A conceptual analysis of system responses to the issue of problematic sexual behaviors in children and recommendations for future work in Children's Advocacy Center multidisciplinary teams

Problematic sexual behavior (PSB) in children is a common, yet frequently misunderstood and mishandled issue facing communities. Because of the intersection of children both causing harm and being harmed, societies across the globe struggle with whether to punish or support during these times. For Children's Advocacy Centers (CACs), whose mandate it is to support victimized children, this tension is exacerbated. CACs have historically relied on identifying a "perpetrator" and "victim" when providing their services, however PSB displaying youth do not fit this classic dichotomy. Compared with other children, PSB displaying youth are more likely to experience greater incidents and types of violent childhood trauma, have increased parent instability, decreased familial support, and struggle with co-occurring mental health diagnoses. Due to the stigma and fear surrounding sexual behaviors in children and systemic barriers including varied definitions of PSB, uncertainty regarding how to respond within the context of child-serving roles, and the criminalization of children's behaviors, access to supportive services is complicated and challenging. Treatment completion rates for this population are as low as 13%, despite most methods being short-term, non-invasive, and community based. This conceptual analysis paper identifies five key themes in the literature that influence these barriers and proposes an interdisciplinary approach for CAC multidisciplinary teams (MDTs) to better support this vulnerable population.

Non-native ants drive dramatic declines in animal community diversity: A meta-analysis

Non-native ants can cause ecosystem-wide ecological change, and these changes are generally assumed to be negative. Despite this, the evidence base has never been holistically synthesised to quantify whether and to what degree non-native ants impact native species diversity.In this study, we performed a meta-analysis of the effects of ant invasion on animal communities. We extracted data from 46 published articles investigating abundance (156 effect sizes) and richness (53 effect sizes) responses of animal taxa to ant invasion in locations relatively unimpacted by other stressors (e.g. human disturbance, other non-native species) to help isolate the effects of invasion.Overall, local animal diversity declined severely, with species abundance and richness lower by 42.79% and 53.56%, respectively, in areas with non-native ants compared with intact uninvaded sites. We then combined responses of individual animal taxa extracted from an article into a single response to represent the 'community' abundance (40 effect sizes) or richness (28 effect sizes) response to non-native ants represented in each article. Local communities decreased substantially in total abundance (52.67%) and species richness (53.47%) in invaded sites.These results highlight non-native ants as the drivers, rather than passengers, of large net-negative reductions to animal community diversity in relatively undisturbed systems around the world, approximately halving local species abundance and richness in invaded areas. Improved international prevention processes, early detection systems harnessing emerging technologies, and well-designed control measures deployable by conservation practitioners are urgently needed if these effects are to be mitigated, prevented or reversed.

Models of Aviation Noise Impact in the Context of Operation Decrease at Tan Son Nhat Airport

Air traffic bans in response to the spread of the coronavirus have changed the sound situation of urban areas around airports. This study aimed to investigate the effect of this unprecedented event on the community response to noise before and after the international flight operation at Tan Son Nhat Airport (TSN) in March 2020. The "before" survey was conducted in August 2019, and the two "after" surveys were conducted in June and September 2020. Structural equation models (SEMs) for noise annoyance and insomnia were developed by linking the questionnaire items of the social surveys. The first effort aimed to achieve a common model of noise annoyance and insomnia, corresponding to the situation before and after the change, respectively. Approximately, 1200 responses were obtained from surveys conducted in 12 residential areas around TSN in 2019 and 2020. The average daily flight numbers observed in August 2019 during the two surveys conducted in 2020 were 728, 413, and 299, respectively. The sound pressure levels of the 12 sites around TSN decreased from 45-81 dB (mean = 64, SD = 9.8) in 2019 to 41-76 dB (mean = 60, SD = 9.8) and 41-73 dB (mean = 59, SD = 9.3) in June and September 2020, respectively. The SEM indicated that the residents' health was related to increased annoyance and insomnia.

Identifying thresholds of nitrogen enrichment for substantial shifts in arbuscular mycorrhizal fungal community metrics in a temperate grassland of northern China

Nitrogen (N) enrichment poses threats to biodiversity and ecosystem stability, while arbuscular mycorrhizal (AM) fungi play important roles in ecosystem stability and functioning. However, the ecological impacts, especially thresholds of N enrichment potentially causing AM fungal community shifts have not been adequately characterized. Based on a long-term field experiment with nine N addition levels ranging from 0 to 50 g N m^-2  yr^-1 in a temperate grassland, we characterized the community response patterns of AM fungi to N enrichment. Arbuscular mycorrhizal fungal biomass continuously decreased with increasing N addition levels. However, AM fungal diversity did not significantly change below 20 g N m^-2  yr^-1 , but dramatically decreased at higher N levels, which drove the AM fungal community to a potentially unstable state. Structural equation modeling showed that the decline in AM fungal biomass could be well explained by soil acidification, whereas key driving factors for AM fungal diversity shifted from soil nitrogen : phosphorus (N : P) ratio to soil pH with increasing N levels. Different aspects of AM fungal communities (biomass, diversity and community composition) respond differently to increasing N addition levels. Thresholds for substantial community shifts in response to N enrichment in this grassland ecosystem are identified.

Does Water Quality Matter for Life Quality? A Study of the Impact of Water Quality on Well-being in a Coastal Community

Most studies of life quality are concentrated on a country-level scale, while local differences within a country or area are less studied. Thus, the effect of the environment on life quality on a local scale remains understudied and is often represented by one generalized common factor. In this study, we investigated the effect of an objectively measured environmental quality variable and subjective reflections of this (perceptions of environmental quality) in relation to life quality in a coastal community. Hence, we tested the effect of objective and subjective water quality measures using a model, accounting for other traditional variables (e.g., income and health) that predict life quality variations. Our findings indicate that perceptions of the environment are strongly associated with life quality, whereas objectively measured environmental quality is associated with life quality to a lesser extent. Thus, our results suggest that the impact of the environment on life quality is mediated via the way the environment is perceived (psychological effects) and less by the actual conditions of the environment.

Responding to Suicide Clusters in the Community: What Do Existing Suicide Cluster Response Frameworks Recommend and How Are They Implemented?

Suicide clusters involve an excessive number of suicides, suicide attempts, or both, that occur close in space or time or involve social links between cluster members. Although suicide clusters are rare, evidence documenting the implementation of suicide cluster response activities in communities is required yet remains limited. In this study, we identified the core components of existing suicide cluster response frameworks through a search of the grey literature and conducted an international survey to assess the implementation of the core components by stakeholders with experience responding to a suicide cluster. The following six core components were identified from five cluster response frameworks and were incorporated into a survey assessing stakeholders’ experiences of responding to a suicide cluster: (1) Preparing for a suicide cluster; (2) Routine monitoring of suicide, suicide attempts, and cluster detection; (3) Coordination with the media and monitoring social media; (4) Identifying and supporting individuals at risk; (5) Promoting help-seeking and building community resilience; and (6) Long-term follow-up and evaluation. Twenty-six stakeholders completed the online survey. Many of the core components were implemented by stakeholders. However, gaps in practice were reported in terms of cluster surveillance, monitoring of referral uptake among bereaved individuals, and long-term evaluation. Barriers to implementation included the perceived availability and suitability of mental health services, and availability of long-term funding. Strategic policy and planning that addresses the practice-based experiences of communities has the potential to facilitate a more coordinated and timely response to suicide clusters.

Rehearsing post-Covid-19 citizenship: Social representations of UK Covid-19 mutual aid

People across the world have responded to the pandemic by mobilizing and organizing to support their communities, setting up mutual aid groups to provide practical, financial, and social support. Mutual aid means short‐term 'crisis response' for some, while for other groups, it is a chance to radically restructure society, and what it means to be a member of that society. Drawing on social representations theory and previous work on citizenship in social and political psychology, we examined the ways in which mutual aid was understood and performed by members of UK Covid‐19 mutual aid groups. We conducted 29 interviews with members of these groups in May/June 2020. A reflexive thematic analysis showed that mutual aid groups were characterized as complex, efficient, and non‐hierarchical units, operating on the principles of solidarity, kindness, and trust. Two tensions were evident in the data, specifically between (1) collaboration with existing organizations and structures (e.g., local government and the police), and resistance to it and (2) maximizing group inclusivity and sustaining political critique. Findings are discussed in relation to existing theoretical and empirical work on citizenship and mutual aid groups.

Adverse childhood experiences and mental and physical health disparities: the moderating effect of race and implications for social work

Adverse childhood experiences (ACEs) have been linked to mental and physical health problems, leading to ACEs being viewed as a public health concern. Yet, less research has focused on the prevalence and impact of ACEs among diverse racial and ethnic groups. Given the increasing diversity in the USA, coupled with research that has found certain racial and ethnic groups to experience larger-scale adversity such as poverty or discrimination more frequently than White individuals, it is important to understand how ACEs are experienced by people of color. The current study examined the prevalence of ACEs among diverse racial and ethnic groups, and associations between ACE score and mental and physical health. Even after adjusting for sociodemographic factors, ACE scores of 3 or higher were linked to more physical and mental health problems. Furthermore, there was a significant interaction effect between ACE score and race on physical health, while none of the interaction terms were significant between ACE score and race on mental health. This suggests that higher ACE scores have a more detrimental impact on physical health for people of color. Implications for social work include implementing community-level ACE-informed responses, especially in communities that serve traditionally marginalized populations.

Community engagement in COVID-19 prevention: experiences from Kilimanjaro region, Northern Tanzania

Prevention of exposure to the COVID-19 virus in the general population is an essential strategy to slow community transmission. This paper shares the experiences and challenges of community engagement in COVID-19 prevention in the Kilimanjaro region, Northern Tanzania implemented by our team from the Institute of Public Health (IPH), Kilimanjaro Christian Medical University College (KCMUCo) in collaboration with the COVID-19 response team in the Moshi Municipality. We conducted an education session with the COVID-19 response team and together brainstormed transmission hotspots and which interventions would be most feasible in their settings. The first hotspot identified was crowded local market spaces. Suggested interventions included targeted and mass public health education through the engagement of market opinion leaders, public announcements, and radio shows. We conducted participatory rural appraisal techniques to enable market vendors and clients to visualize two-meter distances and provided a prototype hand-washing facility that was foot operated. We found mass public health educational campaigns essential to inform and update the public about COVID-19 pandemic and to address rumors and misinformation, which hampers compliance with public health interventions. Coordinated efforts among stakeholders in the country are necessary to develop context-specific prevention and case management strategies following the national and international guidelines. Local ownership of recommended interventions is necessary to ensure compliance.

myResponder Smartphone Application to Crowdsource Basic Life Support for Out-of-Hospital Cardiac Arrest: The Singapore Experience

OBJECTIVE

The Singapore myResponder is a novel smartphone application developed by the Singapore Civil Defence Force (SCDF) that notifies volunteer first responders of a suspected out-of-hospital cardiac arrest (OHCA) case and locations of Automated External Defibrillators (AED) in the vicinity so that they can assist with resuscitation. We aimed to examine the performance of this application, challenges encountered, and future directions. Methods: We analyzed data from the myResponder app since its launch from April 2015 to July 2019. The number of installations, registered community first responders, suspected OHCA cases, notifications sent by the app, percentage of responders who accepted activation and arrived at scene were reviewed. A subgroup of taxi driving responders (within a 1.5-kilometer response radius) carrying an AED under a subsequent pilot program was also analyzed. Results: By July 2019, 46,689 responders were registered in the myResponder app. There were a total of 19,189 cases created for suspected OHCA, with a median of 358 cases per month (IQR 330-430), in which 10,073 responders accepted activation from myResponder and 4,955 arrived on-scene. A total of 135,599 notifications were sent for these cases, with a median of 7.1 notifications per case (IQR 4.3-8.7). In 2019, the percentages of responders who accepted notification and arrived on scene were 45.8% and 24.1%, respectively. 43% (1110/2581) of responders arrived before EMS crew. Conclusion: The myResponder mobile application is a feasible smart technology solution to improve community response to OHCA, and to increase bystander CPR and AED use. Future directions include increasing the number of active responders, improving response rates, app performance, and better data capture for quality improvement.

Community Partnership in Response to Hoarding Disorder in Montreal

Clinical management of hoarding disorder is challenging because of the weak insight of people with hoarding disorder, the lack of available tools for disease management in the health care system, and the absence of communication between health care and primary responders. To tackle this communication gap and, hence, improve clinical management of hoarding disorder, a community partnership initiated by people with hoarding disorder took place in Montreal. This initiative could profitably offer guidelines for other communities facing hoarding disorder challenges.

Differences Between Florida and the Rest of the United States in Response to Local Transmission of the Zika Virus: Implications for Future Communication Campaigns

For those at risk for Zika virus infection, prevention requires an approach that includes individual, interpersonal, and community-level support for behavior change. In August 2016, the announcement of local Zika transmission in Florida provided an opportunity to determine whether Zika-related knowledge, attitudes, and behaviors might be affected differentially in Florida compared to the rest of the nation. From August 8-October 3, 2016, we conducted nationally representative weekly surveys (N = 12,236), oversampling Florida residents, measuring Zika virus news exposure, knowledge about transmission and prevention of the infection, and attitudes and behaviors toward prevention. We tested two classes of models: those focused on individual Zika risk perceptions (e.g., protection motivation theory) and one focused on community action beyond those directly at risk (social consensus model). Analyses assessed differences between Florida and the rest of the nation by survey week. Consistent with both models, Floridians demonstrated significantly higher levels of perceived susceptibility and knowledge, more positive attitudes toward Zika virus prevention, and higher likelihood of engaging in protective behavior than non-Floridians. Consistent with theories of individual risk perception, response was greater among respondents who saw themselves at risk of infection. However, consistent with the SCM, irrespective of personal risk, response was greater among Floridians. Nevertheless, more than half of the public took no direct action to prevent the spread of Zika. Communities at increased risk for a novel infection such as Zika may quickly acquire Zika-related knowledge, attitudes, and behavior, but large-scale community-wide response might be difficult without further community-level public education.

Quantifying the Importance of the Rare Biosphere for Microbial Community Response to Organic Pollutants in a Freshwater Ecosystem

A single liter of water contains hundreds, if not thousands, of bacterial and archaeal species, each of which typically makes up a very small fraction of the total microbial community (<0.1%), the so-called "rare biosphere." How often, and via what mechanisms, e.g., clonal amplification versus horizontal gene transfer, the rare taxa and genes contribute to microbial community response to environmental perturbations represent important unanswered questions toward better understanding the value and modeling of microbial diversity. We tested whether rare species frequently responded to changing environmental conditions by establishing 20-liter planktonic mesocosms with water from Lake Lanier (Georgia, USA) and perturbing them with organic compounds that are rarely detected in the lake, including 2,4-dichlorophenoxyacetic acid (2,4-D), 4-nitrophenol (4-NP), and caffeine. The populations of the degraders of these compounds were initially below the detection limit of quantitative PCR (qPCR) or metagenomic sequencing methods, but they increased substantially in abundance after perturbation. Sequencing of several degraders (isolates) and time-series metagenomic data sets revealed distinct cooccurring alleles of degradation genes, frequently carried on transmissible plasmids, especially for the 2,4-D mesocosms, and distinct species dominating the post-enrichment microbial communities from each replicated mesocosm. This diversity of species and genes also underlies distinct degradation profiles among replicated mesocosms. Collectively, these results supported the hypothesis that the rare biosphere can serve as a genetic reservoir, which can be frequently missed by metagenomics but enables community response to changing environmental conditions caused by organic pollutants, and they provided insights into the size of the pool of rare genes and species.IMPORTANCE A single liter of water or gram of soil contains hundreds of low-abundance bacterial and archaeal species, the so called rare biosphere. The value of this astonishing biodiversity for ecosystem functioning remains poorly understood, primarily due to the fact that microbial community analysis frequently focuses on abundant organisms. Using a combination of culture-dependent and culture-independent (metagenomics) techniques, we showed that rare taxa and genes commonly contribute to the microbial community response to organic pollutants. Our findings should have implications for future studies that aim to study the role of rare species in environmental processes, including environmental bioremediation efforts of oil spills or other contaminants.

Public policy, health system, and community actions against illness as platforms for response to NCDs in Tanzania: a narrative review

BACKGROUND

Most low- and middle- income countries are facing a rise of the burden of non-communicable diseases (NCDs) alongside the persistent burden of infectious diseases. This narrative review aims to provide an inventory of how the existing policy environment, health system, and communities are addressing the NCDs situation in Tanzania and identify gaps for advancing the NCD research and policy agenda.

METHODOLOGY

A literature search was performed on PubMed and Google scholar with full text retrieval from HINARI of English language articles published between 2000 and 2012. Documents were read to extract information on what Tanzanian actors were doing that contributed to NCDs prevention, treatment, and control, and a narration was written out of these. Reference lists of all retrieved articles were searched for additional relevant articles. Websites of organizations active in the field of NCDs including the Government of Tanzania and WHO were searched for reports and grey literature.

RESULTS

Lack of a specific and overarching NCD policy has slowed and fragmented the implementation of existing strategies to prevent and control NCDs and their determinants. The health system is not prepared to deal with the rising NCD burden although there are random initiatives to improve this situation. How the community is responding to these emerging conditions is still unknown, and the current health-seeking behavior and perceptions on the risk factors may not favor control of NCDs and their risk factors.

CONCLUSION AND RECOMMENDATION

There is limited information on the burden and determinants of NCDs to inform the design of an integrative and multisectorial policy. Evidence on effective interventions for NCD services in primary care levels and on community perceptions on NCDs and their care seeking is virtually absent. Research and public health interventions must be anchored in the policy, health system, and community platforms for a holistic response.