Forest Cover Associated with Improved Child Health and Nutrition: Evidence from the Malawi Demographic and Health Survey and Satellite Data

Healthy forests provide human communities with a host of important ecosystem services, including the provision of food, clean water, fuel, and natural medicines. Yet globally, about 13 million hectares of forests are lost every year, with the biggest losses in Africa and South America. As biodiversity loss and ecosystem degradation due to deforestation continue at unprecedented rates, with concomitant loss of ecosystem services, impacts on human health remain poorly understood. Here, we use data from the 2010 Malawi Demographic and Health Survey, linked with satellite remote sensing data on forest cover, to explore and better understand this relationship. Our analysis finds that forest cover is associated with improved health and nutrition outcomes among children in Malawi. Children living in areas with net forest cover loss between 2000 and 2010 were 19% less likely to have a diverse diet and 29% less likely to consume vitamin A-rich foods than children living in areas with no net change in forest cover. Conversely, children living in communities with higher percentages of forest cover were more likely to consume vitamin A-rich foods and less likely to experience diarrhea. Net gain in forest cover over the 10-year period was associated with a 34% decrease in the odds of children experiencing diarrhea (P5.002). Given that our analysis relied on observational data and that there were potential unknown factors for which we could not account, these preliminary findings demonstrate only associations, not causal relationships, between forest cover and child health and nutrition outcomes. However, the findings raise concerns about the potential short- and long-term impacts of ongoing deforestation and ecosystem degradation on community health in Malawi, and they suggest that preventing forest loss and maintaining the ecosystems services of forests are important factors in improving human health and nutrition outcomes

Stress and Burnout in Nurse Leaders

Problem: Nurse leaders commonly experience stress and self-reported burnout. The associated negative consequences are compelling, yet few studies to date consider the nurse leader population. Stress is “a multidimensional phenomenon determined by a person’s perceptions and may be assessed as harm, loss, threat, or challenge” (Udod, Cummings, Care, & Jenkins, 2017a, p. 160). Burnout is a lack of professional fulfillment caused by emotional, physical, and psychological stress (Nurse Burnout, 2019). Drivers are associated and contributing factors which lead to stress and self-reported burnout. Purpose: The purposes of this correlational study are to (a) identify drivers from the literature and adapt an existing model to nurse leader populations, (b) investigate associations between drivers of stress among two nurse leader groups: Nurse Mangers/Nurse Supervisors and Chief Nursing Officers/Nurse Directors, (c) investigate association between drivers and self-reported burnout among all nurse leaders, and (d) compare drivers identified in the literature to drivers from the Minnesota Organization of Leaders in Nursing (MOLN) study. Conceptual Framework: The Job Demands-Resources (JD-R) Model of Burnout guided the literature review. We adapted our own model on stress leading to burnout in nurse leaders entitled Johnson, Nichols, and Sakhitab (JNS) Model of Stress Leading to Burnout in Nurse Leaders. The focus of the JNS model was to identify the drivers of stress leading to burnout in nurse leaders. Literature Search: Eight drivers of stress leading to burnout from the literature were: administrative duties, organizational constraints, role overload, lack of control, preparation, personal characteristics, quality patient care, and social support. Methods Data Analysis: The research method used for this thesis was a secondary analysis of the 2018 MOLN and the Minnesota Hospital Association Nurse Leader Burnout Survey. The Pearson product-moment correlation was used to assess relationships between drivers, stress, and burnout. The total sample included 210 nurse leaders. Results Data Analysis: Results from this secondary analysis found statistically significant drivers of stress in Nurse Managers and Nurse Supervisors (n = 90) were time (r = -.500, p = .000), control (r = -.321, p = .002), and resources (r = -.254, p = .016). The statistically significant drivers of stress in Chief Nursing Officers and Nurse Directors (n = 74) were time (r = -.492, p \u3c .000), resources (r = -.441, p = .000) control (r = -.387, p = .001), team efficiency (r = -.338, p = .003), and autonomy (r = -.250, p =.031). Drivers of self-reported burnout in nurse leaders (n = 210) in order of correlational strength were control, time, autonomy, resources, appreciation, team efficiency, value and quality (-.419 \u3c r \u3c -.181, p ≤ .009). Implications for Practice: Nurse leaders carry a high degree of responsibility and are unable to achieve optimal work/life balance. One solution is to restructure leadership hierarchy to include a co-manager role. A second implication for practice relates to the lack of control driver of stress; nurse leaders desire the freedom, empowerment, and autonomy to make decisions without fear for retribution. Lastly, an implication for practice relates to the drivers of social support and appreciation. It will be prudent for health care administrators to re-focus energies on provision of appreciation and recognition to nurse leaders. Implications for Research: The gap in longitudinal designed studies creates an opportunity for future research. We recommend replicating the MOLN study longitudinally and nationally to support findings from this secondary analysis. Future studies focusing on self-reported burnout need a standardized measurement tool. This will allow for direct comparison of data and stronger analysis of findings. Lastly, drivers of stress leading to burnout in nurse leaders must be universally defined

Feasibility of Using Remotely Sensed Data to Aid in Long-Term Monitoring of Biodiversity

Remote sensing is defined as making observations of an event or phenomena without physically sampling it. Typically this is done with instruments and sensors mounted on anything from poles extended over a cornfield,to airplanes,to satellites orbiting the Earth The sensors have characteristics that allow them to detect and record information regarding the emission and reflectance of electromagnetic energy from a surface or object. That information can then be represented visually on a screen or paper map or used in data analysis to inform decision-making

Forest Conservation: A Potential Nutrition-Sensitive Intervention in Low- and Middle-Income Countries

Rasolofoson, Ricketts, Jacob, Johnson, Pappinen and Fisher. Childhood undernutrition yearly kills 3.1 million children worldwide. For those who survive early life undernutrition, it can cause motor and cognitive development problems that translate into poor educational performance and limited work productivity later in life. It has been suggested that nutrition-specific interventions (e.g., micronutrient supplementation) that directly address the immediate determinants of undernutrition (e.g., nutrient intake) need to be complemented by nutrition-sensitive interventions that more broadly address the underlying determinants of undernutrition (e.g., food insecurity). Here, we argue that forest conservation represents a potentially important but overlooked nutrition-sensitive intervention. Forests can address a number of underlying determinants of undernutrition, including the supply of forest food products, income, habitat for pollinators, women\u27s time allocation, diarrheal disease, and dietary diversity. We examine the effects of forests on stunting—a debilitating outcome of undernutrition—using a database of household surveys and environmental variables across 25 low- and middle-income countries. Our result indicates that exposure to forest significantly reduces child stunting (at least 7.11% points average reduction). The average magnitude of the reduction is at least near the median of the impacts of other known nutrition interventions. Forest conservation interventions typically cover large areas and are often implemented where people are vulnerable, and thus could be used to reach a large number of the world\u27s undernourished communities that may have difficult access to traditional nutrition programs. Forest conservation is therefore a potentially effective nutrition-sensitive intervention. Efforts are needed to integrate specific nutrition goals and actions into forest conservation interventions in order to unleash their potential to deliver nutritional benefits

Upstream watershed condition predicts rural children\u27s health across 35 developing countries

Diarrheal disease (DD) due to contaminated water is a major cause of child mortality globally. Forests and wetlands can provide ecosystem services that help maintain water quality. To understand the connections between land cover and childhood DD, we compiled a database of 293,362 children in 35 countries with information on health, socioeconomic factors, climate, and watershed condition. Using hierarchical models, here we find that higher upstream tree cover is associated with lower probability of DD downstream. This effect is significant for rural households but not for urban households, suggesting differing dependence on watershed conditions. In rural areas, the effect of a 30% increase in upstream tree cover is similar to the effect of improved sanitation, but smaller than the effect of improved water source, wealth or education. We conclude that maintaining natural capital within watersheds can be an important public health investment, especially for populations with low levels of built capital

Soybean Seedling Damage: Is There an Interaction Between the ILeVO Seed Treatment and Pre-Emergence Herbicides?

Farmers who were lucky enough to plant soybeans and spray pre-emergence herbicides in between rain events may now be seeing discolored or injured seedlings. Reports of fields with these issues are widespread across Indiana, Iowa, and surrounding areas, and many farmers and crop advisors are questioning if damage is more severe when pre-emergence herbicides are applied to fields that have been planted with seed treated with the new fluopyram fungicide seed treatment ILeVO

Drug and alcohol trajectories among adults with schizophrenia: Data from the CATIE study

The primary aim is to describe drug and alcohol trajectories in adults with schizophrenia

Can nature deliver on the sustainable development goals?

The increasing availability of data and improved analytical techniques now enable better understanding of where environmental conditions and human health are tightly linked, and where investing in nature can deliver net benefits for people—especially with respect to the most vulnerable populations in developing countries. These advances bring more opportunities for interventions that can advance multiple SDGs at once. We have harmonised a suite of global datasets to explore the essential nexus of forests, poverty, and human health, an overlap of SDG numbers 1, 2, 3, 6, and 15. Our study combined demographic and health surveys for 297 112 children in 35 developing countries with data describing the local environmental conditions for each child (appendix).4 This allowed us to estimate the effect forests might have in supporting human health, while controlling for the influence of important socio-economic differences.4 We extended this work to look at how forests affect three childhood health concerns of global significance for the world's poorest people: stunting, anaemia, and diarrhoeal disease

Jail-to-community treatment continuum for adults with co-occurring substance use and mental disorders: study protocol for a pilot randomized controlled trial

Abstract Background Adults with co-occurring mental and substance use disorders (CODs) are overrepresented in jails. In-custody barriers to treatment, including a lack of evidence-based treatment options and the often short periods of incarceration, and limited communication between jails and community-based treatment agencies that can hinder immediate enrollment into community care once released have contributed to a cycle of limited treatment engagement, unaddressed criminogenic risks, and (re)arrest among this vulnerable and high-risk population. This paper describes a study that will develop research and communication protocols and adapt two evidence-based treatments, dual-diagnosis motivational interviewing (DDMI) and integrated group therapy (IGT), for delivery to adults with CODs across a jail-to-community treatment continuum. Methods/design Adaptations to DDMI and IGT were guided by the Risk-Need-Responsivity model and the National Institute of Corrections’ implementation competencies; the development of the implementation framework and communication protocols were guided by the Evidence-Based Interagency Implementation Model for community corrections and the Inter-organizational Relationship model, respectively. Implementation and evaluation of the protocols and adapted interventions will occur via an open trial and a pilot randomized trial. The clinical intervention consists of two in-jail DDMI sessions and 12 in-community IGT sessions. Twelve adults with CODs and four clinicians will participate in the open trial to evaluate the acceptability and feasibility of, and fidelity to, the interventions and research and communication protocols. The pilot controlled trial will be conducted with 60 inmates who will be randomized to either DDMI-IGT or treatment as usual. A baseline assessment will be conducted in jail, and four community-based assessments will be conducted during a 6-month follow-up period. Implementation, clinical, public health, and treatment preference outcomes will be evaluated. Discussion Findings have the potential to improve both jail- and community-based treatment services for adults with CODs as well as inform methods for conducting rigorous pilot implementation and evaluation research in correctional settings and as inmates re-enter the community. Findings will contribute to a growing area of work focused on interrupting the cycle of limited treatment engagement, unaddressed criminogenic risks, and (re)arrest among adults with CODs. Trial registration ClinicalTrials.gov, NCT02214667 . Registered on 10 August 2014

The frequency of genes encoding three putative group B streptococcal virulence factors among invasive and colonizing isolates

BACKGROUND: Group B Streptococcus (GBS) causes severe infections in very young infants and invasive disease in pregnant women and adults with underlying medical conditions. GBS pathogenicity varies between and within serotypes, with considerable variation in genetic content between strains. Three proteins, Rib encoded by rib, and alpha and beta C proteins encoded by bca and bac, respectively, have been suggested as potential vaccine candidates for GBS. It is not known, however, whether these genes occur more frequently in invasive versus colonizing GBS strains. METHODS: We screened 162 invasive and 338 colonizing GBS strains from different collections using dot blot hybridization to assess the frequency of bca, bac and rib. All strains were defined by serotyping for capsular type, and frequency differences were tested using the Chi square test. RESULTS: Genes encoding the beta C protein (bac) and Rib (rib) occurred at similar frequencies among invasive and colonizing isolates, bac (20% vs. 23%), and rib (28% vs. 20%), while the alpha (bca) C protein was more frequently found in colonizing strains (46%) vs, invasive (29%). Invasive strains were associated with specific serotype/gene combinations. CONCLUSION: Novel virulence factors must be identified to better understand GBS disease