PLOS ONE: [sortOrder=DATE_NEWEST_FIRST, sort=Date, newest first, q=subject:"Geography"]PLOShttps://journals.plos.org/plosone/webmaster@plos.orgaccelerating the publication of peer-reviewed sciencehttps://journals.plos.org/plosone/search/feed/atom?sortOrder=DATE_NEWEST_FIRST&unformattedQuery=subject:%22Geography%22&sort=Date,+newest+firstAll PLOS articles are Open Access.https://journals.plos.org/plosone/resource/img/favicon.icohttps://journals.plos.org/plosone/resource/img/favicon.ico2024-03-28T18:48:25ZResearch on the coupling relationship and interaction between urbanization and eco-environment in urban agglomerations: A case study of the Chengdu-Chongqing urban agglomerationWeilong WuYing HuangYuzhou ZhangBo Zhou10.1371/journal.pone.03012872024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Weilong Wu, Ying Huang, Yuzhou Zhang, Bo Zhou</p>
Urban agglomerations are emerging as new regional units for national participation in global competition and the international division of labor. However, they face increasingly severe resource and eco-environment pressures during urbanization. The coordination of the relationship between urbanization and the eco-environment has attracted global attention. In this study, we used Coupling Coordination Degree and Vector Autoregression models to examine the dynamic evolution, coupling relationships, coordinated development patterns, and interaction mechanisms between urbanization and the eco-environment. The results indicate that: (1) The level of urbanization in the Chengdu-Chongqing Urban agglomeration was relatively low, and the region showed a good eco-environment background. However, rapid urbanization is gradually straining the carrying capacity of the eco-environment. (2) A close and stable coupling relationship exists between urbanization and the eco-environment, which has reached an advanced coupling stage. The status of coordinated development among cities differs considerably, and multiple stable forms may exist simultaneously. (3) Urbanization has a substantial impact on environmental changes, whereas the restrictive effect of the eco-environment on urbanization development is not particularly notable. (4) Various interactive relationships exist between the urbanization and eco-environment subsystems, including positive promotion and negative constraint effects. The positive promotion effect mainly manifests between the economic, social, and ecological response subsystems, while the negative constraint effect is most evident in the mutual coercion and inhibition between the regional urbanization, economic urbanization, ecological status, and ecological pressure subsystems. These findings have important policy implications for decision makers exploring the path of coordinated and sustainable development in urbanization and the eco-environment in Urban agglomerations.Compact rover surveying and laser scanning for BIM developmentSyed Riaz un Nabi JafriSyed Murtaza HussainAsif AhmedSyed Asher Hussain RizviKumayl Hassan KazmiJamshed Iqbal10.1371/journal.pone.03012732024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Syed Riaz un Nabi Jafri, Syed Murtaza Hussain, Asif Ahmed, Syed Asher Hussain Rizvi, Kumayl Hassan Kazmi, Jamshed Iqbal</p>
This paper presents a custom made small rover based surveying, mapping and building information modeling solution. Majority of the commercially available mobile surveying systems are larger in size which restricts their maneuverability in the targeted indoor vicinities. Furthermore their functional cost is unaffordable for low budget projects belonging to developing markets. Keeping in view these challenges, an economical indigenous rover based scanning and mapping system has developed using orthogonal integration of two low cost RPLidar A1 laser scanners. All the instrumentation of the rover has been interfaced with Robot Operating System (ROS) for online processing and recording of all sensorial data. The ROS based pose and map estimations of the rover have performed using Simultaneous Localization and Mapping (SLAM) technique. The perceived class 1 laser scans data belonging to distinct vicinities with variable reflective properties have been successfully tested and validated for required structural modeling. Systematically the recorded scans have been used in offline mode to generate the 3D point cloud map of the surveyed environment. Later the structural planes extraction from the point cloud data has been done using Random Sampling and Consensus (RANSAC) technique. Finally the 2D floor plan and 3D building model have been developed using point cloud processing in appropriate software. Multiple interiors of existing buildings and under construction indoor sites have been scanned, mapped and modelled as presented in this paper. In addition, the validation of the as-built models have been performed by comparing with the actual architecture design of the surveyed buildings. In comparison to available surveying solutions present in the local market, the developed system has been found faster, accurate and user friendly to produce more enhanced structural results with minute details.Urban public services and fertility intentions of internal migrants in ChinaSichen LiuQuanling CaiMingxing WangKaisheng Di10.1371/journal.pone.03003452024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Sichen Liu, Quanling Cai, Mingxing Wang, Kaisheng Di</p>
As China continues to implement its progressive fertility promotion policy, there has been a drastic decline in the fertility rate. Given that the migrant population constitutes more than a quarter of China’s total population, enhancing the willingness of this demographic to have additional children through policy-guided urban public services is pivotal for optimizing China’s population development strategy. This study analyzes the influence of urban public services on the reproductive intentions of the migrant population, utilizing data from 110,667 migrant families with one child, drawn from China’s Migrant Population Dynamic Monitoring data in 2016 and 2018. The data analysis reveals several key findings: (1) Urban public services, overall, exhibit a notable positive effect on the willingness of the migrant population to have more children, albeit with limitations and a declining trend. (2) Among urban public services, primary basic education significantly impacts the willingness of the migrant population to expand their families. (3) Large cities have created a ’reverse screening’ effect on the migrant population, leading to differential access to public services. This scenario caters effectively to the high human capital migrant individuals while reducing accessibility to livelihood public services for the low human capital migrant population. This paper critically evaluates China’s progressively adjusted fertility policy from the perspective of the migrant population. It underscores the necessity of establishing a comprehensive fertility support policy system across China.Driving factors and grouping paths of rural sports development in China ‐ A qualitative comparative analysis based on fuzzy setsDuan YuHongwei FanNing Zhang10.1371/journal.pone.03001692024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Duan Yu, Hongwei Fan, Ning Zhang</p>
The development of rural sports depends on many factors, but the complex causal relationship between various factors and the level of rural sports development is not clear. Using data envelopment analysis (DEA) and fuzzy set qualitative comparative analysis (fsQCA), this study aims to examine the driving role of various factors on rural sports development and construct various grouping paths to improve the level of rural sports development in China. The results shows that the area of fitness venues and social capital participation are sufficient conditions for the development of rural sports in China. Resource endowment through government fing, social capital participation and the construction of sports venues and facilities is the key driving factor for rural sports development in China. There are four grouping paths for the high-quality development of rural sports, which are divided into three configurations by combining the grouping characteristics: the state-social capital jointly controlled type driven by economic development and the resource endowment driven by the modernization of the agriculture promotes production and the grassroots organizations that are supported by the advantage of resource endowment. The results of the study highlight the complex causal relationships and key driving factors of rural sports development in China, highlight the differences in rural sports development patterns in different regions, and provide new ideas and guidelines for improving the level and quality of rural sports development.Attitude and predictors of exclusive breastfeeding practice among mothers attending under-five welfare clinics in a rural community in Southwestern NigeriaTope Michael IpinnimoOlanrewaju Kassim OlasehindeTaofeek Adedayo SanniAyodeji Andrew OmotosoRita Omobosola AlabiPaul Oladapo AjayiKayode Rasaq AdewoyeJohn Olujide OjoOlayinka OloruntobaAdemuyiwa AdetonaMojoyinola Oyindamola AdeosunTemitope Moronkeji OlanrewajuOluseyi Adedeji AderinwaleBlessing Omobolanle OshoAdewumi Rufus FajugbagbePrecious Aderinsola AdeyeyeAyotomiwa Fiyinfoluwa Ajayi10.1371/journal.pone.02998432024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Tope Michael Ipinnimo, Olanrewaju Kassim Olasehinde, Taofeek Adedayo Sanni, Ayodeji Andrew Omotoso, Rita Omobosola Alabi, Paul Oladapo Ajayi, Kayode Rasaq Adewoye, John Olujide Ojo, Olayinka Oloruntoba, Ademuyiwa Adetona, Mojoyinola Oyindamola Adeosun, Temitope Moronkeji Olanrewaju, Oluseyi Adedeji Aderinwale, Blessing Omobolanle Osho, Adewumi Rufus Fajugbagbe, Precious Aderinsola Adeyeye, Ayotomiwa Fiyinfoluwa Ajayi</p>
Background <p>Much previous research on exclusive breastfeeding has focused on urban and semi-urban communities, while there is still a paucity of data from rural areas. We assessed the attitude and practice of exclusive breastfeeding and its predictors among mothers attending the under-five welfare clinics in a rural community.</p> Methods <p>A cross-sectional study was conducted among consecutively recruited 217 mothers attending the three health facilities under-five welfare clinics in Ido-Ekiti, Southwest, Nigeria. Information was collected with a semi-structured interviewer-administered questionnaire adapted from previously published research works. Descriptive and inferential statistics were carried out using IBM SPSS Statistics for Windows, Version 26.0.</p> Results <p>More than half of the mothers, 117(53.9%) were ≥30 years old, and 191(88.0%) were married. Almost all, 216 (99.5%) attended an ante-natal clinic; however, 174(80.2%) delivered in the health facility. The respondent’s mean ± SD exclusive breastfeeding attitudinal score was 29.94 ± 2.14 (maximum obtainable score was 36), and the proportion of mothers that practiced exclusive breastfeeding was 40.6%. Married mothers were more likely to practice exclusive breastfeeding than their unmarried counterparts (AOR:6.324, 95%CI:1.809–22.114). The common reasons for not practicing exclusive breastfeeding were work schedule 57(26.3%), cultural beliefs and the need to introduce herbal medicine 32(14.7%), and insufficient breast milk 30(13.8%).</p> Conclusion <p>This study revealed a good disposition with a suboptimal practice towards exclusive breastfeeding. Also, being married was a positive predictor of exclusive breastfeeding. Therefore, we recommend policies that will improve exclusive breastfeeding among mothers in rural areas, especially those targeting the unmarried, to achieve the World Health Organization’s target.</p>The effect of cooperator recognition on competition among clones in spatially structured microbial communitiesAdrienna BinghamAparajita SurLeah B. ShawHelen A. Murphy10.1371/journal.pone.02995462024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Adrienna Bingham, Aparajita Sur, Leah B. Shaw, Helen A. Murphy</p>
In spatially structured microbial communities, clonal growth of stationary cells passively generates clusters of related individuals. This can lead to stable cooperation without the need for recognition mechanisms. However, recent research suggests that some biofilm-forming microbes may have mechanisms of kin recognition. To explore this unexpected observation, we studied the effects of different types of cooperation in a microbial colony using spatially explicit, agent-based simulations of two interacting strains. We found scenarios that favor a form of kin recognition in spatially structured microbial communities. In the presence of a “cheater” strain, a strain with greenbeard cooperation was able to increase in frequency more than a strain with obligate cooperation. This effect was most noticeable in high density colonies and when the cooperators were not as abundant as the cheaters. We also studied whether a polychromatic greenbeard, in which cells only cooperate with their own type, could provide a numerical benefit beyond a simple, binary greenbeard. We found the greatest benefit to a polychromatic greenbeard when cooperation is highly effective. These results suggest that in some ecological scenarios, recognition mechanisms may be beneficial even in spatially structured communities.Agriculture along the upper part of the Middle Zarafshan River during the first millennium AD: A multi-site archaeobotanical analysisBasira Mir-MakhamadPavel LurjeVikentiy ParshutoAbdurahmon PulotovFiruz AminovMichael ShenkarMuminkhon SaidovNikita SemenovSharof KurbanovSirojiddin MirzaakhmedovKhusniddin RakhmanovRita dal MartelloRobert Spengler III10.1371/journal.pone.02978962024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Basira Mir-Makhamad, Pavel Lurje, Vikentiy Parshuto, Abdurahmon Pulotov, Firuz Aminov, Michael Shenkar, Muminkhon Saidov, Nikita Semenov, Sharof Kurbanov, Sirojiddin Mirzaakhmedov, Khusniddin Rakhmanov, Rita dal Martello, Robert Spengler III</p>
The Zarafshan River runs from the mountains of Tajikistan and terminates in the sands of the Kyzyl-Kum Desert in Uzbekistan; it served as a communication route and homeland for the Sogdians. The Sogdians are historically depicted as merchants existing from the end of the first millennium BC through the first millennium AD. While recent research has provided the first glimpse into cultivation, commerce, communication, and consumption in the Lower Zarafshan, the agricultural heartland of the Middle Zarafshan Basin has remained unstudied. This paper presents the results of archaeobotanical investigations conducted at five ancient urban sites/areas spanning the fifth to the twelfth centuries AD: Kainar (Penjikent citadel), Penjikent (shahristan), Sanjar-Shah, Kuk-Tosh (pre-Mongol Penjikent), and Afrasiab. Collectively, these data show that cereals, legumes, oil/fiber crops, fruits, and nuts were cultivated on the fertile Zarafshan floodplains. In this paper, we discuss evidence for the diversification of the agricultural assemblage over time, including the introduction of new staple crops and fruits into an already complex cultivation system. In addition, we contrast our data with previously published results from sites along the course of the Zarafshan to determine whether there is a dietary difference between pre-and post-Islamic conquest periods at settlements located along the river.National-scale spatiotemporal patterns of vegetation fire occurrences using MODIS satellite dataUpenyu Naume MupfigaOnisimo MutangaTimothy Dube10.1371/journal.pone.02973092024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Upenyu Naume Mupfiga, Onisimo Mutanga, Timothy Dube</p>
As the risk of climate change increases, robust fire monitoring methods become critical for fire management purposes. National-scale spatiotemporal patterns of the fires and how they relate to vegetation and environmental conditions are not well understood in Zimbabwe. This paper presents a spatially explicit method combining satellite data and spatial statistics in detecting spatiotemporal patterns of fires in Zimbabwe. The Emerging Hot Spot Analysis method was utilized to detect statistically significant spatiotemporal patterns of fire occurrence between the years 2002 and 2021. Statistical analysis was done to determine the association between the spatiotemporal patterns and some environmental variables such as topography, land cover, land use, ecoregions and precipitation. The highest number of fires occurred in September, coinciding with Zimbabwe’s observed fire season. The number of fires significantly varied among seasons, with the hot and dry season (August to October) recording the highest fire counts. Additionally, although June, July and November are not part of the official fire season in Zimbabwe, the fire counts recorded for these months were relatively high. This new information has therefore shown the need for revision of the fire season in Zimbabwe. The northern regions were characterized by persistent, oscillating, diminishing and historical spatiotemporal fire hotspots. Agroecological regions IIa and IIb and the Southern Miombo bushveld ecoregion were the most fire-prone areas. The research findings also revealed new critical information about the spatiotemporal fire patterns in various terrestrial ecoregions, land cover, land use, precipitation and topography and highlighted potential areas for effective fire management strategies.Product innovation design process combined Kano and TRIZ with AD: Case studyHui RongWei LiuJin LiZiqian Zhou10.1371/journal.pone.02969802024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Hui Rong, Wei Liu, Jin Li, Ziqian Zhou</p>
In the era of rapid product iteration, companies need simple and effective methods to guide the entire process of product innovation design and enhance their product innovation capabilities. Most research focused on improving one or several steps in the product design process. Although some scholars have proposed methods that guided the entire process, they combined more than three different theories, which increased the difficulty of theoretical learning and the complexity of practical implementation. This paper proposed a product innovation design process composed of three theoretical methods: Kano, Axiomatic Design (AD), and Theory of the Solution of Inventive Problems (TRIZ). This new process guided the entire product design process with fewer theoretical methods, reducing the difficulty of learning and implementation. The paper demonstrated the effectiveness of this method through the design practice of a portable two-wheeled self-balancing vehicle. Additionally, the discussion section explored the method’s potential from the design management perspective.Can cyclone exposure explain behavioural and demographic variation among lemur species?Alison M. BehieTravis S. SteffensKeaghan YaxleyAlan VincentPatricia C. WrightSteig E. JohnsonMary S. M. Pavelka10.1371/journal.pone.03009722024-03-27T14:00:00Z2024-03-27T14:00:00Z<p>by Alison M. Behie, Travis S. Steffens, Keaghan Yaxley, Alan Vincent, Patricia C. Wright, Steig E. Johnson, Mary S. M. Pavelka</p>
Madagascar has a harsh and stochastic climate because of regular natural disturbances. This history of regular cyclones has been hypothesised to have directed evolutionary changes to lemur behaviour and morphology that make them more resilient to sudden environmental change. These adaptations may include: small group sizes, high degrees of energy-conserving behaviours, generalist habitat use, small home ranges, small body size, and a limited number of frugivorous species. To date, however, no one has tested how variation in cyclone exposure across Madagascar is associated with variation in these resilience traits. In this study, we created a detailed cyclone impact map for Madagascar using Koppen-Geiger climate class, historical cyclone tracks, the Saffir Class of cyclone and hurricane intensity, and precipitation data. We also used existing literature to calculate a resilience score for 26 lemur species for which data existed on resilience traits. Our cyclone impact map was then overlaid on known geographic ranges of these species and compared to resilience score while controlling for phylogenetic non-independence and spatial autocorrelation. We found no association between cyclone impact in a lemur range and their resilience score. When assessing traits individually, however, we found that cyclone impact was positively associated with body size, suggesting that the more impacted a species is by cyclones the smaller they are. We also found cyclone impact to be negatively associated with frugivory, with species in higher impact zones eating more fruit. While unexpected, this could reflect an increased production in fruit in tree fall gaps following cyclones. While we did not find a pattern between cyclone impact and behavioural resilience in lemurs, we suggest a similar study at a global scale across all primates would allow for more taxonomic variation and reveal larger patterns key to understanding past and future vulnerability to natural disturbances in primates.Examining the longitudinal associations between activity limitations, instrumental supports and social participation in osteoarthritis: A CLSA population-based studyAnthony V. PerruccioCalvin YipJ. Denise PowerMayilee CanizaresElizabeth M. Badley10.1371/journal.pone.02998942024-03-27T14:00:00Z2024-03-27T14:00:00Z<p>by Anthony V. Perruccio, Calvin Yip, J. Denise Power, Mayilee Canizares, Elizabeth M. Badley</p>
Objective <p>In osteoarthritis (OA) research, disability is largely studied within the context of activities of daily living. Broader consequences for social participation are often overlooked. In prior work, instrumental supports received and their perceived availability were shown to play a role in the maintenance of social participation. Two indicators of social participation were identified, diversity and intensity. The current study extends the findings from this prior cross-sectional work by examining these relationships longitudinally.</p> Methods <p>Data are from the baseline and 3-year follow-up questionnaires of the Canadian Longitudinal Study on Aging, a population-based study of people ages 45–85 years at baseline. The sample was restricted to those who at baseline reported a doctor diagnosis of OA (n = 4104). Using structural equation modeling, latent variables were derived at each time point for activity limitations, instrumental supports perceived and received, and social participation diversity and intensity. Longitudinal factorial invariance was assessed. Model covariates included age, sex, education, income, marital status, smoking status, obesity, and number of chronic conditions.</p> Results <p>For all latent variables, strong factorial longitudinal invariance was found. Activity limitations increased over time. Greater baseline social participation intensity was associated with increases in later intensity and diversity. Increasing activity limitations were associated with decreases in social participation and with increasing receipt of instrumental supports; they were not associated with changes in perceived availability of supports. However, increasing perceived availability was positively associated with social participation intensity.</p> Conclusions <p>With a goal of increasing social participation, findings suggest a focus on interventions to reduce activity limitations in OA is necessary. Findings additionally highlight an important role for perceived availability of instrumental supports in maintaining or improving social participation in OA, in addition to current social participation, particularly intensity, for future social participation status.</p>The great urban shift: Climate change is predicted to drive mass species turnover in citiesAlessandro FilazzolaMarc T. J. JohnsonKimberly BarrettSue HayesNamrata ShresthaLaura TimmsJames Scott MacIvor10.1371/journal.pone.02992172024-03-27T14:00:00Z2024-03-27T14:00:00Z<p>by Alessandro Filazzola, Marc T. J. Johnson, Kimberly Barrett, Sue Hayes, Namrata Shrestha, Laura Timms, James Scott MacIvor</p>
Human experiences with nature are important for our culture, economy, and health. Anthropogenically-driven climate change is causing widespread shifts in biodiversity and resident urban wildlife are no exception. We modelled over 2,000 animal species to predict how climate change will impact terrestrial wildlife within 60 Canadian and American cities. We found evidence of an impending <i>great urban shift</i> where thousands of species will disappear across the selected cities, being replaced by new species, or not replaced at all. Effects were largely species-specific, with the most negatively impacted taxa being amphibians, canines, and loons. These predicted shifts were consistent across scenarios of greenhouse gas emissions, but our results show that the severity of change will be defined by our action or inaction to mitigate climate change. An impending massive shift in urban wildlife will impact the cultural experiences of human residents, the delivery of ecosystem services, and our relationship with nature.Effects of primary health care and socioeconomic aspects on the dispersion of COVID-19 in the Brazilian Northeast: Ecological study of the first pandemic waveLuana Resende CangussúJeisyane Acsa Santos Do NascimentoIgor Rafael Pereira de BarrosRafael Limeira CavalcantiFábio Galvão DantasDiego Neves AraujoJosé Felipe Costa da SilvaThais Sousa Rodrigues GuedesMatheus Rodrigues LopesJohnnatas Mikael LopesMarcello Barbosa Otoni Gonçalves Guedes10.1371/journal.pone.02968372024-03-27T14:00:00Z2024-03-27T14:00:00Z<p>by Luana Resende Cangussú, Jeisyane Acsa Santos Do Nascimento, Igor Rafael Pereira de Barros, Rafael Limeira Cavalcanti, Fábio Galvão Dantas, Diego Neves Araujo, José Felipe Costa da Silva, Thais Sousa Rodrigues Guedes, Matheus Rodrigues Lopes, Johnnatas Mikael Lopes, Marcello Barbosa Otoni Gonçalves Guedes</p>
Background <p>The COVID-19 pandemic has had a negative impact on socioeconomic and public health conditions of the population.</p> Aim <p>To measure the temporal evolution of COVID-19 cases in cities near the countryside outside metropolitan areas of northeastern Brazil and the impact of the primary care organization in its containment.</p> Methods <p>This is a time-series study, based on the first three months of COVID-19 incidence in northeastern Brazil. Secondary data were used, the outcome was number of COVID-19 cases. Independent variables were time, coverage and quality score of basic health services, and demographic, socioeconomic and social isolation variables. Generalizable Linear Models with first order autoregression were applied.</p> Results <p>COVID-19 spreads heterogeneously in cities near the countryside of Northeastern Brazilian cities, showing associations with the city size, socioeconomic and organizational indicators of services. The Family Health Strategy seems to mitigate the speed of progression and burden of the disease, in addition to measures such as social isolation and closure of commercial activities.</p> Conclusion <p>The spread of COVID-19 reveals multiple related factors, which require coordinated intersectoral actions in order to mitigate its problems, especially in biologically and socially vulnerable populations.</p>Social contact as a strategy to reduce stigma in low- and middle-income countries: A systematic review and expert perspectivesCarlijn DamstéPetra C. GronholmTjitske de GrootDristy GurungAkerke MakhmudRuth M. H. PetersKim Hartog10.1371/journal.pgph.00030532024-03-27T14:00:00Z2024-03-27T14:00:00Z<p>by Carlijn Damsté, Petra C. Gronholm, Tjitske de Groot, Dristy Gurung, Akerke Makhmud, Ruth M. H. Peters, Kim Hartog</p>
Social contact (SC) has been identified as a promising strategy for stigma reduction. Different types of SC exist. Various scholars defined positive factors to strengthen SC. This study aims to investigate the application and effectiveness of SC as a strategy to reduce stigmatisation across stigmas, settings and populations in low- and middle-income countries (LMICs). We specifically examine the use of positive factors. A systematic review was conducted in twelve electronic databases using key terms related to stigma AND social contact AND intervention AND LMICs. Data were synthesised narratively. Study quality was assessed with the Joanna Briggs Institute critical appraisal checklists. Additionally, semi-structured interviews were used with first/corresponding authors of included publications to investigate their practical experiences with SC. Forty-four studies (55 publications) were identified. Various stigmas (n = 16) were targeted, including mental health (43%). Indirect (n = 18) and direct contact (n = 16) were used most frequently, followed by collaboration, imagined and vicarious contact, or a combination. The most applied additional strategy was education. Almost half of the studies, explicitly or implicitly, described positive factors for SC, such as PWLE training or disconfirming stereotypes. The majority suggested that SC is effective in reducing stigma, although inconsistent reporting overshadows conclusions. Perspectives of people with lived experience (PWLE) were infrequently included. Expert perspectives stressed the importance of contextualisation, PWLE participation, and evaluation of SC. This study provides an overview of SC as a stigma reduction strategy within LMICs. Conclusions about which type of SC is more effective or whether SC is more effective for a specific stigma category cannot be drawn. We recommend future research to strengthen reporting on effectiveness as well as PWLE perspective and SC processes, and to further critically examine the potential of SC. An overview of positive factors applied to strengthen SC is provided, which can stimulate reflection and guide future SC.Multiple cardiovascular risk factor care in 55 low- and middle-income countries: A cross-sectional analysis of nationally-representative, individual-level data from 280,783 adultsAlpha Oumar DialloMaja E. MarcusDavid FloodMichaela TheilmannNicholas E. RahimAlan KinlawNora FranceschiniTil StürmerDessie V. TienMohsen Abbasi-KangevariKokou AgoudaviGlennis Andall-BreretonKrishna AryalSilver BahendekaBrice BicabaPascal BovetMaria DorobantuFarshad FarzadfarSeyyed-Hadi GhamariGladwell GathechaDavid GuwatuddeMongal GurungCorine HouehanouDismand HouinatoNahla HwallaJutta JorgensenGibson KagarukiKhem KarkiJoao MartinsMary MayigeRoy Wong McClureSahar Saeedi MoghaddamOmar MwalimKibachio Joseph MwangiBolormaa NorovSarah Quesnel-CrooksAbla SibaiLela SturuaLindiwe TsabedzeChea WessehPascal GeldsetzerRifat AtunSebastian VollmerTill BärnighausenJustine DaviesMohammed K. AliJacqueline A. SeiglieEmily W. GowerJennifer Manne-Goehler10.1371/journal.pgph.00030192024-03-27T14:00:00Z2024-03-27T14:00:00Z<p>by Alpha Oumar Diallo, Maja E. Marcus, David Flood, Michaela Theilmann, Nicholas E. Rahim, Alan Kinlaw, Nora Franceschini, Til Stürmer, Dessie V. Tien, Mohsen Abbasi-Kangevari, Kokou Agoudavi, Glennis Andall-Brereton, Krishna Aryal, Silver Bahendeka, Brice Bicaba, Pascal Bovet, Maria Dorobantu, Farshad Farzadfar, Seyyed-Hadi Ghamari, Gladwell Gathecha, David Guwatudde, Mongal Gurung, Corine Houehanou, Dismand Houinato, Nahla Hwalla, Jutta Jorgensen, Gibson Kagaruki, Khem Karki, Joao Martins, Mary Mayige, Roy Wong McClure, Sahar Saeedi Moghaddam, Omar Mwalim, Kibachio Joseph Mwangi, Bolormaa Norov, Sarah Quesnel-Crooks, Abla Sibai, Lela Sturua, Lindiwe Tsabedze, Chea Wesseh, Pascal Geldsetzer, Rifat Atun, Sebastian Vollmer, Till Bärnighausen, Justine Davies, Mohammed K. Ali, Jacqueline A. Seiglie, Emily W. Gower, Jennifer Manne-Goehler</p>
The prevalence of multiple age-related cardiovascular disease (CVD) risk factors is high among individuals living in low- and middle-income countries. We described receipt of healthcare services for and management of hypertension and diabetes among individuals living with these conditions using individual-level data from 55 nationally representative population-based surveys (2009–2019) with measured blood pressure (BP) and diabetes biomarker. We restricted our analysis to non-pregnant individuals aged 40–69 years and defined three mutually exclusive groups (i.e., hypertension only, diabetes only, and both hypertension-diabetes) to compare individuals living with concurrent hypertension and diabetes to individuals with each condition separately. We included 90,086 individuals who lived with hypertension only, 11,975 with diabetes only, and 16,228 with hypertension-diabetes. We estimated the percentage of individuals who were aware of their diagnosis, used pharmacological therapy, or achieved appropriate hypertension and diabetes management. A greater percentage of individuals with hypertension-diabetes were fully diagnosed (64.1% [95% CI: 61.8–66.4]) than those with hypertension only (47.4% [45.3–49.6]) or diabetes only (46.7% [44.1–49.2]). Among the hypertension-diabetes group, pharmacological treatment was higher for individual conditions (38.3% [95% CI: 34.8–41.8] using antihypertensive and 42.3% [95% CI: 39.4–45.2] using glucose-lowering medications) than for both conditions jointly (24.6% [95% CI: 22.1–27.2]).The percentage of individuals achieving appropriate management was highest in the hypertension group (17.6% [16.4–18.8]), followed by diabetes (13.3% [10.7–15.8]) and hypertension-diabetes (6.6% [5.4–7.8]) groups. Although health systems in LMICs are reaching a larger share of individuals living with both hypertension and diabetes than those living with just one of these conditions, only seven percent achieved both BP and blood glucose treatment targets. Implementation of cost-effective population-level interventions that shift clinical care paradigm from disease-specific to comprehensive CVD care are urgently needed for all three groups, especially for those with multiple CVD risk factors.