Nature dependent tourism - Combining big data and local knowledge.

The ability to quantify nature's value for tourism has significant implications for natural resource management and sustainable development policy. This is especially true in the Eastern Caribbean, where many countries are embracing the concept of the Blue Economy. The utilization of user-generated content (UGC) to understand tourist activities and preferences, including the use of artificial intelligence and machine learning approaches, remains at the early stages of development and application. This work describes a new effort which has modelled and mapped multiple nature dependent sectors of the tourism industry across five small island nations. It makes broad use of UGC, while acknowledging the challenges and strengthening the approach with substantive input, correction, and modification from local experts. Our approach to measuring the nature-dependency of tourism is practical and scalable, producing data, maps and statistics of sufficient detail and veracity to support sustainable resource management, marine spatial planning, and the wider promotion of the Blue Economy framework.

Clinical handovers between prehospital and hospital staff: literature review.

BACKGROUND: Clinical handover plays a vital role in patient care and has been investigated in hospital settings, but less attention has been paid to the interface between prehospital and hospital settings. This paper reviews the published research on these handovers. METHODS: A computerised literature search was conducted for papers published between 2000 and 2013 using combinations of terms: 'handover', 'handoff', 'prehospital', 'ambulance', 'paramedic' and 'emergency' and citation searching. Papers were assessed and included if determined to be at least moderate quality with a primary focus on prehospital to hospital handover. FINDINGS: 401 studies were identified, of which 21 met our inclusion criteria. These revealed concerns about communication and information transfer, and themes concerning context, environment and interprofessional relationships. It is clear that handover exchanges are complicated by chaotic and noisy environments, lack of time and resources. Poor communication is linked to behaviours such as not listening, mistrust and misunderstandings between staff. While standardisation is offered as a solution, notably in terms of the use of mnemonics (alphabetical memory aids), evidence for benefit appears inconclusive. CONCLUSIONS: This review raises concerns about handovers at the interface between prehospital and hospital settings. The quality of existing research in this area is relatively poor and further high-quality research is required to understand this important part of emergency care. We need to understand the complexity of handover better to grasp the challenges of context and interprofessional relationships before we reach for tools and techniques to standardise part of the handover process.

Mapping the planet's critical natural assets.

Sustaining the organisms, ecosystems and processes that underpin human wellbeing is necessary to achieve sustainable development. Here we define critical natural assets as the natural and semi-natural ecosystems that provide 90% of the total current magnitude of 14 types of nature's contributions to people (NCP), and we map the global locations of these critical natural assets at 2 km resolution. Critical natural assets for maintaining local-scale NCP (12 of the 14 NCP) account for 30% of total global land area and 24% of national territorial waters, while 44% of land area is required to also maintain two global-scale NCP (carbon storage and moisture recycling). These areas overlap substantially with cultural diversity (areas containing 96% of global languages) and biodiversity (covering area requirements for 73% of birds and 66% of mammals). At least 87% of the world's population live in the areas benefitting from critical natural assets for local-scale NCP, while only 16% live on the lands containing these assets. Many of the NCP mapped here are left out of international agreements focused on conserving species or mitigating climate change, yet this analysis shows that explicitly prioritizing critical natural assets and the NCP they provide could simultaneously advance development, climate and conservation goals.

Transforming Palmyra Atoll to native-tree dominance will increase net carbon storage and reduce dissolved organic carbon reef runoff.

Native forests on tropical islands have been displaced by non-native species, leading to calls for their transformation. Simultaneously, there is increasing recognition that tropical forests can help sequester carbon that would otherwise enter the atmosphere. However, it is unclear if native forests sequester more or less carbon than human-altered landscapes. At Palmyra Atoll, efforts are underway to transform the rainforest composition from coconut palm (Cocos nucifera) dominated to native mixed-species. To better understand how this landscape-level change will alter the atoll's carbon dynamics, we used field sampling, remote sensing, and parameter estimates from the literature to model the total carbon accumulation potential of Palmyra's forest before and after transformation. The model predicted that replacing the C. nucifera plantation with native species would reduce aboveground biomass from 692.6 to 433.3 Mg C. However, expansion of the native Pisonia grandis and Heliotropium foertherianum forest community projected an increase in soil carbon to at least 13,590.8 Mg C, thereby increasing the atoll's overall terrestrial carbon storage potential by 11.6%. Nearshore sites adjacent to C. nucifera canopy had a higher dissolved organic carbon (DOC) concentration (110.0 µMC) than sites adjacent to native forest (81.5 µMC), suggesting that, in conjunction with an increase in terrestrial carbon storage, replacing C. nucifera with native forest will reduce the DOC exported from the forest into in nearshore marine habitats. Lower DOC levels have potential benefits for corals and coral dependent communities. For tropical islands like Palmyra, reverting from C. nucifera dominance to native tree dominance could buffer projected climate change impacts by increasing carbon storage and reducing coral disease.

Asynchronous Delivery of a 400 Level, Partially Peer-Graded, Oral Presentation and Discussion Course in Systems Neuroscience for 60 Students during the COVID-19 Pandemic.

A 400-level undergraduate oral presentation and discussion course in Systems Neuroscience was delivered asynchronously online during the COVID-19 pandemic. Enrolled students banked their narrated oral presentations in video format online then engaged in peer evaluation in virtual classrooms through the course website. Student delivered their oral presentation and responded to peer questions at their leisure and convenience, without the stress and anxiety associated with a "live" performance delivery in front of their peers. A remote and asynchronously delivered course facilitated much more peer contact than "live" versions of the course, which included a total of 62 uploaded presentations, 301 video responses uploaded to 1985 questions posed by peers, a total of 1159 feedback questionnaires submitted, 1066 rankings submitted of viewed oral presentations, and 1091 scores submitted evaluating the quality of questions posed by reviewers of oral presentations. A major drawback in the remote, asynchronous deliver was the enormity of peer engagement through the course website portal, which was mostly blind to the instructor because of the inability to effectively cross-index data linked between the student entries in the LEARN course website and the uploaded videos stored within BONGO Video Assignment tool. Nonetheless, a consistent engagement of students, and the positive feedback from enrolled students, indicate that a future version of this oral/written discussion course will be delivered, in part, remotely and asynchronously, even without a mandated delivery of the course by a remote and asynchronous method due to the COVID-19 pandemic restrictions in 2020-2021.

Increased MMP-9 levels with strain-dependent stress resilience and tunnel handling in mice.

Increased perineuronal net (PNN) deposition has been observed in association with corticosteroid administration and stress in rodent models of depression. PNNs are a specialized form of extracellular matrix (ECM) that may enhance GABA-mediated inhibitory neurotransmission to potentially restrict the excitation and plasticity of pyramidal glutamatergic neurons. In contrast, antidepressant administration increases levels of the PNN-degrading enzyme matrix metalloproteinase-9 (MMP-9), which enhances glutamatergic plasticity and neurotransmission. In the present study, we compare pro-MMP-9 levels and measures of stress in females from two mouse strains, C57BL/6 J and BALB/cJ, in the presence or absence of tail grasping versus tunnel-associated cage transfers. Prior work suggests that C57BL/6 J mice show relatively enhanced neuroplasticity and stress resilience, while BALB/c mice demonstrate enhanced susceptibility to adverse effects of stress. Herein we observe that as compared to the C57BL/6 J strain, BALB/c mice demonstrate a higher level of baseline anxiety as determined by elevated plus maze (EPM) testing. Moreover, as determined by open field testing, anxiety is differentially reduced in BALB/c mice by a choice-driven tunnel-entry cage transfer technique. Additionally, as compared to tail-handled C57BL/6 J mice, tail-handled BALB/c mice have reduced brain levels of pro-MMP-9 and increased levels of its endogenous inhibitor, tissue inhibitor of metalloproteinase-1 (TIMP-1); however, tunnel-associated cage transfer increases pro-MMP-9 levels in BALB/c mice. BALB/c mice also show increases in Western blot immunoreactive bands for brevican, a constituent of PNNs. Together, these data support the possibility that MMP-9, an effector of PNN remodeling, contributes to the phenotype of strain and handling-associated differences in behavior.

Risk of metabolic consequences of rapid weight gain and catch-up growth in the first two years of life: a systematic review protocol.

REVIEW QUESTION: The specific review question to be addressed in this review is: what is the risk of metabolic outcomes for individuals who experience rapid weight gain or catch-up growth during the first two years of life?

"Injuries are beyond love": physical violence in young South Africans' sexual relationships.

South Africa's complex social and political history has produced conditions for interpersonal violence of multiple kinds to flourish. Violence experienced by girls and young women, including within their sexual relationships, has become an area of intense research and policy interest since the end of apartheid. Drawing on a long-term ethnographic study of young people in an urban township, this article explores how violent practices are variously construed, differentiated, and legitimated, in particular through the assignment of blame and the significance accorded to bodily marking. Pointing to the cultural embeddedness of disciplining techniques in this setting, the article examines local understandings of gender hierarchy and power, young men's vulnerabilities in relation to their partners' actions, and the links between disciplining action and notions of anger, love, and shame. Violence is shown to configure lives and subjectivities and to be productive of relationships, in particular playing a part in the organization of inequality within sexual relationships.

Coded talk, scripted omissions: the micropolitics of AIDS talk in an affected community in South Africa.

In this ethnographic article, we explore the character of local discourse about AIDS in an affected township community in South Africa, describing the "indirection" that characterized communication about suspected cases of AIDS. Through a case study of one affected family, the article first explores the diverse ways in which people came to "know" that specific cases of illness were AIDS related, and how this "knowledge" was communicated. We consider why communication was indirect and coded, arguing that this reflected nota "denial" of its presence in this community but, rather, a complex group of overlapping concerns far from unique to AIDS: first, a normative injunction on naming potentially fatal conditions; second, an interest in pursuing different therapeutic options and the need to maintain hope of recovery; and third, a wish to avoid the "disrespect" entailed in referring directly to the nature of the problem in a context where, discursively, stigma was still present. The coded and indirect character of HIV/AIDS-related talk underlines the importance of ethnographic inquiry in understanding community responses to this epidemic, demonstrating that the subtleties entailed by verbal silence and elision should not be interpreted naively as collective "denial" but rather be grounded within existing patterns of responses to dangerous sickness.

"Showing roughness in a beautiful way": talk about love, coercion, and rape in South African youth sexual culture.

Sexual violence within as well as outside sexual relationships has far-reaching public health and human rights implications and is a continuing focus of popular debate, media coverage, and research in postapartheid South Africa. Partly because it has been shown to affect individual vulnerability to HIV/AIDS, sexual violence has in recent years become framed as a global public health issue. International research efforts to document the scale of this personally and politically sensitive problem can encounter conceptual, definitional, and methodological difficulties that anthropology is well placed to assist in alleviating. This article offers an ethnographic exploration of the spectrum of practices relating to sexual coercion and rape among young people in a township in the former Transkei region of South Africa. Contextualizing meanings of sexual coercion within local youth sexual culture, the article considers two emic categories associated with sex that is "forced": ukulala ngekani: "to sleep with by force" or ukunyanzela: "to force," both usually used to describe episodes occurring within sexual partnerships; and ukudlwengula, used to describe rape by a nonpartner or stranger. The article discusses the semantic content of and differences between these two key categories, demonstrating that encounters described as "forced sex" encompass not only various forms of sexual coercion but also, particularly in the narratives of young men, instances of more consensual sex. Of importance, in turn, in defining an act as "rape" rather than as "forced sex" are the character of the relationship between the two parties and interlinked ideas relating to exchange and sexual entitlement, love, and the importance of "intention," violation, and "deserving" victimhood.

'Telling the truth is the best thing': teenage orphans' experiences of parental AIDS-related illness and bereavement in Zimbabwe.

Zimbabwe is one of the countries most affected by HIV/AIDS, and as elsewhere in southern Africa, the impact on children and young people living in affected households is significant. Loss is highly complex and dependent on developmental stage, resilience, quality of care, and social support networks, and often includes a progression of experiences from the onset of a parent's or caregiver's illness, through to the aftermath of death. For several reasons, AIDS-related bereavement is likely to be especially complicated and difficult to accommodate. Understandings of bereavement and grief among African children, and adults' responses to orphans' psychological difficulties, remain under-developed. This paper focuses on the narratives of older children in their teens, who have experienced parental AIDS-related illness and death in six sites in Zimbabwe. A key finding is that, while many orphaned teenagers desire direct communication with adults about parental illness and death, adults themselves--whether the sick parent, other relatives in the household or a caregiver following parental loss--are often ill-equipped to identify and manage children's distress positively. While most existing psychosocial interventions focus on bereaved children, this paper suggests that, in order to create an enabling environment for orphans, building the capacity of key adults in orphans' lives, particularly surviving relatives, caregivers, and teachers to address emotional issues relating to parental loss constructively is an essential, but neglected, area of programming.

A Prospective Multi-Center Audit of Nutrition Support Parameters Following Burn Injury.

The importance of nutrition support delivery to the severe burn-injured patient is well recognized, however, nutrition provision to the patient may be sub optimal in practice. The aim of this study was to conduct a prospective multi-center audit across Australia and New Zealand using the Joanna Briggs Institute Burns Node Nutrition audit criteria. Thirty-four patients with severe burn injury (≥20% TBSA in adults and ≥10% TBSA in children) were identified on admission or on referral to the Dietitian at the eight participating Burn Units between February 1, 2012 and April 30, 2012 for inclusion in the study. De-identified patient data was analyzed using the Joanna Briggs Institute, Practical Application of Clinical Evidence System. Compliance with individual audit criterion ranged from 33 to 100%. Provision of prescribed enteral feed volumes and weekly weighing of patients were highlighted as key areas for clinical improvement. Clinical audit is a valuable tool for evaluating current practice against best evidence to ensure that quality patient care is delivered. The use of the Joanna Briggs Institute Burns Node audit criteria has allowed for a standardized multi-center audit to be conducted. Improving nutrition support delivery in burn patients was identified as a key area requiring ongoing clinical improvement across Australia and New Zealand. Clinician feedback on use of the audit criteria will allow for future refinement of individual criterion, and presentation of results of this audit has resulted in a review of the Bi-National Burns Registry nutrition quality indicators.

Flexor tendon repair, rehabilitation, and reconstruction.

BACKGROUND: Flexor tendon injury is a common problem that plastic surgeons are called on to treat. Despite their common nature, they present a challenge, not necessarily in the surgical treatment per se but in the ability to achieve a "normal" finger as the end result. Because of the difficulty in attaining good outcomes, much continues to be studied and written about flexor tendon injury. METHODS: The current literature on flexor tendon repair, rehabilitation, and reconstruction is reviewed. RESULTS: Aspects reviewed include type of anesthesia, suture material and configuration, repairs in the different flexor tendon zones, types of tendon rehabilitation, complications of flexor tendon surgery, and flexor tendon reconstruction. CONCLUSION: This review provides an update on the current standards in the treatment of flexor tendon injury.

Blood blockages and scolding nurses: barriers to adolescent contraceptive use in South Africa.

A third of adolescent girls in South Africa become pregnant before the age of 20, despite contraception being free and mostly accessible. This qualitative study was undertaken in Limpopo Province in 1997 on the barriers to adolescent girls accessing clinic services for contraception. Thirty-five in-depth interviews and five group discussions were conducted with girls aged 14-20, and interviews with nursing staff at 14 clinics. Many of the girls described pressure from male partners and family members to have a baby or prove their fertility. Other barriers to sustained contraceptive use included medically inaccurate notions about how conception occurs and fears about the effects of contraception on fertility and menstruation, which were not taken seriously by nurses. Nurses' attempts to stigmatise teenage sexuality, their scolding and harsh treatment of adolescent girls, and their unwillingness to acknowledge adolescents' experiences as contraceptive users, undermined the effective use of contraception by girls. Youth need better information on reproductive physiology and sexual health, and detailed information on contraception. Tools to enhance the accuracy and availability of knowledge in the clinic setting have a role, but need to be introduced along with initiatives to ensure that services are adolescent-friendly and do not stigmatise adolescent sexual activity.

A qualitative pilot study of islamic men with lifelong premature (rapid) ejaculation.

INTRODUCTION: Premature ejaculation is a common sexual problem in men. Although the etiology is unclear, there is emerging evidence that men from different ethnic backgrounds may be more at risk. AIM AND OBJECTIVE: The aim of this study was to generate themes and hypotheses around the etiology of premature ejaculation with particular reference to men from Islamic backgrounds. METHODS: This is an explorative qualitative study using semi-structured interviews with 10 male volunteers with a clinical diagnosis of premature ejaculation. Interviews were tape-recorded and transcribed. Transcriptions were then hand-coded and analyzed using grounded theory. RESULTS: Anxious first sexual experience (with subtheme: fear of being discovered and wanting to finish early); sex before marriage; sex outside of marriage; religion; "stress;" exposure to Western images; living in the United Kingdom; and the subsequent feeling of freedom were themes that emerged from the transcripts. CONCLUSIONS: We have identified factors associated with premature ejaculation in patients with Islamic backgrounds attending our unit. This may have useful therapeutic implications when consulting Islamic men with premature ejaculation.

Contextualizing group rape in post-apartheid South Africa.

Collective male sexual violence is part of a continuum of sexual coercion in South Africa. This paper is based on long-term ethnographic work in an urban township in the former Transkei region. Drawing on intensive participant observation and interviews with young men in particular, it attempts to make sense of emergent narratives relating to streamlining, a local term for a not uncommon form of collective sexual coercion involving a group of male friends and one or more women. The paper begins with an overview of existing anthropological literature on collective male sexual violence, going onto elaborate the different scenarios associated with group sexual violence in the fieldsite. It seeks to provide a multi-layered contextualization of the phenomenon by considering prevailing gender discourses, subcultural issues pertaining to the urban tsotsi phenomenon, the rural practice of ukuthwala (bride capture), young working-class Africans' experiences of marginalization, and the complex links between political economy and violence in this setting.

A comparative analysis of communication about sex, health and sexual health in India and South Africa: Implications for HIV prevention.

This paper provides a comparative analysis of modes of dialogue, non-verbal communication and embodied action relating to sex and health in two contrasting countries-India and South Africa-which have the world's two most heavily HIV-affected populations (in terms of numbers of people living with HIV). Drawing on material derived from multiple studies, including ethnographic and other forms of qualitative and multi-disciplinary research, the paper identifies commonalities as well as differences in communication relating to sex and sexual health in these diverse settings. The paper considers: first, how and by whom sex is and is not talked about, in public discourse and private conversation; second, how sexual intention and desire are communicated through indirect, non-verbal means in everyday life; and third, how references to sexuality and the sexual body re-enter within a more explicit set of indigenous discourses about health (rather than 'sexual health' per se), such as semen loss in India and womb 'dirtiness' in South Africa. The concluding section reflects on the implications of a comparative analysis such as this for current policy emphases on the importance of promoting verbal communication skills as part of 'life skills' for HIV prevention.