Community Members Research Articles

Building Relationships, Forming Collaborations: Lessons Learned From an Unconference Seeking to Cultivate Solutions in Healthcare.

Calls for a 'major rethinking' of the delivery of healthcare services are echoed across Canada as the healthcare crisis continues. Proposed strategies to address the challenges of this crisis include: a transdisciplinary approach that is patient-focused and community-based; a representative team composed of patients, caregivers, healthcare providers, decision makers and policymakers; and authentic collaboration among stakeholder groups throughout the research cycle. This study aimed to enable community members to take on a leading role in building capacity and to provide a space for discourse among diverse groups while respecting community wisdom, values and priorities. The Collaborative Health Research Institute of Southern Alberta (CHRISA) organized a participant-oriented Unconference event to address the factors contributing to the healthcare crisis in Alberta, Canada. An Unconference is a participant-oriented meeting where the attendees nominate the topics, agree on the agenda and lead the sessions. This article describes the Unconference programme and presents the findings from a thematic analysis of the discussion notes from breakout sessions, feedback from participants (i.e., lessons learned) and pragmatic recommendations for future Unconference events. Findings from sessions included the following: (1) identifying the 'wicked' problems, (2) the factors/causes contributing to each problem (i.e., contributors) and (3) potential multifaceted solutions or ideas to remedy the problem. Lessons learned from the postevent evaluation resulted in six recommendations for organizing future Unconferences. The CHRISA Unconference achieved its goals by providing a venue for attendees to connect, engage and network on topics of interest, explore new ways of addressing challenges in healthcare and serve as a foundation for future initiatives and collaborations in healthcare research and practice. The Unconference was attended by community members who identify as patients, frontline workers, programme administrators and representatives of public organizations and agencies. Participants contributed to breakout session discussions, provided feedback on the Unconference and offered recommendations for future events. The co-authors are service users, people with lived experience or those work in the healthcare setting; they have been involved in data collection, analysis and interpretation, and contributed to this report.

Conoce Tus Opciones: The Challenges of Communicating Rip Current Information in Spanish

Abstract Rip currents are poorly understood by the public and thus a leading cause of weather-related fatalities in the United States. Individuals who speak languages other than English, such as Spanish-speaking communities, have been historically underserved by communication efforts for natural hazards and thus are at additional risk from rip currents. In response, the National Weather Service (NWS) has developed rip current outreach tools translated into Spanish in recent years, though their efficacy has not been systematically tested. We therefore surveyed members of the Spanish-speaking community in the New York City area to gain insights into how the NWS two-page rip current informational brochure is working and possible improvements to be made. The English version of the brochure was also tested, and the results from the two languages were compared. Quantitative survey results indicate that while both brochures are generally effective, several changes could be made to improve clarity, especially for Spanish speakers, who found more issues with the Spanish version. For example, the translation of the term rip current itself used by the NWS, “corrientes de resaca,” was determined to be confusing by some Spanish speakers, as were other pieces of text with complex scientific terms. Moreover, certain graphics contained in the brochure were difficult to understand for users in both languages. The results of this work can be used by the NWS and other agencies to improve their Spanish risk communication tools and can also be used as a guide when translating scientific information into other languages. Significance Statement Rip currents, narrow channels of fast-moving water that can pull swimmers away from the shore, are among the leading weather-related killers in the United States yet are poorly understood by the public. Recent efforts to reduce society’s vulnerability to rip currents include the translation of outreach materials from English to Spanish. This study evaluated a new National Weather Service Spanish rip current informational brochure and compared it to the English version. The results show that while both the English and Spanish brochures were generally effective at communicating risk, the Spanish version had more issues, primarily surrounding the translation of scientific terms and phrases. Findings from this research can help guide scientists in designing improved non-English severe weather outreach products.

Adapting citizens’ jury methodology for use in Uganda: use of creative arts as a tool in deliberative, participatory research

ABSTRACT A citizens’ jury is a method of deliberative action research to determine the perspectives of community members regarding complex healthcare issues. This approach is a novel paradigm in settings such as Uganda. Implementation of electronic medical records brings the potential to use routinely collected data for health research. It is important to understand community perspectives. A two-day citizens’ jury was hosted in Kampala. ‘Expert witnesses’ provided topical evidence. Three creative arts techniques were implemented to enable interaction and reflection. First, a local Ugandan film team produced summaries. Secondly, a local artist painted emerging themes. Finally, a drama team comprised community members living with HIV developed an interactive sketch highlighting key points. This creative methodology enabled vibrant interaction. Jurors reached a unanimous verdict that with appropriate consent and data protection, electronic medical data could be used for research. This adapted citizens’ jury methodology could be used in other similar settings.

Abstract B091: Listen, Empower, Co-Create: Conducting listening sessions to create tailored messages about colorectal health for American Indian communities

Abstract Background We conducted Listening Sessions using a modified version of boot camp translation (BCT), a validated community engaged approach, to engage American Indian community members in the Great Plains and the Pacific Northwest to develop culturally and locally relevant colorectal cancer (CRC) screening messages and materials. Methods CRC is one of the leading causes of cancer death in the US and disproportionally affects American Indian adults. Routine CRC screening leads to earlier diagnosis and prolonged survival from the disease. In partnership with Great Plains Tribal Leaders Health Board (GPTLHB), South Puget Intertribal Planning Agency (SPIPA), and National Association of Chronic Disease Directors, we used a modified BCT approach to obtain feedback from tribal communities to create CRC screening messages and materials. To make the BCT process more meaningful for our partner communities, we reframed the BCT sessions by referring to them as Listening Sessions. The Listening Session engagement process was designed to help community leaders and champions learn about local barriers and gaps in care (listen), share health information in a collaborative way (empower), and develop messages and materials that resonate with and motivate community members to take control of their health (co-create). Eligible tribal community members from GPTLHB and SPIPA were between the ages of 45-75 and able to participate in three Listening Session meetings (one five-hour in-person meeting including expert presentations, brainstorming opportunities, and interactive small group sessions, and two follow-up virtual sessions (one-hour each) to refine messages and materials). Results Common Themes. Both groups emphasized the importance of using a multigenerational approach by including grandchildren and Elders in the messages and materials. Additionally, they highlighted the need for materials to be relatable and culturally relevant by incorporating local cultural imagery and traditions and multigenerational family support .Differing Themes. The GPTLHB findings focused specifically on including Lakota words to reinforce cultural identity, using visuals for colon health education, and incorporating details about healing traditions. The SPIPA findings recommended highlighting intertribal milestones like the canoe journey and incorporating water as a symbol of spiritual healing. Materials and Dissemination Methods. Preferred materials and channels for dissemination were: 1) fact sheets, posters, and visual stories to be distributed in-clinic or at community events, 2) animated videos for CRC screening education to be shown in clinic, 3) live action videos with community member CRC stories to be shown in clinic. Final materials will be available here: www.KPCHR-engage.org Conclusion We conducted Listening Sessions to incorporate participant feedback to develop CRC screening messages and materials and identified preferred dissemination channels for tribal communities in the Great Plains and Pacific Northwest. Citation Format: Jamie Thompson, Jennifer Rivelli, Priyanka Gautom, LaToya Brave Heart, Jamie Nikander, Lorrie Graaf, Gloria Coronado. Listen, Empower, Co-Create: Conducting listening sessions to create tailored messages about colorectal health for American Indian communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B091.

Abstract B001: Engaging patient advocates in the battle against cancer directly in their communities in culturally and language specific ways

Abstract Background: Patient advocates from diverse communities are at the forefront of informing on the latest scientific findings to different audiences; and connecting to resources to help battle cancer. However, disparities exists that exacerbate barriers to the delivery of cancer information. These disparities are the result of impactful socio-determinants of health that range from language barriers to food insecurity, mental health challenges and a lack of connection to support services and clinical trials. Lazarex Cancer Foundation has established Pop-up Hubs that go directly into the community to alleviate barriers while empowering patient advocates from varied cultural and racial/ethnic groups to deliver cancer information that account for culture, race/ethnicity literacy and numeracy levels, and delivered in multiple languages. Patient advocates are cancer-care ambassadors that help reduce the cancer burden, provide referrals, follow-up with needed information or care, and enroll patients into clinical trials. Methods: With community participation, patient advocates have helped develop culturally and language specific educational materials, approach communities in their own neighborhoods, and help connect to support services, such as free food distribution, mental health services, and raise awareness on environmental and lifestyle factors that can influence a cancer trajectory. Our patient advocates follow up with community members seeking resolution to their cancer concerns. Patient advocates promote screenings and help link individuals and their families. Patient advocates also work with community coalitions, testify before local decision-makers, and promote early detection, screening, tobacco cessation, weight management, nutritious culturally specific meals, and advise on exercise. Results: Working with patient advocates in a participatory manner, we have developed and disseminated educational materials on prostate cancer, breast cancer, colorectal cancer, cervical cancer, and clinical trials. Patient advocates have provided cancer information to 5,000 individuals of Latino/a (Spanish speaking), Black/African American, and Asian (Korean and Mandarin speaking) heritage). 3,773 have received cancer information, have connected 260 individuals to support groups; provided 112 community members with individualized follow-up increasing knowledge and access to services. Reached over 3 million people via various media and between 2018-2024 supported the passing with our partners of 31 tobacco laws in California. Conclusion: Patient advocates have created knowledgeable inviting environments for community members directly in the diverse communities of Los Angeles. The information provided includes screening guidelines, the importance of diversity participation in clinical trials, self or patient advocacy, and accessing trustworthy, reliable sources. Patient advocates are opening new ways to reach communities in a participatory manner in their own backyard; enhancing our ongoing effort to reduce cancer disparities. Citation Format: Lourdes Baezconde-Garbanati, Elena Nieves, Carolina Aristizabal1, Yaneth L. Rodriguez, Rosa Barahona, Marya Shego, Dana Dornsife. Engaging patient advocates in the battle against cancer directly in their communities in culturally and language specific ways [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B001.

Abstract B107: Community scientist research advocacy program: Training our research community

Abstract Community Scientist Research Advocacy (CSRA) training programs serve as fundamental bridges between communities and researchers. By engaging community members, these programs leverage networks, knowledge, and community perspectives to enhance research endeavors. This approach facilitates trust-building between disadvantaged populations and cancer researchers, particularly in the context of clinical trials participation and tissue donation. The purpose of our program was to develop and evaluate an innovative, bi-coastal, and bilingual program to inform, educate and encourage community members to become cancer research advocates in Florida (FL) and California (CA). Our program was culturally tailored for Black/African American and Hispanic/Latino/a adults. Primary objectives were to increase manpower for cancer research advocacy and increase multi-directional communication between cancer advocates with cancer patients, survivors, caregivers, community members, academic scientists, and policy makers. The CSRA program is a 13-week hybrid program implemented by the CaRE2 Health Equity Center, a bi-coastal partnership between the Florida A&M University, University of Florida, and University of Southern California in Los Angeles. Participants studied into cancers disproportionately affecting Black/African American and Hispanic/Latino/a groups, completing pre- and post-surveys to measure knowledge, self-efficacy, and program satisfaction. Additionally, participants concluded mentored advocacy projects for community implementation, with follow-up implemented at three months post-program completion. To date, a total of 45 adults have graduated from our CSRA program. We present data from the 2023 CSRA cohort (pre, N=21, post, N=19) that included participants from FL and CA, which are among the top five states in the U.S with the largest Black/African American and Hispanic/Latino/a populations. Regarding race and ethnicity, 6 participants were Black/African American, 13 Hispanic/Latino/a, 1 Asian, 1 Native Hawaiian or Pacific Islander, and 9 White, with 95% female participants. This cohort had 90% program completion and 7 advocacy projects: 2 on lung cancer, 2 on pancreas cancer, and 3 on prostate cancer. Participants showed an increased in knowledge, from pre- mean 68.1 to post- mean 74.0, and a p-value of 0.018. There was an increased in self-efficacy; program satisfaction and evaluation were rated as high. In summary, our study depicts the effectiveness of a unique CSRA program tailored for Black/African American and Hispanic/Latino/a adults, fostering robust communication channels between cancer research advocates and diverse stakeholders. We emphasize the potential of such initiatives in addressing cancer health disparities and advocating to address specific inequalities by imparting educational initiatives in cancer research advocacy. We look forward to evaluating and enhancing our training program with an additional 21 research advocates in our cohort of 2024. Citation Format: Brooke Hensel, Ileana Guzman, Carolina Aristizabal, Eduardo Ibarra, Rosa Barahona, Lourdes Baezconde-Garbanati, Mariana C. Stern, Sandra Suther, Fern J. Webb. Community scientist research advocacy program: Training our research community [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B107.

Abstract B074: Qualitative assessment of knowledge gaps and barriers to Hepatitis B and liver cancer screening in high-risk U.S. communities

Abstract Background: Up to 2.4 million people in the US live with chronic hepatitis B (HBV) infection (Wong et al., 2021). Foreign-born communities are most impacted, particularly those from Asia, the Pacific Islands, the Caribbean, and sub-Saharan Africa (Conners et al., 2023). Individuals with unmanaged HBV have a 15-40% lifetime risk of dying prematurely from cirrhosis or hepatocellular carcinoma (HCC) (McMahon, 2009). Low awareness, cultural norms, and misperceptions about HBV, HCC, and their connection contribute to low screening and care rates in affected communities. A more robust and comprehensive understanding of these barriers is needed to design effective awareness campaigns to improve HBV screening and care and prevent HCC. To this end, this study aimed to learn about existing knowledge and misconceptions about HBV and its relationship to HCC in high-risk communities, identify barriers to screening, and use the findings to develop effective communication strategies that raise awareness and dispel myths. Methods: Fifteen focus groups and two key informant interviews with community members, leaders, and public health experts were conducted to assess beliefs and attitudes about HBV and HCC and to identify preferred communication strategies. Results: The link between HBV and HCC remains poorly understood, and myths persist about the transmission and outcomes of both conditions. Multiple barriers to HBV and HCC screening exist, including concerns about insurance and immigration status, language barriers, cultural and religious beliefs, lack of general health literacy, lack of resources to cope with a positive diagnosis, widespread distrust of Western medicine, and fear of stigma and isolation. Ideas for effective communication methods included employing community health educators, primary care providers, ethnic media outlets and personal testimonials for delivery of information, and tailoring communications by community, age, and gender. These findings were used to create a suite of culturally and linguistically appropriate educational materials for use in each of twelve communities. Conclusions: Many challenges to increasing screening persist in groups most impacted by HBV and HCC, including a need for increased awareness about their connection. Community engagement is essential to overcoming these challenges, as are specific, targeted messaging and dissemination to improve the uptake of HBV screening and management. Behavioral and Social Science: Community-based Participatory Research Citation Format: Beatrice Zovich, Fiona Borondy-Jenkins, Suzanne Block, Kate Moraras, Thomas Chen, Chari Cohen. Qualitative assessment of knowledge gaps and barriers to Hepatitis B and liver cancer screening in high-risk U.S. communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B074.

Abstract A110: The CaRE2 health equity center Contact Registry: Engaging underrepresented community participants in cancer research

Abstract Background: One of the most common barriers in community participant engagement in cancer research is lack of information, and at times, not being invited to participate. Contact Registries serve as a valuable tool to address this challenge, as they connect community members with cancer health research opportunities. Potential participants can choose to participate in studies they find of interest and are prime candidates for. The Florida-California Cancer Research, Education, and Engagement (CaRE2) Health Equity Center, Community Outreach Core (COC), developed a contact registry designed to engage Black/African American (B/AA) and/or Hispanic/Latinos/a (H/L) individuals in ongoing research studies conducted across our bicoastal center institutions which includes the University of Southern California Norris Comprehensive Cancer Center, the University of Florida, and the Florida Agricultural & Mechanical University. The CaRE2 Contact Registry was implemented in August 2022 by the CaRE2 COC, with the primary objective to increase the number of underrepresented minority individuals participating in cancer research. Methods: Individuals are recruited into the registry utilizing both in-person and online methods. Information is provided in English and Spanish, and data is stored on REDCap. For in-person enrollment, a consent form and OPT-IN survey is completed; our online recruitment utilizes additional screening questions to ensure eligibility. The COC in Florida and Los Angeles promote the registry at local community events and through social media accounts and website (https://care2healthequitycenter.org/the-care2-contact-registry/). A $10.00 physical or electronic gift card is provided as compensation. Results: As of April 30th, 2024, 1,328 individuals have enrolled in the Registry, with participants from FL (887 = 69.5%) and CA (389 = 30.5%); with 737 participants being B/AA (57.8%), 506 H/L (39.7%), 26 non-Hispanic White (2.0%), and 6 individuals self-identified as other race/ethnicity (0.5%). We enrolled 873 female (68.5%) and 402 male (31.5%) participants. A total of 90.4% of enrollees are willing to participate in health research involving surveys, 23% in health research studies requiring saliva (24.1%), hair (23.4%), or blood (22%) sample donations. When registrants were asked for future research interest 99.9% responded Yes. Conclusion: Community participants have a high interest in engaging in research studies regardless of race/ethnicity if its via surveys, attending focus groups, and/or joining community forums. There is greater hesitancy when asked to provide biospecimens (blood, hair or saliva). Mechanisms to understand the reasons for this hesitancy, and address them, to appropriately incentivize individuals about donation of biospecimens are needed. Community efforts that connect potential enrollees to cancer studies of interest can support increased participation in cancer research among B/AA and H/L communities. Citation Format: Carolina Aristizabal, Eduardo Ibarra, Fern Webb, IIeana Guzman, Brooke Hensel, John Luque, Rosa Barahona, Diana Wilkie, Mariana C Stern, Sandra Suther, Lourdes Baezconde-Garbanati. The CaREhealth equity center Contact Registry: Engaging underrepresented community participants in cancer research [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A110.

Flying high and breaking stigma: a social identity perspective on Chinese frisbee participants

ABSTRACT The growing popularity of frisbee sport in China has brought both recognition and stigmatisation. Rooted in the social identity perspective, this study employs in-depth interviews and participatory observation to explore this phenomenon, creating a multifaceted analytical framework that includes affective commitment, self-categorisation, group self-esteem and self-expansion. The study finds that the primary manifestations of frisbee stigmatisation encompass the heightened online attention and scrutiny, conflicts due to limited playing venues, misconceptions from one-sided sport perceptions, and controversies around its use for blind dates. Moreover, the study reveals that frisbee community members employ diverse strategies to counteract stigma, such as positive confrontation, ignoring or humorously resolving stigmatisation, selective online self-presentation, and converting opponents into supporters. This research contributes to the field of leisure studies by offering a deeper understanding of how leisure sports identities are negotiated in the context of societal prejudices. Furthermore, it provides practical insights for fostering resilience, promoting a positive sports culture, and encouraging a healthier approach to leisure sports among youth, potentially minimising the negative impact of stigma on emerging leisure sports activities.

Experiences of ecosystem changes on food services of mopane woodland communities in Vhembe, South Africa

Mopane woodlands have been shifting. While it is important to understand the spatial patterns that characterise this phenomenon, it is even more important to understand the impacts of shifting Mopane woodlands on rural communities that rely on them. This study sought to establish the impacts of shifting mopane woodlands on the production of indigenous plant food in Ward 12 of Musina local municipality in the Vhembe District municipality in the Limpopo province of South Africa. To accomplish this, the study utilised a hybrid inductive approach involving thematic-based questionnaire interviews and an exploratory view to gain insight into the narratives of focus group participants. Results revealed that seven (7) out of eleven (11) indigenous plant foods are becoming extinct, thereby limiting food sources of indigenous and local people who used to rely on them. The spatial pattern of the plant foods that are still available has now changed as they no longer grow within the reach of local communities. The community members are struggling to adapt to these changes. From these observations, we recommend that local and regional levels’ policies related to natural resource management should consider the unique challenges faced by communities experiencing disruptive ecosystem changes and provide the necessary support for sustainable adaptation.

Health of refugees settled in Australia over time and generations: a transformative mixed methods study protocol

BackgroundRefugees resettled in Australia may experience significant physical, mental and emotional health issues on arrival and difficulty accessing mainstream healthcare that often demands specialised services. It is not known if...

Exploring Artistic Hierarchies among Painters in Ramesside Deir el-Medina

Scholarship has described Deir el-Medina as a sophisticated community composed of highly trained and educated individuals, at least compared to most ancient Egyptian villages that were primarily focused on agrarian labor. The tombs at Deir el-Medina indicate that some community members were well-off financially and may have aspired to reach elite levels in ancient Egypt’s social hierarchy. However, this understanding of Deir el-Medina’s community lacks the nuance of the hierarchical structure that defines success and status among the workers, artists, and craftspeople living in the community. This paper will investigate how one’s status within the community might dictate the allocation of artistic roles in the execution of painted royal tomb scenes. It will explore who within the community would have the privilege of depicting the primary motifs of a tomb and who would be responsible for less noticeable areas of the tomb.

A case study of actual versus desired inclusion of community-derived core concepts into neuroscience courses in different disciplines at a large university

Neuroscience is an inherently interdisciplinary and rapidly evolving field. While many universities have neuroscience or related majors, they are highly heterogeneous, and it is unclear how their content aligns with a recent proposal of what ideas make up the field of neuroscience. It is therefore important to document and assess the alignment of neuroscience curricula with core concepts in the field. Recently, a large effort by some members of the neuroscience education community described eight core concepts for undergraduate neuroscience curricula. In this paper, we focus primarily on courses in biology, cognitive science, and psychology at a large university, surveying the recent and current course instructors of these courses to ask them (1) to what extent these community-derived core concepts are incorporated into their classes and (2) to what extent these concepts should be incorporated into their classes. In addition, we map core concepts onto course syllabi. We found that core concepts are well-represented across disciplines, and identified differences between departments' inclusion of core concepts. We found that instructors cover fewer core concepts than they desire, and that two core concepts, “Evolution” and “Gene-environment interactions”, were less frequently addressed across disciplines. We consider barriers to instructors' ability to align course content with core concepts, both within and across disciplines. In this effort, we provide an example of how departments can evaluate their alignment of major requirements with the neuroscience core concepts.

Componer y fragmentar la utopía comunitaria. Vivir la autonomía entre sueños y decepciones

The aim of this article is to discuss the practices, rules, hopes, and setbacks associated with building community autonomy in San Isidro de la Libertad, Chiapas, based on my own ethnographic experience and that of three young community members. Certain local practices lend political power to the project of autonomy, including milpa farming, saint celebrations, citizen assemblies, and shared family meals. The redefinition of these practices in a collective narrative of the past, present, and future of the town is an ongoing process that I refer to as the “utopianizing of traditional life.” These practices, in turn, give shape to the ideal subject of the community utopia, one who embodies hope but also reflects, provokes, and comes from multiple fragmentations.

Community members’ perceptions of community health workers in Melusi, Tshwane, South Africa

Background: Community health workers (CHWs) play an important role in health promotion through health campaigns and home visits, and provide linkage to care and support patient management. In the informal settlements, CHWs identify health challenges and help residents to access healthcare facilities.Aim: This study aimed to explore the perception held by the community members regarding CHWs’ contribution to health promotion in Melusi informal settlements within the Tshwane district.Setting: The study was conducted in Melusi informal settlement situated in Pretoria west in South Africa.Methods: Descriptive exploratory qualitative research methods were used, with open and closed-ended questions during individual interview sessions. Participants were purposefully selected in collaborating with the community leaders and using CHWs’ data to identify individuals with direct interaction with CHWs.Results: Participants praised CHWs’ communication skills, engagement strategies, and ability to provide valuable health services. Community members expected CHWs to provide healthcare services, educational support, advocacy for health issues and guidance on well-being. Barriers such as community resistance, a lack of privacy and difficulties in reaching households were noticed. However, CHWs were commended for their impact on well-being, offering health services, emergency support, food assistance and improved healthcare accessibility.Conclusion: The study indicates that community members have positive perceptions of CHWs. This highlights the significant role of CHWs in promoting health and well-being within the community.Contribution: This study provides insights into community perceptions of CHWs in informal settlements, emphasising their impact on community well-being. It provides a basis for their effectiveness and support in delivering health services in the informal settlement.

Directional switching behavior of swarming systems with social and nonlinear interactions

Coordinated directional switching can occur among members of many mobile biological communities. Some studies show that self-propelled particle models can describe the directional switching behavior well. The key to understanding group movement is to determine the influential factors relevant to directional switching behavior. This paper focuses on the impact of social and nonlinear interactions on the directional switching behavior observed in swarming systems. In which, the nonlinear interaction is represented as a function of a trade-off between the velocity and velocity direction of its neighbors. Based on the framework of dimension reduction theory, the high-dimensional complex model is simplified into a one-dimensional simple model, and the stationary probability density and mean switching time are obtained by theoretical analysis of the one-dimensional model. It can be seen that social and nonlinear interactions play an important role in regulating the directional switching behaviors of swarming systems. Specifically, the increase of group density and nonlinear parameter can inhibit the directional switches. For Erdös-Rényi networks, the large mean degree can suppress the directional switching behavior. For scale-free networks, increasing the degree heterogeneity can reduce the mean switching time. The results reveal the underlying mechanisms by which social and nonlinear interactions influence the directional switching behaviors of swarming systems, and provide a theoretical foundation for the design of bio-inspired devices with specific functions.

Charting the Ethical Frontier in Newborn Screening Research: Insights from the NBSTRN ELSI Researcher Needs Survey

From 2008 to 2024, the Newborn Screening Translational Research Network (NBSTRN), part of the National Institute of Child Health and Human Development (NICHD) Hunter Kelly Newborn Screening Program, served as a robust infrastructure to facilitate groundbreaking research in newborn screening (NBS), public health, rare disease, and genomics. Over its sixteen years, NBSTRN developed into a significant international network, supporting innovative research on novel technologies to screen, diagnose, treat, manage, and understand the natural history of more than 280 rare diseases. The NBSTRN tools and resources were used by a variety of stakeholders including researchers, clinicians, state NBS programs, parents, families, and policy makers. Resources and expertise for the newborn screening community in ethical, legal, and social issues (ELSI) has been an important area of focus for the NBSTRN and this includes efforts across the NBS system from pilot studies of candidate conditions to public health implementation of screening for new conditions, and the longitudinal follow-up of NBS-identified individuals to inform health outcomes and disease understanding. In 2023, the NBSTRN conducted a survey to explore ELSI issues in NBS research, specifically those encountered by the NBS community. Since NBS research involves collaboration among researchers, state NBS programs, clinicians, and families, the survey was broadly designed and disseminated to engage all key stakeholders. With responses from 88 members of the NBS community, including researchers and state NBS programs, the survey found that individuals rely most on institutional and collegial resources when they encounter ELSI questions. Most survey responses ranked privacy as extremely or very important in NBS research and identified the need for policies that address informed consent in NBS research. The survey results highlight the need for improved collaborative resources and educational programs focused on ELSI for the NBS community. The survey results inform future efforts in ELSI and NBS research in the United States (U.S.) and the rest of the world, including the development of policies and expanded ELSI initiatives and tools that address the needs of all NBS stakeholders.

Physical and Spiritual Nourishment in the Catechetical Homilies of John Chrysostom

This article explores the previously underexamined dimension of physical and spiritual nourishment in John Chrysostom’s catechetical homilies, addressing two central inquiries: 1) Chrysostom’s expectations for new church members’ approach to eating and drinking, and 2) the connection between nourishment and their life as members of the liturgical community. Through a systematic analysis, the study reveals a threefold approach to Question 1. Firstly, Chrysostom cautions against the abuse of sustenance, emphasizing its corruptive impact on both body and soul. Secondly, the author expounds upon the functions of nutritional moderation, using the concept of fasting as an image of salutary abstinence from sin. Thirdly, Chrysostom discusses spiritual nourishment, distributed through homiletical discourse and the Eucharist. Addressing Question 2, the study finds connections between hymnody and nutritional moderation, promoting an “angelic” lifestyle that prepares individuals for deeper spiritual nourishment. The article concludes by highlighting the universal applicability of Chrysostom’s teachings on nourishment, intended for all members of the Church, regardless of their level of spiritual maturity, guiding them from moderate consumption of physical sustenance to participation in spiritual nourishment and the pursuit of eternal life.

Design requirements for human UHF magnets from the perspective of MRI scientists

Abstract The highest magnetic field strength for human-sized magnetic resonance imaging (MRI) currently lies at 11.7 tesla. Given the opportunities for enhanced sensitivity and improved data quality at higher static magnetic fields, several initiatives around the world are pursuing the implementation of further human MRI systems at or above 11.7 tesla. In general, members of the MR research community are not experts on magnet technology. However, the magnet is the technological heart of any MR system, and the MRI community is challenging the magnet research and design community to fulfill the current engineering gap in implementing large-bore, highly homogeneous and stabile magnets at field strengths that go beyond the performance capability of niobium-titanium. In this article, we present an overview of magnet design for such systems from the perspective of MR scientists. The underlying motivation and need for higher magnetic fields are briefly introduced, and system design considerations for the magnet as well as for the MRI subsystems such as the gradients, the shimming arrangement, and the radiofrequency hardware are presented. Finally, important limitations to higher magnetic fields from physiological considerations are described, operating under the assumption that any engineering or economic barriers to realizing such systems will be overcome.

Why becoming a positive deviant for malaria prevention and control: a sequential explanatory mixed methods study in Bugesera district, Rwanda

BackgroundMalaria continues to be a significant global health challenge, particularly in sub-Saharan African regions. Effective prevention and control strategies are crucial in mitigating its impact. Therefore, assessing the use of malaria preventive measures, treatment-seeking behaviours, and understanding the motivating factors behind positive behaviours/practices and barriers to using malaria preventive and control measures is essential for designing successful intervention programs.MethodsUsing a sequential explanatory mixed methods design, a descriptive cross-sectional study was conducted among 382 heads of households in the Mareba sector, Bugesera district, Rwanda. A qualitative study followed with 30 in-depth interviews among the top performers and other community members to explore the motivations and barriers to performing positive behaviours. Descriptive statistics for quantitative data and thematic analysis for qualitative data were used.ResultsThis study revealed that among those who own insecticide-treated nets, 234(89.3%) reported that they slept under the bed net the night preceding the survey; 256(67%) had fever cases in the last 24 months preceding the survey; and 214(87%) reported seeking care within 24 h. While almost all 243(98.8%) of participants who had fever case reported that they have taken all medicines as prescribed, however, a large number 263(68.8%) and 148(38.7%) still think that there are people in the community who do not take all malaria medications as prescribed and there are people who share malaria medications in the community, respectively. 82(65.1%) of those who never had a fever case believe that they have been using malaria preventive measures correctly and consistently. This study found that knowledge about malaria, family support, and community mobilization are the top motivating factors to practice positive behaviours while, lack of bet nets, poverty, and lack of time were reported as main barriers.ConclusionInterventions that target key motivating factors for adopting positive behaviours in malaria prevention and control should be prioritized. This, in turn, will reduce the disease burden on affected populations. Efforts to overcome barriers in malaria prevention and control should also be participatory. Community involvement should be at the centre of these interventions.