Dilemmas and Trade-Offs in Peacemaking: A Framework for Navigating Difficult Decisions

This article focuses on the dilemmas and trade-offs that third parties face when mediating violent political conflicts. Should they ignore human rights violations because pushing the issue could jeopardize relationships with political actors who grant access for humanitarian aid? Will bringing moderates and hardliners together help the peace process or radicalize moderate actors? What should dialogue facilitators do when the act of identifying non-mainstream groups to be included into dialogue increases division and polarization? The activity of peacemaking is inherently characterized by such process and strategy dilemmas where two equally compulsory imperatives seem not to be attainable at the same time. The article proposes a framework to break out of either-or thinking in these situations. We argue that: 1) making oneself aware of how a decision is perceived, and 2) systematically exploring a set of different strategies for creating new unexpected options helps to ease these decisions and avoid rotten compromises. The model reworks and combines existing problem-solving strategies to create a new explorative option generation approach to peacemaking dilemmas and trade-offs. Some of these strategies, such as sequencing and incrementalization, are already well-established in peacemaking. Others, such as compartmentalization and utilization, are rather unconsciously used. All identified strategies, however, are not yet systematically employed to manage third parties’ own dilemmas and trade-offs. Under the suggested framework, these strategies can act in complement to synthesize creativity and strategic thinking with surprising ease. Using examples from the authors’ peacemaking activities and observations in Myanmar, Thailand, and Ukraine, the article demonstrates the real-world benefits of the framework in terms of decision assessment and optional thinking

A web-based collaborative translation management system for public health workers

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Financial Burden and Mental Health Among LGBTQIA+ Adolescent and Young Adult Cancer Survivors During the COVID-19 Pandemic

Background In the United States, the cost of cancer treatment can lead to severe financial burden for cancer survivors. The economic impacts of the COVID-19 pandemic compound cancer survivors’ financial challenges. Financial burden may be particularly challenging for lesbian, gay, bisexual, transgender, queer, intersex, asexual and other sexual and gender minority (LGBTQIA+) survivors. LGBTQIA+ survivors who are adolescent and young adults (AYA) may face elevated financial burden due to multiple, intersecting identities. Methods An explanatory sequential mixed methods design was applied, beginning with a survey of AYA cancer survivors in the Mountain West region of the United States. Survey measures included demographics, COVID-19 impacts, the COmprehensive Score for financial Toxicity (COST), Perceived Stress Scale-4 (PSS-4), and PROMIS anxiety and depression scales. Two-way t-tests were used to analyze differences in outcomes between LGBTQIA+ and non-LGBTQIA+ AYAs. All LGBTQIA+ survey participants were invited to complete an interview, and those who agreed participated in descriptive interviews about financial burden due to cancer, COVID-19, and LGBTQIA+ identity. Interviews were audio recorded, transcribed, and analyzed using Dedoose. Results Survey participants (N=325) were LGBTQIA+ (n=29, 8.9%), primarily female (n= 197, 60.6%), non-Hispanic White (n= 267, 82.2%), and received treatment during COVID-19 (n= 174, 54.0%). LGBTQIA+ interview participants (n=9, 100%) identified as a sexual minority and (n=2, 22.2%) identified as a gender minority. Most were non-Hispanic White (n=6, 66.7%) and had received treatment during COVID-19 (n=7, 77.8%). Statistical analyses revealed that LGBTQIA+ AYAs reported significantly worse COST scores than non-LGBTQIA+ AYAs (p=0.002). LGBTQIA+ AYAs also reported significantly higher PSS-4 (p=0.001), PROMIS anxiety (p=0.002) and depression scores (p<0.001) than non-LGBTQIA+ AYAs, reflecting worse mental health outcomes. High costs of cancer treatment and employment disruptions due to COVID-19 contributed to substantial financial stress, which exacerbated existing mental health challenges and introduced new ones. Conclusions LGBTQIA+ AYA survivors reported substantial financial burden and psychological distress exacerbated by cancer, the COVID-19 pandemic, and LGBTQIA+ stigma. Given their multiple intersecting identities and potential for marginalization, LGBTQIA+ AYA survivors deserve prioritization in research to reduce financial burden and poor mental health

Ozone in the Pacific tropical troposphere from ozonesonde observations

Ozone vertical profile measurements obtained from ozonesondes flown at Fiji, Samoa, Tahiti, and the Galapagos are used to characterize ozone in the troposphere over the tropical Pacific. There is a significant seasonal variation at each of these sites. At sites in both the eastern and western Pacific, ozone mixing ratios are greatest at almost all levels in the troposphere during the September‐November season and smallest during March‐May. The vertical profile has a relative maximum at all of the sites in the midtroposphere throughout the year (the largest amounts are usually found near the tropopause). This maximum is particularly pronounced during the September‐November season. On average, throughout the troposphere, the Galapagos has larger ozone amounts than the western Pacific sites. A trajectory climatology is used to identify the major flow regimes that are associated with the characteristic ozone behavior at various altitudes and seasons. The enhanced ozone seen in the midtroposphere during September‐November is associated with flow from the continents. In the western Pacific this flow is usually from southern Africa (although 10‐day trajectories do not always reach the continent) but also may come from Australia and Indonesia. In the Galapagos the ozone peak in the midtroposphere is seen in flow from the South American continent and particularly from northern Brazil. High ozone concentrations within potential source regions and flow characteristics associated with the ozone mixing ratio peaks seen in both the western and eastern Pacific suggest that these enhanced ozone mixing ratios result from biomass burning. In the upper troposphere, low ozone amounts are seen with flow that originates in the convective western Pacific

Health care quality from the patients' perspective: a comparative study between an old and a new, high-tech hospital

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A Population-Based Study of Childhood Cancer Survivors’ Body Mass Index

Background. Population-based studies are needed to estimate the prevalence of underweight or overweight/obese childhood cancer survivors. Procedure. Adult survivors (diagnosed ≤20 years) were identified from the linked Utah Cancer Registry and Utah Population Database. We included survivors currently aged ≥20 years and ≥5 years from diagnosis (N=1060), and a comparison cohort selected on birth year and sex (N=5410). BMI was calculated from driver license data available from 2000 to 2010. Multivariable generalized linear regression models were used to calculate prevalence relative risks (RR) and 95% confidence intervals (95% CI) of BMI outcomes for survivors and the comparison cohort. Results. Average time since diagnosis was 18.5 years (SD=7.8), and mean age at BMI for both groups was 30.5 (survivors SD=7.7, comparison SD=8.0). Considering all diagnoses, survivors were not at higher risk for being underweight or overweight/obese than the comparison. Male central nervous system tumor survivors were overweight (RR=1.12, 95% CI 1.01–1.23) more often than the comparison. Female survivors, who were diagnosed at age 10 and under, had a 10% higher risk of being obese than survivors diagnosed at ages 16–20 (P<0.05). Conclusion. While certain groups of childhood cancer survivors are at risk for being overweight/obese, in general they do not differ from population estimates

Venom biotechnology: casting light on nature’s deadliest weapons using synthetic biology

Venoms are complex chemical arsenals that have evolved independently many times in the animal kingdom. Venoms have attracted the interest of researchers because they are an important innovation that has contributed greatly to the evolutionary success of many animals, and their medical relevance offers significant potential for drug discovery. During the last decade, venom research has been revolutionized by the application of systems biology, giving rise to a novel field known as venomics. More recently, biotechnology has also made an increasing impact in this field. Its methods provide the means to disentangle and study venom systems across all levels of biological organization and, given their tremendous impact on the life sciences, these pivotal tools greatly facilitate the coherent understanding of venom system organization, development, biochemistry, and therapeutic activity. Even so, we lack a comprehensive overview of major advances achieved by applying biotechnology to venom systems. This review therefore considers the methods, insights, and potential future developments of biotechnological applications in the field of venom research. We follow the levels of biological organization and structure, starting with the methods used to study the genomic blueprint and genetic machinery of venoms, followed gene products and their functional phenotypes. We argue that biotechnology can answer some of the most urgent questions in venom research, particularly when multiple approaches are combined together, and with other venomics technologies