Switching the Narrative: Pastor\u27s Beliefs and Reasonings

African-American pastors are seeking culturally competent mental health/addiction (MH/A) professionals who understand the Black Church theology as well as the intersectionality between their African-American clients and their Christian beliefs. Preliminary findings suggested that African-American pastors want mental health and addiction professionals to be culturally competent as well as culturally sensitive to provide parishioners with more holistic and faith-based interventions. The purpose of this qualitative study was to investigate and examine beliefs held by African-American pastors regarding collaborative relationships with mental health and addiction professionals, and how their specific theological beliefs affect these collaborative relationships. Using the narrative approach, three pastoral interviews were analyzed to identify personal and theological beliefs held by pastors and the extent to which they are willing to collaborate with MH/A professionals. This study revealed that pastors who have personal experiences with MH/A varied in their decisions to collaborate with MH/A professionals. Furthermore, this study found that pastors\u27 theological beliefs influence their decision to collaborate with MH/A professionals. It is recommended that pastors and MH/A professionals identify effective and meaningful ways to collaborate to support the mental health and addiction needs of parishioners in the Black Church. NOTE: Presentation recording is available on YouTube: https://youtu.be/Ri9-e4uD954?si=v9xHAbc675EcaOH

Economic Implications of a Changing Climate on Smallholder Pineapple Production in Ghana

Pineapple production in Ghana plays a major role in developing the economy through socioeconomic impacts and export. Climatic variations contribute to variable yield and subsequently affect pineapple productivity. Direct dependence on climate for pineapple production could have significant economic implications.  This study examined the economic impact of a changing climate on smallholder pineapple farming in Ghana.  Data from 400 pineapple farmers was obtained from four pineapple growing districts using a two-stage sampling technique. Ricardian regression approach was used to estimate the relationship between farmer’s net farm revenue per hectare, climate and other control variables such as soil and socio economic characteristics. The results revealed negative economic effect between rainfall and net revenue during vegetative stage of pineapple production as well as temperature and net revenue during the flowering stage. A positive effect between net revenue and temperature during yield formation stage was also observed. The study again discovered a fall in net revenue if temperature increases by 1°C and a rise in net revenue if rainfall increases by 1mm during production. The other variables that were key to net revenue were production on Dystric Planosols soil type, access to credit and membership of farmer-based associations. Given the role of pineapple production in the Ghanaian economy, supporting and promoting adaptation options to address issues of climate variability and change is recommended for improved productivity to sustain the pineapple industry economically. Keywords: Net revenue, temperature, rainfall, pineapple production, Ghan

Switching the Narrative: Pastors’ Beliefs and Reasonings

Although many African Americans experience mental health/addiction (MH/A), only 39% of the population seek professional treatment. Several significant barriers contribute to their ability to seek treatment, and as such, many African Americans feel more comfortable relying on the Black Church and pastors for support. However, many pastors are not prepared to support the MH/A needs of their parishioners thus leaving those who seek help without the proper MH/A care they need. The purpose of this qualitative study was to investigate the perceptions held by African American pastors on preparedness based on experience and theological beliefs to address MH/A issues within the Black Church. This current study also sought to understand pastoral views on potential collaborations with MH/A professionals. The goal of this qualitative study was to obtain a more in-depth understanding of pastors’ perceptions of MH/A needs and to develop directions for potential collaborations between African American pastors and MH/A professionals. Using a narrative approach, interviews with three pastors, derived from secondary data from a previous study conducted in 2021, were analyzed. Results from this current study revealed that pastors’ MH/A experiences and theological beliefs did not lead to a greater perception of preparedness in addressing MH/A issues among their parishioners. Additionally, pastors’ views of potential collaboration with MH/A professionals were ambiguous or conditional. The results suggest that pastors would benefit from more training on how to address MH/A issues and greater knowledge of and accessibility to resources for their parishioners

Cost and benefit analysis of adopting climate adaptation practices among smallholders: The case of five selected practices in Ghana

Smallholder farmers mostly depend on agriculture for their sustenance yet the sector is threatened by changing climate. It is essential for smallholders to adapt to reduce their vulnerability. Estimating the economic effectiveness of climate adaptation practices would enhance planning and actions among stakeholders and consequently impact policy. This study conducted an ex-ante in-depth empirical analysis of the costs and benefits of implementing five climate adaptation strategies identified among smallholder horticultural farmers in Ghana. A total of 180 smallholder households who have implemented the identified practices in two horticultural cropgrowing municipalities were surveyed. Profitability indicators, evaluation of environmental and social externalities were employed to comparatively estimate the cost-effectiveness of the practices. The results indicated that, from private and public perspectives, implementing any of the five adaptation practices would yield positive benefits. However, considering the capital required, payback period for investments made and risks from implementation, two out of the five practices are particularly fitting choices for the smallholders. Institutional and policy support is desirable if all the practices are to be adopted. To broaden information on potential of climate adaptation vis-a-vis ` climatic effects with economic analysis, the study proposes integrating localized climate vulnerability and economic assessments for enhanced climate adaptation actions

Experiences of patients living with HIV and AIDS on antiretroviral therapy in Accra, Ghana

Background: The human immunodeficiency virus and acquired immunodeficiency syndrome (HIV and AIDS) pandemic has greatly affected Africa, particularly Ghana. The pandemic remains a public health concern, particularly in terms of accessing essential medication and improving quality of life for people living with the disease. Objectives: This study aimed to explore and describe the experiences of persons diagnosed and living with HIV who are on antiretroviral therapy. Method: A qualitative, exploratory, descriptive, and contextual design was used. The research population included persons diagnosed with HIV who were receiving antiretroviral therapy at three public hospitals in Ghana. Data saturation was achieved after conducting 15 semi-structured interviews. Creswell’s six steps of data analysis were used to analyse the data, which resulted in the emergence of one main theme and six sub-themes. Results: The main theme identified by the researchers highlighted the participants’ diverse experiences of being diagnosed and living with HIV. It was found that the study participants expressed shock, disbelief, surprise, and fear of death after being diagnosed with HIV. The participants also experienced stigmatisation, discrimination, and rejection. Conclusion: There is a need for further research on the extent of discrimination and stigmatisation and the effect on optimal adherence to antiretroviral therapy. Continuous public education on HIV is required to limit the extent of discrimination and stigmatisation. Contribution: The study has highlighted the various emotions related to stigma and discrimination expressed by persons living with HIV (PLHIV). The findings will guide policy on eliminating discrimination and stigmatisation for people living with HIV

The role of indigenous knowledge and local knowledge in water sector adaptation to climate change in Africa: a structured assessment

Evidence is increasing of human responses to the impacts of climate change in Africa. However, understanding of the effectiveness of these responses for adaptation to climate change across the diversity of African contexts is still limited. Despite high reliance on indigenous knowledge (IK) and local knowledge (LK) for climate adaptation by African communities, potential of IK and LK to contribute to adaptation through reducing climate risk or supporting transformative adaptation responses is yet to be established. Here, we assess the influence of IK and LK for the implementation of water sector adaptation responses in Africa to better understand the relationship between responses to climate change and indigenous and local knowledge systems. Eighteen (18) water adaptation response types were identified from the academic literature through the Global Adaptation Mapping Initiative (GAMI) and intended nationally determined contributions (iNDCs) for selected African countries. Southern, West, and East Africa show relatively high evidence of the influence of IK and LK on the implementation of water adaptation responses, while North and Central Africa show lower evidence. At country level, Zimbabwe displays the highest evidence (77.8%) followed by Ghana (53.6%), Kenya (46.2%), and South Africa (31.3%). Irrigation, rainwater harvesting, water conservation, and ecosystem-based measures, mainly agroforestry, were the most implemented measures across Africa. These were mainly household and individual measures influenced by local and indigenous knowledge. Adaptation responses with IK and LK influence recorded higher evidence of risk reduction compared to responses without IK and LK. Analysis of iNDCs shows the most implemented water adaptation actions in academic literature are consistent with water sector adaptation targets set by most African governments. Yet only 10.4% of the African governments included IK and LK in adaptation planning in the iNDCs. This study recommends a coordinated approach to adaptation that integrates multiple knowledge sources, including IK and LK, to ensure sustainability of both current and potential water adaptation measures in Africa

Carbapenem Resistance in Klebsiella pneumoniae Not Detected by Automated Susceptibility Testing

Detecting β-lactamase–mediated carbapenem resistance among Klebsiella pneumoniae isolates and other Enterobacteriaceae is an emerging problem. In this study, 15 blaKPC-positive Klebsiella pneumoniae that showed discrepant results for imipenem and meropenem from 4 New York City hospitals were characterized by isoelectric focusing; broth microdilution (BMD); disk diffusion (DD); and MicroScan, Phoenix, Sensititre, VITEK, and VITEK 2 automated systems. All 15 isolates were either intermediate or resistant to imipenem and meropenem by BMD; 1 was susceptible to imipenem by DD. MicroScan and Phoenix reported 1 (6.7%) and 2 (13.3%) isolates, respectively, as imipenem susceptible. VITEK and VITEK 2 reported 10 (67%) and 5 (33%) isolates, respectively, as imipenem susceptible. By Sensititre, 13 (87%) isolates were susceptible to imipenem, and 12 (80%) were susceptible to meropenem. The VITEK 2 Advanced Expert System changed 2 imipenem MIC results from >16 μg/mL to <2 μg/mL but kept the interpretation as resistant. The recognition of carbapenem-resistant K. pneumoniae continues to challenge automated susceptibility systems

Determining the Impact of a School-Based Health Education Package for Prevention of Intestinal Worm Infections in the Philippines: Protocol for a Cluster Randomized Intervention Trial

Repeated mass drug administration (MDA) of antihelminthics to at-risk populations is still the main strategy for the control of soil-transmitted helminth (STH) infections. However, MDA, as a stand-alone intervention, does not prevent reinfection. Accordingly, complementary measures to prevent STH reinfection, such as health education and improved sanitation, as part of an integrated control approach, are required to augment the effectiveness of MDA for optimal efficiency and sustainabilitythe UBS-Optimus Foundation, Switzerlan

Status of soil-transmitted helminth infections in schoolchildren in Laguna Province, the Philippines: Determined by parasitological and molecular diagnostic techniques

Background Soil-transmitted helminths (STH) are the most common parasitic infections in impoverished communities, particularly among children. Current STH control is through school-based mass drug administration (MDA), which in the Philippines is done twice annually. As expected, MDA has decreased the intensity and prevalence of STH over time. As a result, the common Kato Katz (KK) thick smear method of detecting STH is less effective because it lacks sensitivity in low intensity infections, making it difficult to measure the impact of deworming programs. Methodology/Principal findings A cross-sectional study was carried out over a four-week period from October 27, 2014 until November 20, 2014 in Laguna province, the Philippines. Stool samples were collected from 263 schoolchildren, to determine the prevalence of STH and compare diagnostic accuracy of multiplex quantitative polymerase chain reaction (qPCR) with the KK. A large discrepancy in the prevalence between the two techniques was noted for the detection of at least one type of STH infection (33.8% by KK vs. 78.3% by qPCR), Ascaris lumbricoides (20.5% by KK vs. 60.8% by qPCR) and Trichuris trichiura (23.6% by KK vs. 38.8% by qPCR). Considering the combined results of both methods, the prevalence of at least one type of helminth infection, A. lumbricoides, and T. trichiura were 83.3%, 67.7%, and 53.6%, respectively. Sensitivity of the qPCR for detecting at least one type of STH infection, A. lumbricoides, and T. trichiura were 94.1%, 89.9%, and 72.3% respectively; whereas KK sensitivity was 40.6%, 30.3%, and 44.0%, respectively. The qPCR method also detected infections with Ancylostoma spp. (4.6%), Necator americanus (2.3%), and Strongyloides stercoralis (0.8%) that were missed by KK. Conclusion/Significance qPCR may provide new and important diagnostic information to improve assessment of the effectiveness and impact of integrated control strategies particularly in areas where large-scale STH control has led to low prevalence and/or intensity of infection.This work is funded by a National Health and Medical Research Council (NHMRC) Australia, project grant (1046901); and the UBS-Optimus Foundation Switzerland. DJG is an Australian NHMRC Career Development Fellow; ACAC is an Australian NHMRC Senior Research Fellow; DPM is an Australian NHMRC Senior Principal Research Fellow