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Most people with mental illness in low and middle-income countries (LMICs) do not receive biomedical treatment, though many seek care from traditional healers and faith healers. We conducted a qualitative study in Buyende District, Uganda, using framework analysis. Data collection included interviews with 24 traditional healers, 20 faith healers, and 23 biomedical providers, plus 4 focus group discussions. Interviews explored treatment approaches, provider relationships, and collaboration potential until theoretical saturation was reached. Three main themes emerged: (1) Biomedical providers’ perspectives on traditional and faith healers; (2) Traditional and faith healers’ views on biomedical providers; and (3) Collaboration opportunities and barriers. Biomedical providers viewed faith healers positively but traditional healers as potentially harmful. Traditional and faith healers valued biomedical approaches while feeling variably accepted. Interest in collaboration existed across groups but was complicated by power dynamics, economic concerns, and differing mental illness conceptualizations. Traditional healers and faith healers routinely referred patients to biomedical providers, though reciprocal referrals were rare. The study reveals distinct dynamics among providers in rural Uganda, with historical colonial influences continuing to shape relationships and highlighting the need for integrated, contextually appropriate mental healthcare systems.
Despite the critical role that quantitative scientists play in biomedical research, graduate programs in quantitative fields often focus on technical and methodological skills, not on collaborative and leadership skills. In this study, we evaluate the importance of team science skills among collaborative biostatisticians for the purpose of identifying training opportunities to build a skilled workforce of quantitative team scientists.
Methods:
Our workgroup described 16 essential skills for collaborative biostatisticians. Collaborative biostatisticians were surveyed to assess the relative importance of these skills in their current work. The importance of each skill is summarized overall and compared across career stages, highest degrees earned, and job sectors.
Results:
Survey respondents were 343 collaborative biostatisticians spanning career stages (early: 24.2%, mid: 33.8%, late: 42.0%) and job sectors (academia: 69.4%, industry: 22.2%, government: 4.4%, self-employed: 4.1%). All 16 skills were rated as at least somewhat important by > 89.0% of respondents. Significant heterogeneity in importance by career stage and by highest degree earned was identified for several skills. Two skills (“regulatory requirements” and “databases, data sources, and data collection tools”) were more likely to be rated as absolutely essential by those working in industry (36.5%, 65.8%, respectively) than by those in academia (19.6%, 51.3%, respectively). Three additional skills were identified as important by survey respondents, for a total of 19 collaborative skills.
Conclusions:
We identified 19 team science skills that are important to the work of collaborative biostatisticians, laying the groundwork for enhancing graduate programs and establishing effective on-the-job training initiatives to meet workforce needs.
“If all of you only grow rice, you cannot get out of poverty.”—Farmer, Ban Phoukhao (citing maize trader).
INTRODUCTION
We met the naiban (village head) on a cool morning near his field hut, at the foot of the hills surrounding Ban Homphou, Houaphan province, Laos. The hut overlooked paddy fields to which the naiban's wife was piping water from the nearby stream, a tributary of the Nam Ma, enabling them to produce two rice crops per year, as with the handful of other households in the village with paddy land. This provided his family with about 20 sacks of rice for consumption, but much of the limited paddy area in the village had been damaged by heavy erosion further up the mountain slopes during the previous rainy season, resulting from consecutive seasons of monoculture maize. The loss of paddy land had contributed to a general expansion of upland rice and maize in the village, to compensate for lost wet-rice production, signifying the extent to which the commodity crop of maize had become insinuated within formerly subsistence-oriented livelihoods. The first job of the day was to sharpen the “pa” (Figure 5.1), hooked machetes we then used to clear a maize field on the hillside above us. The field was covered with thick brush, as the naiban planted the land with maize every second year with a one-year fallow, which he found marginally more productive than continuous cropping. As we worked, the naiban spoke of how many households in the village had become increasingly reliant on maize: “The main product here is maize now, if people have to stop growing maize, they don't know what to do.”
This chapter examines the circumstances behind the initiation of commercial maize in the mid-2000s in two villages near the mountainous border between Houaphan province, Laos and Son La province, Vietnam, upon which the naiban and households had come to consider themselves dependent by the time of this research. The analysis that follows was informed throughout by a multi-sited study conducted from 2016 to 2018, comprising a household component in the two study villages, with periods of participant observation throughout the maize production cycle, random-sampled (n=30 per village) household surveys, purposive-sampled key informant interviews (nineteen per village) and gender-specific focus group discussions (three per village).
The neural mechanisms contributing to the social problems of pediatric brain tumor survivors (PBTS) are unknown. Face processing is important to social communication, social behavior, and peer acceptance. Research with other populations with social difficulties, namely autism spectrum disorder, suggests atypical brain activation in areas important for face processing. This case-controlled functional magnetic resonance imaging (fMRI) study compared brain activation during face processing in PBTS and typically developing (TD) youth.
Methods:
Participants included 36 age-, gender-, and IQ-matched youth (N = 18 per group). PBTS were at least 5 years from diagnosis and 2 years from the completion of tumor therapy. fMRI data were acquired during a face identity task and a control condition. Groups were compared on activation magnitude within the fusiform gyrus for the faces condition compared to the control condition. Correlational analyses evaluated associations between neuroimaging metrics and indices of social behavior for PBTS participants.
Results:
Both groups demonstrated face-specific activation within the social brain for the faces condition compared to the control condition. PBTS showed significantly decreased activation for faces in the medial portions of the fusiform gyrus bilaterally compared to TD youth, ps ≤ .004. Higher peak activity in the left fusiform gyrus was associated with better socialization (r = .53, p < .05).
Conclusions:
This study offers initial evidence of atypical activation in a key face processing area in PBTS. Such atypical activation may underlie some of the social difficulties of PBTS. Social cognitive neuroscience methodologies may elucidate the neurobiological bases for PBTS social behavior.
Healthcare-acquired infections are a tremendous challenge to the US medical system. Stethoscopes touch many patients, but current guidance from the Centers for Disease Control and Prevention does not support disinfection between each patient. Stethoscopes are rarely disinfected between patients by healthcare providers. When cultured, even after disinfection, stethoscopes have high rates of pathogen contamination, identical to that of unwashed hands. The consequence of these practices may bode poorly in the coronavirus 2019 disease (COVID-19) pandemic. Alternatively, the CDC recommends the use of disposable stethoscopes. However, these instruments have poor acoustic properties, and misdiagnoses have been documented. They may also serve as pathogen vectors among staff sharing them. Disposable aseptic stethoscope diaphragm barriers can provide increased safety without sacrificing stethoscope function. We recommend that the CDC consider the research regarding stethoscope hygiene and effective solutions to contemporize this guidance and elevate stethoscope hygiene to that of the hands, by requiring stethoscope disinfection or change of disposable barrier between every patient encounter.
Understanding place-based contributors to health requires geographically and culturally diverse study populations, but sharing location data is a significant challenge to multisite studies. Here, we describe a standardized and reproducible method to perform geospatial analyses for multisite studies. Using census tract-level information, we created software for geocoding and geospatial data linkage that was distributed to a consortium of birth cohorts located throughout the USA. Individual sites performed geospatial linkages and returned tract-level information for 8810 children to a central site for analyses. Our generalizable approach demonstrates the feasibility of geospatial analyses across study sites to promote collaborative translational research.
A majority of the population of Laos continues to derive their livelihoods from smallholder farming, which remains the backbone of rural society both economically and culturally. Smallholder practices, together with related policy narratives, are profoundly influenced by Laos’ geography, commonly divided between upland and lowland spaces. Accelerating domestic and regional economic integration has altered rural life in diverse ways, particularly over the 2000s. These changes have not only widened opportunities for smallholders through access to markets and improved incomes, but also brought new risks of exclusion from land, exposure to competition, and declining landscape functions. This chapter considers the impacts of policies, resource, and market pressures that have driven both transformation and persistence of smallholder agriculture in Laos.
Smallholder agriculture remains central to the livelihoods of most rural households in the Lao People's Democratic Republic (Lao PDR, hereafter Laos), though increasingly in combination with off-farm and non-farm activities as farm households respond to new pressures and opportunities. While the country's rate of urban expansion is among the fastest in Southeast Asia (World Bank 2015), this is starting from a low base. Of Laos’ relatively sparse population of 7 million people, around two thirds live in rural areas, with 72% of the working population continuing to derive a livelihood, according to official data, from agriculture, forestry, and fishing (LSB 2015). Because of the predominance of small-scale farming in Laos, as well as the widely perceived low socio-economic status of smallholders and particularly the landless rural poor (Saykham 2013), agriculture and forestry have long been prioritized in state planning aimed at reducing rural poverty (MAF 2010). This agriculture- and smallholder-focused approach to addressing rural poverty is in line with much mainstream theory (Dercon 2013). By grounding approaches to poverty reduction in the pursuit of a transition from subsistence to commercially oriented production, Lao smallholders are subjected to both the enabling and constraining effects of state policies, international development practices, and heightened integration with and exposure to regional and global markets (Vandergeest 2003; Rigg 2005; Lagerqvist et al. 2014).
Small-scale farming practices, and thus the areas and types of land cultivated by Lao smallholders, are at the outset profoundly influenced by the country's geography, commonly divided into “upland” and “lowland” spaces in both state planning and development discourse.
The current study examined whether social status and social integration, two related but distinct indicators of an adolescent's standing within a peer network, mediate the association between risky symptoms (depressive symptoms and deviant behavior) and substance use across adolescence. The sample of 6,776 adolescents participated in up to seven waves of data collection spanning 6th to 12th grades. Scores indexing social status and integration were derived from a social network analysis of six schools and subsequent psychometric modeling. Results of latent growth models showed that social integration and status mediated the relation between risky symptoms and substance use and that risky symptoms mediated the relation between social standing and substance use during the high school transition. Before this transition, pathways involving deviant behavior led to high social integration and status and in turn to substance use. After this transition, both deviant behavior and depressive symptoms led to low social integration and status and in turn greater substance use. These findings suggest that the high school transition is a risky time for substance use related to the interplay of increases in depressive symptoms and deviant behavior on the one hand and decreases in social status and integration on the other.
During the past decade, solar power has experienced transformative price declines, enabling it to grow to supply 1% of U.S. and world electricity. Addressing grid integration challenges, increasing grid flexibility, and further reducing cost will enable even greater potential for solar as an electricity source.
During the past decade, solar power has experienced transformative price declines, enabling it to become a viable electricity source that is supplying 1% of U.S. and world electricity. Further cost reductions are expected to enable substantially greater solar deployment, and new Department of Energy cost targets for utility-scale photovoltaics (PV) and concentrating solar thermal power are $0.03/kW h and $0.05/kW h by 2030, respectively. However, cost reductions are no longer the only significant challenge for PV—addressing grid integration challenges and increasing grid flexibility are critical as the penetration of PV electricity on the grid increases. The development of low cost energy storage is particularly synergistic with low cost PV, as cost declines in each technology are expected to support greater market opportunities for the other.
Timing of weed emergence and seed persistence in the soil influence the ability to implement timely and effective control practices. Emergence patterns and seed persistence of kochia populations were monitored in 2010 and 2011 at sites in Kansas, Colorado, Wyoming, Nebraska, and South Dakota. Weekly observations of emergence were initiated in March and continued until no new emergence occurred. Seed was harvested from each site, placed into 100-seed mesh packets, and buried at depths of 0, 2.5, and 10 cm in fall of 2010 and 2011. Packets were exhumed at 6-mo intervals over 2 yr. Viability of exhumed seeds was evaluated. Nonlinear mixed-effects Weibull models were fit to cumulative emergence (%) across growing degree days (GDD) and to viable seed (%) across burial time to describe their fixed and random effects across site-years. Final emergence densities varied among site-years and ranged from as few as 4 to almost 380,000 seedlings m−2. Across 11 site-years in Kansas, cumulative GDD needed for 10% emergence were 168, while across 6 site-years in Wyoming and Nebraska, only 90 GDD were needed; on the calendar, this date shifted from early to late March. The majority (>95%) of kochia seed did not persist for more than 2 yr. Remaining seed viability was generally >80% when seeds were exhumed within 6 mo after burial in March, and declined to <5% by October of the first year after burial. Burial did not appear to increase or decrease seed viability over time but placed seed in a position from which seedling emergence would not be possible. High seedling emergence that occurs very early in the spring emphasizes the need for fall or early spring PRE weed control such as tillage, herbicides, and cover crops, while continued emergence into midsummer emphasizes the need for extended periods of kochia management.
Annual ryegrass has been proposed as a cover crop in the corn–soybean cropping systems of the U.S. Midwest because of its low seed cost, rapid establishment, contribution to soil quality, weed suppressive abilities, and susceptibility to common broad-spectrum herbicides. However, cover crops can reduce the subsequent main crop yield by creating unfavorable germination and emergence conditions, harboring pests, and if not controlled, competing with the main crop. This study, conducted in Illinois, Oregon, and Tennessee, investigated the efficacy of glyphosate for annual ryegrass winter cover crop removal. Glyphosate at 415, 830, and 1,660 g ae/ha was applied to annual ryegrass at late tiller, second node, boot, and early flowering stages. Annual ryegrass control was consistently maximized with the highest glyphosate rate applied at the boot or early flower stage. Annual ryegrass biomass was generally the lowest with the highest rate of glyphosate applied at the earlier stages. Overall, no single application timing at any glyphosate rate provided complete control or biomass reduction of the annual ryegrass cover crop. A sequential herbicide program or a glyphosate plus a graminicide tank-mix probably will be needed for adequate annual ryegrass stand removal.
Small-scale late Holocene vegetation changes were determined from a series of 13 modern and fossil packrat middens collected from a site in the Greenwater Valley, northern Mojave Desert, California. Although the site is above the modern lower limit of Coleogyne ramosissima (black-brush), macrofossils of this shrub are only present in samples younger than 270 yr B.P. In order to measure changes more subtle than presence vs absence, macrofossil concentrations were quantified, and principal components and factor analyses were used to distinguish midden plant assemblages. Both the presence/absence data and the statistical analyses suggest a downward shift of 50 to 100 m for Coleogyne (blackbrush) communities between 1435 and 1795 A.D.
We studied neuroinflammation in individuals with late-life, depression, as arisk factor for dementia, using [11C]PK11195 positron emissiontomography (PET). Five older participants with major depression and 13controls underwent PET and multimodal 3T magnetic resonance imaging (MRI),with blood taken to measure C-reactive protein (CRP). We found significantlyhigher CRP levels in those with late-life depression and raised [11C]PK11195 binding compared with controls in brain regionsassociated with depression, including subgenual anterior cingulate cortex,and significant hippocampal subfield atrophy in cornu ammonis 1 andsubiculum. Our findings suggest neuroinflammation requires furtherinvestigation in late-life depression, both as a possible aetiologicalfactor and a potential therapeutic target.
The effect of hemodilution, with α-α cross-linked hemoglobin (DCLHb), on brain injury and edema was assessed after temporary middle cerebral artery occlusion in rats. Injury was analyzed with 2,3,5-triphenyltetrazolium chloride (TTC) stain and edema by microgravimety. Part A: DCLHb was given to maintain one of the following hematocrits (Hct) and normotension: 1) 45/Hct, 2) 30/Hct, 3) 16/Hct, or 4) 9/Hct. Brain injury (% of ischemic hemisphere, mean ± SD) was less in the 30/Hct group (31 ±4) versus the 45/Hct group (42 ± 5); and in the 16/Hct (20 ± 3) and 9/Hct (19 ± 4) groups versus the 45/Hct and 30/Hct groups. Edema was less in the hemodiluted groups versus the 45/Hct group. Part B: DCLHb was given to maintain one of the following hematocrits and hyper (HTN) − or normotension (Norm): 1) 45/Norm, 2) 30/Norm, 3) 30/HTN, 4) 16/Norm, or 5) 16/HTN. In hematocrit matched groups hypertension decreased brain injury (30/HTN − 24 ± 2 < 30/Norm − 34 ± 4; and 16/HTN − 17 ± 3 < 16/Norm − 24 ± 4). Edema was not effected by hypertension. These results suggest that hemodilution with DCLHb decreases focal ischemic injury, and is most effective when given in a manner that induces hypertension.