A dietary transition away from traditional foods and toward a diet of the predominantly unhealthy market is a public health and sociocultural concern throughout Indigenous communities in Canada, including those in the sub-Arctic and remote regions of Dehcho and Sahtú of the Northwest Territories, Canada. The main aim of the present study is to describe dietary intakes for macronutrients and micronutrients in traditional and market food from the Mackenzie Valley study. We also show the trends of contributions and differences of dietary intakes over time from 1994 data collected and reported by the Centre for Indigenous People’s Nutrition and Environment (CINE) in 1996. Based on 24-h dietary recall data, the study uses descriptive statistics to describe the observed dietary intake of the Dene First Nations communities in the Dehcho and Sahtú regions of the NWT. Indigenous people in Canada, like the sub-Arctic regions of Dehcho and Sahtú of the NWT, continue to consume traditional foods, although as a small percentage of their total dietary intake. The observed dietary intake calls for action to ensure that traditional food remains a staple as it is critical for the wellbeing of Dene in the Dehcho and Sahtú regions and across the territory. Indigenous peoples  living in Canada, including those who live in remote sub-Arctic regions, partake in subsistence harvesting—hunting, fishing, and gathering—for traditional food, and purchasing of market/commercial food with a varied emphasis ,2,3,4. “Throughout Canada, a dietary transition has been observed, and while colonial and post-colonial policies, such as the Indian Act and residential schools, have disrupted Traditional Knowledge transfer and wellbeing , the queLikewise, the remoteness of sub-Arctic Indigenous communities within Canada has not excluded them from the dietary transition observed in other Indigenous communities nationally. While there is a variance in traditional food consumption within the Arctic and sub-Arctic regions, higher consumption of market foods relative to traditional foods has been observed for First Nations, Métis, and Inuit communities ,14,18,19The Dene Nation inhabit the large area of Denendeh and includes the Dehcho and Sahtú regions of the Northwest Territories (NWT). These sub-Arctic regions are considered remote and contain rivers, lakes, and mountains, e.g., Great Bear lake, the Mackenzie Mountains, and the basin of the Mackenzie river/Dehcho river . While t® principles [The community-based project was designed based on community consultations at the outset of the project. Discussion with communities began in 2014 and helped ensure that community needs were met and that the purpose and scope of the Mackenzie Valley Study were well understood before beginning. Researchers worked with representatives from each participating community to develop community research agreements to respect OCAPinciples . The agrThirteen communities were approached to participate in the project. Nine accepted, with six communities in the Dehcho and three in the Sahtú regions see . CommuniAdditionally, to follow a more inclusive approach, walk-in participants to the sampling clinics were welcomed. This method of open recruitment was requested by communities during the consultation stage of the project. As a result, community members were invited to come to a biomonitoring “clinic” where the samples and survey data were collected. The locations of the clinic in each community were determined in consultation with the local leadership and were often housed centrally in community centers. Once at the clinic, the participants in the broader project were invited to complete the 24-h dietary recall.All potential participants had the project objectives and informed consent procedures explained during individual sessions with the research team and local coordinators. After this introduction to the project, participants who chose to partake in the study were asked to sign a consent form and provide basic demographic  and personal characteristics . Participants could choose one, a few, or all of the six study components that involved the collection of blood, urine, and hair samples, two dietary surveys , and a (n = 25) from northern Ontario in 2004, with good relative validity when compared to dietitian-administered interviews [For those choosing to complete the 24-h dietary recall component of the study, participants were asked in detail what they had eaten over the previous 24 h using a web-based survey of eating behaviors  called tterviews . Wein anterviews . Limitatterviews . AdditioEnergy and nutrient content were analyzed using the Canadian Nutrient File Database  and, occ® Office Excel by gender, age , and adults vs. children (with adults being 18 years old and older and children being 6–17 years old). Additionally, R Studio was used to model linear and multivariable linear regression by gender, age , and traditional food consumption status  but is not reported in the present study as the findings were not statistically significant. This paper reports aggregate data from the 24-h dietary recall for all nine participating communities and some disaggregated data for the Dehcho and Sahtú regions and by age and sex. Results for individual communities are not shared to respect the agreements with communities and to maintain the anonymity of participants from smaller communities. Food group consumption data were examined separately from calculated values of macronutrients, vitamins, and minerals and compared to the available data from the 90 s in the region. Descriptive statistics of frequencies were conducted in MicrosoftThe paper also reports aggregate data from a 24-h dietary recall study by the CINE team conducted in 1994 in the Yukon and the NWT  for the Ethics approval was obtained by the University of Waterloo Research Ethics Committee , the Stanton Territorial Health Authority for Human Research (29/12/2015), and the Aurora Research Institute . Community research agreements were established between the research team and each participating community in the Mackenzie Valley study.n = 197). Participation of women and men were similar at 50.5% and 49.7%, respectively. Ages ranged from seven to 85 years old, with a mean age of 39.9 years. For the Mackenzie Valley study, a total of 199 participants completed the 24-h dietary recall, with 132 from the Dehcho and 67 from the Sahtú regions. However, two participants were removed from the dataset because their reported calorie intake was outside a normal range . Both paThe 1994 24-h recall data reported by the CINE researchers and the current 24-h recall data from the Mackenzie Valley study provide two points in time to show observed trends in traditional food consumption over two decades apart. Further, the study depicts a subset of data from In this study, we describe the consumption of traditional and market foods from the Mackenzie Valley study and present the data alongside the consumption patterns captured by the CINE publications. To our knowledge, it is one of few studies reporting up-to-date dietary intake of traditional foods and market food for the Dehcho and Sahtú regions of the NWT. The present study’s observations display that traditional food appears to continue to be consumed in the Dehcho and Sahtú region diets, based on macronutrient intake with traditional food to be similar to those without traditional food. Likewise, the percent average energy from traditional food was similar between genders in both regions. Distinctively, women over the age of 51 years from both regions had the highest percentage of energy from traditional food. However, the Mackenzie Valley 24-h recall survey found a majority of participants reported not consuming traditional foods in the last 24 h. Moreover, the average energy of traditional foods appears to be low overall in both study regions. Importantly, there was an observed high prevalence of respondents in the current study that do not meet the EAR and AI for Vitamin A and D. The discussion will focus on studies within similar regions and First Nation groups to maximize comparability. In examining the results, it is evident that although the majority of energy does not come from traditional foods, it continues to be an important source of food and nutrients for the Dehcho and Sahtú region. While macronutrient breakdown was similar within the previous 24 h between those who ate traditional foods and those who did not, overall, the majority of respondents did not eat traditional foods within the last 24 h, and the average energy from traditional foods was observed to be the highest in those 51 years or older. Considering these observations, it can be suggested that a nutrition transition is occurring away from the consumption of traditional foods, as younger demographics may be demonstrating an increased reliance on market foods. Compared to the 1994 CINE study, the overall macronutrient consumption breakdown appears to be similar, while saturated fats appear to be overall higher in the present study and protein appears to be slightly lower. Like the present study, energy intakes were higher in those who consumed traditional foods in the 1994 CINE publications . FurtherMoreover, previous literature may give insights into what may have influenced the consumption of traditional foods in the current study. Phillipps and colleagues found that 54% of participants in the Sahtú region could not afford to eat a balanced meal, and 60% of participants reported that the cost of fishing and hunting prevented their household from being out on the land to harvest traditional food . This maAdditionally, the difference in the consumption of traditional foods gives further insight into the reported nutrition transition. In the present study, those 51 years or older age had the highest consumption of country food while those aged 6–17 had the lowest consumption. Similar to the present study, Batal et al. also found differences in age and traditional food consumption, with the oldest demographics reporting the highest amount of consumed traditional food . The stuAccordingly, investigations into different sources of food may help give insight into the differences in traditional food consumption by age. Presently, many school programs exist to combat food insecurity through breakfast programs, lunch programs, snack grants, gardening workshops, and nutrition education ,61,62. HMoreover, health risk communication and advisories are important tools for public health officials. However, improper communications, such as communication on environmental contaminants, may unnecessarily increase fear and confusion regarding traditional food. For example, Brandow found that 39% and 28% of participants in the Sahtú had heard consumption notice messaging that pregnant women and children, respectively, should avoid eating lake trout or northern pike that are larger than 60 cm . LikewisFinally, consumption of traditional foods was found to be overall similar in men and women, with women over the age of 51 years old having the highest average percent energy from traditional foods. Importantly, men and women were represented almost equally in the sample group and age groups. Additionally, more women than men were meeting the EAR for Vitamin A, but conversely, the present study found men were meeting the AI of Vitamin D. While it appears that Vitamin A intake has improved compared to the CINE study in both men and women, men meeting the AI of Vitamin D appears to be higher than the currently observed proportion, with the percentage of men not meeting the AI appearing to be higher than that of the CINE cohort. The CINE study found women to consume more grains, sweets, fruits and vegetables, and fats compared to men, and found that men consumed slightly more meat and land animals. However, mixed dishes of traditional food and market food, sea mammals, fish, and birds contributed very similarly to the percent total energy between men and women . AdditioThe current study used a cross-sectional design to assess dietary intake of the Dehcho and Sahtú region using a 24-h recall survey. While a 24-h recall survey is useful in gathering data efficiently, it is difficult to generalize a dietary pattern, especially in a population in which seasons impact food availability and consumption patterns, particularly for traditional foods. The current study does not represent the seasonal variability of available traditional food. Depending on the animals available at the time (season) of the 24-h recall, it may affect the dietary intake between men and women. As such, the present study conducted surveys from January 2016 to March 2018 with the data collected in winter months, while the CINE study conducted 24-h recall surveys in March-April and October-November 1994 with the intention of capturing the lowest and highest traditional consumption periods, respectively. Subsequently, due to migration patterns of harvested animals, traditional food is often consumed more during the fall and spring hunting periods, and thus, the current study may not reflect year-round consumption patterns compared to the CINE publications. Furthermore, although the present study assesses the same regions as the CINE publications, they do not use the same cohort and, in fact, are sampled from different communities within each region. Therefore, a temporal association cannot be established between the two groups. However, the current study is the most recent to conduct dietary intake assessments of the same regions, and thus, we hope to give readers some temporal insight and updates into the dietary intake status of the Dehcho and Sahtú regions.Further, while the WEB-Q survey was designed as an easy-to-use tool with photo-images of foods and portion sizes relative to a standard place setting, the range of food options was limited to approximately 24 animal and fish species that had contributed the most nutrients in the CINE study. In contrast, the 1992 data collection was done through one-on-one interviews and includes over 100 traditional food species specific to the region and used analyzed values of locally harvested and prepared Canadian Arctic traditional food. Finally, with both studies, the validity of a 24-h recall survey may be influenced by response bias due to a more favorable response (may be increased as the researcher is present) and the ability to recall specifically what one ate in the last 24 h . Additionally, the design of the current study limits its ability to interpret reasons for gender and age differences, and rather we can only simply present the dietary intake data. Finally, the present study’s sample size represents about 4% to 16% of the represented communities’ populations. While the sample ratio to population is considered to be mostly low, the data collected is extremely valuable as dietary intake data in the region had not been collected for many years, and data collection in remote and rural regions is difficult.The findings of the present study warrant a prospective cohort study investigating the nutrition transition observed in the Dehcho and Sahtú regions and other Indigenous groups within Canada to establish a temporal association between dietary intake changes and possible independent variables. Future studies should also strive to sample at multiple times of the year to accurately capture the seasonal variability of traditional food and also warrant investigation into dietary intake by gender, age, and influencing variables. Transformative-oriented studies with the aim of investigating promotion strategies to support the consumption of traditional foods and health communication that acknowledges and promotes the nutritional value of traditional food would be of value. Strategies meriting investigation include the usefulness of improving school food environments to foster traditional food consumption and dietary preferences of children and youth  and the Likewise, the present study warrants further investigation into the direct health effects of low Vitamin A and D intake and its association by gender, as the majority of the CINE and Mackenzie Valley groups did not meet the EAR or AI of Vitamin A and D, including men’s intake of Vitamin D, which appeared to decrease. The present study shows the most up-to-date dietary intake data for the Dene/Métis in the Dehcho and Sahtú Regions of the NWT and is similar to other dietary intake studies of First Nation communities within Canada. Importantly, traditional food is still being consumed, although as a small percentage of their dietary intake and less in younger demographics. Findings from the current study point to the importance of traditional food as it continues to be eaten and contributes important nutrients. The observed dietary intake calls for action to ensure that traditional food remains a staple, as it is critical for the wellbeing of Dene in the Dehcho and Sahtú regions and across the territory.


The gap between research and its practical application in community settings limits its impact on public health. Closing this gap has the potential to improve the well-being of underserved groups, such as children with disabilities. Mobile health has the potential to improve access to community resources and support for underserved populations, thereby encouraging improved health behaviors.In this feasibility pilot study, we describe the development of the mobile app Jooay. Jooay was developed in partnership with stakeholders to facilitate access to leisure and physical activity community programs for children and youth with disabilities. We also reflect on the lessons learned throughout the implementation process that are relevant for improving the health behaviors of children with disabilities.We used a participatory action research approach to develop the app. We also administered a survey to current Jooay users and analyzed various app usage indicators to explore use patterns, user feedback, and preferences. Finally, we critically appraised the implementation process through a best practices for implementation research framework.We developed a product that responds to users’ identified need to find information and follows accessibility and user-centered design standards. The analysis of usage data revealed that access to the Jooay app is concentrated in urban areas. Perceptions, attitudes, and information needs varied according to the type of user. The use of the mobile app changed over time, and usage decreased after the app was downloaded, indicating a need for the sustained engagement of app users. Users found value in the ability to identify activities that they would not otherwise know about. However, app use alone was not sufficient to improve participation. Although the app was developed based on users’ active input in multiple iterations, we encountered challenges with survey recruitment and attrition, suggesting the need for more seamless and engaging means for collecting data within this population.Interactions between users and the app can sustain user engagement and behavior change. We will improve the app’s next iterations by using the information gained from this study to conduct a larger study to assess the relationship among social and material deprivation, urban design, and access to inclusive and adaptive leisure programs. This study will inform the improvement of app listings to improve the use of Jooay by different user groups and promote health through mobile apps for marginalized groups. Implementation research involves studying research uptake and its effect on the outcomes of multiple stakeholders ,2. In meInnovative strategies for facilitating changes in health behavior are particularly important for underserved communities and populations. People with disabilities comprise approximately 15% of the global population and are at risk of poor health outcomes . ChildreHealth promotion initiatives can improve outcomes for children living with a diverse range of social, emotional, and behavioral disabilities -14. ContMobile health  is gaining primacy for the creation of targeted, accessible, and context-appropriate health promotion solutions. mHealth tools include various devices, software, and solutions that use mobile phones to improve health . PotentiAlthough there have been several pilot studies on mHealth interventions, knowledge gaps remain regarding the appropriate development and use of mHealth to promote health equitably . PrelimiIn addition, research on mHealth has not yet sufficiently demonstrated efficacy, effectiveness, user engagement, effective scale-up, and competitive value ,27. ManyIn this study, we explore the feasibility of mHealth to improve access to information on community-based inclusive leisure activities for children with disabilities. Our specific objectives are to (1) describe the development process of the mHealth solution and (2) identify use patterns and user preferences. The secondary objective is to establish the feasibility of using a mobile app to test behavior change and to pilot test data collection through app analytics and users.Understanding the development, implementation, and uptake of mHealth can facilitate the design and use of future technologies for health promotion in high-risk groups. The knowledge gained will also inform the scale-up of the app and, more broadly, the field of implementation research.In this pilot feasibility study , we askeWe adopted a hybrid implementation research design , wherebyEthical approval for this study was obtained from the McGill University Institutional Ethics Review Board as well as the Centre for Interdisciplinary Research in Rehabilitation.Several theoretical frameworks informed our approach and study objectives. The overall approach to app development and evaluation was based on the participatory action research (PAR) framework . PAR aimThe overarching objective and the development process (specific objective 1) were informed by the best practices for implementation research prescribed by Peters et al . SpecifiTo expand on step 5 (appropriately considering outcome variables of the implementation), we adopted the Health Behavior Framework . This frOur pilot intervention tool is Jooay, a free mobile app that aggregates information on leisure activities for children and youth with disabilities aged 6-21 years in Canada. The Jooay app was launched in the spring of 2015 on iOS and other web platforms. The version used for this pilot study listed approximately 1000 activities distributed in 5 of the 10 Canadian provinces.First, we organized 4 stakeholder forums across the Canadian provinces. Participants were a purposeful sample of youth with disabilities, caregivers of children with disabilities, health and education providers, policy makers, and community organization leaders. They were invited by pediatric rehabilitation center collaborators and city leisure departments in Montreal, Toronto, Calgary, and Vancouver.Each forum was a 1-day event with the following objectives: (1) to present the current research evidence on determinants of leisure participation for children and youth with disabilities and (2) to identify strategies to improve access to leisure opportunities for children and youth with disabilities across Canada.Using a business canvas model , particitop solution on a card. Instructions were that the top solution depicted in the card should be actionable, be feasible, and have an impact on the participation levels of children with disabilities. Participants then engaged in a prioritization exercise in which they exchanged cards and, in pairs, compared and ranked 2 ideas. The solution that ranked higher at the end of 5 rounds of paired ranking was considered the one that, according to the forum participants, would yield the highest impact on participation in leisure for children with disabilities. The solution ranked as the most feasible and promising solution to overcome systems barriers and promote participation in leisure across the 4 forums was “[a]n electronic list of inclusive and adapted activities.” Participants in each forum volunteered to form a working group to support the development of the idea.Each participant was invited to write their selected The Jooay app was developed in 2 phases: (1) prototype development and (2) test version development.A convenience sample of 5 users  and several research team members  provided input into the user interface development, user experience development, and final test versions during both phases.A larger group of stakeholders comprising clinicians , physical educators, caregivers of children with disabilities, and representatives of community organizations constituted the user partners who provided input during the development phase of the app. These stakeholders provided insights into the best features and types of information to be listed and were involved in the conception of the app, the testing of multiple versions, and the development of the research protocols to address the feasibility and pilot testing of the app. The stakeholders were chosen based on the following considerations: (1) willingness to participate; (2) direct experience working or advocating for children with disabilities; and (3) representation across diverse areas of involvement that included pediatric rehabilitation centers, school boards, community organizations, newsletters of organizations, and networks related to adapted leisure and addressing caregivers of children with disabilities.A dynamic protocol for testing and responses was established using a collaboration platform and the research team made connections between the developers and user testers.The mobile app was initially developed as a prototype during a hackathon . The first test version was developed for iOS, Android, and the web. It was made available to users free of charge through regular channels .A partnership with an external mobile app developer was necessary to secure further development, and multiple funding sources were required to attain industry standards. Suggestions that arose from user partners and technology developers resulted in the creation of 3 native platforms for iOS, Android, and the web.Core technology developments included mandatory implementation of full accessibility protocols for mobile and web platforms . An accessibility consultant was hired to test and assess these features during development.The participants provided important information on preferences for the type of information displayed for each activity listed. The selection of included domains had an impact on development cost; therefore, there was an assessment of the most relevant information components to be retained in the app.all are welcome), cost, and time frame. The same decision algorithm was used to create filters within the map search as well as to collect basic demographic information from users when they registered to use the app.The final domains reflected stakeholders’ preferences for information and included activity description, types of equipment required, type of disability . They also supported survey distribution to a larger sample of community organizations and rehabilitation centers, in addition to the list of app users, and acted as champions to disseminate the survey and the app as a product to other users.Activities in the app were initially populated on the basis of pre-existing lists of adapted and inclusive leisure activities from pediatric rehabilitation centers in the targeted provinces and schools serving children with disabilities in 6 provincial capitals across Canada. Using the key terms identified on the websites of these organizations, the research team searched for additional activities and continued populating the app database.This pilot project used 2 sources of data: (1) analytics of the Jooay app users and (2) electronic surveys sent to registered participants.Through a preliminary analysis of app analytics data from approximately 600 users, we determined that approximately half were health or education service providers and the other half were caregivers of children with disabilities. No further sociodemographic information was required from the users upon registration. Furthermore, 2 different surveys were subsequently developed to target service providers and caregivers. This pilot study was conducted with all app users who had registered with the app using their email. Registration was not a mandatory requirement to gain access to information on Jooay.A total of 273 of approximately 600 user emails were initially available. Additional users who downloaded the app and registered during the 6-month data collection period also received an invitation to participate. A brief explanation of the study and survey links were also posted through social media channels, specifically through parent support groups and the Jooay page on Facebook, asking app users who might not have registered emails to complete the survey. Study knowledge brokers in pediatric rehabilitation centers, school boards, community organizations, newsletters of organizations, and networks related to adapted leisure and addressing caregivers of children with disabilities also shared information about the app and survey. Additional participants in the regions where the activities were published on Jooay at the time of the study, namely, the 6 provinces—Alberta, British Columbia, Quebec, Nova Scotia, Saskatchewan, and Ontario—were targeted in addition to existing users of the app.Participants were required to own a smartphone, have access to the internet, and understand English or French. Users aged <13 years were excluded from the survey, given that 13 was the established minimum age to own social media accounts, such as Facebook and Twitter, and the legal age required to download Jooay from the App Store. Assent was required for participants aged <18 years.Potential participants received an email with a brief explanation of the study and a link to a web-based survey on REDCap  hosted in a research database. Participants were prompted to provide consent before the initiation of the survey. A total of 5 invitations were sent by email within a 2-week interval.Confidentiality and anonymity of survey responses were ensured by deidentifying survey responses. Participant emails were only used to prompt their participation in the study and were not associated with their answers. A 2-step password-protected REDCap account accessible only to the survey team was used to ensure data privacy. The survey questions analyzed as part of this pilot study are provided in Questions about the app and app use1. Rank the relevance of the current existing features of the app (are these sections important in helping you find an activity to pursue?)2. Was information in the following sections helpful in finding activities?costtype of activitydescription of activitytype of disabilitylocationage rangescheduleseasonreviews or ratingsother links and related informationQuestions with "agree," "neutral," or "disagree" responses1. The app is easy to use2. The app has a comprehensive list of existing activities3. The information on the app is accurateHow did you learn about Jooay?1. Social media2. Health or education professional3. Other sources (which one?)Open-ended questions1. What feature you would like to see in the app that is currently not available?2. What are main issues of the app?3. Do you intend to uninstall the app? (yes or no)If yes, explain why (open ended)Questions about health behavior1. The person for whom the app information is being used  has engaged in regular leisure activities before using the app? (yes or no)2. My child, client, or student participation in leisure has increased because of informationfound in the app? If participation improved, explain why (open ended)3. The activities in the app fits my, my child’s, or my client’s needs (yes—moderately—no)Sociodemographic questions1. Your age (respondent)2. Age of the person with disabilities for whom you’re using the app info3. Province of residenceAfter the REDCap surveys were distributed , responsThe question of power calculation is often a challenge in assessing the impact of mHealth tools on health outcomes , given tThe results of the development process and feasibility testing are presented in the context of the 2 guiding theoretical frameworks: the Implementation Framework and the Health Behavior Framework. We identify which domains of these frameworks are addressed in each of the following sections.Implementation Framework: Identifying the audience and how they will use the researchHealth Behavior Framework: Health policy environment, health or community care system, community capacity and engagement, and social advocacyMore than 200 stakeholders representing diverse groups participated in the development process of the mHealth solution. An average of 50 participants in each of the 4 stakeholder forums identified that a mobile listing of leisure activities was the most desirable and feasible solution to promote participation in leisure activities for children with disabilities.Stakeholders in the forums represented a range of health and policy environments, communities, and health care systems. They presented the key factors for the use of the app in the health and community environments . Stakeholders in the forums and in the advisory group also contributed the listings that they currently had in the municipal, local listings of activities to the database and engaged in social advocacy.Implementation Framework: Examining the implementation strategy thoroughly, describing the sample population clearlyHealth Behavior Framework individual variables: knowledge, health beliefs, social norms and supports, cultural factors and beliefs, barriers and supports, and structural factorsA total of 239 participants received the survey. The response rate was 38.9% (93/239). Participants were asked to rank the relevance of app features. Participants reported that the most useful information was age range and location, followed by the activity type and description of activity. Most participants found that information in all sections of the app was helpful; sections that had less information, such as reviews and ratings (which is expected because the app is new and not many reviews had been done yet), were perceived as less helpful . The linParticipants were asked to indicate (open-ended questions) the features they would like to see added to the app. A total of 34 participants responded to this question, and their responses were categorized as follows: development of a web-based community or forum , a means to track their participation in leisure and physical activities , positive prompts for action , and a points or rewards system to incentivize participation .When asked about their concerns with the app, the main negative feedback was related to the insufficiency of listings , followed by the lack of activities in the regions where participants worked or lived . Half of the respondents agreed that the app was easy to use and accessible. However, 37% (10/26) disagreed that it was comprehensive, and 62.5% (16/26) indicated that they were neutral about whether the information was accurate. Although 85% (17/20) of the service providers using the app noted that they did not intend to uninstall the app, 72% (27/38) of the caregivers said they might intend to.other sources, such as word of mouth or through advertising in hospitals.We asked participants to identify how they heard about the Jooay app as a means of increasing our understanding of how information spreads in this population. Overall, 22% (20/93) of respondents indicated social media as their source of information, followed by those who indicated that they heard about it from their physical therapist, OT, or recreational therapist ; 32% (30/93) indicated Respondents had the opportunity to respond to open-ended questions on whether the app contributed to increased child leisure participation, and if so, how. One of the ways in which participants indicated that the app contributed to increased participation in leisure was by raising their awareness of community resources and programs. Service providers (clinicians and educators) who responded to the survey noted that they had used the app to provide information to families, caregivers, and clients about leisure opportunities, but they could not indicate whether the app had contributed to an actual increase in leisure participation. Caregivers indicated that although the app increased their awareness of activities that they were not aware of, it was still challenging to find activities that were suitable for their children. They indicated that the app needed to include more activities to enhance opportunities for participation.P=.01). Most of the caregivers indicated that their child was actively engaging in physical activities before accessing the Jooay app .We originally intended to explore the associations of sociodemographic characteristics, such as age, gender, type of disability, and place of residence, with perceptions of the app’s features and app use patterns. However, a significant amount of missing data (61%-91% of data are missing for some variables) precluded us from doing so. However, the preliminary exploratory analysis identified significant associations between the age of the caregiver and whether the person with a disability had engaged in physical activity before using the Jooay app . Most of the responses  were from Quebec, and of those responses, 9 (75%) respondents found that the app had a moderate fit with their needs. The lack of diversity in the users’ responses precluded a valid test of the association between user type  and whether users found the activities in the app were a good fit; however, half of the respondents in both categories (n=10) indicated that the activities they found in the app had moderate to no fit with what they were looking for.There was also a significant relationship among the users who indicated that the app had the information they were looking for and the province where they were located , and 84% (17/20) of them indicated that their child’s participation increased after app use only slightly or moderately.P=.005). Most of the respondents to this category of questions were community organizations  and health care professionals ; 45% (11/24) of respondents reported using the app multiple times without finding an appropriate activity for their client or child. The other 55% (13/24) of respondents had used the app less frequently and did not indicate whether they found an activity they were looking for or were only browsing through activities or exploring the app.There was also an association between user type (caregiver vs service provider) and how frequently they used the app  and which elements did . For elements requiring ethics approval, we agreed to an open protocol with the core elements of the project being initially approved through the regular, extended ethics review board procedures, and future iterations  to undergo an expedited review, allowing for a reduced turnover time.It is important to advance implementation science on mHealth; it requires careful consideration of the interaction between technology development, participatory research and stakeholders involvement. We must develop protocols and standard operational procedures detailing aspects such as legal agreements between industry and research partners and business development plans that include design and maintenance discussions, establish a clear communication platform and verify with end users that they are able to access it. Flexibility in accepting other forms of communication that may be preferred by stakeholders have to be considered, and detailed note taking, with designated communication contacts on the team, is ideal.The vast majority of the app users found that the information contained in the app was relevant, albeit not comprehensive , to really affect the desired health behavior change of increased participation for their child. This may have been the reason why 72% of caregivers planned to uninstall the app. Service providers indicated that they did not intend to uninstall the app; thus, they likely perceived greater utility. Several studies have shown that lack of information is one of the key barriers to participation and perception of good health services for families of children and youth with disabilities -39. CreaThe lack of comprehensive information about activities in the app can be attributed to 2 main reasons: (1) the scarcity of activities offered in the community for this population and (2) the limited capacity to generate a comprehensive list of existing activities manually. The first issue is being addressed in a separate study  where we conducted an in-depth analysis of the sociodemographic characteristics of regions and the availability of inclusive leisure activities, as listed in the app, with the objective of informing policy and program creation.The second challenge relates to technology development. Creating comprehensive listings of activities that are constantly changing is a key challenge that can be addressed through technology but requires extensive sustainability planning. Sustainability and business models of mobile technology may be typical in design and industry but are foreign in health research when primary funds for development and co-design are obtained through research grants of limited duration. A sustainability model for mHealth needs to be further developed and tested to ensure the efficient use of research and user resources -42.Most survey respondents were caregivers of children with disabilities living in urban areas. Most activities listed in the app are located in urban areas. In the stakeholder forums, participants indicated that it is paramount to consider mHealth solutions that target populations that face multiple layers of marginalization, such as those who live in rural areas, indigenous children and families, and those who may not have access to mobile technology. Caregivers and service providers in rural areas have been identified as populations lacking access to services and other resources ,44. TherThis pilot study sheds light on the challenges of including proxies as the main users of interventions. The target population using the app are caregivers and service providers, but the actual expected behavior change (participation in leisure) is targeted at the children under their care. Information on the participation patterns of families came mainly from caregivers providing answers to the survey. We identified an association between previous participation levels and the caregivers’ age and between their familiarity with apps and the technology associated with the actual frequency of use of the Jooay app. It is known that caregiver behavior regarding leisure has an influence on the child’s level of participation . The priAnother important characteristic of this particular mHealth solution was accessibility for persons with disabilities. Although the app users are not necessarily children and youth with disabilities  but rather the caregivers, it is important to consider that a mobile app for persons with disabilities should comply with accessibility standards. The challenges of following accessibility standards were perceived by our accessibility consultant and were outlined in previous research . It was The survey results suggested that participants were not sure of the impact of the app on their children or clients’ participation levels but that they were certain that their knowledge about existing community activities had increased because of the app use. Ideally, mHealth should include artificial intelligence to directly track participation and objectively quantify the increase in participation as the desired outcome . AlthougFor effective mHealth implementation, movement beyond pilot studies is needed to better understand the characteristics, preferences, and real-time use patterns of users. Partnership development with community organizations, cities, and other layers of governments is also needed to identify solutions to link resource databases and create machine learning algorithms that maintain relevant information for the public.This pilot feasibility study faced limitations that supported several important considerations for future studies. First, this study was conducted in a real-world setting. We had no control over the location, type of activity offered, and the match between these activities and the participants’ preferences or needs. Previous research has indicated that preference for certain types of activities is associated with engagement in these activities . This piThe implementation strategy for this project was built in partnership with stakeholders. Implementation strategies included word of mouth and the use of local and web-based champions to disseminate information about the app and invite people to download it and use it. This project informed the important aspects of the implementation strategy on a larger scale. Recent studies have assessed the implementation of different data collection strategies through mobile apps and have reported mixed results. One study found that improving compliance with medication through digital data entry was feasible and reliable in a population of adults with HIV/AIDS . AlternaImprovements in the recruitment strategy that will be implemented in the next phase of this study are the use of push notifications directly through the app, the shortening of the consent form to the minimal requirements, and the shortening of the survey. We will also ask our parent-partners, clinicians, and other coinvestigators to design a message that will be sent through push notifications. This message should be more welcoming of the participants’ responses. Future implementation efforts include making registration mandatory to use the app, increasing the relevance of information by implementing machine learning to update information, and increasing opportunities for interactions . Future research must also address potential ethical constraints by appropriately adjusting their study design to elicit participation by using a mobile app as the only source for data collection.The limited capacity of using app analytics across platforms and automated database updates imposed limitations to the data collected. Artificial intelligence to directly track participation, to objectively quantify increases in participation as the desired outcome, and improved analytics protocols are necessary to evaluate the effects on health behavior . TherefoLarge-scale implementation research efforts using mHealth will need to consider better ways to engage the ecosystem of stakeholders, from users to rehabilitation centers, and community-based leisure centers to scale up and test more complex interventions. Efforts to elicit information from this population may require automated modes for data collection and partnerships between municipalities and organizations to link databases of activities and the app.Implementation research holds the potential to drive real increments in public health by translating research findings to real-world testing. At-risk and underserved populations, such as people with disabilities, require increased efforts toward change, as they face multiple contextual barriers often leading to poor health outcomes .This study piloted the development and use of Jooay, a mobile app listing inclusive leisure activities. We also sought to understand user demographics and characteristics and the corresponding variables that would be of value to support its scale-up and effectiveness testing. Our intended use of this information was to better meet the needs of children and young people with disabilities and their support systems while also informing the literature to guide similar efforts.mHealth is promising as a viable and feasible tool to execute implementation efforts, especially for this subpopulation. mHealth tools should integrate health promotion strategies for children with disabilities considering how to overcome poverty , be enjoThe next phase of this project will also inform programs and policy changes that can support a sustained model of inclusive leisure activities, mHealth integration into macrosystems of information sharing, and equitable distribution of health-promoting opportunities for children with disabilities and their families.


Learning new movement patterns is a normal part of daily life, but of critical importance in both sport and rehabilitation. A major question is how different sensory signals are integrated together to give rise to motor adaptation and learning. More specifically, there is growing evidence that pain can give rise to alterations in the learning process. Despite a number of studies investigating the role of pain on the learning process, there is still no systematic review to summarize and critically assess investigations regarding this topic in the literature. Here in this systematic review, we summarize and critically evaluate studies that examined the influence of experimental pain on motor learning. Seventeen studies that exclusively assessed the effect of experimental pain models on motor learning among healthy human individuals were included for this systematic review, carried out based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. The results of the review revealed there is no consensus regarding the effect of pain on the skill learning acquisition and retention. However, several studies demonstrated that participants who experienced pain continued to express a changed motor strategy to perform a motor task even 1 week after training under the pain condition. The results highlight a need for further studies in this area of research, and specifically to investigate whether pain has different effects on motor learning depending on the type of motor task. Pain is an unpleasant but important perception, in order to attract attention and avoid further damage to the body. However, patients and athletes are often required to learn new movement patterns as part of a rehabilitation program in the presence of pain conditions. While it may be necessary to perform rehabilitation exercise immediately after an injury in order to return to optimal performance, there is concern surrounding the effect of pain on the learning process. It has been reported that pain, as a sensory input, might affect the sensorimotor system leading to changes in motor performance, including redistribution of muscle activation patterns, and a reduction in muscle endurance that is essential for performing dynamic motor skills . In thisIn order to investigate the influence of pain on the learning process, experimental pain models, including muscle and cutaneous pain, have been used to test its effect on motor learning . Other sTo date, although many studies  have exaDespite the growing literature on the knowledge of the learning process in the presence of experimental pain models, there has been no systematic study reviewing this literature. Considering the contradictory results related to motor learning during pain, it is important to synthesize and critically assess the studies on motor learning to assess experimental pain models. This information will help to a better understanding of the effect of pain on skill learning acquisition and retention, which is important for developing sport training and rehabilitation programs. Hence, the aim of the current study is to systematically review the research outputs that have examined the effect of experimental pain models (including muscle pain and cutaneous pain) on motor learning  among healthy human participants.This systematic review was reported based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines  and the via Google Scholar.Electronic databases  were used to search the literature up to April 2021. A combination of free-text terms and MeSH terms regarding motor learning (including retention) and experimental pain was applied see . Search All studies that have the following criteria were included in this systematic review: (1) results of research from healthy human subjects; (2) experimental pain was induced in order to detect the effect of pain on the learning process; (3) original research with full text written in the English language; and (4) all study designs other than all types of reviews, meta-analysis, letter to editors, and theses. Studies that induced pain that can result in structural tissue damage, including pain with eccentric exercise and ischemia, were excluded from this study.Extraction of studies was performed by one reviewer, after which two authors independently reviewed retrieved titles and abstracts after removing duplicates. In the title and abstract screen phase, the two reviewers discussed any dispute regarding mismatch between their selections, and the full-text of any studies that were not agreed to be removed were considered for assessment in the second phase. Full-text was also reviewed by the two reviewers to ensure that studies were selected in accordance with the inclusion and exclusion criteria. In the case of disagreement between the two authors surrounding the inclusion or exclusion of a study in the full-text screen phase, the issue was resolved through consultations with a third reviewer. The two reviewers agreed on 3058 studies at the title and abstract screening stage, in which the full-text of 16 studies were directly agreed upon for full text screening. Discussion on a further 17 studies was done, out of which an additional 10 studies were selected to screen full-text. This resulted in 26 studies total for the full-text screening. Out of this number, 21 studies were agreed between the two reviewers at the full-text screening stage. The third reviewer consulted on the five other studies.In order to collect data, a standard form was used so that the following information was included in a table: (1) pain characteristics ; (2) outcome variables ; (3) test protocol; (4) general information about characteristics of subjects; and (5) main results. One author gathered the mentioned data from all included studies and another author checked the collected data to decrease error and bias in data collection. A narrative synthesis was also applied to describe the collected data, which were categorized into cutaneous pain, muscle pain, and tongue pain. Furthermore, it was determined that it was not feasible to conduct a meta-analysis because of a methodological heterogeneity among the included studies. A qualitative synthesis, therefore, was considered for the current review.Two authors independently assessed the quality and bias of all included studies based on a modified version of the checklist for measuring the quality of RCTs  and non-RCTs written by via electronic databases. The titles and abstracts of 3075 studies were screened after removing 425 duplicates. The full text of 26 studies  or numeric rating system (NRS) to measure pain intensity, each study varied the evaluation methods, which can affect the interpretations of research findings . In addiSince there are reports that ethnicity, race, and culture may bring about different pain perceptions , theses have not been peer reviewed. Here we focused only on including peer reviewed and published literature. Third, pain can trigger alterations in the construct of learning, which in turn can lead to neuroplastic changes in the cortex; however, we only reported data regarding behavioral response in the presence of experimental pain models, and excluded studies that focused only on neural plasticity. While a recent systematic  examinedOverall, this systematic review found heterogeneous results regarding experimental pain models’ influence on motor learning. In particular, although experimental pain models have been reported to lead to changes in the skill learning acquisition and retention, many studies have also shown unaltered adaptation in motor learning outcomes. Finally, several studies have shown that distinct strategies have been observed in the pain group even after pain resolution. These variable results highlight the need for further studies to clarify the effect of pain on motor learning.The original contributions presented in the study are included in the article/MI and DF contributed to study design and writing the first draft. SF, MI, and MB contributed to data collection, synthesizing the data, and searching the literature. All authors contributed to revising the manuscript and preparing the final version of the manuscript.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


In order to cut down on costs to the greatest possible extent, enterprises hope to distribute goods to different customers at the lowest costs possible. Based on this, this paper proposes an optimal location method for an intelligent transportation logistics warehouse. This scheme combines a variety of complex mechanisms to allow IoT devices to provide input. The scheme makes full use of the irreducibility of a blockchain system to promote the development and design of blockchain logistics applications. This method is aimed at tracking the progress of transportation of products in the whole supply chain. Experimental results show that, compared with traditional methods, the optimal positioning method has the advantages of fewer calculations, a high positioning accuracy, and a low overall cost, and it obtains the best warehouse positioning results. Based on the Internet of Things and blockchain technology, the application of intelligent logistics systems enables enterprises to intuitively understand their current inventory and the transportation status of goods, thus better controlling changes in enterprise resources. Logistics refers to the business of maintaining and managing a commodity supply chain from the output end to the consumption end . Every tAt present, the development of China’s logistics industry has started focusing on the field of intelligence, and all major domestic logistics fields are exploring application solutions of the Internet of Things (IoT) in logistics intelligence . IoT-divModern industrial warehouses are often large-scale, and efficiency can be improved by improving accurate warehouse management . In ordeIn the The degree of warehouse management directly determines developmental prospects of an enterprise. In addition, how to reasonably improve operational efficiency and the safety of warehouses is one of the most important considerations of enterprises. However, there are few studies focusing on the use of blockchain technology in logistics, and most of these focus on proposals and improvements to concepts. In , the devIn recent years, cloud warehouse mode has emerged in the field of e-commerce logistics, and has shown strong circulation capacity. Based on warehouse distribution networks and advanced software and hardware facilities, the cloud warehouse mode takes big data technology as its core, providing customers with efficient storage, distribution, and a series of value-added services. The author of  introducWith the rapid development of online shopping, consumers prefer more and more people-oriented services from the logistics industry. Many customers want more detailed information about goods that are on route and to be able to trace the current location of goods in real time. Some customers also want transportation services for special goods at low costs. The above research results laid a foundation for research on the location and positioning of intelligent logistics management systems. However, most research results focus on the concept of, and improvement to, blockchain technology in logistics. Based on IoT and blockchain technology, this paper proposes an optimal warehouse location method for intelligent transportation. This method combines a variety of complex mechanisms, allows IoT equipment input, and promotes the development and design of logistics applications with blockchain. As a result, this method can be used to track the transportation itinerary of products during the entire supply chain process. On this basis, using the decentralized characteristics of blockchain, this method provides full support to its trust mechanism to establish a trust relationship between the demanders and the providers. Meanwhile this method can handle transaction processes more transparently. Combining with big data from an Internet database, we will broaden the practical applications and fully establish a divergent and large-scale Internet of Things system.Radio frequency identification indoor positioning technology uses radio frequencies to modulate radio signals into electromagnetic fields and then attach them to objects, so that the magnetic fields can induce currents and transmit data and information, obtain the specific position of objects for the purpose of triangulating communications, and exchange data .Wireless fidelity (WIFI) positioning technology aims to access wireless signals sent by terminal equipment and different third-party wireless devices, and then analyze the signal strength of a radio using a differential algorithm, using a three-point positioning method for accurate positioning . WIFI poThe principle of locating indoor objects is to emit infrared rays from emitting equipment, receive infrared rays using optical sensors installed indoors, and then locate objects by analyzing the propagation path of the infrared rays . AlthougBluetooth positioning technology also uses a radio for positioning, and the power consumption of this positioning technology is extremely low. By installing a connection port for a Bluetooth LAN in a room, the network mode is set to a network connection mode that can be used by many people. Bluetooth connection ports that are accessed by all users are guaranteed to be connected to the same host device, so that the location information of all users connected to the host Bluetooth device can be obtained through the Bluetooth host device . The bigThe technologies used to obtain the position of objects using IoT are collectively called “positioning technology”. In IoT, the accurate positioning of people or things is the basis of IoT implementation. In early navigation technology, ordinary ships could only sail according to navigation lines and with pilot lights. This positioning technology had a low efficiency, large error margins and a small coverage area; it also needed manual intervention, which consumed significant manpower, material resources, and financial resources. Early IoT positioning technology was used for issuing commands on a battlefield, knowing the position of troops, and making strategic adjustments and ordering precise strikes. Presently, IoT positioning technology is mostly used in intelligent transportation and disaster relief. In order to effectively navigate and track vehicles in intelligent transportation systems, a satellite navigation system is needed to determine the location information of vehicles in real time. With the progress and development of human society, the birth of radio technology and satellites have brought about more effective positioning methods. Using radio and satellites for positioning can allow a greater positioning range and a higher accuracy. With the Wenchuan earthquake relief efforts, the Beidou communication system could quickly and accurately locate survivors to facilitate rescue. The Beidou satellite was used to scan for vital signs in a wide range, and quickly transmitted the information back to the command center. Regardless of the aspect or field in the data age, IoT positioning technology of has played a key role.Based on the traditional logistics industry, applying the latest computer technology to logistics systems makes the operational process of logistics enterprises simpler and more efficient. It also allows users to have a richer and more human experience, and supports the special transportation of special goods, which is a new trend in current logistics development. The overall architecture of an IoT connection management platform is shown in Environmental sensing equipment can intelligently adjust cold, hot, wet or dry environments in a warehouse by sensing indoor and outdoor temperatures and humidity, which is more conducive to the proper storage of goods. With the development of the information era, the amount of data is increasing day by day, which requires greater efficiency and accuracy in terms of data collection, which involves the hierarchical processing of data by equipment. Multi-functional nodes need to complete physical positioning, information identification, dynamic collection and pre-processing of over-limit warnings, and, finally, integrate warehouse operation information in a computer monitoring and information processing center.Blockchain can realize comprehensive transmission of information over an entire network and check the accuracy of information throughout the hierarchical structure of a scattered network connected by nodes. This feature improves the convenience and intelligence of IoT transactions to a certain extent. Blockchain points have free access, and can independently participate in, or leave, the blockchain system without any causing any interference to the whole system. Based on in-depth research and applications of blockchain, it is more closely integrated with big data. In the future, more solutions can be derived from blockchain + big data solutions, and IoT will be improved at the infrastructure level.“Modern logistics” refers to an integrated management system. It is a combination of logistic activities, such as transportation, information, inventory, storage, packaging, and processing. The elements of modern logistics are shown in Blockchain + big data solutions make full use of the integration capabilities of big data to promote a directional expansion of basic IoT users, and also facilitate user expansion among dispersed smart logistics users. Blockchain + big data solutions utilize the automatic filtering mode of big data, establishing credit resources in the blockchain, which improves the security of transactions and the convenience of IoT transactions. An IoT model based on blockchain and the conceptual model of an urban logistics system are shown in The emergence of IoT technology has increased convenience in human society, and as people rely on food, such as fruits and vegetables, as well as medicines and other items, special storage conditions are needed. When storing dangerous and corrosive goods, a warehouse management system should use the sensing functions of IoT positioning technology to understand the security of the storage environment and to control risks related to changes in environment in real time. In transportation and distribution, real-time and accurate calculations are also needed to greatly improve work efficiency. In the era of big data, using IoT technology can provide more optimized configuration for warehouse management; it can reduce social logistics costs and achieve more efficient service goals.Warehouse location is essentially a planning problem. For planning problems, optimization methods are usually used to minimize costs or maximize profits. The problem of intelligent transportation logistics in the context of an optimal warehouse location is how to locate the optimal warehouse, to ensure the lowest cost of transporting goods from the warehouse to each demand point. A multi-route real-time scheduling model for intelligent transportation logistics is shown in Among heuristic algorithms, the tabu search algorithm has a global optimization ability and it is easy to implement; however, its local search performance is easily affected by dispersion. The ant colony algorithm introduces a positive feedback parallel mechanism, which has the advantages of a strong robustness, excellent distributed computing mechanism, and it can be easily combined with other methods. However, its global optimization performance is largely related to the selection of the evaporation coefficient. If this is not properly selected, the algorithm will easily fall into a local optimum. Therefore, this paper combines the two methods to make up for their respective shortcomings. As only some road sections change with a change in warehouse location, this research can be limited to those road sections. Therefore, the vehicle routing stage is actually local research, rather than global research in terms of moving all routes, which will eliminate many unnecessary calculations and allow the two-stage algorithm to obtain a better solution with a reasonable calculation time.n warehouses for a certain item, and there are m demand points that require this item. Suppose also that the quantity of items that each warehouse can provide is i to demand point j is i to demand point j, where n × m.Suppose there are Restrictions:Objective function:i) and demand point (j), supply constraints require that the storage volume of goods in a warehouse should not be less than the shipped volume, and the total amount shipped to any demand point reaches a minimum requirement for that point. Removing non-negative constraints, there are n + m constraints. The market demand can only be met when the total warehouse supply is equal to the minimum market demand. The formula for this is described as follows:For any warehouse  to describe the taboo state of node r. Then, the objective function solving process is as follows:Since the tabu search algorithm always starts with the initial solution, it is necessary to calculate the initial solution before calculation. The tabu search algorithm has a strong dependence on the initial solution. A good initial solution can allow tabu search to find a better solution in the solution space, while a poor initial solution will reduce the convergence speed and search quality. Therefore, a greedy heuristic algorithm is used to get a better initial solution to improve the performance of the algorithm. This research uses (1)Obtain the initial solution through the greedy heuristic method.(2)δ*. During iteration, the number of neighbors (K), taboo length h and the penalty function of the current solution are solved. Let E of U should be found.Input parameters, including the number of termination iteration steps, (3)U, is processed using the pairwise exchange method. If the exchange point is not an element in taboo table A, a certain area, U′, of U can be obtained, and the solution to U′ can be obtained using the solution evaluation method. The evaluation of value E′ is performed, obtaining a path using the ant colony method, and the taboo table is updated.The current optimal solution, (4)δ*. If it reaches this value, output the results; otherwise, repeat step (3).Judge whether the process reaches the number of termination iteration steps, The accurate location of a warehouse is the basis of the optimal location in intelligent transportation logistics. Firstly, the accuracy of the Beidou location needs to be verified, and then whether the optimal location results achieve the low-cost target needs to be verified. In the formula, In the formula: Spatial information fusion is the multi-level and multi-faceted detection, correlation, correlation, estimation, and synthesis of data and information from multiple sensors. As shown in The wood of a wireless sensor network in IoT has the characteristics of a dynamic topology, limited energy consumption, limited node resources, unreliable data transmission, etc. It is necessary to improve the system to meet the performance requirements of a wireless sensor network for a task scheduling system from four aspects: practicality, economy, energy saving, and coordination. Analyzing the number of social relations, network density, and central potential of intelligent transportation logistics network should be done, as shown in Through empirical results, it can be determined that IoT and blockchain technology have a good application effect in intelligent transportation and warehouse positioning. In the scheduling process, vehicles are first scheduled according to current traffic volumes and priority, then the vehicles can start moving after being fully loaded, according to the priority order. When there is no vehicle on site, after the arrival of high priority business, or when vehicles that are on site cannot meet the transportation demands of the current business, the current lowest priority running business will be stopped, and the goods at the transfer station nearest to the current driving point will be unloaded. In the process of cargo transportation, if there are special environmental requirements, special cargo transportation vehicles can be adopted and the on-board equipment carried by such vehicles can integrate various sensors. When the goods are received, the alarm threshold of each sensor is set, and the collected data are sent back to the server in real time via GPRS for subsequent processing. When logistics personnel use cargo transport vehicles to work in the logistics warehouses, they will transport the goods to specific cargo positions so as to realize centralized placement of the goods, which is convenient for later management and pickup. As shown in When using background management with the system, the logistics operators can inquire about relevant department information, relevant employee information, and announcement message content for the company, as well as manage basic report data information and inquire about the basic data of related reports. In the scheduling process, first, vehicles are scheduled according to current traffic volumes and priority, and then the vehicles can start moving after being fully loaded according to the priority order. When there is no vehicle on site after the arrival of high priority business, or when the vehicles that are on site cannot meet the transportation demands of the current business, the currently running business with lowest priority is stopped and goods are unload at the transfer station nearest to the current driving point.For traditional logistics and warehousing operations, the application of IoT positioning technology has significantly increased the efficiency and stability of the industry, and can adapt to the service needs of today’s society. Blockchain is flexible and open, and based on these attributes, the industrialization of blockchain is bound to show progress. Based on the ideas of big data and internet communication, IoT technology is being used in warehouse management systems more widely. IoT provides convenience for warehouse management systems, but it also faces great challenges in terms of cost control and network security. This paper proposes an optimal location method of intelligent transportation logistics warehouse based on Internet of Things blockchain technology. This application combines a variety of complex mechanisms and the design of blockchain logistics. Therefore, this application sets up efficient and accurate tracking and traceability control throughout the entire supply chain process.In this paper, the objective function is established and solved using the tabu search method, and the optimal warehouse location result is obtained. The experimental results show that the proposed method has a high overall performance. The location method of intelligent transportation logistics warehouse perfectly handles strategic processes and caters to the trends of modern enterprises. With input from IoT devices, many different functions have been successfully realized. Based on the analysis of current logistics systems and according to the continuous developments in the logistics industry, an intelligent logistics system based on IoT and blockchain technology is proposed. In the process of transportation, if there are special requirements, special vehicles can be used, and the on-board equipment of such vehicles can integrate various sensors. When the goods are received, alarm thresholds are set for each sensor and the collected data are sent back to the server in real time via GPRS. According to this design scheme, real-time querying of goods-in-transit information can be realized, and work efficiency can be improved. Although blockchain technology has already been used to support complex applications, the application of these systems is still limited. The most typical bottlenecks are scalability management and the high storage costs. The blockchain + big data model is still in a stage of continuous development and exploration. Therefore, there is still a long way to go in terms of the development process of this combination. The application of intelligent logistics may be further developed and applied with the continuous improvement of the blockchain + big data model in the future.


This paper uses linked Swiss administrative and survey data to examine the relationship between educational mismatch in the labour market and emigration decisions, carrying out the analysis for both Swiss native and previous immigrant workers. In turn, migrants’ decisions separate returning home from onward migration to a third country. We find that undereducation is positively associated with the probability of emigration and return to the country of origin. In contrast, the reverse relationship is found between overeducation and emigration, especially among non-European immigrant workers. According to the predictions of the traditional model of migration, based on self-selection, migrants returning home are positively selected relative to migrants emigrating to other countries. We also find that immigrants from a country outside the EU27/EFTA have little incentive to return home and generally accept jobs for which they are mismatched in Switzerland. These results highlight the relevance to understand emigration behaviours in relation to the type of migrant that is most integrated, and productive, in the Swiss market, hence enabling better migration and domestic labour market policy design. In today’s labour market, there are increasing differences between the actual skills of the workforce and the requirements of the economy, as the tasks associated with each occupation change rapidly due to technology, automation, and globalization among others. Consequently, the incidence of educational and skills mismatches is not uncommon. A mismatch between a worker’s skills and their job may arise in the form of educational mismatch ,Educational mismatches are associated with reduced levels of satisfaction at work  and positive economic growth, offering employment opportunities in the labour market. In this context, failure or success in the labour market is better expressed by educational mismatches rather than by labour market participation.Wages are higher in Switzerland than in most of the industrialized countries, a factor that may deter natives from emigration, though emigrating Swiss people generally move to countries with lower wages, possibly masking the effect of expatriates relocating within multinational corporations.According to the literature, the impact of educational mismatch should vary not only depending on the type of emigration but also according to the country of origin. In particular, different results are also expected depending on whether or not the migrant belongs to the regime of free circulation of persons prevalent in the EU27/EFTA region, which includes Switzerland. Therefore, based on the literature, we test the following three hypotheses:A failure in terms of labour market integration, which here takes form of overeducation, leads to an increase in emigration compared to the case of little or no educational mismatch . Among the persons interviewed by the Structural Survey aged 20–59, 93% of men and 57% of women report working full-time at the time of the survey, but we do not know the percentage of (average) time spent working at other points of time. To avoid persons leaving Switzerland for retirement reasons, we only retain workers aged 20–59. To perform comparative analyses, we also run separate models for natives, in order to evaluate whether the factors behind emigration are the same according to the migratory status.The data are not covering border workers living in neighbouring countries, neither illegal workers; however, for a country such as Switzerland, their anticipated number is low  during the whole year is not known.Episodes of unemployment are estimated through the Unemployment Register, which provides information on the type of unemployment  for the years 2010–2016.The final sample consists of 175,902 individuals born abroad and 348,029 natives, aged 20–59, with valid information on earnings and working full-time at the time of the survey.Immigration towards Switzerland is based on different permits, the most frequent being the resident permit (C-permit) and the annual permit (B-permit), respectively. The C-permit allows the migrant to stay in Switzerland almost indefinitely, while the B-permit is renewable every year depending on the availability of a job. In general, migrants holding an annual permit are more frequently characterized by circular or “serial” migration Ossman, . The resn = 54,663) and holders of a resident permit (C-permit), including naturalized migrants .In order to control for the impact of the permit on remigration, the foreign born were split into two groups based on those permits: Holders of an annual permit  left the country during this period. The number of permanent permit holders leaving Switzerland was 964 (0.8%), and the number of annual permit holders leaving was 1,469 (5%). To validate those proportions, we computed the emigration rates among the whole population aged 20–59 living in Switzerland: the rates in 2017 were of 0.5% (Swiss born), 1.5% (holders of a permanent permit) and 8% , respectively. The sample of the Structural Survey therefore underestimates the actual level of emigration among foreign-born individuals. People who are planning to leave Switzerland in the weeks or months following the survey feel less obligation to complete the survey. It is assumed that the participants surveyed before their departure are, however, representative of all those who leave, which leads us to believe that there is no specific bias associated with this under-representation.Among the foreign born who emigrated, a majority returned to their country of origin  with the modal years of education required for the occupation ,Age and age squared,Level of education ,Country of birth: EU27/EFTA countries—reference category, other European countries, non-European countries that are members of the OECD, non-European countries not members of the OECD,Civil status ,Region of residence in Switzerland ,Type of municipality Language skills, using two variables. The first one indicates the main language . The second one determines the number of languages spoken by the migrant ,Year of the survey (2010 to 2015)Status of employment: For the foreign born only, the number of years since migration (and its square).Unfortunately, we were not able to control for all relevant confounding factors due to the lack of information on some of them, such as the reason for immigration to Switzerland or the family composition, as well as the ties between Switzerland and the country of birth.Taking into account those confounding factors allows us to estimate how educational mismatch influences the probability of leaving Switzerland. Two variables were introduced in the model: the years of overeducation and the years of undereducation.Based on the factors of emigration identified in the literature, control variables included in the analyses are the following:p) of educational mismatch according to the dimensions under study and different control variables (Cox et Snell 1989). The formula is as follows:i denotes an individual unit, β_0 is a constant and β_ are the coefficients of the explanatory variables x_.In a first step, logistic regressions were run to measure the association of different factors identified in the literature with outmigration, without distinguishing between return and onward migration. Logistic regressions are used to explain the probability  are presented to facilitate the interpretation of the results.For all models, the levels of significance . For comparative purposes, the model was also computed for Swiss natives. In this case, the duration of stay, language indicators and the place of birth were not introduced in the model. Because return migration is not prevalent for Swiss natives, only onward migration was considered as emigration.To measure the consistency of our measurement of educational mismatch and because salary data are available, we also run models using the individual income as a dependent variable (log-wage). Although the relationship between possible overeducation and a salary penalty is not the main subject of our study, the analysis is conducted in order to check the consistency of our measure of educational mismatch, since overeducation has been shown to be associated with a wage penalty in the literature.Finally, it should be noted that the relationship being estimated is not necessarily causal but serves to identify important correlations in the data.We discuss first the results from the logistic model, which does not distinguish between the two types of emigration (return vs. onward), including all countries of birth and natives. In a second step, we focus on migrants and distinguish between return and onward migration.Table In line with the literature, sex slightly affects the probability of outmigration among foreign-born individuals. It does not significantly change the probability of outmigration among natives, but being a woman appears to significantly decrease the probability of outmigration for both EU27/EFTA and non-EU27/EFTA natives holding an annual permit. It does not influence the probability for holders of a permanent permit. As only full-time salaried workers are included, the sample generally contains women without young children: recent mothers generally work part-time in Switzerland  slightly decreases the probability of outmigration. This means that re-integration in the labour market after a period of unemployment intensifies attachment to the host country.English-speaking migrants are more likely to emigrate than those speaking another foreign language. In contrast, the probability of outmigration is reduced for French speakers. This result can be explained by the relative lack of professional opportunity in France compared to Switzerland as well as the discrepancy in terms of working conditions between Switzerland and France. Foreign-born individuals with bilingual proficiency show a decreased probability of outmigration. This can most likely be explained by the fact that for those foreign-born individuals, one of the spoken languages is often a language officially spoken in SwitzerlandAfter taking these confounding factors into account, the level of education plays a significant role in the probability of leaving the country, which differs according to the place of birth. Among natives, less educated persons are more mobile internationally. Among foreign-born individuals, holding an upper secondary or tertiary education (compared to a lower secondary level) increases the probability of outmigration for migrants. This result confirms those obtained in previous studies  are less mobile than the reference category, as those born in OECD countries outside Europe are more mobile.After taking into account those factors, the number of years of actual education is significantly associated with mobility; that is, the more years of education, the higher the probability of outmigration. The average marginal effects are the highest among annual permit holders, who are also the more mobile group Fig. . The yeaBeing undereducated significantly increases the probability of outmigration among both the native born and foreign born (except those from non-EU27/EFTA countries with permanent permits). This result can be easily explained by the fact that the undereducated workers perform well not only in the Swiss labour market but also abroad. For this reason, they are mobile in the labour market and likely to be employed in other countries, compared to the reference category of workers who are not undereducated. Overeducated workers are no more mobile than those who are adequately educated. In contrast, international mobility is hampered for those from non-EU27/EFTA countries with annual permit.Table Considering all foreign-born individuals and introducing the place of birth as a variable in the model significantly influences the likelihood of onward/return migration. Compared to migrants from the EU27/EFTA, those from non-European/OECD countries are more likely to migrate back home or to another country. Such workers are generally highly qualified and stay in Switzerland temporarily, often in the context of multinational relocations, which can explain their mobility.On the other hand, the probability of return and onward migration is lower among migrants from other European countries (not members of EU27/AELE). For these migrants, the probability of return is also lower, as the probability of onward migration is significantly increased. Those migrants have fewer incentives to return to their country of origin when they are of working age because their earnings potential is lower back home, while migration costs are substantial due to immigration restrictions. The results are therefore in line with the literature .Second, consistent with the overeducation literature, we examine the relationship between mismatch and wages to evaluate the consistency of our measure in relation to various forms of emigration. Table Among overeducated persons, the wage penalty is the highest for the foreign born from non-UE/EFTA countries and the lowest among the natives. The impact of an additional year of overeducation is three times higher for non-UE27/EFTA migrants than for natives. Workers from EU27/EFTA countries are in between. Years of undereducation lead to the most significant increase in wages among EU27/EFTA migrants and the lowest increase among natives.Educational mismatch is a common issue in industrialized countries. Based on a meta-analysis of more than 180 studies, Leuven and Oosterbeek  indicateEmigration flows are generally difficult to document based on registers, as emigrants do not always declare their departure. However, for the categories of migrants covered by this study, incentives to declare are important: at the arrival in Switzerland, every inhabitant has to contract an insurance with a Swiss health insurance company. This insurance is mandatory for natives or migrants with a medium- and long-term permit. The only exceptions refer to undocumented migrants, international civil servants and embassy staff, who are not included in this study. Health insurance being expensive (more than 4000 euros per year), the incentive to declare the departure is high. Another incentive is linked to the possibility of keeping one's old-age pension (sometimes to receive them directly at the time of departure). We are however aware that a few numbers of emigrants will keep a residence in Switzerland and remain registered as resident . This can lead to a slight underestimation of emigration flows.Another specificity of our analysis refers to the measure of educational mismatch, based on the comparison between the years of schooling and the modal years of education required for the occupation by age cohorts. This measurement method assumes that a migrant will compare his/her situation with the one of the general population and not with the one of his/her own community. This assumption makes sense for the groups under study, even if migrants, in particular those arriving from non-EU27/EFTA countries, are aware of the fact the general population is not always a valid benchmark.Many studies analyse emigration without distinguishing return and onward migration. This choice is generally explained by the lack of data regarding the country where the emigrant moves. The few studies considering this distinction conclude that the determinants of both types of emigration differ considerably, particularly for non-EU citizens. Therefore, accounting for onward and return migration separately is of crucial importance to understand how the lack of integration in the labour market will affect migrants’ outmigration behaviour. Based on the existing studies and theories on return migration, our hypothesis state that a failure of labour market integration, expressed in terms of overeducation, leads to an increase in emigration for workers who belong to the free movement of persons area (natives and EU27/EFTA migrants) because these workers can easily leave Switzerland for another labour market where they can find positions that better correspond to their skills. However, this hypothesis is not verified, and two reasons can explain why: On the one hand, the workers may have unmeasured incentives to stay in Switzerland, such as higher wages than in foreign countries or more attractive working conditions. On the other hand, they may also anticipate an improvement in their professional status in the medium term. Finally, other elements such as family factors, can also act as barriers to mobility.Undereducated migrants are, by contrast, more mobile, particularly those holding an annual permit. Those coming from EU27/EFTA countries tend to move to third countries, meaning that they are more sensitive to their labour market outcomes in the host country. Such results may be explained by the free movement for EU27/EFTA workers that significantly increases international mobility and allows immigration to ‘grease the wheels’ of the Swiss labour market. Non-EU migrants have fewer work opportunities in Europe and are not characterized by onward migration. Therefore, even if they are in a situation of overeducation, they tend to stay in Switzerland, where they find working conditions that are better than those expected in the country of origin. Probably migrants in Switzerland not only consider their own situation in the host country, but as Engzell and Ichou  suggesteUndereducation, by contrast, increases their probability of returning in line with the Roy model of self-selection. As a whole, it should be noted that the causality of the relationship between emigration and mismatch is not clear: educational mismatch can, in certain cases, stem from a voluntary choice to work in Switzerland with the objective of returning home or emigrating to a third country after some months or years. It can also be the consequence of non-work-related migration–for example, dictated by the desire to accompany a family or join a partner–and thus be accepted by the worker, who finds other advantages to staying in Switzerland.Finally, mobility depends on the residence permit. An annual permit favours mobility, while a settlement permit significantly reduces it. This result is explained by the fact that the settlement permit characterizes people who have been living in Switzerland for a long period, and mobility decreases with the length of residence.Only EU27/EFTA citizens have full access to the Swiss labour market according to the free movement of persons. They also have better opportunities, compared to other foreigners, concerning the recognition of diplomas and professional mobility across cantons. Migrants arriving from a country outside the EU27/EFTA do not have access to the free movement of persons, and their stay in Switzerland depends on their professional activity. Those from countries in transition  have little incentive to return home due to the lack of occupational opportunities in their home country. Put differently, they generally accept occupations for which they are mismatched in Switzerland, as the anticipated situation in their country of origin is probably worse in terms of earnings, job security or working conditions. Moreover, for some groups, the political situation in the country of origin can make a return difficult.The Swiss labour market is relatively open and is thus influenced by the surrounding countries. This opening mainly attracts low-educated and highly qualified workers, or those who have been successful in their occupations. Therefore, in terms of economic policy implications, our results demonstrate the need to rethink how to retain the most successful workers in the Swiss labour market.