT FROM AUTHOR]

The Ganges-Brahmaputra Delta (GBD) in Bangladesh exists at a nexus of stability and vulnerability, as the rivers annually carry ~ 800–1000 MT of sediment from the Himalayan Mountains, yet coastal poldering and sediment extraction within the rivers remove elevation capital from the low-lying delta plain. Recent research in the GBD has begun to unravel how the world's largest fluvio-deltaic mangrove forest—the Sundarbans—is keeping pace with sea level rise (SLR); however, this is contingent on adequate sediment supply delivered to the platform during semi-diurnal tides and the seasonal monsoon. Little is known about the elevation dynamics within human-modified polders by comparison, other than an elevation deficit of 1–1.5 m exists. In this study, seasonal data from Rod Surface Elevation Tables (RSETs) installed within a polder in the southwest region (Polder 32) are compared to the Sundarbans. Over ~ 8 years, results show that surface elevation is gaining within the Sundarbans at a more significant rate (~ 58.4%), and this is due to the higher vertical accretion rates measured in the Sundarbans (~ 67%) from abundant sources of allochthonous material. Elevation gain in the polder, particularly close to the embankment, appears to be attributed to sediment supplied from eroded embankments and local sluice gates, in addition to seasonal subsurface clay swelling during the monsoon. Shallow subsidence within both study areas appears to take place seasonally, but with less delivery of new sediment, the rate of shallow subsidence is lower in the polder compared to the Sundarbans. Despite seasonal shallow subsidence, the elevation change is net positive in both study areas if taken as a whole; however, interior poldered regions exhibit net elevation loss. This comparison in change of elevation, vertical accretion, and shallow subsidence shows how human modification has drastically changed the natural processes. Furthermore, our results are compared to rates of relative and effective SLR, which show that the Sundarbans is keeping pace in this region, while Polder 32 is not. These results are vital to inform embankment mitigation and flood risk in this dynamic delta system. [ABSTRACT FROM AUTHOR]

Environmental markets are a rapidly emerging tool to mobilize private funding to incentivize landholders to undertake more sustainable land management. How units of biodiversity in these markets are measured and subsequently traded creates key challenges ecologically and economically because it determines whether environmental markets can deliver net gains in biodiversity and efficiently lower the costs of conservation. We developed and tested a metric for such markets based on the well‐established principle of irreplaceability from systematic conservation planning. Irreplaceability as a metric avoids the limitations of like‐for‐like trading and allows one to capture the multidimensional nature of ecosystems (e.g., habitats, species, ecosystem functioning) and simultaneously achieve cost‐effective, land‐manager‐led investments in conservation. Using an integrated ecological modeling approach, we tested whether using irreplaceability as a metric is more ecologically and economically beneficial than the simpler biodiversity offset metrics typically used in net gain and no‐net‐loss policies. Using irreplaceability ensured no net loss, or even net gain, of biodiversity depending on the targets chosen. Other metrics did not provide the same assurances and, depending on the flexibility with which biodiversity targets can be achieved, and how they overlap with development pressure, were less efficient. Irreplaceability reduced the costs of offsetting to developers and the costs of ecological restoration to society. Integrating economic data and systematic conservation planning approaches would therefore assure land managers they were being fairly rewarded for the opportunity costs of conservation and transparently incentivize the most ecologically and economically efficient investments in nature recovery. [ABSTRACT FROM AUTHOR]

Objective To assess global, regional and national trends in the impact of floods from 1990 to 2022 and determine factors influencing flood-related deaths. Methods We used data on flood disasters from the International Disaster Database for 1990--2022 from 168 countries. We calculated the annual percentage change to estimate trends in the rates of people affected and killed by floods by study period, World Health Organization (WHO) region, country income level and flood type. We used multivariable logistic regression analysis to assess the factors associated with death from floods. Findings From 1990 to 2022, 4713 floods were recorded in 168 countries, which affected > 3.2 billion people, caused 218 353 deaths and were responsible for more than 1.3 trillion United States dollars of economic losses. The WHO Western Pacific Region had the most people affected by floods (> 2.0 billion), accounting for 63.19% (2 024 599 380/3 203 944 965) of all affected populations. The South-East Asia Region had the most deaths (71 713, 32.84%). The African and Eastern Mediterranean Regions had the highest number of people affected and killed by floods per 100 000 population in 2022. The odds of floods causing more than 50 deaths were significantly higher in low-income countries (adjusted odds ratio: 14.34; 95% confidence interval: 7.46 to 30.04) compared with high-income countries. Numbers of people affected and mortality due to floods declined over time. Conclusion Despite the decreases in populations affected and deaths, floods still have a serious impact on people and economies globally, particularly in lower-income countries. Action is needed to improve disaster risk management and flood mitigation. [ABSTRACT FROM AUTHOR]

Globally, children have been adversely affected by the wide variety of impacts of SARS-CoV-2 (Coronavirus | COVID-19). Vulnerable children who depend on the support of education and health and social care systems were left unprotected as these systems were weakened by the pandemic. COVID-19 has exposed the already fragile situations in which many children and young people live and that thousands of children and young people would need ongoing support but remained invisible to statutory authorities. COVID-19 has also been a stark reminder of the vulnerability of individuals and societies and it has exposed deep divisions, inequalities, and injustices between different countries and groups of people. M'Lop Tapang is a local nonprofit organization registered with the Royal Government of Cambodia. This report discusses the efforts of M'Lop Tapang following the declaration of the COVID-19 global pandemic in early 2020, to address the local community needs; to ensure the voices of children remained heard; and to promote children's rights remaining a priority throughout the remainder of the pandemic. What is already known on this topic Vulnerable children are dependent on remaining visible to education and health and social care systems to ensure they are safeguarded and protected. Poor safety, financial instability, unemployment, challenges to children's rights and displacement all have the potential to increase vulnerabilities and intensify inequalities. The COVID-19 global pandemic has widened the global lens for the nursing profession and to effect change, children's nurses need to think globally and act locally. What this study adds This study provides insights into the challenges faced by children and families in Sihanoukville, Cambodia, during the early part of the SARS-CoV-2 (COVID19) pandemic in 2020–2021. The economic impact of COVID-19 on children and families living in Sihanoukville, Cambodia, between 2020 and 2021 is reviewed. The learning from the pragmatic and rapid interventions of M'Lop Tapang, Sihanoukville during the early phase of the SARS-CoV-2 (COVID-19) pandemic, are of use in other countries around the world in future epidemic or pandemic situations. [ABSTRACT FROM AUTHOR]

While a gambler may occasionally win, continuous gambling inevitably results in a net loss to the casino. This study experimentally demonstrates the profitability of a particularly deceptive casino game: a two-armed antique Mills Futurity slot machine. The main findings clearly show that both non-random and random two-arm strategies, predetermined by the player and repeated without interruption, are always profitable for the casino, despite two coins being refunded for every two consecutive losses by the gambler. We theoretically explore the cyclical nature of slot machine strategies and speculate on the impact of the frequency of switching strategies on casino returns. Our results not only assist casino owners in developing and improving casino designs, but also guide gamblers to participate more cautiously in gambling. [ABSTRACT FROM AUTHOR]

The total consumption model (TCM) postulates a close link between total consumption and levels of harm within the population, which has important implications for prevention. This review aimed to explore evidence relating to the application of the TCM and theoretical elements associated with it (i.e. the distribution of harms; the concentration of consumption) to gambling by reviewing evidence pertaining to the distribution of harms across the population; the concentration of gambling consumption; and evidence of the validity of the TCM in gambling. Systematic literature searches were performed using MEDLINE, PsycINFO, and Web of Science databases, restricted to publications between January 1, 2010, and March 29, 2023. The search identified seven studies examining risk curves for gambling harm, of which only two employed continuous consumption measures. This nascent literature suggests mixed evidence for the relationship between gambling consumption (e.g. losses, frequency, expenditure, and expenditure as a percentage of income) and risk of harm. Five publications found that the concentration of gambling consumption was high among those experiencing gambling harms, with some evidence that spending is more concentrated for certain games (e.g. online casinos) than for others (e.g. lotteries). Finally, four studies assessed the TCM, suggesting close association between gambling consumption and problem gambling, lending empirical support to the validity of the TCM. However, robust evidence is nascent and further research is required to assess these relationships. [ABSTRACT FROM AUTHOR]

Background: Hospitals are required to improve the quality of health services provided to patients. Purpose: Evaluating and comparing the healthcare quality received by insured patients hospitalized in two Indonesian regional public hospitals. Methods: Secondary data analysis used the 2019 and 2020 Indonesian National Health Insurance e-claim databases of Hospital A and Hospital B. Descriptive and crosstabs analyses were used to determine INA-CBGs diagnoses that were categorized as high volume, high risk, and high cost. Results: The admissions that caused financial loss at the Hospital A were 21.1% in 2019 and 19.8% in 2020, while 30.3% in 2019 and 27.5% at the Hospital B. More than 60% of these admissions were placed in the 3rd class of inpatient wards of the two hospitals. Of these admissions, < 5% at the Hospital A and >5% at the Hospital B were readmitted within 30 days, although more than 90% were previously discharged based on physicians' approval. Conclusions: Inadequate healthcare quality received by insured patients. Hence, an integrated clinical pathways based professional nursing practice model is highly recommended to increase patient outcomes and decrease 30 days hospital readmission rates. [ABSTRACT FROM AUTHOR]

Chronic testosterone (T) substitution and short-term T administration positively affect protein metabolism, however, data on acute effects in humans are sparse. This study aimed to investigate T's acute effects on whole body protein metabolism in hypogonadal and eugonadal conditions. We designed a randomized, double-blind, placebo-controlled, crossover study, including 12 healthy young males. Whole body protein metabolism was evaluated during 1) eugonadism, and after medically induced hypogonadism, with application of a gel on each trial day containing either 2) placebo, 3) T 50 mg, or 4) T 150 mg; under basal (5-h basal period) and insulin-stimulated conditions (3-h clamp). The main outcome measure was a change in net protein balance. The net protein loss was 62% larger in the placebo-treated hypogonadal state compared with the eugonadal state during the basal period (−5.5 ± 3.5 µmol/kg/h vs. −3.4 ± 1.2 µmol/kg/h, P = 0.038), but not during the clamp (P = 0.06). Also, hypogonadism resulted in a 25% increase in whole body urea flux (P = 0.006). However, T did not result in any significant changes in protein breakdown, synthesis, or net balance during either the basal period or clamp (all P > 0.05). Protein breakdown was reduced during clamp compared with the basal period regardless of gonadal status or T exposure (all P ≤ 0.001). In conclusion, the application of transdermal T did not counteract the negative effects of hypogonadism with no effects on protein metabolism within 5 h of administration. Insulin (during clamp) mitigated the effects of hypogonadism. This study is the first to investigate acute protein metabolic effects of T in hypogonadal men. NEW & NOTEWORTHY: In a model of medically induced hypogonadism in male volunteers, we found increased whole body urea flux and net protein loss as an expected consequence of hypogonadism. Our study demonstrates the novel finding that the application of transdermal testosterone had no acute effects on whole body protein metabolism under eugonadal conditions, nor could it mitigate the hypogonadism-induced changes in protein metabolism. In contrast, insulin (during clamp) mitigated the effects of hypogonadism on protein metabolism. [ABSTRACT FROM AUTHOR]

Neobanks have risen as popular digital challengers to incumbent banks, especially in emerging markets (EMs) where the banking sector is often characterized by oligopolies. This article first estimates the value of Nubank and StoneCo in Brazil, two of the fastest-growing neobanks in Brazil. Normalizing revenue growth assumptions from their financial data, valuation models uncover that Nubank could be overvalued by about two times, whereas StoneCo could be undervalued by 80% of its fair value, as of March 19, 2024. This article then discusses firm-specific (high cumulative net operating losses, low long-term operating margins, high borrowing costs) and adherent macroeconomic (political uncertainty, foreign exchange risks, high equity risk premia) risks in EMs that explain the volatility in Nubank's and StoneCo's stock prices. These risks are instructive for understanding the challenges facing the business model of neobanks in EMs. [ABSTRACT FROM AUTHOR]

Adolescent and young adult (AYA) cancer patients receive palliative medicine consultation at a late stage and face diagnostic delays. Failure to address social determinants of health (SDOH) and AYA-specific needs can adversely impact patient experience. This retrospective observational cohort study used data from chart review to assess the frequency of SDOH impacting AYA patients and setting of initial diagnosis at a US urban safety-net hospital. The association of SDOH variables with delays in treatment, loss of follow-up, and no-shows was tested using Chi-square and t -tests. One hundred seventy five patient charts were reviewed. Sixty-two percent were diagnosed in acute care settings. Substance use disorders, financial, employment, and insurance issues were associated with delayed treatment, with weak to moderate effect sizes. Mental health diagnoses, substance use disorder, homelessness, and financial burdens were associated with patient no-shows, with moderate to large effect sizes. Twenty-five percent of patients received palliative medicine consultation; 70% of these occurred at end of life. This study demonstrates the impact of SDOH on AYA cancer care and the need for policy allowing for intervention on SDOH. [ABSTRACT FROM AUTHOR]

The global community has outlined ambitious ecosystem restoration targets. Yet implementation is slow, and a lack of funding is a key barrier to upscaling restoration activities. Most restoration projects are funded by public institutions and recent high-level initiatives have emphasised the need to scale private finance in restoration. Private finance can be channelled into restoration through various financial mechanisms but is held back by a lack of return-making investment opportunities. Various institutions have now been created to commodify previously non-market ecosystem services and make them investable, most prominently voluntary carbon markets and biodiversity compliance market-like mechanisms, such as biodiversity-offsetting systems targeting the achievement of 'no net loss' of biodiversity for a given regulated sector. However, attracting private finance into restoration comes with risks, as private finance objectives in restoration often are misaligned with wider social and ecological objectives. Private finance mechanisms to date have tended to underinvest in monitoring and impact evaluation mechanisms and to favour investments in cost-effective nature-based solutions such as plantation monocultures over naturally regenerated ecosystems. Many technological and institutional solutions have been proposed, but these cannot mitigate all risks. Therefore, scaling of ecosystem restoration through market-like mechanisms requires substantial fundamental investments in governance and civil society oversight to ensure that ecological integrity and social equity is safeguarded. Here, we outline the high-level policy landscape driving restoration finance and explore the roles and potential of both public and private investment in restoration. We explain how some common mechanisms for drawing private investment into restoration work in practice. Then, we discuss some of the shortcomings of past private finance initiatives for ecosystem restoration and highlight essential lessons for how to safeguard the ecological and social outcomes of private investments in ecosystem restoration. Sophus zu Ermgassen and Sara Löfqvist outline the high-level policy landscape driving restoration finance and explore the roles and potential of both public and private investment in restoration. [ABSTRACT FROM AUTHOR]

Climate change poses significant risks to health and health systems, with the greatest impacts in low- and middle-income countries - which are least responsible for greenhouse gas emissions. The Conference of Parties 28 at the 2023 United Nations Climate Change Conference led to agreement on the need for holistic and equitable financing approaches to address the climate and health crisis. This paper provides an overview of existing climate finance mechanisms - that is, multilateral funds, voluntary market-based mechanisms, taxes, microlevies and adaptive social protection. We discuss these approaches' potential use to promote health, generate additional health sector resources and enhance health system sustainability and resilience, and also explore implementation challenges. We suggest that public health practitioners, policy-makers and researchers seize the opportunity to leverage climate funding for better health and sustainable, climate-resilient health systems. Emphasizing the wider benefits of investing in health for the economy can help prioritize health within climate finance initiatives. Meaningful progress will require the global community acknowledging the underlying political economy challenges that have so far limited the potential of climate finance to address health goals. To address these challenges, we need to restructure financing institutions to empower communities at the frontline of the climate and health crisis and ensure their needs are met. Efforts from global and national level stakeholders should focus on mobilizing a wide range of funding sources, prioritizing co-design and accessibility of financing arrangements. These stakeholders should also invest in rigorous monitoring and evaluation of initiatives to ensure relevant health and well-being outcomes are addressed. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has exhibit deep stress all over the world. Despite recent speculative suggestions of poorer psychological state in all age in India, since the beginning of the pandemic, there are no systematic efforts to help consequences. This research tried to report on the content of effect of lockdown on individual economy in Luck now city, those who could also be notably liable to negative emotions alongside news on the impact of corona virus on their lives. These impacts consecutively related to negative have an effect on. Participants' high worries centred on economy attainments, social and recreational activities, and physical health. A lot of females than males disturbed regarding educational attainment and physical health whereas a lot of males disturbed regarding economical, social and recreational activities. Thus, Indian individuals report important impact of the pandemic on varied aspects of their life and area unit notably disturbed regarding economical and educational attainments, social and recreational activities and physical health. During pandemic and lockdown people lost their jobs, their business were closed, they have had no option for their livelihood They were suffered from more stress. They were panic to thought about how to move their family life. How to secure their family. Thus Pandemics are extremely impactful and endangering the protection and traditional functioning of the community. [ABSTRACT FROM AUTHOR]

Livestock abortion is a source of economic loss for farmers, but its economic impact has not been estimated in many Low and Middle-Income Countries. This article presents an estimation methodology and estimates for the gross and net cost of an abortion based on a sample of livestock-owning households in three regions of northern Tanzania and market data. We then generate aggregate estimates of abortion losses across Tanzania. We estimate annual gross and net annual losses of about $263 Million (about TZS 600 billion) and $131 million (about TZS 300 billion), respectively. [ABSTRACT FROM AUTHOR]

In this critical narrative review, we challenge the belief that single-moment-in-time high-stakes examinations (SMITHSEx) are an essential component of contemporary specialist training. We explore the arguments both for and against SMITHSEx, examine potential alternatives, and discuss the barriers to change. SMITHSEx are viewed as the "gold standard" assessment of competence but focus excessively on knowledge assessment rather than capturing essential competencies required for safe and competent workplace performance. Contrary to popular belief, regulatory bodies do not mandate SMITHSEx in specialist training. Though acting as significant drivers of learning and professional identity formation, these attributes are not exclusive to SMITHSEx. Skills such as crisis management, procedural skills, professionalism, communication, collaboration, lifelong learning, reflection on practice, and judgement are often overlooked by SMITHSEx. Their inherent design raises questions about the validity and objectivity of SMITHSEx as a measure of workplace competence. They have a detrimental impact on trainee well-being, contributing to burnout and differential attainment. Alternatives to SMITHSEx include continuous low-stakes assessments throughout training, ongoing evaluation of competence in the workplace, and competency-based medical education (CBME) concepts. These aim to provide a more comprehensive and context-specific assessment of trainees' competence while also improving trainee welfare. Specialist training colleges should evolve from exam providers to holistic education sources. Assessments should emphasise essential practical knowledge over trivia, align with clinical practice, aid learning, and be part of a diverse toolkit. Eliminating SMITHSEx from specialist training will foster a competency-based approach, benefiting future medical professionals' well-being and success. [ABSTRACT FROM AUTHOR]

We conducted a quantitative, interdisciplinary study that investigated how financial concerns and varying family connections influence the retirement choices of Latiné immigrants in terms of returning to their country of origin. We hypothesized that being worried about one's finances for retirement, and having strong transnational ties, would lead to familial expectations to return to one's country of origin. Through data collected from a survey through Qualtrics, we found that higher levels of financial worry significantly affected greater familial expectations to return to their country of origin. The transnational ties that influenced the families' expectations to return to their country of origin was having children, friends, and family not residing in the U.S. Following our findings, we discuss potential future directions and implications relating to transnational ties, remittances, and older Latiné immigrants. [ABSTRACT FROM AUTHOR]

Floods are increasing in frequency and may increase the risk for experiencing emotional distress, anxiety, depression and PTSD. The aim of this study was to determine the extent of damage, loss, injury and death resulting from floods that occurred in and around the city of Durban, South Africa, in April 2022, and associated changes in mental health pre- to post-floods in a low-income setting. Seventy-three women between the ages of 18 and 45, residing in flood affected, low-income settings, were interviewed prior to the floods occurring. Mental health measures were repeated with 69 of the 73 women during the post-flood interview along with a questionnaire measuring flood-related exposures. Loss of infrastructure (lacked access to drinking water, electricity, fresh food, could not travel to work, had to stay in a shelter and could not get hold of friends or family) was a predictor of post-flood change in levels of emotional distress and anxiety. Higher levels of prior trauma exposure were associated with higher post-flood levels of emotional distress. Higher pre-flood food insecurity was also associated with higher post-flood anxiety. Women affected by poverty, food insecurity and a history of trauma are vulnerable to the additive adverse mental health effects of floods. Proactive approaches to diminishing the impact of floods on the livelihood of women is needed and post-flood relieve efforts may be more affective if they are enhanced by providing mental health support. [ABSTRACT FROM AUTHOR]

During public health crises, newspapers play the significant role of disseminating health information, shaping the public response to public health messaging, and encouraging efficacious risk-reducing behaviors. In conducting this study which explored early news media coverage of the COVID-19 (coronavirus disease 2019) pandemic, we analyzed the content of articles from 14 major U.S. newspapers published from January 21, 2020 to September 22, 2020. In addition to identifying the news frames employed by newspapers, including health risks, prevention/education, political/legal issues, economic consequences, societal problems, and medical-scientific issues, we also found alarmist and fear-mongering newspaper coverage of the COVID-19 pandemic. Furthermore, the impacts of COVID-19 on African American/Black populations and Hispanic/Latino populations in the reviewed articles were mostly framed from the economic loss and societal problem perspectives. Another common observation was the newspaper coverage's frequent focus on individualist explanations (e.g., health behaviors, lifestyles) for racial differences in COVID-19-related outcomes rather than systematic inequalities. Information concerning solutions to the disparities resulting from the pandemic was also limited. Essentially, our research results highlight how, during times of crisis, it is crucial for news media to convey accurate information to limit, mitigate, and reduce public harm. [ABSTRACT FROM AUTHOR]

In this qualitative sociological study we explore the significance of social integration and social strain in gambling suicides. There is evidence that gambling and suicidality are associated. Mental distress is common among people experiencing gambling harm. Indebtedness and financial losses are also associated with suicidality among people experiencing gambling harm. The significance of social factors and social context on gambling suicides is understudied. Social integration theory proposes that social ties, such as marriage, can protect people from suicide. Strain theory explains suicide by social factors causing strain. Our research question is: How are social integration and different sources of strain related to cases of gambling suicides? The data consists of police investigation reports of 21 suicide cases. The data was analyzed with thematic content analysis. The results show variation in the social integration and strain the deceased experienced before their deaths. None of the deceased were without social ties. The entanglement of different sources of strain was manifest. The results suggest that a typology consisting of four categories of suicide contexts can be distinguished by the respective strength of integration and the number of different strains. We conclude that gambling policy with a focus on harm prevention is also a matter of suicide prevention. [ABSTRACT FROM AUTHOR]

Background: Gambling is connected to important financial harms, including debt. Most existing research has investigated the relationship between gambling and debt using self-reported data. Only a few studies have used objective data. The current study focuses on the gambling of indebted individuals. It investigates the amounts and types of gambling consumed by indebted individuals, and the amounts of unsecured debt among heavy gamblers. Methods: We use past-year banking data of Finnish individuals (N=23 231) collected between 2018 and 2021 among applicants to a debt consolidation service. The transactions consist of deposits to, and winnings paid by gambling operators, distinguished by type of gambling (sports betting, casino, lottery) as well as active loans divided into secured and unsecured loans. Results: Gambling is widespread among indebted individuals in Finland. In terms of gambling types, casino-type gambling is the most popular among indebted individuals. Gambling spending is highly concentrated. Nearly half (49.5%) of all gambling deposits are concentrated among the highest spending 5% of indebted individuals. Individuals with unsecured loans have higher median losses than those without unsecured loans. Conclusions: The results suggest that gambling and indebtedness are strongly linked. The connection is stronger for individuals with unsecured debt. This has implications for prevention and treatment. Easy access to unsecured credit is likely to worsen gambling harms. Debt counselling services routinely encounter gambling-related harms and need to be equipped to manage these issues. [ABSTRACT FROM AUTHOR]

A major reason for the gendered division of parental leave use is the financial compensation during leave. Swedish national parental leave benefit provides 77.6 percent of earlier earnings up to an income ceiling, but collective agreements cover part of the income loss above the ceiling during leave. We focus on the importance of such collective agreements by examining fathers' parental leave take-up across the 2000s, as agreements were expanded during this period in time. We combine register data for the period 2001 to 2011 with the Longitudinal Integrated Database for Health Insurance and Labour Market Studies (LISA) being the key data source. The main division of agreements is between the state, the municipality and county, and the private sector. Results indicate that fathers with income above the income ceiling increase their use over the time period. Especially in the private sector a polarisation can be seen, where high income fathers increase their leave use, while fathers with lower income fall behind. As we do not find stronger increase in fathers' leave use in sectors where agreements expanded across time there is no evident support of a direct effect of the top-ups. [ABSTRACT FROM AUTHOR]

Disordered gambling is a behavioural addiction that causes harms to individuals, their families and wider society. Gambling harms have been recognised as a public health concern, but little attention has been given in health care to enable community nurses to identify and support patients experiencing gambling-related harms. Uptake of gambling support has been low due to the perceived stigma experienced by the person. Community nurses can use the Making Every Contact Count (MECC) approach when interacting with patients by identifying the signs of harmful gambling, discussing this with their patients, and signposting them to appropriate support. This article explores how community nurses can do this. [ABSTRACT FROM AUTHOR]

This paper investigates the origin and geomorphic evolution of Shadow Vlei, a depression wetland located approximately 30 km northwest of Gqeberha, South Africa. The wetland is on sandstone on the African Erosion Surface. The depression wetland has a rim of high-lying ground surrounding a central depression. Fluctuations between wet and dry periods create both highly reducing conditions in soils during wet phases in the depression, and highly oxidising conditions in the depression margin. Under reducing conditions, iron(III) oxides that are insoluble, are reduced to soluble iron(II), which is transported to and trapped in the margins of the depression under oxidising conditions when the water table declines and iron(II) is oxidised to iron(III). There is also a moderate flux of silica from the surface in the centre of the depression to the margins, which is suggested to be associated with maximum alkalinity associated with iron(III) reduction, and decreased alkalinity in the margins associated with iron(II) oxidation. However, the main flux of silica is from the surface in the centre of the depression to depth of greater than 1.5 m, again associated with variations in pH linked to iron-cycling. These reactions have thus caused a net volume loss in the centre of the depression, causing sagging, and a net volume gain at the margins of the depression, causing swelling. Wetland formation associated with alteration of landform morphology as a consequence of alternating redox conditions represents a novel mechanism that has not yet been described. [ABSTRACT FROM AUTHOR]

This paper investigates the employment effects of innovation over the business cycle with a large data set of manufacturing firms from 26 European countries from 1998 to 2014. The paper reveals four important findings: First, the net employment effect of product innovation is pro-cyclical and positive except in recessions. Second, product innovators are more resilient in recessions than non-product innovators because they are able to substitute demand losses in old products with new products. As a result, the net employment losses of product innovators are significantly lower in recessions than those of non-product innovators. Third, we find resilience only among small and medium-sized enterprises (SMEs), but not among large firms. Fourth, process and organizational innovations displace labor primarily during upturn and downturn periods. [ABSTRACT FROM AUTHOR]

Measurement of planktonic chlorophyll‐a—a proxy for algal biomass—in rivers may represent local production or algae transported from upstream, confounding understanding of algal bloom development in flowing waters. We modeled 3 years of chlorophyll‐a transport through a 394‐km portion of the Illinois River and found that although algal biomass is longitudinally widespread, most net production occurs at river control points in the upper reaches (up to 3.7 Mg chlorophyll‐a y−1 km−1). Up to 69% of the algal biomass in the upper river was a result of within‐reach production, with the remainder recruited from headwaters and tributaries. High chlorophyll‐a measured farther downstream was largely because of transport from source‐area control points, with substantial net losses of algal biomass occurring in the lower river. Modeling the often‐overlooked river transport component is necessary to characterize where, when, and why planktonic algae grow and predict how far and fast they move downstream. Plain Language Summary: Planktonic algae in rivers may accumulate during periods of high productivity stimulated by favorable light, temperature, nutrient, and flow conditions, which can disrupt ecological processes and affect human uses including recreation and drinking water supply. Planktonic algae observed in rivers may occur because of local growth or transport from upstream source areas. Therefore, considering both local and upstream conditions may improve early warnings of potentially harmful blooms. Along a 394‐km stretch of the Illinois River, we found that most of the algae grew in the upper reaches and was then transported to downstream reaches, contributing to potential downstream harms such as excessive turbidity, organic carbon, biological oxygen demand, and algal toxins. We demonstrate how the often‐overlooked river transport component can be quantified to better identify where, when, and why algae grow in river networks. Key Points: Planktonic algal biomass is pervasive in the Illinois River, yet production is favored at certain locations and timesMost planktonic algal biomass was produced in upper‐reach control points that supplied downstream areasTransport analysis using local and upstream data improves understanding of river algal blooms [ABSTRACT FROM AUTHOR]

In High Mountain Asia, most glaciers and glacial lakes have undergone rapid variations throughout changes in the climate. Unlike land-terminating glaciers, lake-terminating glaciers show rapid shrinkage due to dynamic interactions between proglacial lakes and glacier dynamics. In this study, we conducted a detailed analysis of the changes in the surface elevation, velocity, and especially frontal ablation on Jiongpu Co lake-terminating glacier. The results show that the Jiongpu Co glacier has twice as much negative mass balance compared to other glaciers, and the annual surface velocity has anomalously increased (3.6 m a−1 per decade) while other glaciers show a decreased trend. The frontal ablation fraction in the net mass loss of the Jiongpu Co glacier increased from 26% to 52% with the accelerated expansion of the proglacial lake. All available evidence indicates the presence of positive feedback between the proglacial lake and its host glacier. Our findings highlight the existence of proglacial lake affects the spatial change patterns of the lake-terminating glacier. Furthermore, the ongoing enlargement of the lake area amplifies the changes associated with the evolution of the lake-terminating glacier. [ABSTRACT FROM AUTHOR]

Media stories highlighted accounts of migration away from city centers towards more rural destinations during the COVID‐19 pandemic, but systematic research about how the pandemic changed migration in more rural destinations is only starting to emerge. This paper relies on U.S. Postal Service change‐of‐address data to describe whether and how established domestic migration systems changed during the COVID‐19 pandemic, focusing on differences across the rural–urban gradient and by outdoor recreation resources. We find little evidence of massive urban exodus. We do find that out‐migration from rural counties declined post‐pandemic onset and has stayed low in the 3 years since, stemming the tide of net population loss in many rural places. Most rural counties that experienced net population loss prior to the pandemic saw either less net loss or net gains during the pandemic. Rural recreation counties experienced greater gains through both decreased out‐migration and increased in‐migration in the first year of the pandemic; but by year three, differences between rural recreation and non‐recreation counties had balanced. Overall, counties across Rural America saw notable change to pre‐pandemic migration patterns. This shift may benefit rural areas through long‐term population stability and/or growth but might also exacerbate housing and childcare shortages. [ABSTRACT FROM AUTHOR]

Objective: Natural disasters cause enormous environmental, economic, and human losses. Children are the most vulnerable group and face severe consequences. While the primary cause of post-traumatic death is direct injury, the secondary cause is crush syndrome (CS). In this study, we aimed to share our experience in the management of children with CS during disasters by evaluating the clinical and laboratory outcomes of a group of 26 paediatric patients. Materials and Methods: Age, weight, length of time under rubble, laboratory results, and characteristics of crush injuries were assessed in 26 paediatric patients admitted to the emergency department after the earthquake. Diagnostic criteria for CS were established and the need for dialysis, hyperbaric oxygen or amputation and its determinants were assessed. Results: Crush syndrome was observed in 10 of the 26 patients. Significant differences in creatinine, aspartate aminotransferase, alanine aminotransferase, creatine kinase, hematocrit, pH, HCO3, and myoglobin levels were observed between patients with and without CS. None of the individuals rescued from the rubble within the first 6 hours had symptoms associated with CS. These 10 patients who developed CS were rescued within the first 48 hours of the earthquake, while 2 siblings were rescued after 81 hours and did not develop CS. Conclusion: The fact that the children were rescued from the rubble after 81 hours without developing CS shows the importance of patience in rescue operations. In addition, the very cold weather conditions during this earthquake may have prevented the development of dehydration and acute kidney injury and reduced the possibility of CS. [ABSTRACT FROM AUTHOR]

Purpose: Non‐operating revenue (NOR), derived from investments, contributions, government appropriations, and medical space rentals, can contribute to financial stability of hospitals by offsetting operating losses and improving profitability. NOR might benefit rural hospitals that often face intense financial pressures. However, little is known about how much rural hospitals rely on NOR and if certain organizational characteristics are associated with differences in NOR. Methods: Healthcare Cost Report Information System data from 2011 to 2019 were used to analyze sources of revenue among Critical Access Hospitals (CAHs) and Rural Prospective Payment System (R‐PPS) hospitals through descriptive statistics and regression models. Reliance on NOR was measured by the percentage of total revenue from non‐operating sources. Findings: Results indicate that both CAHs and R‐PPS hospitals rely on NOR; however, CAHs have a higher percentage of total revenue derived from non‐operating sources (3.2%) as compared to R‐PPS hospitals (1.9%) (p < 0.001). Government‐owned hospitals have significantly higher reliance on NOR than other ownership types. System affiliation also influences reliance on NOR. Lastly, results suggest that NOR may play a role in improving overall profit margins. Conclusions: As rural hospitals disproportionately face challenges related to declining profitability and the risk for closure, they may rely on NOR to continue to strengthen financial performance and provide health care to their communities. However, NOR is not guaranteed, and reliance on NOR further reiterates the value of stable, adequate reimbursement to guard against fluctuations in NOR. [ABSTRACT FROM AUTHOR]