The influence and impact of livelihood capitals on livelihood diversification strategies in developing countries: a systematic literature review.

Livelihood diversification is an essential strategy for managing economic and environmental shocks and reducing rural poverty in developing countries. This article presents a comprehensive two-part literature review on livelihood capital and livelihood diversification strategies. Firstly, it identifies the role of livelihood capital in determining livelihood diversification strategies, and secondly, it assesses the role of livelihood diversification strategies in reducing rural poverty in developing countries. Evidence suggests that human, natural, and financial capitals are the primary determining assets of livelihood diversification strategies. However, the role of social and physical capital with livelihood diversification has not widely been studied. Education, farming experience, family size, land holding size, access to formal credit, access to market, and membership in village organizations were the major influencing factors in the adoption process of livelihood diversification strategies. The contribution of livelihood diversification in poverty reduction (SDG-1) was realized through improved food security and nutrition, increased income level, sustainability of crop production, and mitigating climatic vulnerabilities. This study suggests enhanced livelihood diversification through improved access to and availability of livelihood assets is vital in reducing rural poverty in developing countries.

Determinants of livelihood diversification in rural rain-fed region of Pakistan: evidence from fractional multinomial logit (FMLOGIT) estimation.

Sustainable livelihoods in less developed countries are threatened by human, natural, physical, social and financial factors. Pakistan is also facing severe negative impacts of these factors in the form of climate shocks, market imperfections and insufficient formal credit availability on rural livelihoods. This study explores rural Pakistani's adaptation to these threats by diversifying income sources and explores the determining factors for adopting specific livelihood diversification strategies. The study is based on a quantitative survey of 295 households in three districts of rain-fed rural regions of Pakistan's Punjab with differing annual rainfall. Results showed that households mitigated against threats to their livelihood by having a diversity of income sources (Simpson Diversity Index = 0.61). Moreover, fractional multinomial regression modelling revealed that greater education was associated with a more diversified livelihood strategy, where income was predominantly derived from off-farm and non-farm livelihood activities. On the other hand, households with older members, more livestock and larger farm size focused their livelihoods on their own farms, or primarily diversified into an off-farm strategy by working on other farms. These findings underscore the importance of improved access to education and infrastructure for livelihood diversification. A policy that focuses on reducing low literacy rates in rural Pakistan may also provide new avenues of livelihood diversifications with enhancement of rural literacy rate to mitigate the risks associated with livelihood strategies of smallholders.

Debridement of diabetic foot ulcers: public health and clinical implications - a systematic review, meta-analysis, and meta-regression.

Background: Diabetic foot ulceration (DFU) has devastating complications and a lifetime occurrence of 15%-34%. Debridement of DFU is regarded as an intervention that accelerates ulcer healing and may reduce complications including amputations, infections, and poor quality of life (QoL), which have serious public health and clinical implications. A systematic review (SR) of SRs and of randomized controlled trials (RCTs) with meta-analyses (MAs) on debridement of DFU that synthesizes all human experimental evidence is warranted. Objectives: Are debridement methods in DFU beneficial over other forms and standard gauze dressings (control condition) in these outcomes? Study eligibility criteria: All SRs/MAs/RCTs comparing debridement methods for DFU with alternative methods of debridement and with control. Data sources: Cochrane Wounds Group Specialized Register, Cochrane Central Register of Controlled Trials (Cochrane Library), Ovid MEDLINE, PubMed, EMBASE, EBSCO, CINAHL, and Web of Science. Participants and interventions: Adults with type 1/2 diabetes with DFU and any debridement method compared with alternative debridement methods or control. Main Outcomes: Amputation rates, wound infections, QoL, proportion of ulcers healed, time to complete healing, ulcer recurrence, and treatment cost. Study selection and analysis: Data extraction/synthesis by two independent reviewers pooled using a random-effects model with sensitivity analysis. Results: 10 SRs were retrieved and reported qualitatively. Six SRs included MAs. This SR included 30 studies, with 2654 participants, using 19 debridement combinations. The debridement methods were compared with findings pooled into MAs. Meta-regression (MR) did not identify significant predictors/moderators of outcomes. Limitations: The studies may have been under-powered. The inclusion/exclusion criteria varied and the increased risk of bias contributed to low-quality evidence. Discussion/Conclusion: Weak evidence exists that debridement methods are superior to other forms of debridement or control in DFU. Implications: Researchers should follow standardized reporting guidelines (Consolidated Standards of Reporting Trials). Clinicians/investigators could use the findings from this SR/MA/MR in guiding patient-individualized decision making and designing future RCTs.

Debridement of Diabetic Foot Ulcers.

Diabetic foot ulcerations have devastating complications, including amputations, poor quality of life, and life-threatening infections. Diabetic wounds can be protracted, take significant time to heal, and can recur after healing. They are costly consuming health care resources. These consequences have serious public health and clinical implications. Debridement is often used as a standard of care. Debridement consists of both nonmechanical (autolytic, enzymatic) and mechanical methods (sharp/surgical, wet to dry debridement, aqueous high-pressure lavage, ultrasound, and biosurgery/maggot debridement therapy). It is used to remove nonviable tissue, to facilitate wound healing, and help prevent these serious outcomes. What are the various forms and rationale behind debridement? This article comprehensively reviews cutting-edge methods and the science behind debridement and diabetic foot ulcers.