The religious itinerary of a people: the impact of the Christian gospel (We chona) on the Kasena of Ghana from 1906 to 1992

The Kasena in northern Ghana first encountered Christian missionaries in 1906 and so began to hear about We chona (God's way). For 50 years, the Roman Catholic Church functioned alone among the Kasena. Over this time most Kasena perceived We chona to be the "white man's religion" and largely irrelevant. Of those who became Christians many appeared to live a dichotomous life. They attended church on Sundays, requesting prayer and Mass be said for their crises and problems, but also sought to resolve issues through divination and traditional means which the church had condemned. From the 1950s, Kasena began to change their perception and acceptance of We chorja. This period is also marked by the entry of new churches into the Kasena homeland, exposure to new aspects of the Christian message and increased Kasena migration to the south of Ghana.migration to the south of Ghana. This study attempts to understand from the Kasena their reasons for accepting We chona and to discover in what ways they perceive it as relevant to their world and in the context of their family and daily life.The study initially identifies the historic, environmental and socio-political context of the Kasena. It explores Kasena organisation of social and family life, and the way they seek to live in their environment, to resolve some of their problems and clarify issues, with a view to gaining insight into their ideas and beliefs about life and the transcendental realm. There follows a study of Kasena stories of conversion, the establishment of churches through archival and literary sources and 185 unstructured, open-ended interviews with men and women in different churches and communities. The most significant problems and issues Kasena face, as well as questions they ask each other, are identified through archival material, personal observation, discussion, interviews and from information provided by eighteen church leaders from six denominations who recorded problems and questions addressed to them personally or which were raised in the context of church meetings. Christian reactions to resolve or manage a selected number of these problems, issues and questions are examined through 195 intensive open-ended interviews. The results of the interviews and analysis of selected stories, songs, proverbs, prayers, sermons, and "testimonies" provide an insight into the emerging Kasena Christian thought and theology.The process may enable us to develop a framework to explore the early stages of Christian development in other places and periods of time as diverse as the Bobo of Burkina Faso and the Franks, Angles and Saxons of Europe

A Public Option for Employer Health Plans

Following the 2020 presidential election, health care reform discussions have centered on two competing proposals: Medicare for All and an individual public option (“Medicare for all who want it”). Interestingly, these two proposals take starkly different approaches to employer-provided health coverage, long the bedrock of the U.S. health care system and the stumbling block to many prior reform efforts. Medicare for All abolishes employer-provided coverage, while an individual public option leaves it untouched.This Article proposes a novel solution that finds a middle ground between these two extremes: an employer public option. In contrast to the more familiar public option proposal, which would offer government sponsored health insurance directly to individuals, our plan creates a public option for employers, who can select a public plan—based on Medicare and altered to meet the needs of working populations—instead of a private health plan for their employees. Employer-based private health coverage is in decline and increasingly leaves workers vulnerable. Our proposal offers a gradual way to loosen reliance on this system.We review the policy, regulatory, fiscal, and business arguments in favor of this form of public option, which we argue is less disruptive than Medicare for All but more impactful than an individual public option. Because employer take up would be gradual and voluntary, our plan has lower fiscal costs and should face less resistance from employees and vested interests than Medicare for All. Over time, if the plan meets employers’ and employees’ needs, more people would be covered by a public option, moving away from over-reliance on private employer plans and toward something akin to Medicare-for-Many in a less politically, legally, and fiscally fraught way

Ground water and surface water under stress

Presented at Ground water and surface water under stress: competition, interaction, solutions: a USCID water management conference on October 25-28, 2006 in Boise, Idaho.Includes bibliographical references.Renewed interest in cotton production in the Ogallala aquifer region can be tied to development of early maturing varieties, and declining water levels in the Ogallala aquifer. However, the feasibility of growing cotton considering thermal characteristics of the region has not been determined. In this study, the heat unit based county-wide exceedance probability curves for potential cotton yield were developed using a long term temperature dataset (1971-2000) and identified counties that have the potential to grow cotton at 1- and 2-year return periods. Out of 131 counties in the study area, 105 counties have the potential to grow cotton with lint yield more than 500 kg/ha. Evaluation of county-wide potential cotton yield indicate that yield goals based on a 2-year return period may improve the chances of better profits to producers than yield goals with 1-year return period. However, management uncertainties on irrigation efficiencies, fertilizer and pest management, planting and harvesting schedule may require further consideration for estimating potential cotton yield. Nevertheless, these results show that cotton is a suitable alternative crop for most counties in southwest Kansas and all counties in Texas and Oklahoma Panhandles. Also, a significant reduction in annual water withdrawals (about 60.4 million ha-mm) from the Ogallala aquifer for irrigation is possible if producers were to switch 50 percent of their corn acreage to cotton in counties that have yield potential more than 500 kg/ha

Ground water and surface water under stress

Presented at Ground water and surface water under stress: competition, interaction, solutions: a USCID water management conference on October 25-28, 2006 in Boise, Idaho.Includes bibliographical references.Irrigated crop production in the Texas High Plains is dependent on the Ogallala Aquifer, which has declined by up to 50 percent in some areas since irrigation development began in the 1930-40s. About 6.5 million acre-feet (ac-ft) of water was pumped to irrigate 4.6 million acres in 2000, with most irrigation demand being for corn and cotton production. Cotton is produced primarily in the Southern Texas High Plains, with corn and winter wheat comprising most of the irrigated area in the Northern Texas High Plains. However, cotton production is expanding northward again and replacing corn in some areas because both crops currently have similar revenue potential but cotton has about half the irrigation water requirement, and may result in profitable yields under dryland and deficit irrigated conditions. In the Northern Texas High Plains, combined annual irrigation demand for corn and cotton could be reduced from 2.6 to 2.0 million ac-ft by replacing 50 percent of the irrigated corn area with cotton, and combined irrigation demand could be reduced to 1.6 million ac-ft if cotton irrigation applications were reduced to 50 percent of full crop evapotranspiration minus rainfall. In the Southern Texas High Plains, annual irrigation demand for cotton could be reduced from 1.4 to 1.0 million ac-ft if overall irrigations were reduced to 50 percent of full crop evapotranspiration minus rainfall. Deficit irrigation results in some yield penalty; however, if the crop is relatively drought tolerant, this may be offset somewhat by the reduced energy costs of pumping

Effect of using an exercise and nutrition secure email message on the implementation of health promotion in a large health care system

Background and Program: Secure email messaging is used to provide timely communication between healthcare providers and patients with medical information and education. There have been increasing rates of overweight and obesity among military healthcare patients. To address this issue, we utilized a secure email messaging system that is primarily used for medication refills. This commentary demonstrates the extent to which the message was viewed and how much the message was liked. Preliminary Results: Of the 16,020 individuals emailed, 7,011 participants (43.8%) opened the email, and 1,023 patients (14.6% of those who opened it) completed the survey. Satisfaction rate for the health promotion message was 77.2%. Participants reported an intent to eat more fruit and vegetables (49.6%), decrease portion sizes (38.8%), and increase physical activity (51.1%), while 33.6% reported having no intent to change. Conclusion: The majority were satisfied with the health promotion message. This email method enables a single provider to have increased contact with patients. It is unknown if this message reached higher risk or harder to reach participants, a patient subset that could benefit most from this type of communication. This study is unique in that to our knowledge it is the first one to use secure email messaging in the military healthcare system for health promotion

Targeted, structured text messaging to improve dietary and lifestyle behaviours for people on maintenance haemodialysis (KIDNEYTEXT): Study protocol for a randomised controlled trial

Introduction Managing nutrition is critical for reducing morbidity and mortality in patients on haemodialysis but adherence to the complex dietary restrictions remains problematic. Innovative interventions to enhance the delivery of nutritional care are needed. The aim of this phase II trial is to evaluate the feasibility and effectiveness of a targeted mobile phone text messaging system to improve dietary and lifestyle behaviours in patients on long-term haemodialysis. Methods and analysis Single-blinded randomised controlled trial with 6 months of follow-up in 130 patients on haemodialysis who will be randomised to either standard care or KIDNEYTEXT. The KIDNEYTEXT intervention group will receive three text messages per week for 6 months. The text messages provide customised dietary information and advice based on renal dietary guidelines and general healthy eating dietary guidelines, and motivation and support to improve behaviours. The primary outcome is feasibility including recruitment rate, drop-out rate, adherence to renal dietary recommendations, participant satisfaction and a process evaluation using semistructured interviews with a subset of purposively sampled participants. Secondary and exploratory outcomes include a range of clinical and behavioural outcomes and a healthcare utilisation cost analysis will be undertaken. Ethics and dissemination The study has been approved by the Western Sydney Local Health District Human Research Ethics Committee-Westmead. Results will be presented at scientific meetings and published in peer-reviewed publications. Trial registration number ACTRN12617001084370; Pre-results

Changes in the relationship between self-reference and emotional valence as a function of dysphoria

The self-positivity bias is found to be an aspect of normal cognitive function. Changes in this bias are usually associated with changes in emotional states, such as dysphoria or depression. The aim of the present study was to clarify the role of emotional valence within self-referential processing. By asking non-dysphoric and dysphoric individuals to rate separately the emotional and self-referential content of a set of 240 words, it was possible to identify the differences in the relationship between self-reference and emotional valence, which are associated with dysphoria. The results support the existence of the self-positivity bias in non-dysphoric individuals. More interestingly, dysphoric individuals were able to accurately identify the emotional content of the word stimuli. They failed, however, to associate this emotional valence with self-reference. These findings are discussed in terms of attributional self-biases and their consequences for cognition

Intestinal schistosomiasis in Uganda at high altitude (>1400 m): malacological and epidemiological surveys on Mount Elgon and in Fort Portal crater lakes reveal extra preventive chemotherapy needs

Background Intestinal schistosomiasis is of public health importance in Uganda but communities living above 1400 m are not targeted for control as natural transmission is thought unlikely. To assess altitudinal boundaries and at-risk populations, conjoint malacological and epidemiological surveys were undertaken on Mount Elgon (1139 m–3937 m), in Fort Portal crater lakes and in the Rwenzori Mountains (1123 m–4050 m). Methods Seventy freshwater habitats [Mount Elgon (37), Fort Portal crater lakes (23), Rwenzori Mountains (8) and Lake Albert (2)] were inspected for Biomphalaria species. Water temperature, pH and conductivity were recorded. A parasitological examination of 756 schoolchildren [Mount Elgon (300), Fort Portal crater lakes (456)] by faecal microscopy of duplicate Kato-Katz smears from two consecutive stool samples was bolstered by antigen (urine-CCA dipstick) and antibody (SEA-ELISA) diagnostic assays. Results Biomphalaria spp. was found up to 1951 m on Mount Elgon and 1567 m in the Fort Portal crater lakes. Although no snail from Mount Elgon shed cercariae, molecular analysis judged 7.1% of snails sampled at altitudes above 1400 m as having DNA of Schistosoma mansoni; in Fort Portal crater lakes three snails shed schistosome cercariae. Prevalence of intestinal schistosomiasis as measured in schoolchildren by Kato-Katz (Mount Elgon = 5.3% v. Fort Portal crater lakes = 10.7%), CCA urine-dipsticks (18.3% v. 34.4%) and SEA-ELISA (42.3% v. 63.7%) showed negative associations with increasing altitude with some evidence of infection up to 2000 m. Conclusions Contrary to expectations, these surveys clearly show that natural transmission of intestinal schistosomiasis occurs above 1400 m, possibly extending up to 2000 m. Using spatial epidemiological predictions, this now places some extra six million people at-risk, denoting an expansion of preventive chemotherapy needs in Uganda

Understanding the impact of COVID-19 on women’s access to and experiences of contraceptive services in England: a qualitative study

Abstract Background The COVID-19 pandemic response prompted rapid changes to how contraceptive services were delivered in England. Our aim was to examine women’s experiences of accessing contraceptive services since March 2020 and to understand any inequalities of access. Methods We conducted telephone interviews with 31 women aged 17–54 years who had accessed contraceptive services in England since March 2020. The sample was skewed to include participants with lower educational attainment and higher deprivation. Interview transcripts were thematically analysed using inductive and deductive approaches. Results Few differences were found regarding educational attainment. Participants using contraceptive injections (all living in areas in the most deprived quintile) reported the greatest access challenges. Some switched method or stopped using contraception as a result. More general barriers reported by participants included service closures, unclear booking processes, and lack of appointment availability. Many participants welcomed the flexibility and convenience of remote contraceptive services. However, telephone appointments posed challenges for those at school or living with parents, and some described them as rushed and inconducive to asking questions or raising concerns. Those accessing contraception for the first time or nearing menopause felt they were unable to access sufficient support and guidance during the pandemic. Some participants voiced concerns around the lasting effects of COVID-19 on appointment availability and inadequate service delivery. Conclusions Women’s experiences of accessing contraceptive services in England since March 2020 are diverse. While remote services were suitable for some, COVID-19 restrictions unequally impacted women depending on their method of contraception and life stage.Output Status: Forthcoming/Available Onlin