Community Level Research Articles

Formation of Ethnic Minority Organizations in the First Years of Ukrainian Independence

historical retrospectives of the formation and activities of ethnic minority organizations in the early 1990s as one of the factors of state-building remains relevant. This study aims to analyze the historical context and peculiarities of the institutionalization of ethnic minority structures in Ukraine at the initial stage of the restoration of Ukrainian state independence. The research object is ethnic minority organizations, primarily those that focused their activities on national and cultural revival. The methodological framework includes the principles of historicism, tolerance, scientific impartiality, and impartiality. We have traced the specifics of the formation of ethnic community organizations and the main vectors of their activities during the specified period. Despite many common historical, cultural, and socio-political backgrounds, the formation of such organizations for different communities could have its peculiarities. For example, for Jewish organizations, the demographic issue was acute due to emigrant sentiments in the Jewish community. As for ethnic minorities like Hungarians and Romanians, they had close ties with their historical homelands. This fact also influenced their organizational structure in Ukraine. The Georgian minority built their organizations emphasizing cooperation between Ukraine and Georgia. Germans also sought to maintain ties with their historical homeland. For Poles, the religious factor was significant. Overall, in Ukraine, there were quite favorable conditions for the full development and activities of ethnic minorities despite the complex political and economic situation of the early 1990s. Nowadays, the issue of organizational development of ethnic communities is a matter of focus for state authorities both at the legislative level and at the level of local communities.

Release from aboveground enemies increases seedling survival in grasslands

Abstract Plant enemies can influence plant community assembly and structure. However, it is unclear how insect herbivores and fungal pathogens affect seedling recruitment. Complex interactions with competition and resource availability make it difficult to isolate the effect of enemies. This uncertainty can impede understanding of community assembly drivers, species coexistence and trophic interactions; and limits hypothesis testing such as of the enemy release hypothesis, a key hypothesis in invasion biology. Using a novel species‐specific approach, we examine how enemies affect seedling survival and recruitment of 16 grassland species. We planted seedlings of 16 native species from two functional groups (C4 grasses and non‐legume forbs) into two grassland sites (early and mid‐succession). We hand‐painted 1512 individual seedlings with pesticides (insecticide and fungicide) over the course of one growing season to enforce aboveground species‐specific release from enemies and tested whether it enhanced survival relative to untreated controls. Applying treatments to individuals allowed us to test for the effect of enemies on plant performance while controlling for contexts such as competition from the resident community and resource levels. Release from insects increased seedling survival by 56% on average, with no additional benefit of release from fungal pathogens. This effect was observed for both forbs and C4 grasses across both sites and was strongest in resource‐acquisitive species. There was no effect of the mean phylogenetic distance between our target species and the resident plant community, or of light availability or soil moisture. Synthesis. The significant positive effect of release from insect herbivores on survival early in colonisation—a trend that held across functional groups and types of resident community—suggests insects play an important regulatory role in community assembly, especially for resource‐acquisitive species. As variation between species could be explained by traits but not by phylogeny, we emphasise the importance of trait‐based approaches to plant community ecology. Our results also support the key mechanism (increased performance following release from enemies) underlying the enemy release hypothesis. Enemy release may therefore aid initial recruitment of plants during the invasion process.

Increasing tree cover and high-albedo surfaces reduces heat-related ER visits in Los Angeles, CA.

There is an urgent need for strategies to reduce the negative impacts of a warming climate on human health. Cooling urban neighborhoods by planting trees and vegetation and increasing albedo of roofs, pavements, and walls can mitigate urban heat. We used synoptic climatology to examine how different tree cover and albedo scenarios would affect heat-related morbidity in Los Angeles, CA, USA, as measured by emergency room (ER) visits. We classified daily meteorological data for historical summer heat events into discrete air mass types. We analyzed those classifications against historical ER visit data to determine both heat-related and excess morbidity. We used the Weather Research and Forecasting model to examine the impacts of varied tree cover and albedo scenarios on meteorological outcomes and used these results with standardized morbidity data algorithms to estimate potential reductions in ER visits. We tested three urban modification scenarios of low, medium, and high increases of tree cover and albedo and compared these against baseline conditions. We found that avoiding 25% to 50% of ER visits during heat events would be a common outcome if the urban environment had more tree cover and higher albedo, with the greatest benefits occurring under heat events that are moderate and those that are particularly hot and dry. We conducted these analyses at the county level and compared results to a heat-vulnerable, working-class Los Angeles community with a high concentration of people of color, and found that reductions in the rate of ER visits would be even greater at the community level compared to the county.

Factors affecting catches of bark beetles and woodboring beetles in traps

AbstractThe use of semiochemical-baited traps for detection, monitoring, and sampling bark beetles and woodboring beetles (BBWB) has rapidly increased since the early 2000s. Semiochemical-baited survey traps are used in generic (broad community level) and specific (targeted toward a species or group) surveys to detect nonnative and potentially invasive BBWB, monitor established populations of invasive or damaging native species, and as a tool to survey natural communities for various purposes. Along with expansion in use, much research on ways to improve the efficacy of trapping surveys for the detection of specific pests as well as BBWB in general has been conducted. In this review, we provide information on intrinsic and extrinsic factors and how they influence the efficacy of detecting BBWB in traps. Intrinsic factors, such as trap type and color, and other factors are described, as well as important extrinsic factors such as habitat selection, horizontal and vertical placement, and disturbance. When developing surveys, consideration of these factors should increase the species richness and/or abundance of BBWB captured in traps and increase the probability of detecting nonnative species that may be present. During generic surveys, deploying more than one trap type or color, using an array of lures, and trapping at different vertical and horizontal positions is beneficial and can increase the number of species captured. Specific surveys generally rely on predetermined protocols that provide recommendations on trap type, color, lure, and trap placement.

Below‐ground root nutrient‐acquisition strategies are more sensitive to long‐term grazing than above‐ground leaf traits across a soil nutrient gradient

Abstract Understanding how plant nutrient acquisition strategies respond to grazing at the community level is critical understanding ecosystem structure and functioning in grasslands. However, few studies have simultaneously compared the difference in above‐ground (leaf) and below‐ground (root) nutrient‐acquisition strategies in response to long‐term grazing, especially at the regional scale. Here, we measured a set of leaf and fine‐root traits that correspond to the fast‐slow economic spectrum at the community level in 10 experimental sites from paired grazed and ungrazed grasslands across a soil nutrient gradient covering three major types of grasslands in northern China. We found that patterns of variations of leaf and fine‐root traits were consistent with both a leaf and root economic spectrum at the community level for both grazed and non‐grazed plots. Grazing had minor effect on community‐level leaf nutrient‐acquisition strategies but strongly influenced community‐level root nutrient‐acquisition strategies. Specifically, root nutrient‐acquisition strategies were shifted to more exploitative resource use in grazed communities. Moreover, soil nutrient contributed to the changes in both leaf and root nutrient‐acquisition strategies, which tended towards a more resource acquisition strategy with increasing soil nutrient levels. Grazing significantly interacted with soil nutrient to affect root nutrient‐acquisition strategies, and grazing contributed more to root nutrient‐acquisition strategies than soil nutrient. Synthesis. Our results demonstrated completely inconsistent responses of community‐level above‐ and below‐ground resource acquisition strategies to long‐term grazing, and below‐ground acquisition strategies were more sensitive to long‐term grazing. Our findings also suggest that high intensity anthropogenic activities such as grazing may strongly modify below‐ground resource acquisition strategies. Read the free Plain Language Summary for this article on the Journal blog.image

COVID‐19’s effects on sense of place and pro‐environmental behaviour

AbstractCOVID‐19 substantially disrupted daily life globally. Human geography and environmental psychology scholars have argued that dramatic shifts in how people used urban environments during the pandemic could have important implications for those studying human–environment relationships and for planners designing urban spaces. Nevertheless, empirical data that examine shifts in human–environment relationships in urban areas during the pandemic are still limited. We explored how COVID‐19 influenced sense of place and investigated how sense of place and changes to daily life because of the pandemic affected environmentally friendly behaviours. A case study involved working with 10 interview participants and 302 survey respondents in Wuhan, China—the city where the pandemic started, and which experienced very strict lockdowns. Data collection occurred in June 2021. The results reveal three main findings. First, stronger emotions directed towards the pandemic and heightened pandemic responses positively affected sense of place, with response behaviours including taking disease prevention measures, spending more time with families/friends, and helping others during the crisis. Second, sense of place and behavioural response to the pandemic were both associated with environmentally friendly behaviours, but not with environmentally friendly attitudes. Third, the nation and city, rather than the community level, are the geographic scales most consonant with respondent notions of place; sense of place grew most at these scales during the pandemic. We conclude that contrary to some speculation, sense of place was enhanced during the pandemic, at least in Wuhan. The pandemic also provided an opportunity for behaviour transitions, but not necessarily via changes in sense of place.

Temperature exposure and health inequality

This paper analyzes the relationship among temperature exposure, health inequality, and adaptive behavior in China, a country with diverse climate zones ranging from the cold, arid northwest to the warm, humid south. Utilizing follow-up survey data spanning from 2000 to 2015, this paper constructs a measure of health inequality at the community level. Our findings reveal that extremely cold or hot days increase the health inequality at the community level. Specifically, with each incremental rise in the day’s extreme temperature, the Gini coefficient of community health rises by 0.0032, which constitutes approximately 0.4% of the community average. Furthermore, vulnerable communities, which are characterized by low average income, education levels, per capita electricity consumption, and urbanization, are highly susceptible to the effects of extreme temperatures on health equality. From the perspective of adaptive behavior, residents in high-income communities exhibit elevated electricity consumption and engage in frequent preventive health check-ups during extreme temperature exposure. This phenomenon may exacerbate social polarization because well-resourced individuals and communities are better equipped to withstand the challenges posed by climate change and extreme weather events compared with impoverished ones. Addressing this disparity requires local managers to implement comprehensive policies and interventions that can enhance the adaptability of low-income communities, improve public health facilities, and promote social equity.

The Equity Impact of Universal Home Visits to Pregnant Women and Their Spouses in Bauchi State, Nigeria: Secondary Analysis From a Cluster Randomised Controlled Trial.

Socio-economically disadvantaged women have poor maternal health outcomes. Maternal health interventions often fail to reach those who need them most and may exacerbate inequalities. In Bauchi State, Nigeria, a recent cluster randomised controlled trial (CRCT) showed an impressive impact on maternal health outcomes of universal home visits to pregnant women and their spouses. The home visitors shared evidence about local risk factors actionable by households themselves and the program included specific efforts to ensure all households in the intervention areas received visits. To examine equity of the intervention implementation and its pro-equity impact. The overall study was a CRCT in a stepped wedge design, examining outcomes among 15,912 pregnant women. We examined coverage of the home visits (three or more visits) and their impact on maternal health outcomes according to equity factors at community, household, and individual levels. Disadvantaged pregnant women (living in rural communities, from the poorest households, and without education) were as likely as those less disadvantaged to receive three or more visits. Improvements in maternal knowledge of danger signs and spousal communication, and reductions in heavy work, pregnancy complications, and post-natal sepsis were significantly greater among disadvantaged women according to the same equity factors. The universal home visits had equitable coverage, reaching all pregnant women, including those who do not access facility-based services, and had an important pro-equity impact on maternal health.

Exploring actors' collaborations and involvement in the Namibian learner pregnancy policy

IntroductionThe Namibia Education Sector Policy on the Prevention and Management of Learner Pregnancy (ESPPMLP) aims to reduce the cases of learners falling pregnant and increase learner-parent completion of education. The ESPPMLP addresses the fact that learner pregnancy and school drop-out are collaborative efforts between parents, the community, schools, and non-governmental organizations. However, Namibia continues to have had a problem with the high rate of learner pregnancy and school drop-out for many years. Previous studies reported the absences and limitations of both internal and external actors' collaboration in its implementation. This paper aims to clarify the lack of stakeholder involvement and cooperation in the ESPPMLP activities within selected rural schools in Namibia.MethodsUsing the qualitative approach mixed with phenomenological and content data analysis, the study conducted 19 individual interviews with schoolteachers, one school board member, one NGO representative, and six focus group discussions with 27 parents.Results and findingsAmong others, results show the limited life skills of teachers in schools, the attitude of the community toward schoolteachers, making them feel devoid of influence in collaborations, and the lack of sexual reproductive activities programs in school settings. The findings reveal the reliance of the activities of prevention and management of learner pregnancy on donor-driven initiatives, the lack of task forces at the community level, the shortage of knowledge and understanding about the ESPPMLP and the lack of policy implementation guidelines. Establish learner pregnancy leadership structures at the community level for coordination, introduce community parenting, and execute partnership of monitoring activities to boost stakeholder collaborations.

Six in ten female youths in low-income East African countries had problems in accessing health care: a multilevel analysis of recent demographic and health surveys from 2016–2021

BackgroundAccess to health care services is a basic human right, and an individual’s health and overall quality of life may suffer as a result of barriers to accessing health services. Access to comprehensive and quality health care is fundamental for promoting and maintaining health, preventing and treating diseases, and reducing premature deaths. However, only half of the African population has access to modern health services. Therefore, this study aimed to assess the health care access and associated factors among female youths in low-income East African countries.MethodsThis study used secondary data from 2016 to 2021 demographic and health surveys of 7 low-income East African countries. A total weighted sample of 51,064 youths was included. A multilevel binary logistic regression was employed to identify the associated factors of access to health care since the data has a hierarchical structure. Adjusted Odds Ratio (AOR) with a 95% confidence interval (CI) at a p-value less than 0.05 was used to measure the association of variables whereas Intra-class correlation coefficient (ICC), Median Odds Ratio (MOR), and proportional change in variance (PCV) were used to measure random effects.ResultThe overall magnitude of access to healthcare among female youths in low-income East African countries was 38.84% (95% CI: 38.41, 39.26). Youth’s educational level, rich wealth status, media exposure, and community level education were the positive while higher youth’s age and rural residence were the negative predictors of access to healthcare among female youths. Besides, living in different countries compared to Burundi was also an associated factor for accessing healthcare in low-income East African countries.ConclusionAbout six in ten female youths were not accessing health care in low-income East African countries. Therefore, to increase healthcare access, health managers and policymakers needed to develop strategies to improve the poor household wealth index, and redistribution of health services for rural residents. The decision-makers and program planners should also work on increasing access to education and media exposure for youths. Further research including health system and quality of service-related factors for accessing healthcare should also be considered by researchers.

A framework for assessing social structure in community governance of sustainable urban drainage systems: insights from a literature review

The utilization of Sustainable Urban Drainage Systems (SUDS) as Nature-based Solutions (NBS) holds significant promise for enhancing resilience against climate change-induced flooding and promoting community well-being in urban areas of Sub-Saharan Africa. While existing research predominantly emphasizes technical aspects within the NBS framework, understanding the socio-governance dynamics at the community level is equally imperative, particularly given the decentralized nature of SUDS. This study aims to complement the prevailing technical focus by examining the social dimensions of community governance related to SUDS implementation. Through a literature review, key determinants of social structure influencing successful community governance in SUDS management are identified, and categorized into actors, resources, discourses, and rules of engagement. An innovative assessment framework comprising 65 indicators is proposed to evaluate these determinants, offering a comprehensive tool for scholars and practitioners. By integrating social considerations into SUDS management practices, this research seeks to inform policy formulation and strategies tailored to Sub-Saharan African cities, facilitating equitable and participatory urban stormwater management initiatives crucial for addressing climate change challenges.

What drives growth responses of nitrogen and phosphorus (co-)limited primary producer communities?

The growth of autotroph communities is frequently (co-)limited by essential nutrients such as nitrogen (N) and phosphorus (P). Several mechanisms have been proposed to explain the observed co-limitation patterns at different levels of biological organization, especially at the biochemical level for individual species. When considering communities, the presence of different species and functional groups with contrasting physiologies and nutrient requirements leads to a more difficult understanding of the mechanisms involved in nutrient (co-)limitation. To investigate what drives co-limitation patterns and possible underlying mechanisms based on biomass responses in autotroph communities, we grew phytoplankton communities differing in species composition in experimental microcosms on three N:P ratios to impose different limiting conditions. Afterwards, N, P, both, or none were factorially supplied to the communities to test which nutrients were limiting growth. We measured the biovolume of single species in the communities to assess how they responded to nutrient additions and compared it to the response of the overall community biovolume. The types of nutrient (co-)limitation identified, i.e. the factorial limitation scenarios for community biomass were single N limitation or simultaneous co-limitation by N and P, and were strongly driven by the dominant species. The phytoplankton species in the communities responded differently to the nutrient addition treatments, i.e. they showed contrasting limitation outcomes and therefore likely different nutrient requirements. Our experiment indicates that phylogenetically distantly-related phytoplankton species grown in a community can have different resource use efficiencies and thus can be limited by different nutrients. We suggest that the dominance of species or groups with similar traits in nutrient requirements and acquisition is one of the leading mechanisms that determines the biomass pattern of nutrient (co-)limitation observed at the community level. This work also highlights the potential of predicting community growth limitation outcomes based on knowledge of nutrient use efficiencies of one or few dominant species, which can be a suitable tool for lake restoration and oligotrophication efforts.

Adaptive strategies based on shrub leaf-stem anatomy and their environmental interpretations in the eastern Qaidam Basin

BackgroundWater stress seriously affects the survival of plants in natural ecosystems. Plant resistance to water stress relies on adaptive strategies, which are mainly based on plant anatomy with following relevant functions: (1) increase in water uptake and storage; (2) reduction of water loss; and (3) mechanical reinforcement of tissues. We measured 15 leaf-stem anatomical traits of five dominant shrub species from 12 community plots in the eastern Qaidam Basin to explore adaptive strategies based on plant leaf-stem anatomy at species and community levels. and their relationship with environmental stresses were tested.ResultsResults showed that the combination of leaf-stem anatomical traits formed three types of adaptive strategies with the drought tolerance of leaf and stem taken as two coordinate axes. Three types of water stress were caused by environmental factors in the eastern Qaidam Basin, and the established adaptive strategy triangle could be well explained by these environmental stresses. The interpretation of the strategic triangle was as follows: (1) exploitative plant strategy, in which leaf and stem adopt the hydraulic efficiency strategy and safety strategy, respectively. This strategy is mostly applied to plants in sandy desert (i.e., Nitraria tangutorum, and Artemisia sphaerocephala) which is mainly influenced by drought stress; (2) stable plant strategy, in which both leaf/assimilation branches and stem adopt hydraulic safety strategy. This strategy is mostly applied to plants in salty desert (i.e., Kalidium foliatum and Haloxylon ammodendron) which aridity has little effect on them; and (3) opportunistic plant strategy, in which leaf and stem adopt hydraulic safety strategy and water transport efficiency strategy. This strategy is mostly applied to plants in multiple habitats (i.e., Sympegma regelii) which is mainly affected by coldness stress.ConclusionThe proposed adaptive strategy system could provide a basis for elucidating the ecological adaptation mechanism of desert woody plants and the scientific management of natural vegetation in the Qinghai-Tibet Plateau.

Impact of SARS-CoV-2 vaccines on Covid-19 incidence and mortality in the United States.

Given the waning of vaccine effectiveness and the shifting of the most dominant strains in the U.S., it is imperative to understand the association between vaccination coverage and Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) disease and mortality at the community levels and whether that association might vary according to the dominant SARS-CoV-2 strains in the U.S. Generalized estimating equations were used to estimate associations between U.S. county-level cumulative vaccination rates and booster distribution and the daily change in county-wide Coronavirus 2019 disease (COVID-19) risks and mortality during Alpha, Delta and Omicron predominance. Models were adjusted for potential confounders at both county and state level. A 2-week lag and a 4-week lag were introduced to assess vaccination rate impact on incidence and mortality, respectively. Among 3,073 counties in 48 states, the average county population complete vaccination rate of all age groups was 50.79% as of March 11th, 2022. Each percentage increase in vaccination rates was associated with reduction of 4% (relative risk (RR) 0.9607 (95% confidence interval (CI): 0.9553, 0.9661)) and 3% (RR 0.9694 (95% CI: 0.9653, 0.9736)) in county-wide COVID-19 cases and mortality, respectively, when Alpha was the dominant variant. The associations between county-level vaccine rates and COVID-19 incidence diminished during the Delta and Omicron predominance. However, each percent increase in people receiving a booster shot was associated with reduction of 6% (RR 0.9356 (95% CI: 0.9235, 0.9479)) and 4% (RR 0.9595 (95% CI: 0.9431, 0.9761)) in COVID-19 incidence and mortality in the community, respectively, during the Omicron predominance. Associations between complete vaccination rates and COVID-19 incidence and mortality appeared to vary with shifts in the dominant variant, perhaps due to variations in vaccine efficacy by variant or to waning vaccine immunity over time. Vaccine boosters were associated with notable protection against Omicron disease and mortality.

Anthropometric failures and its predictors among under five children in Ethiopia: multilevel logistic regression model using 2019 Ethiopian demographic and health survey data

BackgroundComposite Index of Anthropometric Failure (CIAF) combines all three forms of anthropometric failures to assess undernutrition status of children. There is no study on CIAF to identify the real and severe form of under nutrition among Ethiopian children that addressed community level factors. So, this study determined CIAF and identified important factors which helps to design appropriate intervention strategies by using multi-level advanced statistical model.MethodsThe study included 5,530 under five children and utilized a secondary data (EMDHS 2019) which was collected through community-based and cross-sectionally from March 21 to June 28, 2019. Composite index of anthropometric failure among under five children was assessed and a two-stage sampling technique was used to select the study participants. Descriptive summary statistics was computed. A multi-level binary logistic regression model was employed to identify important predictors of CIAF in under five children. Adjusted odds ratio with its 95% CI was estimated and level of significance 0.05 was used to determine significant predictors of CIAF.ResultsThe prevalence of composite index of anthropometric failure (CIAF) was 40.69% (95% CI: 39.41, 42.00) in Ethiopia. Both individual and community level predictors were identified for CIAF in under five children. Among individual level predictors being male sex, older age, short birth interval, from mothers who have not formal education, and from poor household wealth quintile were associated with higher odds of CIAF among under five children. Low community women literacy and being from agriculturally based regions were the community level predictors that were associated with higher odds of CIAF in under five children in Ethiopia.ConclusionsThe burden of composite index of anthropometric failure in under five children was high in Ethiopia. Age of child, sex of child, preceding birth interval, mother’s education, household wealth index, community women literacy and administrative regions of Ethiopia were identified as significant predictors of CIAF. Therefore, emphasis should be given for those factors to decrease the prevalence of CIAF in under five children in Ethiopia.

Investigating Factors Associated with Migration and Cultural Adaptation in Relation to Change in Attitudes and Behavior towards Female Genital Mutilation/Cutting (FGM/C) among Populations from FGM/C-Practicing Countries Living in Western Countries: A Scoping Review

A growing body of evidence indicates a significant decrease in support for female genital mutilation/cutting (FGM/C) within post-migration communities in Western countries. Addressing knowledge gaps and comprehending the factors associated with FGM/C discontinuation in these communities is crucial. The objective of this scoping review is to describe the effects of migration and cultural change on factors supporting FGM/C cessation in migrant communities. The review, from 2012 to 2023, included the following databases: Embase, PubMed, Google Scholar, Swisscovery, CINAHL, APA PsycInfo, and gray literature. Applying the PRISMA-ScR framework, we identified 2819 studies, with 17 meeting the inclusion criteria. The results revealed seven key factors shaping attitudes and behavior toward FGM/C abandonment: (1) legislation against FGM/C, (2) knowing that FGM/C is not a religious requirement, (3) enhancing education about the practice, (4) migration and cultural change, (5) awareness of the harmful effects of FGM/C, (6) a positive view of uncut girls, and (7) a sense of self-agency. These findings highlight factors on a social, community, interpersonal, and personal level that enhance the abandonment of the practice. Further research in the FGM/C field will gain more accuracy in understanding and accounting for these multilevel factors in post-migration settings, offering valuable insights for targeted interventions to promote the cessation of the practice.

Exploring the Threefold Viewpoint on Children's Oral Health in a Cross-Sectional Study.

Oral health is situated within the framework of the global health agenda, addressing facets pertaining to well-being and quality of life. The research is based on the need to address variables at the community level to improve schoolchildren's oral health and promote healthy behaviors and aims to carry out an in-depth analysis from the perspective of the factors that influence children's oral health. Step 1, designed by the World Health Organization, was utilized. An easy-to-use web interface was created for data collection. The statistical analysis consisted of using multinomial and binominal logistic regression models. The level of education of the adult has a high probability of influencing the consumption of unhealthy or healthy foods, it has a significant probability of exerting influence on social or medical problems and a correlation was found between the level of academic education and the pattern of dental visits. The development of health-promoting behaviors begins in childhood and involves parents, who have an essential role in the education of their children. Oral health promotion programs in schools need to target the child-adult-teacher-dentist relationships. Taking into consideration the aforementioned, a threefold viewpoint is necessary for the development of a national program aimed at promoting the oral health of schoolchildren in Romania.

A mixed methods evaluation of the impact of ECHO® telementoring model for capacity building of community health workers in India

IntroductionIndia has the largest cohort of community health workers with one million Accredited Social Health Activists (ASHAs). ASHAs play vital role in providing health education and promoting accessible health care services in the community. Despite their potential to improve the health status of people, they remain largely underutilized because of their limited knowledge and skills. Considering this gap, Extension for Community Healthcare Outcomes (ECHO)® India, in collaboration with the National Health System Resource Centre (NHSRC), implemented a 15-h (over 6 months) refresher training for ASHAs using a telementoring interface. The present study intends to assess the impact of the training program for improving the knowledge and skills of ASHA workers.MethodsWe conducted a pre–post quasi-experimental study using a convergent parallel mixed-method approach. The quantitative survey (n = 490) assessed learning competence, performance, and satisfaction of the ASHAs. In addition to the above, in-depth interviews with ASHAs (n = 12) and key informant interviews with other stakeholders (n = 9) examined the experience and practical applications of the training. Inferences from the quantitative and qualitative approaches were integrated during the reporting stage and presented using an adapted Moore’s Expanded Outcomes Framework.ResultsThere was a statistically significant improvement in learning (p = 0.038) and competence (p = 0.01) after attending the training. Participants were satisfied with the opportunity provided by the teleECHO™ sessions to upgrade their knowledge. However, internet connectivity, duration and number of participants in the sessions were identified as areas that needed improvement for future training programs. An improvement in confidence to communicate more effectively with the community was reported. Positive changes in the attitudes of ASHAs towards patient and community members were also reported after attending the training. The peer-to-peer learning through case-based discussion approach helped ensure that the training was relevant to the needs and work of the ASHAs.ConclusionsThe ECHO Model ™ was found effective in improving and updating the knowledge and skills of ASHAs across different geographies in India. Efforts directed towards knowledge upgradation of ASHAs are crucial for strengthening the health system at the community level. The findings of this study can be used to guide future training programs.Trial registration The study has been registered at the Clinical Trials Registry, India (CTRI/2021/10/037189) dated 08/10/2021.

Intraspecific alternative phenotypes contribute to variation in species' strategies for growth.

Ecologists have historically sought to identify the mechanisms underlying the maintenance of local species diversity. High-dimensional trait-based relationships, such as alternative phenotypes, have been hypothesized as important for maintaining species diversity such that phenotypically dissimilar individuals compete less for resources but have similar performance in a given environment. The presence of alternative phenotypes has primarily been investigated at the community level, despite the importance of intraspecific variation to diversity maintenance. The aims of this research are to (1) determine the presence or absence of intraspecific alternative phenotypes in three species of tropical tree seedlings, (2) investigate if these different species use the same alternative phenotypes for growth success, and (3) evaluate how findings align with species co-occurrence patterns. We model species-specific relative growth rate with individual-level measurements of leaf mass per area (LMA) and root mass fraction (RMF), environmental data, and their interactions. We find that two of the three species have intraspecific alternative phenotypes, with individuals within species having different functional forms leading to similar growth. Interestingly, individuals within these species use the same trait combinations, high LMA low RMF and low LMA high RMF, in high soil nutrient environments to acquire resources for higher growth. This similarity among species in intraspecific alternative phenotypes and variables that contribute most to growth may lead to their negative spatial co-occurrence. Overall, we find that multiple traits or interactions between traits and the environment drive species-specific strategies for growth, but that individuals within species leverage this multi-dimensionality in different ways for growth success.

Projection of Interspecific Competition (PIC) Matrices: A Conceptual Framework for Inclusion in Population Risk Assessments.

Accounting for intraspecific and interspecific competition when assessing the effects of chemical and nonchemical stressors is an important uncertainty in ecological risk assessments. We developed novel projection of interspecific competition (PIC) matrices that allow for analysis of population dynamics of two or more species exposed to a given stressor(s) that compete for shared resources within a landscape. We demonstrate the application of PIC matrices to investigate the population dynamics of two hypothetical fish species that compete with one another and have differences in net reproductive rate and intrinsic rate of population increase. Population status predictions were made under scenarios that included exposure to a chemical stressor that reduced fecundity for one or both species. The results of our simulations demonstrated that measures obtained from the life table and Leslie matrix of an organism, including net reproductive rate and intrinsic rate of increase, can result in erroneous conclusions of population status and viability in the absence of a consideration of resource limitation and interspecific competition. This modeling approach can be used in conjunction with field monitoring efforts and/or laboratory testing to link effects due to stressors to possible outcomes within an ecosystem. In addition, PIC matrices could be combined with adverse outcome pathways to allow for ecosystem projection based on taxonomic conservation of molecular targets of chemicals to predict the likelihood of relative cross-species susceptibility. Overall, the present study shows how PIC matrices can integrate effects across the life cycles of multiple species, provide a linkage between endpoints observed in individual and population-level responses, and project outcomes at the community level for multiple generations for multiple species that compete for limited resources. Environ Toxicol Chem 2024;00:1-17. Published 2024. This article is a U.S. Government work and is in the public domain in the USA.