'First of all, I need training': a qualitative study evaluating the Fiji community health worker training program.

BACKGROUND: Fiji faces a growing burden of diseases and a significant emigration of health workers, heightening the role of community health workers (CHWs) in healthcare delivery. Effective training is crucial for CHWs to enhance their capacity and service quality. This study evaluates CHW training in Fiji, aiming to identify areas for improvement. METHODS: A qualitative study was conducted, encompassing a review of national policies on CHW training, six focus group discussions, and interviews with CHWs and their supervisors across Fijian subdivisions. This study was collaboratively designed with Fiji's Ministry of Health and Medical Services (MOHMS). Data was transcribed, coded, and thematically analysed using the Community Health Workers Assessment and Improvement Matrix (CHW-AIM). FINDINGS: While CHW training policies in Fiji are well-established, discrepancies exist between the policy and its implementation. Challenges include inconsistent training for new recruits, limited resources, and variability in training content and frequency of training across divisions, especially concerning noncommunicable disease (NCD) training. INTERPRETATION: To enhance the CHW training program in Fiji, a restructuring and standardisation of both pre-service and in-service training is necessary, tailored to the needs of each division. Investment in ongoing capacity building, alongside the development and revision of training guidelines, particularly for managing NCD complications in the community, is crucial. Implementing these changes will enable CHWs in Fiji to be better equipped for providing essential community-based care.

Early Adaptive Schemas and Sexual Wellbeing in Women: Exploring Differences in Menopausal Status.

There is limited research concerning the relationship between early adaptive schema, from Young's Schema Theory, and women's sexual wellbeing. Schema Theory posits that early adaptive schema start forming in early childhood from core emotional needs being met, and positively influence individuals' concept of self, relationships with others, and their behaviours. Building on this theory, the current study explored the relationship of early adaptive schema and adult women's sexual wellbeing at pre-, peri-, and post-menopause. Four hundred and sixty-seven women, mostly partnered and heterosexual, from over ten countries, participated in an online survey measuring relationships between early adaptive schema and sexual wellbeing, measured by sexual functioning and sexual satisfaction. The strength of association of early adaptive schema and sexual well-being were evaluated in addition to known predictors. The results showed higher early adaptive schema were associated with higher sexual wellbeing, measured by sexual satisfaction and sexual functioning,with medium-to-large effect sizes, at pre and peri-menopause, and produced a non-significant result for post-menopause. The association of early adaptive schema continued after known factors were accounted for. The results support the use of early adaptive schema to promote sexual wellbeing for women at pre- and peri-menopause.

Self-perceptions of aging: A systematic review of longitudinal studies.

As the population of older adults increases, it is important to understand what may assist every older person to live well and longer. Using a systematic review, this study examined the longitudinal consequences of self-perceptions of aging (SPA), a measure of internalized stereotypes of aging, in participants 50 years or older. The sample comprised 21 studies published in English that used the Attitudes Toward Own Aging (ATOA) scale to measure SPA. Studies were conducted in the United States (10), Germany (7), Australia (2), and one each from Israel and Switzerland. Risk of bias was low, study design and assessment showed good to high quality, and the ATOA scale was reliable in all studies. Primary outcomes were physiological (N = 15; longevity and better health, health behaviors, and diseases) and psychological (N = 6; depression, cognitive function, and other psychological outcomes) rather than social. More positive SPA was consistently associated with healthier longitudinal outcomes, including better self-rated health and less obesity, greater longevity, better performance of the activities of daily living, less depression, and better cognitive functioning (including reductions in cognitive decline and incidence of dementia). These were both direct and indirect pathways and provide support for the consequences of aging stereotypes, providing support for Levy's Stereotype Embodiment theory. The results have public health implications, broadly as community messaging about the benefits of positive SPA and usual and healthy aging, and more narrowly in using ATOA to screen for middle-aged adults with negative SPA to prevent future physical and psychological decline. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Hybrid millidecade spectra: A practical format for exchange of long-term ambient sound data.

This Letter proposes a frequency scaling for processing, storing, and sharing high-bandwidth, passive acoustic spectral data that optimizes data volume while maintaining reasonable data resolution. The format is a hybrid that uses 1 Hz resolution up to 455 Hz and millidecade frequency bands above 455 Hz. This hybrid is appropriate for many types of soundscape analysis, including detecting different types of soundscapes and regulatory applications like computing weighted sound exposure levels. Hybrid millidecade files are compressed compared to the 1 Hz equivalent such that one research center could feasibly store data from hundreds of projects for sharing among researchers globally.

Erratum: Hybrid millidecade spectra: A practical format for exchange of long-term ambient sound data [JASA Express Lett. 1(1), 011203 (2021)].

In the original paper [JASA Express Lett. 1(1), 011203 (2021)], a method for processing, storing, and sharing high-bandwidth, passive acoustic spectral data that optimizes data volume while maintaining reasonable data resolution was proposed. The format was a hybrid that uses 1-Hz resolution up to 455 Hz and millidecade frequency bands above 455 Hz. The choice of 455 Hz was based on a method of computing the edge frequencies of millidecade bands that is not compatible with summing millidecades to decidecades. This has been corrected. The new transition frequency is the first frequency with a millidecade with greater than 1 Hz, 435 Hz.

Pain and Problem Behavior in Cats and Dogs.

We argue that there is currently an under-reporting of the ways in which pain can be associated with problem behavior, which is seriously limiting the recognition of this welfare problem. A review of the caseloads of 100 recent dog cases of several authors indicates that a conservative estimate of around a third of referred cases involve some form of painful condition, and in some instances, the figure may be nearly 80%. The relationship is often complex but always logical. Musculoskeletal but also painful gastro-intestinal and dermatological conditions are commonly recognized as significant to the animal's problem behavior. The potential importance of clinical abnormalities such as an unusual gait or unexplained behavioral signs should not be dismissed by clinicians in general practice, even when they are common within a given breed. In general, it is argued that clinicians should err on the side of caution when there is a suspicion that a patient could be in pain by carefully evaluating the patient's response to trial analgesia, even if a specific physical lesion has not been identified.

Owner observations regarding cat scratching behavior: an internet-based survey.

OBJECTIVES: This study was performed to examine aspects of the cat, environment and scratching post that might influence scratching behavior, in an effort to determine how inappropriate scratching behavior might be refocused on acceptable targets. METHODS: An internet survey, posted on several public websites, gathered details about scratching behavior, as described by owners in their home environments, from 4331 respondents over a 4 month period. Responses from 39 different countries were analyzed, mostly from the USA, Canada and the UK. RESULTS: Owners offered traditionally recommended scratching substrates including rope, cardboard, carpet and wood. Rope was most frequently used when offered, although carpet was offered most commonly. Most owners provided at least one scratching post; cats scratched the preferred substrate more often when the post was a simple upright type or a cat tree with two or more levels and at least 3 ft high. Narrower posts (base width ⩽3 ft) were used more often than wider posts (base width ⩾5 ft). Intact or neutered cats (males and females) were as likely to scratch inappropriately, and inappropriate scratching decreased with age. Geriatric cats between the ages of 10 and 14 years preferred carpet substrate most frequently; all other ages preferred rope first. Inappropriate scratching decreased as the different types/styles of posts increased in the home. Inappropriate scratching did not increase if the number of cats or dogs increased in the household. Declawed cats were preventatively declawed most often to prevent household item destruction. CONCLUSIONS AND RELEVANCE: Although cats can have individual preferences, our data provide a starting point for veterinarians recommending scratching posts to clients.

Hazardous metal pollution in the republic of fiji and the need to elicit human exposure.

The fact that hazardous metals do not bio-degrade or bio-deteriorate translates to long-lasting environmental effects. In the context of evidently rapid global industrialization, this ought to warrant serious caution, particularly in developing countries. In the Republic of Fiji, a developing country in the South Pacific, several different environmental studies over the past 20 years have shown levels of lead, copper, zinc and iron in sediments of the Suva Harbor to be 6.2, 3.9, 3.3 and 2.1 times more than the accepted background reference levels, respectively. High levels of mercury have also been reported in lagoon shellfish. These data inevitably warrant thorough assessment of the waste practices of industries located upstream from the estuaries, but in addition, an exposure and health impact assessment has never been conducted. Relevant government departments are duty-bound, at least to the general public that reside in and consume seafood from the vicinities of the Suva Harbor, to investigate possible human effects of the elevated hazardous metal concentrations found consistently in 20 years of surface sediment analysis. Furthermore, pollution of the intermediate food web with hazardous metals should be investigated, regardless of whether human effects are eventually confirmed present or not.

Activation of the canonical Wnt/beta-catenin pathway enhances monocyte adhesion to endothelial cells.

Monocyte adhesion to vascular endothelium has been reported to be one of the early processes in the development of atherosclerosis. In an attempt to develop strategies to prevent or delay atherosclerosis progression, we analyzed effects of the Wnt/beta-catenin signaling pathway on monocyte adhesion to various human endothelial cells. Adhesion of fluorescein-labeled monocytes to various human endothelial cells was analyzed under a fluorescent microscope. Unlike sodium chloride, lithium chloride enhanced monocyte adhesion to endothelial cells in a dose-dependent manner. We further demonstrated that inhibitors for glycogen synthase kinase (GSK)-3beta or proteosome enhanced monocyte-endothelial cell adhesion. Results of semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) indicated that activation of Wnt/beta-catenin pathway did not change expression levels of mRNA for adhesion molecules. In conclusion, the canonical Wnt/beta-catenin pathway enhanced monocyte-endothelial cell adhesion without changing expression levels of adhesion molecules.