Diagnostic potential of structural neuroimaging for depression from a multi-ethnic community sample

Background At present, we do not have any biological tests which can contribute towards a diagnosis of depression. Neuroimaging measures have shown some potential as biomarkers for diagnosis. However, participants have generally been from the same ethnic background while the applicability of a biomarker would require replication in individuals of diverse ethnicities. Aims We sought to examine the diagnostic potential of the structural neuroanatomy of depression in a sample of a wide ethnic diversity. Method Structural magnetic resonance imaging (MRI) scans were obtained from 23 patients with major depressive disorder in an acute depressive episode (mean age: 39.8 years) and 20 matched healthy volunteers (mean age: 38.8 years). Participants were of Asian, African and Caucasian ethnicity recruited from the general community. Results Structural neuroanatomy combining white and grey matter distinguished patients from controls at the highest accuracy of 81% with the most stable pattern being at around 70%. A widespread network encompassing frontal, parietal, occipital and cerebellar regions contributed towards diagnostic classification. Conclusions These findings provide an important step in the development of potential neuroimaging-based tools for diagnosis as they demonstrate that the identification of depression is feasible within a multi-ethnic group from the community. Declaration of interests C.H.Y.F. has held recent research grants from Eli Lilly and Company and GlaxoSmithKline. L.M. is a former employee and stockholder of Eli Lilly and Company.

Tying it Together: Education-Focused Community Change Initiatives

Policymakers make many demands of our schools to produce academic success. At the same time, community organizations, government agencies, faith-based institutions, and other groups often are providing support to students and their families, especially those from high-poverty backgrounds, that are meant to impact education but are often insufficient, uncoordinated, or redundant. In many cases, these institutions lack access to schools and school leaders. What’s missing from the dominant education reform discourse is a coordinated education-focused approach that mobilizes community assets to effectively improve academic and developmental outcomes for students. This study explores how education-focused comprehensive community change initiatives (CCIs) that utilize a partnership approach are organized and sustained. In this study, I examine three research questions: 1. Why and how do school system-level community change initiative (CCI) partnerships form? 2. What are the organizational, financial, and political structures that support sustainable CCIs? What, in particular, are their connections to the school systems they seek to impact? 3. What are the leadership functions and structures found within CCIs? How are leadership functions distributed across schools and agencies within communities? To answer these questions, I used a cross-case study approach that employed a secondary data analysis of data that were collected as part of a larger research study sponsored by a national organization. The original study design included site visits and extended interviews with educators, community leaders and practitioners about community school initiatives, one type of CCI. This study demonstrates that characteristics of sustained education-focused CCIs include leaders that are critical to starting the CCIs and are willing to collaborate across institutions, a focus on community problems, building on previous efforts, strategies to improve service delivery, a focus on education and schools in particular, organizational arrangements that create shared leadership and ownership for the CCI, an intermediary to support the initial vision and collaborative leadership groups, diversified funding approaches, and political support. These findings add to the literature about the growing number of education-focused CCIs. The study’s primary recommendation—that institutions need to work across boundaries in order to sustain CCIs organizationally, financially, and politically—can help policymakers as they develop new collaborative approaches to achieving educational goals.

“Never Give up:” The Strengths and Strategies Used Among Undocumented College Students From Central America to Access and Persist in U.S. Higher Education

The purpose of this study was to identify the strengths and strategies that undocumented college students from Central America used to access and persist in United States higher education. A multiple-case study design was used to conduct in-depth, semi-structured interviews and document collection from ten persons residing in Illinois, Maryland, Ohio, Texas, and Washington. Yosso’s (2005, 2006) community cultural wealth conceptual framework, an analytical and methodological tool, was used to uncover assets used to navigate the higher education system. The findings revealed that participants activated all forms of capital, with cultural capital being the least activated yet necessary, to access and persist in college. Participants also activated most forms of capital together or consecutively in order to attain financial resources, information and social networks that facilitated college access. Participants successfully persisted because they continued to activate forms of capital, displayed a high sense of agency, and managed to sustain college educational goals despite challenges and other external factors. The relationships among forms of capital and federal, state, and institutional policy contexts, which positively influenced both college access and persistence were not illustrated in Yosso’s (2005, 2006) community cultural wealth framework. Therefore, this study presents a modified community cultural wealth framework, which includes these intersections and contexts. In the spirit of Latina/o critical race theory (LatCrit) and critical race theory (CRT), the participants share with other undocumented students suggestions on how to succeed in college. This study can contribute to the growing research of undocumented college students, and develop higher education policy and practice that intentionally consider undocumented college students’ strengths to successfully navigate the institution.

Dissonant Belonging and the Making of Community: Native Hawaiian Claims to Selfhood and Home

In 1898 the United States illegally annexed the Hawaiian Islands over the protests of Queen Liliʽuokalani and the Hawaiian people. American hegemony has been deepened in the intervening years through a range of colonizing practices that alienate Kanaka Maoli, the indigenous people of Hawaiʽi, from their land and culture. Dissonant Belonging and the Making of Community is an exploration of contemporary Hawaiian peoplehood that reclaims indigenous conceptions of multiethnicity from colonizing narratives of nation and race. Drawing from archival holdings at the University of Hawaiʽi, Mānoa and in-depth interviews, this project offers an analysis of public and everyday discourses of nation, race, and peoplehood to trace the discursive struggle over Local identity and politics. A context-specific social formation in Hawaiʽi, “Local” is commonly understood as a multiethnic identity that has its roots in working-class, ethnic minority culture of the mid-twentieth century. However, American discourses of race and, later, multiethnicity have functioned to render invisible the indigenous roots of this social formation. Dissonant Belonging and the Making of Community reclaims these roots as an important site of indigenous resistance to American colonialism. It traces, on the one hand, the ways in which Native Hawaiian resistance has been alternately erased and appropriated. On the other hand, it explores the meanings of Local identity to Native Hawaiians and the ways in which indigenous conceptions of multiethnicity enabled a thriving community under conditions of colonialism.

RISK FACTORS FOR NONMEDICAL PRESCRIPTION ANALGESIC USE AMONG COLLEGE STUDENTS: RESULTS OF A PROSPECTIVE STUDY

Purpose—Nonmedical Prescription Analgesic (NPA) use is a serious public health concern and studies on risk factors for NPA use are lacking. This investigation used preexisting data from a landmark longitudinal, prospective study of college students, the College Life Study (CLS), to examine the longitudinal relationship between four suspected risk factors—affective dysregulation, conduct problems, depressive symptoms, and general psychological health—and NPA use. Methods—The sample was comprised of 1,253 young adults originally recruited as first-year college students from a large, mid-Atlantic university. Results—10.5% (n=103) of the participants during year 3 of the study reported past year NPA use, of which 55.3% (n=57) were male and 81.6% (n=84) were white. Affective dysregulation and conduct problems were found to be significantly and longitudinally (baseline to year 3) associated with incident NPA use after controlling for gender, parents’ education, and race/ethnicity. Conclusions—Affective dysregulation and conduct disorder are longitudinally associated with NPA use among college students. These findings might aid in prevention efforts to reduce NPA use among college students.

Community- and population-level effects of chytridiomycosis in a Neotropical amphibian community

As the number of fungal pathogen outbreaks become more frequent worldwide across taxa, so have the number of species extirpations and communities persisting with the pathogen. This phenomenon raises questions, such as: “what leads to host extinction during an outbreak?” and “how are hosts persisting once the pathogen establishes?.” But the data on host populations and communities across life stages before and after pathogen arrival rarely exist to answer these questions. Over the past three to four decades, the amphibian-killing fungus Batrachochytrim dendrobatidis (Bd) spread in a wave-like manner across Central America, leading to rapid species extirpations and population declines. I collected data on tadpole and adult amphibians in El Copé, Panama before, during, and after the Bd outbreak to answer these questions. I used Bayesian statistical approaches to account for imperfect host and pathogen detection of marked and unmarked individuals. In the tadpole community, within 11 months of Bds arrival, density and occupancy rapidly declined. Species losses were phylogenetically correlated, with glass frogs disappearing first, and tree frogs and poison-dart frogs remaining. I found that tadpole communities resembled one another more strongly after the outbreak than they did before Bd invasion. I found no tadpoles within 22 months of the outbreak and limited signs of recovery within 10 years. In contrast, at the same site, for a population of male glass frogs, Espadarana prosopleon, I found that 10 years post-outbreak, the population was consistently half its historic abundance, and that the lack of recruits to the population explained why the population had not rebounded, rather than high pathogen-induced mortality. And finally, examining the entire amphibian community, I found high pathogen prevalence, low infection intensities, and high survival rates of uninfected and infected hosts. Bd transmission risk, i.e., the probability a susceptible host becomes infected, did not relate to host density, pathogen prevalence, or infection intensity– Bd transmission risk was uniform across the study area. My results are especially relevant to conservation biologists aiming to predict the future impacts of Bd outbreaks, those trying to manage persisting populations, and those interested in reintroducing species back into wild amphibian communities.

Establishing community advisory boards for clinical trial research in Malawi: engendering ethical conduct in research

In this article I deal with extending the ethical principles of research to include communities through the establishment of Community Advisory Boards (CABs). The aim of the project on which this article is based demonstrates the need for protecting communities that participate in research in order to stimulate ethical conduct in research in Malawi. In the article, I provide an overview on the role and functions of CABs. I discuss the establishment of CABs in Malawi and present descriptions of the processes and challenges involved. I conclude by sharing experiences of some of the key lessons learnt from the establishment of CABs.

Changes in the community structure of urban and rural forest patches in Baltimore from 1998 to 2015

Urban forests are often highly fragmented with many exotic species. Altered disturbance regimes and environmental pollutants influence urban forest vegetation. One of the best ways to understand the impacts of land-use on forest composition is through long-term research. In 1998, the Baltimore Ecosystem Study established eight forest plots to investigate the impacts of urbanization on natural ecosystems. Four plots were located in urban forest patches and four were located in rural forests. In 2015, I revisited these plots to measure abundances and quantify change in forest composition, diversity, and structure. Sapling, shrub, and seedling abundance were reduced in the rural plots. Alpha diversity and turnover was lower in the rural plots. Beta diversity was reduced in the rural plots. The structure of the urban plots was mostly unchanged, except for a highly reduced sapling layer. Beta diversity in the urban plots was consistent across surveys due to high species turnover.

Community satisfaction with indoor residue spraying for Malaria control in Karonga, Northern Malawi

Background The Malawi National Malaria Control Program conducted Indoor Residual Spraying (IRS) in 2010 and 2013 in selected hot districts along the valleys including Karonga, but no study has been done to measure community satisfaction levels in these areas. Aim To assess satisfaction levels of community with IRS in both rural and urban settings, in Karonga district. Methods A cross-sectional study was conducted in urban village of Mwahimba and rural village of Fundi. Qualitative and quantitative data was collected from households’ representatives through Focus Group Discussions (FGDs) using De Wets’s Schutte tool. Qualitative data was analysed using thematic analysis while numbers and percentages were generated using Microsoft excel. Results Overall level of satisfaction in Fundi was estimated at 69% while that of Mwahimba was at 60.9%. In Fundi village, 66.1 % (37) of the household representatives were satisfied while in Mwahimba village, 60.7 % (34) were satisfied with the IRS programme. Factors that led to satisfaction were minimal adverse effects of the chemical on people after spraying, killing of other insects, sprayer’ courtesy and good communication. Factors behind dissatisfaction include: short residual effect of the chemical used, over-dilution of the chemical and minimal community involvement. Conclusion Despite finding high satisfaction levels in rural village than in an urban village, overall all the villages reported low levels of satisfaction with IRS due to various factors some of which common to both villages. Karonga District Health Office needs to involve the community in the process of spraying by recruiting sprayers from the target area and also explaining the purpose of dilution and the dilution factor to community members.

FOOD FOR THE CITY: CULTIVATING COMMUNITY IN BALTIMORE CITY

One in four residents of Baltimore City live in a food desert. Food desert disproportionately affects the low income neighborhoods more than the neighborhoods with financial stability. Throughout history, food became a commodity that depends on and dictates the market force. Food sources were being eliminated in the inner city while the suburbs saw rising development of grocery stores. Without grocery stores and other food retailers, communities are missing gathering and commercial hubs that make neighborhoods livable and help the local economy sustain and thrive. This thesis studies why food was further displaced from suffering communities and how an inclusive sustainable urban food system can help create a hub of neighborhood revitalization and promote health, social, safety, stability, and economic well-being of the community.

Falls and other geriatric syndromes in Blantyre, Malawi: a community survey of older adults

Background The prevalence of geriatric syndromes (falls, immobility, intellectual or memory impairment, and incontinence) is unknown in many resource-poor countries. With an aging population such knowledge is essential to develop national policies on the health and social needs of older people. The aim of this study was to provide a preliminary survey to explore the prevalence of falls and other geriatric syndromes and their association with known risk factors in people aged > 60 years in urban Blantyre, Malawi. Methods This was a cross-sectional, community survey of adults aged > 60 years. Subjects were recruited at home or in the waiting areas of chronic care clinics. They were interviewed to complete a questionnaire on ageassociated syndromes and comorbid problems. The Abbreviated Mental Test (AMT) and Timed Up and Go (TUG) tests were carried out. Results Ninety-eight subjects were studied; 41% reported falling in the past 12 months, 33% of whom (13% of all subjects) were recurrent fallers. Twenty-five percent reported urine incontinence, 66% self-reported memory difficulties, and 11% had an AMT score < 7. A history of falling was significantly associated with urine incontinence (p=0.01), selfreported memory problems (p=0.004) and AMT score < 7 (p=0.02). Conclusions Geriatric syndromes, including falls, appear to be prevalent in older people in Blantyre, Malawi. Falling is associated with cognitive impairment and urinary incontinence. There is an urgent need for more understanding of geriatric problems in this setting to develop national policies on health and social needs of older people. It is likely that many of the contributory factors to falls would be amenable to multifactorial interventions similar to those found to be effective in developed countries.

The Co-Adapted Community: A New Vision for the Parks at Walter Reed

The human-canine bond is one that has existed for thousands of years, yet not until more recently has it gained serious attention in the military medical field. The following thesis will use architecture as a way to explore the physical and psychological rehabilitative relationship between veterans and rescued canines. As soldiers return home from deployment, many struggle with reintegration into civilian life. The therapeutic potential of service dogs, however, has become a widely recognized recovery tool. Meanwhile, there are thousands of non-service dogs suffering extended periods in animal shelters with adverse psychological effects. In a society primarily centered on the typical human experience, the built environment often demonstrates a narrow perspective that lacks sensitivity towards the atypical user. Soldiers and dogs alike perceive and experience the world uniquely, and a further exploration of their distinct relationship can begin to inform how we might develop a new type of shared healing environment or co-adapted community.

The Effectiveness of Community-Based Nutrition Education on the Nutrition Status of Under-five Children in Developing Countries. A Systematic Review

Aim This systematic review aimed at examining the best available evidence on the effectiveness of community-based nutrition education in improving the nutrition status of under five children in developing countries. Methods A systematic search of the literature was conducted utilising the following data bases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Medline, and Web of Knowledge. 9 studies were identified for the critical appraisal process. The Joanna Briggs Institute (JBI) critical appraisal check-list for experimental studies was utilised and two reviewers conducted the appraisal process independently. 7 studies were included for this review and data was extracted using the JBI data extraction form for experimental studies. The extracted data was heterogeneous as such narrative synthesis was conducted. Results The nutritional status of children in all studies improved and this was evidenced by increases in weight, height, mid upper arm circumference and reduced morbidity. Key messages about education were age at introduction of complementary foods, nutrition value on different types of feeds found locally and frequency of feeding the children. However, there were varied Results regarding the effects of the intervention on the nutrition status of children. This was attributed by differences in implementers’ characteristics, different intervention strategy and intensity, difference in age of the children at enrolment, pre-existing children’s growth and nutritional status and follow-up periods. In addition to home visiting, conducting group meetings of care givers and community leaders, providing education twice a week and use of cooking demonstrations have shown that they produce highly significant findings. Conclusion The evidence from the identified studies suggests that community- based nutrition education improves the nutrition status of under-five children in developing countries.

The Influence of Pre-Migration Factors and Post-Migration Climate of the Receiving Community on the Psychological Distress of Latino Immigrants

Over forty million foreign-born residents currently live in the United States. Latinos make up the largest population of immigrants living in the U.S. Previous research suggests that Latino immigrants often experience pre-migration stressors, such as traumatic experiences, political upheaval, and unplanned migration. These stressors may have a negative impact on immigrants’ post-migration mental health. Research also suggests that the post-migration climate of the receiving community may inform the connection between pre-migration experiences and post-migration mental health. The current study examined the relationship between Latino immigrants’ reasons for migration, migration planning, and pre-migration experience of political and/or interpersonal violence, and post-migration symptoms of psychological distress. In addition to examining the effect of these pre-migration factors, the current study also examined the community “climate” experienced by Latino immigrants post-migration by assessing the influence of three post-migration factors: 1) community support and engagement, 2) discrimination, and 3) employment. The study was a secondary analysis of data collected for the National Latino and Asian American Study, which focused on the mental health and service utilization of Latinos and Asian Americans. Participants included 1,629 Latino immigrants from across the United States. Results indicated that pre-migration experience of political and/or interpersonal trauma, post-migration experience of discrimination, and female sex were positively associated with psychological distress. Post-migration employment was negatively associated with psychological distress. In addition, discrimination modified the association between unplanned migration and psychological distress; the relationship between unplanned migration and psychological distress decreased for participants who reported more discrimination. Furthermore, employment modified the association between political and/or interpersonal trauma and psychological distress; the connection between trauma and psychological distress increased among those who reported having less employment. Recommendations for further research were presented. Policy and clinical practice implications were discussed, particularly given the current climate of high anti-immigrant sentiment and hostility in the U.S.

The Ecology of Urbanization: A Study of Soil Microbial Community Rosponse

Urbanization is associated with global biodiversity loss of macrophauna and flora through direct and indirect mechanisms, but to date few studies have examined urban soil microbes. Although there are numerous studies on the influence of agricultural management on soil microbial community composition, there has been no global-scale study of human control over urban soil microbial communities. This thesis extends the literature of urban ecology to include soil microbial communities by analyzing soils that are part of the Global Urban Soil Ecology and Education Network (GLUSEEN). Chapter 1 sets the context for urban ecology; Chapters 2 addresses patterns of community assembly, biodiversity loss, and the phylogenetic relationships among community members; Chapter 3 addresses the metabolic pathways that characterize microbial communities existing under different land-uses across varying geographic scales; and Chapter 4 relates Chapter 2 and 3 to one another and to evolutionary theory, tackling assumptions that are particular to microbial ecology.