“Provide care for everyone please”: Engaging Community Leaders as Sexual and Reproductive Health Advocates in North and South Kivu, Democratic Republic of Congo

Background: Inadequate infrastructure, security threats from ongoing armed conflict, and conservative socio-cultural and gender norms that favour large families and patriarchal power structures contribute to poor sexual and reproductive health (SRH) outcomes in North and South Kivu provinces, Democratic Republic of the Congo (DRC). In order to expand contraceptive and post-abortion care (PAC) access in North and South Kivu, CARE, the International Rescue Committee and Save the Children provided technical support to the Ministry of Health and health facilities in these regions. Partners acknowledged that community leaders, given their power to influence local customs, could play a critical role as agents of change in addressing inequitable gender norms, stigma surrounding SRH service utilization, and topics traditionally considered taboo within Congolese society. As such, partners actively engaged with community leaders through a variety of activities such as community mapping exercises, values clarification and transformation (VCAT) activities, situational analyses, and education. Methods: This manuscript presents findings from 12 key informant interviews (KIIs) with male political and non-political community leaders conducted in six rural health zones of North and South Kivu, DRC. Transcripts were analysed thematically to explore community leaders’ perceptions of their role in addressing the issue of unintended pregnancy in their communities. Results: While community leaders in this study expressed overall positive impressions of contraception and strong support for ensuring access to PAC services following spontaneous and induced abortions, the vast majority held negative beliefs concerning women who had induced abortion. Contrasting with their professed opposition to induced abortion, leaders’ commitment to mediating interpersonal conflict arising between community members and women who had abortions was overwhelming. Conclusion: Results from this study suggest that when thoughtfully engaged by health interventions, community leaders can be empowered to become advocates for SRH. While study participants were strong supporters of contraception and PAC, they expressed negative perceptions of induced abortion. Given the hypothesized link between the presence of induced abortion stigma and care-avoidance behavior, further engagement and values clarification exercises with leaders must be integrated into community mobilization and engagement activities in order to increase PAC utilization

Trauma Hemorrhagic Shock-Induced Lung Injury Involves a Gut-Lymph-Induced TLR4 Pathway in Mice

Injurious non-microbial factors released from the stressed gut during shocked states contribute to the development of acute lung injury (ALI) and multiple organ dysfunction syndrome (MODS). Since Toll-like receptors (TLR) act as sensors of tissue injury as well as microbial invasion and TLR4 signaling occurs in both sepsis and noninfectious models of ischemia/reperfusion (I/R) injury, we hypothesized that factors in the intestinal mesenteric lymph after trauma hemorrhagic shock (T/HS) mediate gut-induced lung injury via TLR4 activation.The concept that factors in T/HS lymph exiting the gut recreates ALI is evidenced by our findings that the infusion of porcine lymph, collected from animals subjected to global T/HS injury, into naïve wildtype (WT) mice induced lung injury. Using C3H/HeJ mice that harbor a TLR4 mutation, we found that TLR4 activation was necessary for the development of T/HS porcine lymph-induced lung injury as determined by Evan's blue dye (EBD) lung permeability and myeloperoxidase (MPO) levels as well as the induction of the injurious pulmonary iNOS response. TRIF and Myd88 deficiency fully and partially attenuated T/HS lymph-induced increases in lung permeability respectively. Additional studies in TLR2 deficient mice showed that TLR2 activation was not involved in the pathology of T/HS lymph-induced lung injury. Lastly, the lymph samples were devoid of bacteria, endotoxin and bacterial DNA and passage of lymph through an endotoxin removal column did not abrogate the ability of T/HS lymph to cause lung injury in naïve mice.Our findings suggest that non-microbial factors in the intestinal mesenteric lymph after T/HS are capable of recreating T/HS-induced lung injury via TLR4 activation

Network Physiology reveals relations between network topology and physiological function

The human organism is an integrated network where complex physiologic systems, each with its own regulatory mechanisms, continuously interact, and where failure of one system can trigger a breakdown of the entire network. Identifying and quantifying dynamical networks of diverse systems with different types of interactions is a challenge. Here, we develop a framework to probe interactions among diverse systems, and we identify a physiologic network. We find that each physiologic state is characterized by a specific network structure, demonstrating a robust interplay between network topology and function. Across physiologic states the network undergoes topological transitions associated with fast reorganization of physiologic interactions on time scales of a few minutes, indicating high network flexibility in response to perturbations. The proposed system-wide integrative approach may facilitate the development of a new field, Network Physiology.Comment: 12 pages, 9 figure

Implications of changing trends in hydroclimatic and water quality parameters on estuarine habitats in the Gulf Coastal Plain

Florida’s low elevation and geographic location make it particularly vulnerable to climate change effects such as sea level rise, increased intensity and frequency of storm events, and altered precipitation. Climate change is expected to exacerbate hydrological cycling with potential widespread implications for estuarine habitats that thrive under specific salinity regimes. We used historical data from sites in the eastern Gulf Coastal Plain, USA to examine trends and trend variability of several climatic, hydrologic, and estuarine water quality variables which have implications on seagrass and oyster habitat extent in downstream estuarine environments. We analyzed temperature, precipitation, low-flow and high-flow metrics (including the highest or lowest daily, 7-day average, and 30-day average) for each season annually over the period 1985–2020. We also analyzed estuarine water clarity metrics and salinity within waterbody segments of four estuary systems within the study area. Hydroclimate results showed that temperature increased at most sites. While there was variation in streamflow, the overall trend was declining streamflow. Declining trends were observed in most water clarity metrics, indicating improved clarity, especially in winter. Salinity generally declined across the study area. While overall streamflow decreased, main river stems to the estuaries had increasing trends in maximum streamflow characteristics, likely contributing to the decrease in estuarine salinity across the region. These results indicate that trends in streamflow (both magnitude and timing) in the watershed affect downstream estuarine water quality. These results have important implications on seagrass and oyster restoration and management efforts in the region, indicating that it is important to understand changing climatic and hydrologic conditions and how they may impact the estuarine resources

Social representations and community attitudes towards spring breakers

Social representations theory has been adopted for explaining tourism impacts and local attitudes. However, its usefulness in segmenting local population in terms of their attitudes towards specific types of tourists has not been tested. This study identifies the attitudes of local people towards spring break, a North American young tourist phenomenon in the context of the Mexican beach resort of Acapulco. Although residents perceive an increase in alcohol consumption, drug use, noise and litter during the spring break season, they largely recognise economic benefits and are thus generally supportive for the phenomenon. Based on these attitudes, three clusters were identified: spring break supporters (identified by their high appreciation of spring break benefits), ambivalents (who are uncertain about both benefits and costs) and realistics (characterised by recognising both benefits and costs). The main contribution of this study lies in the confirmation of the usefulness of social representations theory in explaining residents’ attitudes towards a very specific type of tourists whose hedonist behaviours are a common characteristic