The Current Status of Telehealth and Distance Learning in Palau

In 2017 the Republic of Palau installed fiber optic cables, allowing access to high speed internet for the first time and the capacity for growth in telehealth. Given Palau's poor access to specialists and resources, telehealth has the potential to radically change health care delivery. Currently, the status of telehealth in Palau is unknown. This study describes telehealth resources utilized at the Ministry of Health in Palau and potential future directions for telehealth. Thirty-four people, mostly health professionals at the Belau National Hospital in Palau were interviewed, including physicians, information technology personnel, public health department staff, department managers of allied health, and telehealth experts in the Pacific. Standardized questions and surveys were conducted in-person during July 2019. All departments utilized some form of telehealth. Common needs for the advancement of telehealth included: a telehealth champion, a resource facilitator, successful distance learning for auxiliary staff, dedicated telehealth space, technological help, and better telehealth communication with rural clinics. Survey respondents indicated that they would like to use some sort of distance learning, most commonly for professional betterment (86%) and upskilling of staff (86%). There are numerous distance learning and telehealth opportunities available, yet recurrent barriers to these opportunities were noted across all departments. The barriers identified in the current study and recommendations to overcome them may be applicable to other Pacific nations who face similar challenges.

Mental health is biological health: Why tackling "diseases of the mind" is an imperative for biological anthropology in the 21st century

The germ theory of disease and the attendant public health initiatives, including sanitation, vaccination, and antibiotic treatment, led to dramatic increases in global life expectancy. As the prevalence of infectious disease declines, mental disorders are emerging as major contributors to the global burden of disease. Scientists understand little about the etiology of mental disorders, however, and many of the most popular psychopharmacological treatments, such as antidepressants and antipsychotics, have only moderate-to-weak efficacy in treating symptoms and fail to target biological systems that correspond to discrete psychiatric syndromes. Consequently, despite dramatic increases in the treatment of some mental disorders, there has been no decrease in the prevalence of most mental disorders since accurate record keeping began. Many researchers and theorists are therefore endeavoring to rethink psychiatry from the ground-up. Anthropology, especially biological anthropology, can offer critical theoretical and empirical insights to combat mental illness globally. Biological anthropologists are unique in that we take a panhuman approach to human health and behavior and are trained to address each of Tinbergen's four levels of analysis as well as culture. The field is thus exceptionally well-situated to help resolve the mysteries of mental illness by integrating biological, evolutionary, and sociocultural perspectives.

Exploitation of secondary metabolites by animals: A response to homeostatic challenges

We propose that the exploitation of the bioactive properties of secondary metabolites (SMs) by animals can provide a "treatment" against various challenges that perturb homeostasis in animals. The unified theoretical framework for the exploitation of SMs by animals is based on a synthesis of research from a wide range of fields and although it is focused on providing generalized predictions for herbivores that exploit SMs of plants, predictions can be applied to understand the exploitation of SMs by many animals. In this review, we argue that the probability of SM exploitation is determined by the relative difference between the cost of a homeostatic challenge and the toxicity of the SM and we provide various predictions that can be made when considering behavior under a homeostatic perspective. The notion that animals experience and respond to costly challenges by exploiting therapeutic SMs provides a relatively novel perspective to explain foraging behavior in herbivores, specifically, and behavior of animals in general. We provide evidence that animals can exploit the biological activity of SMs to mitigate the costs of infection by parasites, enhance reproduction, moderate thermoregulation, avoid predation, and increase alertness. We stress that a better understanding of animal behavior requires that ecologists look beyond their biases that SMs elicit punishment and consider a broader view of avoidance or selection of SMs relative to the homeostatic state. Finally, we explain how understanding exploitation of SMs by animals could be applied to advance practices of animal management and lead to discovery of new drugs.