World Vision

Introduction and/or theoretical framework and/or review of the literature:Climate change poses a serious threat to global food security, with Bangladesh among the most vulnerable countries. In the High Barind Tract, increasing temperatures, frequent droughts, cyclones, and irregular rainfall have reduced agricultural productivity and endangered rural livelihoods, heightening the risk of food insecurity for many.Purpose and objectives:This study assessed how climate-resilient agricultural practices affect food security among small-scale farmers in Bangladesh's High Barind Tract, focusing on (i) identifying these practices, (ii) examining factors influencing their adoption, and (iii) evaluating their impact on household food security.Methods and/or data sources, theoretical/philosophical themes, or processes of a programs or product development:The study was conducted in the drought-prone High Barind Tract of Bangladesh, concentrating on the Tanore and Godagari upazilas. A questionnaire survey examined the impact of climate-resilient agricultural practices on food security, gathering data from 384 randomly selected small-scale farmers, with the sample size calculated using Kothari’s formula:n= pqz2/E2Findings, products, and/or conclusions:The study found low adoption of climate-resilient practices, (i) mainly in crop management, with limited use in soil and livestock areas. (ii) adoption is influenced by socio-economic and institutional factors, and (iii) using a combination of practices significantly improves food security for small-scale farmers.Theoretical and practical implications and recommendations:Implementing climate-resilient practices can improve food security by boosting yields and sustainability. Key recommendations include promoting drought-resistant crops and efficient water management to enhance resilience and support rural livelihoods.

Purpose This study examines the effects of digital health technologies on enhancing children's healthcare utilization in the Kigoma region of Tanzania. It also investigates the factors that influence both the adoption and the extent of usage of digital health technologies among caregivers. Design/methodology/approach A cross-sectional research design was employed, using data collected from 400 respondents selected through a multi-stage sampling technique. A double-hurdle model was applied to analyze the determinants of digital health technology adoption and usage intensity, while a probit model was used to assess the effect of digital health usage on children's healthcare utilization. Findings The results indicate that awareness (ß = 0.643; p = 0.061), ease of use (ß = 0.113; p = 0.000), internet connectivity (ß = 0.512; p = 0.000), and participation in digital health education campaigns (ß = 0.373; p = 0.000) significantly increase the likelihood of adopting digital health technology. In contrast, negative attitudes (ß = −0.738; p = 0.069), low household income (ß = −0.649; p = 0.000), and larger household sizes (ß = −0.217; p = 0.000) reduce the probability of adoption. Among adopters, usage intensity is significantly enhanced by ease of use (ß = 0.747; p = 0.000), better internet connectivity (ß = 0.406; p = 0.001), higher household income (ß = 0.429; p = 0.000), participation in health education programs (ß = 0.607; p = 0.000), and healthcare provider assistance (ß = 0.419; p = 0.001). The double-hurdle model is strongly significant (?2 = 148.61; p = 0.000), confirming the explanatory strength of the selected variables. Regarding children's healthcare utilization specifically on vaccination uptake, mobile health applications (dy/dx = 0.384; p = 0.000) and online appointment/reminder systems (dy/dx = 0.725; p = 0.000) have significant positive effects, while electronic health records show a marginal positive influence (dy/dx = 0.162; p = 0.075). Also, socio-economic factors such as education level of the respondent (dy/dx = 0.118, p < 0.01) is positively and significantly associated with timely vaccination, Household income (dy/dx = 0.074, p < 0.05) similarly shows a positive and statistically significant effect, Participation in health education campaigns (dy/dx = 0.244, p < 0.01) is positively associated with vaccination uptake. Research limitations/implications Although the study provides valuable insights, several limitations should be considered. First, the cross-sectional design restricts causal interpretation of the observed associations. Second, self-reported measures on digital health usage may be influenced by recall or social desirability bias. Third, the study focused on mothers with children under five years, and perspectives from fathers or other caregivers were not captured. Lastly, findings are limited to Kigoma and may not fully represent all regions of Tanzania with different digital health infrastructures. Future studies could adopt longitudinal or mixed-method approaches to strengthen causal inference and generalizability. Practical implications The study recommends expanding digital health training, improving internet access, subsidizing digital health services and strengthening trust-building initiatives to enhance adoption and utilization. Policymakers should focus on integrating digital health into mainstream healthcare services to maximize its impact on healthcare accessibility, particularly for children in resource-constrained settings such as Kigoma. Originality/value This study is among the first to empirically assess both the determinants and effects of digital health technology adoption on children's healthcare utilization in a resource-constrained setting such as Kigoma, Tanzania. By applying a double hurdle model alongside a probit framework, it provides a nuanced understanding of adoption drivers, usage intensity and health outcomes. The findings highlight the distinct impact of mobile health applications and online reminder systems on pediatric healthcare access, offering actionable insights for policymakers and practitioners aiming to integrate digital health into underserved healthcare systems.

Acute pancreatitis (AP) ranges clinically from mild, self-limiting inflammation to severe disease with multi-organ failure. Visceral adipose tissue (VAT), a key contributor to systemic inflammation and metabolic dysfunction, may therefore influence AP severity, yet its prognostic value in the Indian population remains limited in the literature. The aim of this study is to assess whether VATand the VAT/SMT (skeletal muscle tissue) ratio can predict clinical severity and short-term prognosis of AP in a tertiary care hospital in Chennai. This cross-sectional study included 62 patients aged 18-60 years diagnosed with AP at ACS Medical College and Hospital from December 2023 to February 2025. Contrast-enhanced CT scans obtained within 24 hours were used to quantify VAT, subcutaneous adipose tissue, SMT, and VAT/SMT ratios at the L3-L4 vertebral level. Severity grading was performed using APACHE II (Acute Physiology and Chronic Health Evaluation), modified computed tomography severity index (MCTSI), and the Revised Atlanta Classification. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26 (Released 2018; IBM Corp., Armonk, New York, United States). Higher VAT values and elevated VAT/SMT ratios showed significant associations with increased APACHE II and MCTSI scores (p < 0.001). Patients with VAT >180 cm² and VAT/SMT >1.5 exhibited more severe disease patterns. The MCTSI demonstrated strong concordance with the Revised Atlanta Classification. Male sex with alcohol consumption was significantly associated with higher severity, while age showed no significant impact. CT-derived VAT and VAT/SMT ratios are useful early markers associated with increased severity. Integrating CT-based VAT assessment with the MCTSI may enhance early risk stratification and guide timely clinical management.

Rice is a staple food for about three billion people and is crucial for global food security, but climate change poses serious threats to water resources and crop yields. Alternate Wetting and Drying (AWD) irrigation has emerged as a promising solution, enabling farmers to reduce water use by up to 25 percent compared to traditional irrigation practices. The main purpose of this study was to determine farmers’ perceptions of climate change and the adoption of Alternate Wetting and Drying irrigation technology for rice production in northwest Bangladesh. Specifically, the study assessed farmers’ perceptions of climate change in relation to AWD use in rice production and examined the adoption status of AWD and the factors influencing its adoption among farmers. The study was conducted in Kalma village, Tanore Upazila, in northwest Bangladesh. Data were collected through a questionnaire survey administered to 80 randomly selected farmers. SPSS software was used to analyze farmers’ perceptions of climate change and their adoption of AWD irrigation in rice farming. The findings show that AWD adoption in the study area is satisfactory and largely driven by water scarcity, although 45 percent of adopters lack full knowledge of the technology. AWD adoption improves water-use efficiency, reduces production costs and greenhouse gas emissions, and increases rice yields. The adoption of AWD is significantly influenced by farmers’ education level, household size, farm size, farming experience, access to information, and training. The study concludes that AWD adoption in northwest Bangladesh contributes to improved water efficiency, reduced emissions, and higher rice yields. To maximize the benefits of AWD, adequate farmer training, access to resources, and supportive infrastructure and policy measures are essential.

This study, grounded in the Resource-Based View (RBV) theory, investigates the mediating role of talent management in the relationship between project manager competencies and sustainable competitive advantages. The Ghana construction industry faces various challenges, including project delays, budget overruns, and compromised quality, mainly due to inadequate talent management practices and underutilization of project manager competencies. Using the convenience sampling technique, the study used a valid response of 373 from project managers in the Ghanaian construction industry. The study employed Covariance-Based Structural Equation Modeling (SEM) and Confirmatory Factor Analysis (CFA) using AMOS 20 to analyze the relationships. The findings revealed a positive and significant relationship between project manager competencies and sustainable competitive advantages, as well as a positive and significant relationship between project manager competencies and talent management. The study revealed that talent management partially mediates the relationship between project manager competencies and sustainable competitive advantages. Project managers should balance competencies development and strategic initiatives carefully, ensuring that project manager competencies are aligned with and support long-term competitive positioning without inadvertently diminishing sustainable competitive advantages.

A new GREAT GAME is being played out between regional and world powers over resources of the Central Asian region, being reminiscent of the classic “Great Game” of the nineteenth century between the British Empire and Tsarist Russia. The Central Asian States, becoming independent after disintegration of Union of Soviet Socialist Republics (USSR), found themselves owning vast resources, including large oil and gas reserves, minerals and other raw materials and access to attractive land-locked markets. This triggered a rush between the regional and international powers to access and control these resources. Connectivity – whether through roads, pipelines or other routes – is the most crucial factor to determine success. In contrast to the classic Great Game between the British and Russian empires, there are multiple protagonists in the present Game – Russia, China, USA, India, Turkey, Iran, Pakistan and the Central Asian States. Each of these has its own objectives and strategies, leading to a complex, ever-changing and high-stakes Game. While Russia is trying to regain its control in Central Asia and China is attempting to expand its sphere of influence; the USA is trying to contain both. “The New Silk Road”, “One-Belt-One-Road”, “String of Pearls” and the China Pakistan Economic Corridor (CPEC) are some of the strategies being implemented. The smaller powers are maneuvering to leverage their geo-strategic situation and relations to further their own interests. This New Great Game has created opportunities for Pakistan to alleviate some of its chronic problems such as energy shortage, trade deficit and low GDP. However, to reap the maximum benefits from the situation, it must carefully weigh its options and review its relations with the other protagonists. This study finds that following a balanced, moderate and pro-active strategy may yield the best dividends for Pakistan. However, in order for this to succeed, Pakistan also needs to put its internal affairs in order, especially focusing on reducing extremism and Baloch separatism.

Objectives. We report here the results of the 9th National Census (Cs-24) of Peritoneal Dialysis in Italy, carried out in 2025 by the Italian Society of Nephrology's Peritoneal Dialysis Project Group and relating to 2024. Methods. The Census was conducted in the 228 non pediatric centers which performed Peritoneal Dialysis (PD) in 2024. The results have been compared with previous Censuses carried out since 2005. Results. Incidence: in 2024, 1,398 patients (CAPD = 55.1%) started on PD (1st treatment for ESRD). PD was started incrementally by 40.2% of these in 155 Centers. The catheter was positioned exclusively by a Nephrologist in 19.2% of known cases. Prevalence: of the 4,322 patients on PD at 31/12/2024 (CAPD=43.7%), 21.4% were on assisted PD (family member caregiver: 86.2%). Out: in 2024 the PD dropout rate (ep/100 pt-yrs) was: 12.7 to HD; 9.7 death; 8.5 Tx. The main cause of transfer to HD remains peritonitis (21.8%), although it is still decreasing (Cs-05: 37.9%). Peritonitis/EPS: the incidence of peritonitis in 2024 was 0.164 ep/pt-yr (647 episodes). The incidence of new cases of EPS in 2023-24 (9 cases) was unchanged. Other results: 3.86%-PET remains the most widely-used test (58.1%); most of the Centers do not carry out Home Visits (54.1%); training is mainly carried out in-Center (49.1% of the Centers). Conclusions. Cs-24 confirms the good results PD is having in Italy, where it is experiencing a slight upturn.