Let's agree to agree : effects of self-awareness and social identity on online deliberation

This experiment assesses the effects of ingroup versus outgroup communication in an online, one-on-one, anonymous setting on perceptions of deliberation quality in a conversation task pertaining to abortion policy. Additionally, the study examines the effects of different secondary goals during converstion tasks--those of persuasion, and those of other-awareness, or understanding--in concert with trait online disinhibition tendencies in individuals. Finally, outcomes related to perceptions of one's conversation partner (civility, intelligence, rationality, hostility, and others), perceived compromise, feelings of political deliberation cynicism, and accuracy of other awareness (i.e., ability to correctly recall a partner's abortion-related attitudes gleaned through conversation) were also measured. Many similar studies have found that the majority of online hostility will be committed by, accepted by, or even expected by those with higher levels of toxic online disinhibition--but as of yet, there has been relatively little research that inquires how civility can be encouraged in those predisposed to such toxic behaviors online. Notably, this study finds that those with higher levels of toxic, but not benign, online disinhibition prior to the task are capable of engaging amicably in deindividuated, anonymous online settings if their partner demonstrates a commitment to rationality even more than civility or intelligence, and at the same time does not compromise too easily.Includes bibliographical reference

Gender balance in committees and how it impacts participation : evidence from Costa Rica's legislative assembly

Artículo originalWe examine participation by women and men in legislatures in a critical case. Previous studies found that women often participate less than men in committee hearings and plenary debates. Yet these studies were conducted in cases where women held a fairly small share of seats and generally did not hold leadership positions or have seniority – factors expected to decrease participation. We use data from the Costa Rican Legislative Assembly (2010-2012) to assess whether women still participate less than men when placed in conditions of (near) institutional equality. Costa Rica has a successful 40% gender quota, a woman president, and no immediate reelection to the Assembly so all deputies lack seniority, thus many sex barriers have been broken in Costa Rican politics. In this apparently favorable environment, do women deputies participate equally with men? We answer this question using data from two standing committees, which offer variance on the percentage of women in attendance at each session. Empirical findings suggest that women participate as much as men in committee, even when the number of women on the committee is few. We also find that committee leaders are very active participants, which underscores the importance for women of obtaining committee leadership positions

A New Era in Mental Health Care in Vanuatu

Inequity in health-care delivery for those with mental illness is widespread throughout low- and middle-income countries. In the Pacific Island countries there are many barriers to addressing the growing mental health burden. In an effort to address this problem, the WHO is coordinating the Pacific Islands Mental Health Network involving 18 countries in the Pacific region with the financial support of New Zealand Aid (NZAid). JB and DP have developed and presented mental health training to health professionals, community leaders, and social service personnel in an environment in Vanuatu that is very different from that of their usual Australian-based general practices. They discuss evidence for their work, an outline of the programme, some difficulties working across different cultures, and the enthusiasm with which the training has been greeted. Vanuatu is now well on its way to addressing the inequity of access to mental health care with a culturally appropriate and self-sustaining mental health workforce

ATTITUDES AND MANAGING ALCOHOL PROBLEMS IN GENERAL PRACTICE: AN INTERACTION ANALYSIS BASED ON FINDINGS FROM A WHO COLLABORATIVE STUDY

Aims: To determine if GPs' attitudes towards working with drinkers moderated the impact that training and support had on screening and brief intervention activity in routine practice. Methods: Subjects were 340 GPs from four countries who were part of a World Health Organization randomized controlled trial to evaluate the effectiveness of training and support in increasing screening and brief alcohol intervention. GPs' self-reported attitudes towards working with drinkers were measured with the Shortened Alcohol and Alcohol Problems Perception Questionnaire. Results: Whereas training and support increased GPs' screening and brief intervention rates, it did so only for practitioners who already felt secure and committed in working with drinkers. Training and support did not improve attitudes towards working with drinkers and, moreover, worsened the attitudes of those who were already insecure and uncommitted. Conclusions: To enhance the involvement of GPs in the management of alcohol problems, interventions that increase both actual experience and address practitioners' attitudes is required. Such support could take the form of on-site support agents and facilitator

Building a Leadership Culture for Environmental Health in a Nurse-Led Clinic

Climate change is the biggest global health threat of the 21st century (Costello et al., 2009). Temperature shifts caused by greenhouse gases have negative health impacts such as worsening of chronic diseases and increases in vector-borne diseases (American Public Health Association, 2016), which nurses are ethically responsible to address (American Nurses Association, 2015). At an interdisciplinary nurse-led clinic, staff were not prepared to assist patients in building resiliency related to the health impacts of climate change or to implement environmental sustainability in their workplace. Based on principles of partnership-based healthcare (Eisler & Potter, 2014), this project included Climate Conversations - sharing stories, values, and knowledge about climate change – (Minnesota Interfaith Power & Light, 2010) and evidence-based transformational leadership. The Nurses’ Environmental Awareness Tool (Schenk et al., 2015) was used to survey staff before and after they participated in behavioral interventions to incorporate environmental sustainability at their workplace. Compared to baseline, staffs’ knowledge of environmental sustainability increased significantly (p

A retrospective analysis of survival and prognostic factors after stereotactic radiosurgery for aggressive meningiomas

BACKGROUND: While most meningiomas are benign, aggressive meningiomas are associated with high levels of recurrence and mortality. A single institution’s Gamma Knife radiosurgical experience with atypical and malignant meningiomas is presented, stratified by the most recent WHO classification. METHODS: Thirty-one patients with atypical and 4 patients with malignant meningiomas treated with Gamma Knife radiosurgery between July 2000 and July 2011 were retrospectively reviewed. All patients underwent prior surgical resection. Overall survival was the primary endpoint and rate of disease recurrence in the brain was a secondary endpoint. Patients who had previous radiotherapy or prior surgical resection were included. Kaplan-Meier and Cox proportional hazards models were used to estimate survival and identify factors predictive of recurrence and survival. RESULTS: Post-Gamma Knife recurrence was identified in 11 patients (31.4%) with a median overall survival of 36 months and progression-free survival of 25.8 months. Nine patients (25.7%) had died. Three-year overall survival (OS) and progression-free survival (PFS) rates were 78.0% and 65.0%, respectively. WHO grade II 3-year OS and PFS were 83.4% and 70.1%, while WHO grade III 3-year OS and PFS were 33.3% and 0%. Recurrence rate was significantly higher in patients with a prior history of benign meningioma, nuclear atypia, high mitotic rate, spontaneous necrosis, and WHO grade III diagnosis on univariate analysis; only WHO grade III diagnosis was significant on multivariate analysis. Overall survival was adversely affected in patients with WHO grade III diagnosis, prior history of benign meningioma, prior fractionated radiotherapy, larger tumor volume, and higher isocenter number on univariate analysis; WHO grade III diagnosis and larger treated tumor volume were significant on multivariate analysis. CONCLUSION: Atypical and anaplastic meningiomas remain difficult tumors to treat. WHO grade III diagnosis and treated tumor volume were significantly predictive of recurrence and survival on multivariate analysis in aggressive meningioma patients treated with radiosurgery. Larger tumor size predicts poor survival, while nuclear atypia, necrosis, and increased mitotic rate are risk factors for recurrence. Clinical and pathologic predictors may help identify patients that are at higher risk for recurrence

Profiling the types of restaurants that sell wild meat in Central African cities

Central African cities are major centres of demand for wild meat, even when affordable alternative proteins are widely available. Many people eat wild meat in restaurants; therefore, restaurateurs are well placed to provide insights into the wild meat trade and consumer preferences. We surveyed 326 restaurants in Brazzaville and Kinshasa, the adjoining capital cities of the Republic of Congo and Democratic Republic of the Congo, to determine which types of restaurants sell wild meat, how sales of wild meat dishes compared with those containing other proteins, and the importance of wild meat to these businesses. The majority of wild meat-selling restaurants are informal establishments owned by women. Although most only sell wild meat dishes weekly, we estimate that nearly 10,000 wild meat dishes are consumed daily in restaurants across Brazzaville and Kinshasa. Its wide availability reinforces the social norm around eating wild meat, yet few restaurateurs considered wild meat to be central to the viability of their business. It is important to distinguish between restaurants reliant on wild meat sales and those that offer it to diversify their menus. Forging partnerships with restaurateurs offer untapped potential to develop mutually beneficial allegiances to further wild meat demand reduction efforts

An assessment of mental health policy in Ghana, South Africa, Uganda and Zambia

<p>Abstract</p> <p>Background</p> <p>Approximately half of the countries in the African Region had a mental health policy by 2005, but little is known about quality of mental health policies in Africa and globally. This paper reports the results of an assessment of the mental health policies of Ghana, South Africa, Uganda and Zambia.</p> <p>Methods</p> <p>The WHO Mental Health Policy Checklist was used to evaluate the most current mental health policy in each country. Assessments were completed and reviewed by a specially constituted national committee as well as an independent WHO team. Results of each country evaluation were discussed until consensus was reached.</p> <p>Results</p> <p>All four policies received a high level mandate. Each policy addressed community-based services, the integration of mental health into general health care, promotion of mental health and rehabilitation. Prevention was addressed in the South African and Ugandan policies only. Use of evidence for policy development varied considerably. Consultations were mainly held with the mental health sector. Only the Zambian policy presented a clear vision, while three of four countries spelt out values and principles, the need to establish a coordinating body for mental health, and to protect the human rights of people with mental health problems. None included all the basic elements of a policy, nor specified sources and levels of funding for implementation. Deinstitutionalisation and the provision of essential psychotropic medicines were insufficiently addressed. Advocacy, empowerment of users and families and intersectoral collaboration were inadequately addressed. Only Uganda sufficiently outlined a mental health information system, research and evaluation, while only Ghana comprehensively addressed human resources and training requirements. No country had an accompanying strategic mental health plan to allow the development and implementation of concrete strategies and activities.</p> <p>Conclusions</p> <p>Six gaps which could impact on the policies' effect on countries' mental health systems were: lack of internal consistency of structure and content of policies, superficiality of key international concepts, lack of evidence on which to base policy directions, inadequate political support, poor integration of mental health policies within the overall national policy and legislative framework, and lack of financial specificity. Three strategies to address these concerns emerged, namely strengthening capacity of key stakeholders in public (mental) health and policy development, creation of a culture of inclusive and dynamic policy development, and coordinated action to optimize use of available resources.</p

A decade of nutrition research in Africa: Assessment of the evidence base and academic collaboration

Objective: Malnutrition in Africa has not improved compared with other regions in the world. Investment in the build-up of a strong African research workforce is essential to provide contextual solutions to the nutritional problems of Africa. To orientate this process, we reviewed nutrition research carried out in Africa and published during the last decade. Design: We assessed nutrition research from Africa published between 2000 and 2010 from MEDLINE and EMBASE and analysed the study design and type of intervention for studies indexed with major MeSH terms for vitamin A deficiency, protein–energy malnutrition, obesity, breast-feeding, nutritional status and food security. Affiliations of first authors were visualised as a network and power of affiliations was assessed using centrality metrics. Setting: Africa. Subjects: Africans, all age groups. Results: Most research on the topics was conducted in Southern (36 %) and Western Africa (34 %). The intervention studies (9 %; n 95) mainly tested technological and curative approaches to the nutritional problems. Only for papers on protein–energy malnutrition and obesity did lead authorship from Africa exceed that from non-African affiliations. The 10 % most powerfully connected affiliations were situated mainly outside Africa for publications on vitamin A deficiency, breast-feeding, nutritional status and food security. Conclusions: The development of the evidence base for nutrition research in Africa is focused on treatment and the potential for cross-African networks to publish nutrition research from Africa remains grossly underutilised. Efforts to build capacity for effective nutrition action in Africa will require forging a true academic partnership between African and non-African research institutions

Mapping the availability of bushmeat for consumption in Central African cities

The trade of bushmeat from rural areas to supply burgeoning cities is a major conservation and livelihood concern. Using a whole-city sampling strategy we mapped the distribution and numbers of meat outlets in the Kinshasa-Brazzaville metropolitan area, two neighboring capital cities in Central Africa. We show that both cities differ in the number and density of meat outlets, with more in Brazzaville per area sampled and inhabitants. The number of meat outlets is related to human population densities and primarily concentrated along the banks of the Congo River, in the more affluent areas of the cities. Across the two cities, roughly 22% of all sampled markets (50% in Brazzaville and 19% in Kinshasa) and 24% of all visited restaurants (24% in each city) were selling bushmeat during our survey. Despite the relatively low number of establishments offering bushmeat for sale, extrapolated to the entire area and population of both cities, we expect the overall amounts of wild animal meats consumed per annum to be significantly high. We suggest that the supply of such amounts of wild animal meat will strongly impact the animal populations sourcing these cities. Our data also indicate that the number of domestic meat outlets may be adequate to supply urban dwellers with sufficient animal protein