Sustainability Assessment of Banana (Musa spp.) Yield Gap Reduction through Value Chain Development Interventions in Smallholder Farming Systems in Manicaland, Zimbabwe

This study evaluated the effectiveness of donor supported agricultural value chain development projects in sustainably narrowing yield gaps for banana smallholder farmer producers in Manicaland, Zimbabwe. The study used a mixed methods research design that relied on farmers records for the quantitative analysis and focus group discussion and in-depth interviews for key experts for the qualitative aspects. A mix of regression analysis, t-tests, Pearsons’s correlation and analysis of variance statistical methods were used for the quantitative analysis while thematic response analysis was used for the qualitative engagements. The findings showed that by the end of the activity, the project had successfully narrowed the banana yield gaps to 18.66 tons per hectare working with a potential yield base of 40 tons. However, 5 years after the project closure the yield gap had fallen to 24.7 tons indicating a lack of sustainability of yield gap reduction. However, the yield gap slump does not override the fact that farmers on average were still able to sell approximately 5 tons per every 6 months after 5 years from the project closure which is beyond any poverty threshold. This suggests genuine upward economic mobility. Additionally, in analyzing what factors had the greatest influence on yield gap reduction, the access to fertilizer ranked highest where genetics, irrigation and improved agronomy followed in that respective order. The study further showed that farmers who receive value chain development support whilst at an already commercialized state tend to maintain productivity thresholds higher in comparison to those who are at a pre commercial state. This is evidenced by the fact that the pre commercial farmers had a yield reduction of 30.83 percent after 5 years of the project closure whereas the former realized a productivity growth of 7.84%. In conclusion, whilst the intervention was successful in transitioning farmers out of poverty, more investment should be made towards transitioning smallholder farmers to integrated soil fertility management practices and improvement of agronomic efficiency through stronger on field collaboration between research institutions, the government and development institutions.

Motives Underlying Organic Food Consumption in Turkey： Impact of Health, Environment, and Consumer Values on Purchase Intentions

Raising ecological awareness and health concerns create question marks about healthiness and sustainability of conventional foods in customers＇ minds. Due to augmented mass media coverage of environmental problems, health concerns related to consumption of genetically modified food and/or chemical contaminants in food, and consumers＇ increasing interest in healthy nutrition and environmental protection, there is a growing interest for organic foods in all over the world. Growing interest for organic foods, and increasing production and demand in organic food market has made organic food consumption a significant topic of research. Although organic food market and demand for organic foods have also been growing in Turkey, literature regarding organic food consumption is not very extensive. Therefore, this study aims to understand the underlying motives for organic food consumption in Turkey, and to explore the factors affecting Turkish consumers＇ attitudes towards organic foods and the behavioral intention of Turkish consumers to purchase organic food by the help of the theory of reasoned action （TRA）. The results of 622 successful surveys used for this empirical research indicate that Turkish consumers＇ attitudes towards organic foods are determined by perception of organic foods, consumer values, and price perception, while their purchase intention is determined by health consciousness, perception of organic foods, consumer values, price perception, and environmental concerns.

Female Genital Cut in Relation to Its Value and Health Risks among the Kisii of Western Kenya

Background: The practice of female genital cutting as a cultural obligation is widespread in Kenya but there is little consensus about its effects on health. Some of the health risks associated with female genital cut range from minor and short-term to major and long-term effects including pain, bleeding, infections, and, in the extreme, death. Female genital cut is widespread among the Kisii but there is no adequate information about how it is currently practised and the value people attach to it. Objective: The objective was to establish the value of female genital cut as well as the health risks associated with the practice among the Kisii community of western Kenya. Methods: This was a cross-sectional study, which employed a mixed method approach to generate both quantitative and qualitative data. The quantitative data were obtained from a randomly selected sample of 373 respondents while quantitative data were generated from focus group discussions as well as key informants interviews. Results: The Kisii consider female genital cut a cultural identifier inherited from past generations and whose main value is a rite of passage from girlhood to womanhood. Majority (63%) had heard of the health risks associated with female genital cut including transmission of infections, excessive bleeding and pain. But most of the community did not seem to know the long-term health consequences associated with female genital cut. Even though knowledge on the campaigns to eradicate the practice was found to be wide spread, the community’s response toward the campaigns was less than positive. Conclusions: The authors conclude that female genital cut continues to persist in this community because of its value as a rite of passage, which currently has no substitute. This cultural demand by far outweighs the health risks associated with female genital cut, which are being mitigated through medicalization of the practice. For intervention programmes to succeed a more culturally sensitive campaign that is acceptable or appropriate alternative rite of passage is required.

An investigation of the health value and self-care capabilities of the elderly in urban-rural fringe area nursing homes and the related in？uencing factors

Objective：To investigate the health value and self-care capabilities of the elderly living in urban-rural fringe area nursing homes and the factors that influence these variables.Methods：A cluster sampling method was used to select 280 elderly individuals from seven urban-rural fringe communities in Xianning to complete a survey regarding their health value and self-care capabilities.Results：The total health value and self-care capability scores of the elderly were 7.45 ± 1.45 and100.25±22.56,respectively.Both of these scores significantly differed by age,education level,marital status,and income（P 〈 0.05,P 〈 0.01）.Self-care capability was correlated with health value（r=0.521）.A multivariate linear regression analysis showed that health value,marital status,and age predicted selfcare capability.Conclusions：Elderly people living in the urban-rural fringe area with higher health values also had higher self-care capabilities.The self-care capabilities of the elderly can be enhanced by improving their health value using the ＂knowing-trusting-acting＂ model.

The value rationality and tool rationality of Health Priority

Health Priority is increasingly becoming a human need and an international consensus.In addition to the basic value judgment and direction-leading function,Health Priority also has a clear,practical meaning and distinct tool attributes.The text adheres to the organic unity of regularity and purpose,follows the modern medical model and the philosophy of system theory,combines the characteristic facts,and discusses the value rationality and tool rationality of Health Priority based on the whole process management,and tries to refine the Health Priority governance model with Chinese characteristics,so as to provide a reference for global health governance.

The Nutritional Value and Research Status of Oats

Oats is a kind of food which has all sorts of nutrition.This paper mainly discussed nutritional ingredients and function of health protection of oats,simply introduced the use of it's functional ingredients,for developing natural resources rationally and efficiently.Oats are very nourishing.The oats may reduce the cholesterol of the body and to reduce the blood glucose because of its rich protein,fat,soluble diet fiber and saponin.It was very significance to study the improving of the food flavor,utilizing all the parts of the oats,and processing the functional foods.

Integration of Individualized Management Systems （MSs） as an Aggregating Factor of Sustainable Value for Organizations An Overview Through a Review of the Literature

Nowadays, there exist various standards for individual management systems （MSs）, at least, one for each stakeholder. New ones will be published. An integrated management system （IMS） aims to integrate some or all components of the business into one coherent and efficient MS. Maximizing integration is more and more a strategic priority in that it constitutes an opportunity to eliminate and/or reduce potential factors of destruction of value for the organizations and also to be more competitive and consequently promote its sustainable success. A preliminary investigation was conducted on a Portuguese industrial company which, over the years, has been adopting gradually, in whole or in part, individualized management system standards （MSSs）. A research, through a questionnaire, was performed with the objective to develop, in a real business environment, an adequate and efficient IMS-QES （quality, environment, and safety） model and to potentiate for the future a generic IMS model to integrate other MSSs. The strategy and research methods have taken into consideration the case study. It was obtained a set of relevant conclusions resulting from the statistical analyses of the responses to the survey. Globally, the investigation results, by themselves, justified and prioritized the conception of a model of development of the IMS-QES and consequent definition and validation of a structure of an IMS-QES model, to be implemented at the small- and medium-sized enterprise （SME） where the investigation was conducted.

Valuing Health Effects of Natural Radionuclides Releases from Yatagan Power Plant

The objective of this paper is the valuation of radiological health effects of Yatagan Power Plant. To this aim the radiation dose calculations are carried out for the population living within 80 km radius of the plant. The average of the maximum measured specific isotopes 238U, 232Th and 226Ra in the flying ash samples are considered as radioactive sources. Based on the dose calculations, first the stochastic health effects and then monetary health effects are estimated. The estimated total collective dose and economic value of the pre-dicted health effects are 0.3098 man Sv/y and 14791 US$/y respectively. The results obtained from the dose calculations are lower than the limits of International Commission of Radiation Protection (ICRP) and it does not pose any risk for public health. Monetary value of health risks is also negligible in comparison to the av-erage yearly sales revenue of the plant which is 250 million US$.

A Study Protocol on the Evaluation of Referral Strategies for Inflammatory Arthritis in Primary Care Patients at the Level of Healthcare Organization, Patient Relevant Outcomes and Costs

Background: Considering the importance of getting the right patient at the right location to maintain and optimize quality of life of inflammatory arthritis patients, appropriate referral by general practitioners is essential. This study aims to assess the effect and cost effectiveness of different referral strategies for inflammatory arthritis in primary care patients. Methods: This study follows a cluster randomized controlled trial design. General practitioners from primary care centers in Southwest-The Netherlands are randomly assigned to either one of the two strategic interventions for referring adult patients who are in the opinion of the general practitioner suspected of inflammatory arthritis: 1) Standardized digital referral algorithm based on existing referral models PEST, CaFaSpA and CARE;2) Triage by a rheumatologist in the local primary care center. These interventions will be compared to a control group, e.g. usual care. The primary outcome is the percentage of patients diagnosed with inflammatory arthritis by the rheumatologist. Secondary outcomes are quality of life as a patient reported outcome, work participation and healthcare costs. These data, including demographic and clinical parameters, are prospectively collected at baseline, three, six, and twelve months. Discussion: If this study can demonstrate improvements in appropriate referrals to the rheumatologist, thereby improving cost-effectiveness, there is sufficient supporting evidence to implement one of the referral strategies as a standard of care. Finally, with these optimization strategies a higher quality of care can be achieved, that might be of value for all patients with arthralgia. Trial Registration: NCT03454438, date of registration: March 5, 2018. Retrospectively registered: https://clinicaltrials.gov/ct2/show/NCT03454438?term=NCT03454438&draw=1&rank=1.

Nutritional Value of Date Fruits and Potential Use in Nutritional Bars for Athletes

The date palm (Phoenix dactylifera L.) is one of the oldest primary staple crops in Southwest Asia and North Africa. Date palms are also grown in Australia, Mexico, South America, Southern Africa, and the United States, especially in Southern California, Arizona, and Texas. Date fruit is a high nutritional value food that is rich in carbohydrates, dietary fibers, proteins, minerals and vitamin B complex such as thiamine (B1), riboflavin (B2), niacin (B3), pantothenic (B5), pyridoxine (B6), and folate (B9). Carbohydrates comprise 70% of date fruit mainly as fructose and glucose. Minerals in date fruits are calcium, iron, magnesium, selenium, copper, phosphorus, potassium, zinc, sulfur, cobalt, fluorine, and manganese. Date fruits are highly nourishing and may thus confer numerous potential health benefits. In recent years, a huge interest in the abundant health promoting properties of date fruits has led to the need to develop new food products using dates as a source of nutrients. Thus, the aim of this paper is to review the nutritional value of date fruits in the context of the potential use of dates in nutrition bars for athletes.

The Reference Value for Biomonitoring in Chemicals Risk Area in Thailand

The workers’biological standard value(WBSV)is generally used to assess chemicals health risks in community.It may cause the deviate biomonitoring.Therefore,this study was aimed to set the pilot reference value for exposed people to chemicals.The study was divided into three phases:the two phases for field-study method and one phase for stakeholder’s adoption.Phase I was proceeded in one industrial zone in Thailand during the years 2012-2014 to collect blood and urine samples of 402 working-age people in community accompanied with in-depth interview.The 4 heavy metals(arsenic,cadmium,lead,mercury)in blood and urine were analyzed by atomic absorption spectroscopy(AAS)analysis and inductively coupled plasma mass spectrometry(ICP-MS).The metabolites of 4 volatile organic compounds(VOCs,benzene,toluene,styrene,xylenes)in urine were analyzed by high performance liquid chromatography(HPLC)analysis.The 8 chemicals concentrations of the volunteers’average chemicals concentration(VACC)were calculated.Phase II was proceeded during the years 2015-2016 to compare risk group identification between usage of VACC and usage of WBSV.The results were presented in mean value,standard deviation,percentage,and significant.The results showed approximately 90 percent of VACCs were lower than WBSV.The exceptional result was volunteers’average urinary arsenic concentration.It was clearly higher than WBSV.The comparative results showed the adjusted amount of risk people by VACC was higher than the adjusted amount risk people by WBSV.Phase III was proceeded in the year 2017 for stakeholder’s adoption.This study indicated that general people’s average chemicals concentration should be used as the reference value for biomonitoring and active health surveillance.

Exploring the Significance and Implementation Strategies of Mental Health Education for College Students

College students are influenced by diverse cultures in the new era,thus their inner world is rich and changing rapidly.The acceleration of social rhythm can easily lead to different kinds of psychological problems.Mental health education is people-oriented,using scientific methods and means to train high-quality talents with all-round development across the world.A healthy psychological state can promote the sound development of students,make them establish correct core social values,and realize self-value.At present,there are some problems in university mental health education,such as single form and imperfect system.At the same time,college education plays an important role in the formation of ideas for college students’ideological values.As a front-line student worker,college counselors should cooperate with the school’s psychological departments to improve the college psychological education system,rationally plan the psychological teaching program,and pay attention to the college students’mental health education.The government should also take into account the need to ensure that the education system is not undermined by the lack of a comprehensive and effective education system.

AgBB《建筑产品挥发性有机化合物(VVOC,VOC和SVOC)释放的健康评估程序》及风险指数(R-Value)浅析

介绍了AgBB建筑产品挥发性有机化合物释放的健康评估程序。通过背景阐述及相关测试方法的解释,可以更好地理解AgBB评估程序。最后解释了“风险指数(R-Value)”在整个评估体系中的作用,并指出引入“风险指数(R-Value)”是AgBB评估体系的核心精神。

Frequency Dependence of the <i>b</i>-Value Used for Acoustic Emission Analysis of Glass Fiber Reinforced Plastics

Acoustic Emission Testing (AT) is one of the major non-destructive testing methods used for severity evaluation of structures. Amplitude distributions of AE signals are characterized by b-value and the value is mainly used for the severity evaluation of concrete structures until now. The value is assumed to be independent with propagation distance between acoustic emission sources to AE sensors. We evaluate the influence of the wide frequency band encountered in the fracture behavior of glass fiber reinforced plastic (GFRP) on the b-value analysis. In tensile tests, the b-value was determined from an acoustic emission (AE) source generated near a centered hole in a specimen of GFRP. At 15 mm from the hole, the b-value analysis indicated a decreasing trend with increasing tensile stress. At a propagation length of 45 mm, farthest from the hole, a?small number of AE signals were received. The attenuation is more rapid for high-frequency AE signals. Thus, the amplitude distribution bandwidth is wide and the b-value changes. This change in b-value for GFRPs is investigated by analyzing the spectral components of the AE signals. For a single-frequency AE source, the b-value is unchanged with propagation length. In contrast, multiple-frequency AE sources produce changes in b-value proportional to the fraction of each spectral component in the received signal. This is due to the frequency dependence of the attenuation with propagation length.?From these results, the b-value analysis cannot be applied to considering frequency dependence of AE attenuation.

Delivering reproductive health services through non-state providers in Pakistan:understanding the value for money of different approaches

Background:Delivering Reproductive Health Results(DRHR)programme used social franchising(SF)and social marketing(SM)approaches to increase the supply of high quality family planning services in underserved areas of Pakistan.We assessed the costs,cost-efficiency and cost-effectiveness of DRHR to understand the value for money of these approaches.Methods:Financial and economic programme costs were calculated.Costs to individual users were captured in a pre-post survey.The cost per couple years of protection(CYP)and cost per new user were estimated as indicators of cost efficiency.For the cost-effectiveness analysis we estimated the cost per clinical outcome averted and the cost per disability-adjusted life year(DALY)averted.Results:Approximately£20 million were spent through the DRHR programme between July 2012 and September 2015 on commodities and services representing nearly four million CYPs.Based on programme data,the cumulative cost-efficiency of the entire DRHR programme was£4.8 per CYP.DRHR activities would avert one DALY at the cost of£20.Financial access indicators generally improved in programme areas,but the magnitude of progress varies across indicators.Conclusions:The SF and SM approaches adopted in DRHR appear to be cost effective relative to comparable reproductive health programmes.This paper adds to the limited evidence on the cost-effectiveness of different models of reproductive health care provision in low-and middle-income settings.Further studies are needed to nuance the understanding of the determinants of impact and value for money of SF and SM.

Examining the Economic Value of Investing in Health

This review article examines the relationship between health and economic development,highlighting the economic benefits of investing in health.The rise of non-communicable diseases(NCDs)and the COVID-19 pandemic have exposed high demand for increased investment in health as well as critical gaps in the global health system,particularly in low-and middle-income countries,where investments in primary healthcare and innovations in health technologies are lacking.The article emphasizes the importance of examining the economic impact of health,providing a summary of the different pathways through which health impacts the economy and reviewing various economic analyses,including a novel methodology called the health-augmented macroeconomic model(HMM)for evaluating the macroeconomic value of investing in health.The article suggests that reducing disease burdens can effectively generate sizable economic returns,and it is vital to integrate the concept of economic value in health policies and interventions.

Human Exposure Assessment of Element Pollution for Environmental Health Implications: Teeth as a Biomonitoring Tool

Reference values reflecting the findings of natural concentrations of teeth in a well-defined group of individuals, are indispensable, if one is to interpret results generated for clinical utility. Hence, a comprehensive compilation of literature survey is attempted to make available as a reference guideline for tooth element concentrations. Presently, the reference values are proposed for 19 elements. Several factors that are found influencing element levels, are common to any biosample and are broadly grouped under four categories namely, the factors of teeth, donor, environment and analytical methods. How best the influencing factors to be considered during analysis, are discussed. It is elucidated that standardized method of analysis with quality assurance and precision will reduce the ambiguity of comparison of inter-laboratory measurement. When the merits and demerits of element measurements are evaluated, it is recognized that except a hurdle of difficult specific sampling, many advantages make teeth an attractive material for environmental health monitoring of population and for assessment of element status of deficiency and excess due to differential exposure. The available data of tooth elements are lesser in comparison to data of blood and hair;further studies are required for reference values of others elements and for distribution pattern in different conditions, parts and types of teeth.

Circular Economy in HealthCare Challenges and Issues

Some major countries like India investing in biopharmaceutical industry have designed new business models of circular economics called the“Uber for HealthCare”for instance by Basu et al.,for medical equipment in India(Euro,Healthcare Stream,&Dublin 2018).This raises major challenges for global supply of medicine and Value Chains in life science.This contribution will provide a review of recent experiences and an analysis of how it impacts current global value chains.Current economic model development strengthening the demand side of the system and applications of choice modeling to capture heterogeneity of demand at individual level face with new circular strategies implemented by health care organizations and economic suppliers.The all-value system is challenged by such models including the critical decision points at prognostic,diagnostic,and treatment stages;platforms such as the Her2adaptive technology platform with cost sensitivity indexes proposed by Huttin and Liebman(Technology&HealthCare,2011)face also potential adaptation to integrate new priorities:for instance,in circular economy with integration of circular touch points.Research results like Van Boerdonk et al.(2021),demonstrate that reaching cleaner production with higher environmental values may become“paradoxical with lower or unimportant customer value”.Government and payers may need to create new policies for waste management and for sustaining reasonable and fair value for money in the health system.Moreover,the economics of sharing economy may need to find appropriate forms of centralization or decentralization in the organizations of health systems and decision-making processes.Circular models in health care in sharing economy may benefit single pathway models,often too expensive for affordable welfare contracts.This paper will continue the previous research agenda and papers on global value chains with the use of TiVa OECD database(joined in the WB-WTO project)and a quality paper on the biotech development chain and Covid-19(Huttin,2019;2021).

基层医疗卫生机构以健康价值为导向的运行成就与效能研究

目的:分析健康价值导向下基层医疗卫生服务绩效评价指标体系的应用效果,评估基层医疗卫生机构以健康为中心的运营成就与效能。方法:选取杭州市X地区和台州市Y地区6家基层医疗卫生机构作为调查对象,采用综合指数法和数据包络分析测算基层医疗卫生机构健康产出的运行效能。结果:样本地区基层医疗卫生机构以健康价值为导向的整体运行成就平均得分为70.01分、整体运行效能为0.794,66.67%的基层医疗卫生机构存在着不同程度的医疗和预防资源投入冗余与健康产出不足。结论:基层医疗卫生机构以健康价值为导向的整体运行成就仍有较大提升空间,应增强基层健康管理能力,提升内在运行过程效能,实现健康产出效益最大化。

发酵白酒糟的营养价值及其在动物生产中应用的研究进展

白酒糟是酿酒产业的副产品,是一种优质的粗饲料资源。白酒糟经微生物发酵后,能改善白酒糟营养特性,提高饲用价值,进而提高白酒糟的利用率。本文综述了发酵白酒糟的营养价值、发酵工艺及对动物生长、免疫、肠道健康的影响,旨在为饲用豆粕减量替代行动的深入实施提供参考。