Traditional Healers and Mental Health in Nepal: A Scoping Review.

Despite extensive ethnographic and qualitative research on traditional healers in Nepal, the role of traditional healers in relation to mental health has not been synthesized. We focused on the following clinically based research question, "What are the processes by which Nepali traditional healers address mental well-being?" We adopted a scoping review methodology to maximize the available literature base and conducted a modified thematic analysis rooted in grounded theory, ethnography, and phenomenology. We searched five databases using terms related to traditional healers and mental health. We contacted key authors and reviewed references for additional literature. Our scoping review yielded 86 eligible studies, 65 of which relied solely on classical qualitative study designs. The reviewed literature suggests that traditional healers use a wide range of interventions that utilize magico-religious explanatory models to invoke symbolic transference, manipulation of local illness narratives, roles, and relationships, cognitive restructuring, meaning-making, and catharsis. Traditional healers' perceived impact appears greatest for mild to moderate forms of psychological distress. However, the methodological and sample heterogeneity preclude uniform conclusions about traditional healing. Further research should employ methods which are both empirically sound and culturally adapted to explore the role of traditional healers in mental health

DPHL: A DIA Pan-human Protein Mass Spectrometry Library for Robust Biomarker Discovery

To address the increasing need for detecting and validating protein biomarkers in clinical specimens, mass spectrometry (MS)-based targeted proteomic techniques, including the selected reaction monitoring (SRM), parallel reaction monitoring (PRM), and massively parallel data-independent acquisition (DIA), have been developed. For optimal performance, they require the fragment ion spectra of targeted peptides as prior knowledge. In this report, we describe a MS pipeline and spectral resource to support targeted proteomics studies for human tissue samples. To build the spectral resource, we integrated common open-source MS computational tools to assemble a freely accessible computational workflow based on Docker. We then applied the workflow to generate DPHL, a comprehensive DIA pan-human library, from 1096 data-dependent acquisition (DDA) MS raw files for 16 types of cancer samples. This extensive spectral resource was then applied to a proteomic study of 17 prostate cancer (PCa) patients. Thereafter, PRM validation was applied to a larger study of 57 PCa patients and the differential expression of three proteins in prostate tumor was validated. As a second application, the DPHL spectral resource was applied to a study consisting of plasma samples from 19 diffuse large B cell lymphoma (DLBCL) patients and 18 healthy control subjects. Differentially expressed proteins between DLBCL patients and healthy control subjects were detected by DIA-MS and confirmed by PRM. These data demonstrate that the DPHL supports DIA and PRM MS pipelines for robust protein biomarker discovery. DPHL is freely accessible at https://www.iprox.org/page/project.html?id=IPX0001400000

A multimodal cell census and atlas of the mammalian primary motor cortex

ABSTRACT We report the generation of a multimodal cell census and atlas of the mammalian primary motor cortex (MOp or M1) as the initial product of the BRAIN Initiative Cell Census Network (BICCN). This was achieved by coordinated large-scale analyses of single-cell transcriptomes, chromatin accessibility, DNA methylomes, spatially resolved single-cell transcriptomes, morphological and electrophysiological properties, and cellular resolution input-output mapping, integrated through cross-modal computational analysis. Together, our results advance the collective knowledge and understanding of brain cell type organization: First, our study reveals a unified molecular genetic landscape of cortical cell types that congruently integrates their transcriptome, open chromatin and DNA methylation maps. Second, cross-species analysis achieves a unified taxonomy of transcriptomic types and their hierarchical organization that are conserved from mouse to marmoset and human. Third, cross-modal analysis provides compelling evidence for the epigenomic, transcriptomic, and gene regulatory basis of neuronal phenotypes such as their physiological and anatomical properties, demonstrating the biological validity and genomic underpinning of neuron types and subtypes. Fourth, in situ single-cell transcriptomics provides a spatially-resolved cell type atlas of the motor cortex. Fifth, integrated transcriptomic, epigenomic and anatomical analyses reveal the correspondence between neural circuits and transcriptomic cell types. We further present an extensive genetic toolset for targeting and fate mapping glutamatergic projection neuron types toward linking their developmental trajectory to their circuit function. Together, our results establish a unified and mechanistic framework of neuronal cell type organization that integrates multi-layered molecular genetic and spatial information with multi-faceted phenotypic properties

Satisfaction in the Soul: Common Factors Theory Applied to Traditional Healers in Rural Nepal

© 2020 by the American Anthropological Association To explore the relationship between traditional healers and conventional psychotherapy, we conducted a combined ethnographic study and structured observational rating of healers in the middle hill region of central Nepal. We conducted in-depth interviews and ethnographic observations of healing with 84 participants comprising 29 traditional healers and 55 other community members. Overall, our observations and participant responses yielded a range of interventions that improved health through belief, satisfaction in the soul, social support, transference, and symbolic narration. The findings from our overall ethnography suggest that healers offer a platform for their patients to accept a disease state, cope with it, and to experience palliation of distress. We additionally focused on one participant who saw multiple healers for a case study, during which we rated healing behavior using an observational measure of empathy, emotional validation, and therapeutic alliance. Using this measure, healers who were perceived as successful, scored high on alliance, empathy, promoting expectations of recovery, and use of cultural models of distress. The results of our structured observation suggest healers draw upon processes also observed in psychotherapy. Further research is needed to explore if these practices can be generalized to healers in other parts of Nepal and other settings

Reassessing the Mental Health Treatment Gap: What Happens if We Include the Impact of Traditional Healing on Mental Illness?

© 2020, Springer Science+Business Media, LLC, part of Springer Nature. In this Fresh Focus, we reassess what the mental health treatment gap may mean if we consider the role of traditional healing. Based on systematic reviews, patients can use traditional healers and qualitatively report improvement from general psychological distress and symptom reduction for common mental disorders. Given these clinical implications, some high-income countries have scaled up research into traditional healing practices, while at the same time in low-and middle-income countries, where the use of traditional healers is nearly ubiquitous, considerably less research funding has studied or capitalized on this phenomena. The World Health Organization 2003–2020 Mental Health Action Plan called for government health programs to include traditional and faith healers as treatment resources to combat the low- and middle-income country treatment gap. Reflection on the work which emerged during the course of this Mental Health Action Plan revealed areas for improvement. As we embark on the next Mental Health Action Plan, we offer lessons-learned for exploring potential relationships and collaborations between traditional healing and biomedicine

Hemp Agronomy: Current Advances, Questions, Challenges, and Opportunities

Hemp (Cannabis sativa L. ssp. sativa) has a long history of domestication due to its versatile use. Recently, different sectors in the economy are investigating hemp cultivation to increase agronomic production and to limit delta-9-tetrahydrocannabinol (THC). Despite the rapid growth of hemp literature in recent years, it is still uncertain whether the knowledge gained from higher latitude regions is applicable to low latitude and tropical regions where hemp has not been grown traditionally. This review provides a comprehensive and updated survey of hemp agronomy, focusing on environmental and management factors influencing the growth and yield of hemp, methods of cannabinoids detection and quantification, and hemp breeding. This review suggests that some previous claims about hemp as a low input crop may not hold true in low-latitude regions. Additional research strategies, such as the integration of experimentation and modeling efforts, are encouraged to hasten new discoveries. Furthermore, to effectively increase the outputs of value products (cannabinoids, seeds, fiber and biomass, etc.) while limiting the THC level, new collaborations between hemp agronomists and economists may streamline the production process by increasing the efficiency of the total production system of hemp as a multifaceted crop

Towards Sustainable Tax Policies in Asean – A Case of Corporate Income Tax Incentives

IT IS HIGH TIME FOR ALL ASEAN MEMBER STATES TO COLLABORATE WITH ONE ANOTHER AND AGREE UPON THE COMMON MINIMUM STANDARDS FOR CORPORATE TAX INCENTIVES IN THE REGION, TO PREVENT HARMFUL TAX PRACTICES THAT DRAIN ESSENTIAL PUBLIC REVENUE AND CREATE UNNECESSARY COMPETITION AMONG MEMBERS, AND TO ACHIEVE A COMMON GOAL OF BUILDING A SUSTAINABLE AND RESILIENT REGION. The ASEAN region is experiencing unprecedented economic inequality, as some countries still have the highest poverty levels in the world and most countries in the region are failing to invest sufficiently in essential public services. Progressive tax collection and social spending on essential public services such as healthcare, education, and social protection are the most effective ways to fight poverty and inequality. However, most countries in the region fail to invest sufficiently in those services. For some countries (Cambodia, Laos, Vietnam, Malaysia, and Myanmar), the situation is so critical that the Asian Development Bank has already warned that if they do not mobilize significantly greater revenues in the coming years, the 2030 Sustainable Development Goals (SDGs) will not be met. The most worrying aspect is that this lack of spending is being seen at a time when countries in the region already seeing their fiscal space stretched. Most ASEAN countries have suffered persistent budget deficits for a long period. Malaysia, Myanmar, and Laos are expected to experience these deficits throughout 2000-2020. Vietnam, Cambodia, Indonesia, and the Philippines will have run the deficits for 17 to 20 years in the same period. In 2018 alone, six ASEAN countries had significant budget deficits, and some have high levels of public debt. On average, the ASEAN region saw a budget deficit of 1.5% of gross domestic product (GDP) in 2018. Budget deficits and consequently public debt are likely to see further significant increases due to the extra budgetary efforts that will be required to overcome the current economic challenges and the health crisis created by the COVID-19 pandemic. It is expected that nine ASEAN countries face budget deficits in 2020 with the average one at 4.2% of GDP. In the ASEAN region, levels of revenue collection, measured as a proportion of GDP, remain very low compared with OECD countries. The average ratio across the region was 19.1% of GDP in 2018, lower than half that collected on average in the OECD countries and lower than in the Latin America and the Caribbean region. These low ratios mean that countries in the region have little budget capacity and are running public deficits, and this gap has dramatic consequences for the quality of public services, infrastructure, and levels of good governance. Even before the COVID 19 pandemic, the situation in ASEAN was already unsustainable. Now the situation is even more dire. Initial estimates from the OECD3 predict that the pandemic will have significant negative impacts on tax revenues, while at the same time budget burdens will increase due to governments’ efforts to introduce supportive packages to help cope with the disease. In ASEAN countries, the expected budget spending in response to the coronavirus is enormous. Singapore, for example, will spend a sum equivalent to about 13% of its GDP on extensive fiscal stimulus measures and Thailand 9%, while in the Philippines, Indonesia, and Vietnam the figure will be about 3% of GDP. Despite decades-long sustained economic growth, why do countries in the ASEAN region still collect such low amounts of revenue? Because these countries are still highly dependent on revenues from corporate income tax (CIT); however, they are giving up huge amounts of revenue by offering large tax incentives to both domestic and foreign investors. International institutions have repeatedly warned countries in the region to stop offering redundant tax incentives. Tax losses due to corporate tax incentives were estimated to be 6% of GDP in Cambodia and 1% of GDP in Vietnam and the Philippines.5 These lost revenues could have been crucial now in covering large parts of the extra budget spending on responses to COVID-19: These in the Philippines and Vietnam, for example, are equivalent to a third of their financial efforts in response to the COVID 19 pandemic. ASEAN countries need to stop this race to the bottom in taxation at the political level to improve their domestic revenue mobilization if they are serious about overcoming sustainable development challenges such as climate change, widening inequality and high levels of poverty while also recovering from the COVID-19 crisis. In light of this, the report recommends ASEAN to take the following actions to strengthen tax cooperation across the region: 1. DRAW UP A WHITELIST AND A BLACKLIST OF TAX INCENTIVES 2. AGREE ON A MINIMUM TAX STANDARD ACROSS THE ASEAN REGION 3. ESTABLISH RULES FOR THE GOOD GOVERNANCE OF TAX INCENTIVE