Cultural values influencing iTaukei women's discussion of family planning in the home.

Pacific Sexual and reproductive health is influenced by cultural taboos and sensitivities. Although Pacific values are integral to family planning, open communication in the home is often difficult in the face of changing socio-cultural norms. This study explores the experiences of iTaukei Pacific women living in Fiji and Aotearoa New Zealand, and their discussion of family planning within the family setting. The study utilises talanoa methodology to understand women's realities and their navigation through shifting sexual and reproductive norms in both countries. The study found that although family may be seen as a place of 'truth' in which appropriate, culturally sensitive family planning communication should be available, this was challenged by cultural taboos or tabu which were persistent in family planning discussions. The study calls for greater reliance on holistic approaches to Pacific family planning perspectives and a greater examination of va or the spaces within which Pacific women's experiences are negotiated and informed.

A Tale of Childhood Loss, Conditional Acceptance and a Fear of Abandonment: A Qualitative Study Taking a Narrative Approach to Eating Disorders.

Eating disorders (EDs) are serious mental health illnesses, yet there is a need to better understand the illness experience to improve treatment outcomes. Qualitative research, and narrative approaches in particular, can elicit life stories that allow for the whole illness journey to be explored. This study aimed to explore the experiences of women with a history of an ED, identifying the life events they perceived were relevant to the onset of their ED through to recovery. Interviews were conducted with 18 women with lived experience of an ED. Through structural narrative analysis, an overarching storyline of childhood loss contributing to a belief of conditional acceptance, fear of abandonment and struggle to seek emotional support due to the fear of being a burden was identified. Negative experiences with the health sector were common. These findings have implications for the way medical professionals respond to help seeking and deliver treatment.

Nuts and berries from agroforestry systems in temperate regions can form the foundation for a healthier human diet and improved outcomes from diet-related diseases.

Agroforestry is a specific type of agroecosystem that includes trees and shrubs with the potential to yield nutrient-rich products that contribute to human health. This paper reviews the literature on the human health benefits of tree nut and berry species commonly associated with agroforestry systems of the United States, considering their potential for preventing certain diet-related diseases. Emphasis is placed on those diseases that are most closely associated with poor outcomes from COVID-19, as they are indicators of confounding health prognoses. Results indicate that tree nuts reduce the risk of coronary heart disease, and walnuts (Juglans species) are particularly effective because of their unique fatty acid profile. Berries that are grown on shrubs have the potential to contribute to mitigation of hypertension, prevention of Type II diabetes, and reduced risk of cardiovascular disease. To optimize human health benefits, plant breeding programs can focus on the traits that enhance the naturally-occurring phytochemicals, through biofortification. Value-added processing techniques should be selected and employed to preserve the phytonutrients, so they are maintained through the point of consumption. Agroforestry systems can offer valuable human health outcomes for common diet-related diseases, in addition to providing many environmental benefits, particularly if they are purposefully designed with that goal in mind. The food system policies in the U.S. might be reoriented to prioritize these food production systems based on the health benefits.

Consistent condom use and its predictors among female sexual Partners of People who Inject Drugs in Klang Valley, Malaysia.

BACKGROUND: Men who inject drugs (MWIDs) comprise the highest percentage of diagnosed HIV cases in Malaysia. Their female partners risk being infected through unprotected sexual contact. This paper reports the prevalence of consistent condom use and its predictors among the wives and regular sexual partners of MWIDs in Klang Valley, Malaysia. METHODS: A cross-sectional study using a self-administered questionnaire was conducted among the wives and regular sexual partners of MWIDs in the study location; 221 women were recruited through respondent-driven sampling. Data were analysed descriptively for the prevalence of consistent condom use, HIV status and HIV risk-related behaviour. Subsequently, simple and multiple logistic regressions were undertaken to identify the predictors of consistent condom use. RESULTS: The prevalence of consistent condom use among respondents was 19.5%. Slightly more than half (52.5%) of respondents had never used condoms with their partner. Fourteen women (6.3%) reported being HIV positive. While 7.7% had HIV-positive partners, 45.7% were unaware of their partner's HIV status. Consistent condom use was significantly higher among single women (AOR = 4.95; 95% CI: 2.45, 9.99), women who lived in urban areas (AOR = 2.97; 95% CI: 1.30, 6.78), HIV-positive women (AOR = 3.45; 95% CI: 1.13, 10.5) and women involved in sex work (AOR = 3.55, 95% CI: 1.45, 8.67). CONCLUSIONS: Inconsistent condom use among the majority of female sexual partners of MWIDs underscores the heightened risk faced by these women and calls for alternative prevention methods that women are able to control.

Frontiers in alley cropping: Transformative solutions for temperate agriculture.

Annual row crops dominate agriculture around the world and have considerable negative environmental impacts, including significant greenhouse gas emissions. Transformative land-use solutions are necessary to mitigate climate change and restore critical ecosystem services. Alley cropping (AC)-the integration of trees with crops-is an agroforestry practice that has been studied as a transformative, multifunctional land-use solution. In the temperate zone, AC has strong potential for climate change mitigation through direct emissions reductions and increases in land-use efficiency via overyielding compared to trees and crops grown separately. In addition, AC provides climate change adaptation potential and ecological benefits by buffering alley crops to weather extremes, diversifying income to hedge financial risk, increasing biodiversity, reducing soil erosion, and improving nutrient- and water-use efficiency. The scope of temperate AC research and application has been largely limited to simple systems that combine one timber tree species with an annual grain. We propose two frontiers in temperate AC that expand this scope and could transform its climate-related benefits: (i) diversification via woody polyculture and (ii) expanded use of tree crops for food and fodder. While AC is ready now for implementation on marginal lands, we discuss key considerations that could enhance the scalability of the two proposed frontiers and catalyze widespread adoption.

Environmental challenges threatening the growth of urban agriculture in the United States.

Urban agriculture, though often difficult to define, is an emerging sector of local food economies in the United States. Although urban and agricultural landscapes are often integrated in countries around the world, the establishment of mid- to large-scale food production in the U.S. urban ecosystem is a relatively new development. Many of the urban agricultural projects in the United States have emerged from social movements and nonprofit organizations focused on urban renewal, education, job training, community development, and sustainability initiatives. Although these social initiatives have traction, critical knowledge gaps exist regarding the science of food production in urban ecosystems. Developing a science-based approach to urban agriculture is essential to the economic and environmental sustainability of the movement. This paper reviews abiotic environmental factors influencing urban cropping systems, including soil contamination and remediation; atmospheric pollutants and altered climatic conditions; and water management, sources, and safety. This review paper seeks to characterize the limited state of the science on urban agricultural systems and identify future research questions most relevant to urban farmers, land-use planners, and environmental consultants.

Understanding the contextual and cultural influences on women's modern contraceptive use in East Uganda: A qualitative study.

Unmet need for contraception, defined as the percentage of women who are sexually active and want to avoid, space or limit pregnancies, but are not using a method of contraception, stands at 28.4% of all married women in Uganda. An understanding of women's contraceptive behaviours, and the motivations that drive these, are key to tackling unmet need, by way of designing, implementing and improving family planning programs to effectively meet the needs of different population groups. This qualitative study sought to understand women's contraceptive use and identify strategies to strengthen contraceptive uptake among women in the Busoga region of east Uganda (chosen due to its low contraceptive prevalence of 31.3% and high unmet need of 36.5% among married women of reproductive age). Six focus group discussions were conducted with single and married women across different age groups (18-24, 25-34, and ≥ 35 years), living in three urban and three rural districts. Thematic analyses of the data highlighted three major themes pertaining to the complex, multi-level nature of contributors to unmet need and women's use of contraception in the Busoga region. Within a largely patriarchal society, women had to navigate many obstacles. Some of these included: fears about contraceptive side effects; partner opposition, community beliefs and stigma that dissuaded contraceptive use; traditional gender and socio-cultural norms that dictated women's fertility choices; and service delivery limitations. Changing community narratives about family planning through testimonies from satisfied users, increasing male acceptance of contraception, and encouraging joint-decision making on matters of reproductive health are strategic focal areas for family planning initiatives to effectively tackle the problem of unmet need among women, and make contraceptives more accessible to women in Uganda.

Quantification of Vitamins, Minerals, and Amino Acids in Black Walnut (Juglans nigra).

This paper aims to quantify the micronutrients in black walnut and address its human health benefits. The metabolic profiling of 11 black walnut cultivars was accomplished using ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight high-resolution mass spectrometer. Results revealed that the highest concentration of vitamin B9 was present in cultivar "Daniel" (avg. relative signal intensity 229.53 × 104 mAU). "Surprise" and "Daniel" cultivars had the highest amount of vitamin B5. However, vitamin A, D3, E, and K showed no significant difference among the cultivars. The vitamin content levels among the cultivars were compared by applying one way ANOVA method with (P < 0.05) significance level. Mineral analysis for the black walnut kernel, Persian walnut, and black walnut protein powder was done using Inductively Coupled Plasma Optical Emission spectroscopy. The experimental data for black walnut kernel is 0.04 mg/g for Fe and 0.03 mg/g for Zn, and for black walnut, protein powder is 0.07 mg/g for Fe and 0.07 mg/g for Zn. The amino acid analysis and comparison with black walnut kernel show that black walnut flour and protein powder have a higher amount of essential and non-essential amino acids. Therefore, researchers, food process engineers, and food product developers should consider the health benefits of black walnuts and explore the commercial potential of this native agroforestry crop.

A Roadmap for Participatory Chestnut Breeding for Nut Production in the Eastern United States.

Chestnut cultivation for nut production is increasing in the eastern half of the United States. Chinese chestnuts (Castanea mollissima Blume), or Chinese hybrids with European (C. sativa Mill.) and Japanese chestnuts (C. crenata Sieb. & Zucc.), are cultivated due to their high kernel quality, climatic adaptation, and disease resistance. Several hundred thousand pounds of high-quality fresh nuts are taken to market every fall, and several hundred additional orchards are entering bearing years. Grower-led on-farm improvement has largely facilitated this growth. A lack of significant investments in chestnut breeding in the region, paired with issues of graft incompatibility, has led many growers to cultivate seedlings of cultivars rather than grafted cultivars. After decades of evaluation, selection, and sharing of plant materials, growers have reached a threshold of improvement where commercial seedling orchards can be reliably established by planting offspring from elite selected parents. Growers recognize that if cooperation persists and university expertise and resources are enlisted, improvement can continue and accelerate. To this end, the University of Missouri Center for Agroforestry (UMCA) and chestnut growers throughout the eastern United States are partnering to formalize a participatory breeding program - the Chestnut Improvement Network. This partnership entails the UMCA providing an organizational structure and leadership to coordinate on-farm improvement, implement strategic crossing schemes, and integrate genetic tools. Chestnut growers offer structural capacity by cultivating seedling production orchards that provide financial support for the grower but also house segregating populations with improved individuals, in situ repositories, and selection trials, creating great value for the industry.

Predictors of modern contraceptive use among women and men in Uganda: a population-level analysis.

OBJECTIVES: Despite substantial and rapid improvements in contraceptive uptake in Uganda, many women continue to have unmet need for contraception. As factors affecting contraceptive use are dynamic and complex, this study seeks to identify current predictors and provide effect size estimates of contraceptive use among women and men in Uganda. STUDY DESIGN: A nationally representative cross-sectional population survey, using secondary data from Uganda's 2016 Demographic and Health Survey. Stratified by sex, weighted bivariable and multivariable logistic regression models were derived from a suite of potential predictor variables. Predictive abilities were assessed via 10-fold cross-validated area under the receiver operating characteristic curves (AUCs). SETTING: Uganda. PARTICIPANTS: All women aged 15-49 years who were permanent residents of the selected households or stayed in the household the night before the survey were eligible to participate. In one-third of the sampled households, all men aged 15-54 years who met the same residence criteria were also eligible. PRIMARY OUTCOME MEASURES: Modern contraceptive use. RESULTS: Overall, 4914 (26.6%) women and 1897 (35.6%) men reported using a modern contraceptive method. For women and men, both demographic and proximate variables were significantly associated with contraceptive use, although notable differences in effect sizes existed between sexes-especially for age, level of education and parity. Predictively, the multivariable model was acceptable for women with AUC=0.714 (95% CI 0.704 to 0.720) but less so for men with AUC=0.654 (95% CI 0.636 to 0.666). CONCLUSIONS: Contemporary significant predictors of contraceptive use among women and men were reported, thereby enabling key Ugandan subpopulations who would benefit from more targeted family planning initiatives to be identified. However, the acceptable AUC for women and modest AUC for men suggest that other important unmeasured predictors may exist. Nonetheless, these evidence-based findings remain important for informing future programmatic and policy directions for family planning in Uganda.

Landscape and local site variables differentially influence pollinators and pollination services in urban agricultural sites.

Urbanization has detrimental effects on biodiversity and ecosystem functioning, as agricultural and semi-natural habitats are converted into landscapes dominated by built features. Urban agricultural sites are a growing component of urban landscapes and have potential to serve as a source of biodiversity conservation and ecosystem service provisioning in urban areas. In 19 urban agricultural sites, we investigated how surrounding land cover and local site variables supported bees and pollination services. We found the abundance of bees differentially responded to landscape and local scale variables depending on body size and nesting habit. Large-bodied bees, Bombus and Apis species, were positively associated with increasing amounts of impervious cover, while the abundance of small-bodied soil nesting Halictus species increased as the proportion of flower area, a local variable, increased. Bee richness declined with increasing levels of impervious cover, while bee community composition changed along a gradient of increasing impervious cover. Pollination services, measured at each site using sentinel cucumber plants, declined as hardscape, a local variable, increased. To improve bee conservation and pollination services in urban agricultural sites, our results suggest urban planning strategies should minimize impervious cover at large spatial scales while land managers should focus locally on incorporating floral resources, which increases food and nesting resources especially for smaller bee species. Local site design coupled with regional urban planning can advance the success of urban agriculture, while benefiting biodiversity by creating opportunities for pollinator conservation in urban landscapes.

Improved contraceptive use among women and men in Uganda between 1995-2016: A repeated cross-sectional population study.

BACKGROUND: Research on contraceptive behaviour changes over time in Uganda is scarce, yet it has among the highest fertility and maternal mortality rates of any country in the East African region. Understanding temporal patterns of contraceptive use for both women and men is vital in evaluating the effectiveness of family planning interventions and strategies, and identifying those with the most unmet need. Using repeated nationally representative cross-sectional samples, this study charts the changes in Uganda's population-based contraceptive use over recent years. METHODS: Five Demographic and Health Survey datasets for Uganda over 21 years, from 1995 to 2016, were sourced and interrogated. Eligible participants included all women aged 15-49 years and men aged 15-54 years. Responses to questions on modern and any (modern or traditional) contraceptive use were analysed. Stratified by gender, weighted regression analyses were employed to detect change over time. The patterns associated with key demographic variables were also investigated. RESULTS: Overall, 50,027 women and 14,092 men were included within the study. In 2016, 30.3% of women and 39.9% of men were using any contraceptive method, a significant non-linear increase from 13.4% of women and 20.3% of men in 1995. Furthermore, 27.3% of women and 35.9% of men were using modern contraceptive methods in 2016, an increase from 7.4% of women and 10.4% of men in 1995. All considered demographic variables were significantly associated with contraceptive use for both women and men (all P<0.001); and for women, all variables differentially changed over time (all P<0.001). CONCLUSION: This study showed a significant increase and dynamism across key demographic variables in contraceptive uptake by both women and men. Sustained family planning programs and interventions have successfully resulted in behaviour change across the Ugandan population. However, continued efforts are needed to further reduce Uganda's relatively high fertility and associated maternal mortality rates.

Services for seniors in small-town Canada: the paradox of community.

There is a prevailing argument that what small towns lack in formal services they make up for in close ties among rural people and a shared understanding of the notion of community. Drawing on research undertaken in 9 small towns across Canada, the authors examine how the concept of community operates with respect to the provision ofin-home and community care for seniors. The analysis is based on interviews with 55 key informants from local governments, health and social care agencies, voluntary sector organizations, and community groups. The findings reveal the paradox of the conventional belief that rural communities can compensate for lack of services for seniors while failing to take into account the uncertain coping ability of the local informal sectors. The authors challenge rural health policy decision-makers, researchers, and providers to debunk assumptions about services for seniors in rural Canada.

Awareness and use of family planning methods among iTaukei women in Fiji and New Zealand.

OBJECTIVE: iTaukei women's awareness and practice of family planning methods was investigated in New Zealand and Fiji to ascertain differences in behaviour within the context of changing developmental settings. METHODS: The study was cross-sectional in nature and recruited women aged 18 years and over from three suburbs in Suva, Fiji, and five cities in New Zealand. RESULTS: Overall, 352 women participated in the study, 212 in Fiji and 140 in New Zealand. The study found that living in New Zealand was significantly associated with lower odds of being aware of family planning (OR 0.4, 95%CI 0.2-0.9, p=0.029) and using family planning methods (OR 0.5, 95%CI 0.2-0.9, p=0.027). Tertiary education was found to increase the odds of being aware (OR 2.8, 95%CI 1.3-6.2, p=0.009) and of using (OR 3.9, 95%CI 1.9-7.8, p=0.000) family planning. CONCLUSIONS: Despite the greater availability of services and higher standards of living experienced in New Zealand compared with Fiji, there was no improvement in awareness and use of family planning among New Zealand participants. Implications for public health: Reduced awareness and use of family planning in New Zealand indicates a need for better targeting of services among minority Pacific ethnic groups.

Sociocultural barriers to cervical screening in South Auckland, New Zealand.

Cervical screening has been subject to intense media scrutiny in New Zealand in recent years prompted by a series of health system failings through which a number of women developed cervical cancer despite undergoing regular smears. This paper considers why underscreening persists in a country where cervical screening has a high profile. It explores how the promotion of cervical screening has impacted on the decisions of women to undergo a smear test. Ideas of risk and the new public health are deployed to develop a context for thinking about screening as a form of governing the body. Qualitative interviews with 17 women who were overdue for a cervical smear were undertaken in 2001-2002, yielding understandings of their knowledge of screening and their reasons for postponement. Nine providers of screening services were also interviewed. Concurrent with socioeconomic limitations, concerns over exposing one's body loomed large in women's reasons for delaying being screened. In particular, feelings of shyness and embarrassment were encountered among Maori and Pacific women for whom exposing bodies in the process of smear taking compromises cultural beliefs about sacredness. We conclude that medicalization of the body has, paradoxically, assisted many women in dealing with the intrusion of screening. For others, compliance with the exhortations to be screened brings a high emotional and cultural cost which should at least be considered in health policy debates.

Family planning unmet need and access among iTaukei women in New Zealand and Fiji.

AIM: The aim of the study was to identify unmet need and family planning access among indigenous Fijian or iTaukei women living in New Zealand and Fiji. METHOD: A cross-sectional survey was undertaken between 2012-2013 in five major cities in New Zealand: Auckland, Hamilton, Wellington, Christchurch and Dunedin; and in three suburbs in Fiji. Women who did not want any (more) children but were not using any form of contraception were defined as having an unmet need. Access experiences involving cost and health provider interactions were assessed. RESULTS: Unmet need in New Zealand was 26% and similar to the unmet need found in Fiji (25%). Cost and concern over not being seen by a female provider were the most problematic access factors for women. CONCLUSION: There is a need for better monitoring and targeting of family planning services among minority Pacific groups, as the unmet need found in New Zealand was three times the national estimate overall and similar to the rate found in Fiji. Cost remains a problem among women trying to access family planning services. Gendered traditional roles in sexual and reproductive health maybe an area from which more understanding into cultural sensitivities and challenges may be achieved.

Place, health, and community attachment: Is community capacity associated with self-rated health at the individual level?

Community-level interventions dominate contemporary public health responses to health inequalities as a lack of political will has discouraged action at a structural level. Health promoters commonly leverage community capacity to achieve programme goals, yet the health implications of low community capacity are unknown. In this study, we analyse perceptions of community capacity at the individual-level to explore how place-based understandings of identity and connectedness are associated with self-rated health. We examine associations between individual community capacity, self-rated health and income using a cross-sectional survey that was disseminated to 303 residents of four small (populations 1500-2000) New Zealand towns. Evidence indicating a relationship between individual community capacity and self-reported health was unconvincing once the effects of income were incorporated. That is, people who rated their community's capacity higher did not have better self-rated health. Much stronger evidence supported the relationship between income and both higher individual community capacity and higher self-rated health. We conclude that individual community capacity may mediate the positive association between income and health, however, overall we find no evidence suggesting that intervening to enhance individual community capacity is likely to improve health outcomes.

Neurotypical Peers are Less Willing to Interact with Those with Autism based on Thin Slice Judgments.

Individuals with autism spectrum disorder (ASD), including those who otherwise require less support, face severe difficulties in everyday social interactions. Research in this area has primarily focused on identifying the cognitive and neurological differences that contribute to these social impairments, but social interaction by definition involves more than one person and social difficulties may arise not just from people with ASD themselves, but also from the perceptions, judgments, and social decisions made by those around them. Here, across three studies, we find that first impressions of individuals with ASD made from thin slices of real-world social behavior by typically-developing observers are not only far less favorable across a range of trait judgments compared to controls, but also are associated with reduced intentions to pursue social interaction. These patterns are remarkably robust, occur within seconds, do not change with increased exposure, and persist across both child and adult age groups. However, these biases disappear when impressions are based on conversational content lacking audio-visual cues, suggesting that style, not substance, drives negative impressions of ASD. Collectively, these findings advocate for a broader perspective of social difficulties in ASD that considers both the individual's impairments and the biases of potential social partners.

To dialyse or delay: a qualitative study of older New Zealanders' perceptions and experiences of decision-making, with stage 5 chronic kidney disease.

BACKGROUND: Issues related to renal replacement therapy in elderly people with end stage kidney disease (ESKD) are complex. There is inadequate empirical data related to: decision-making by older populations, treatment experiences, implications of dialysis treatment and treatment modality on quality of life, and how these link to expectations of ageing. STUDY POPULATION: Participants for this study were selected from a larger quantitative study of dialysis and predialysis patients aged 65 years or older recruited from three nephrology services across New Zealand. All participants had reached chronic kidney disease (CKD) stage 5 and had undergone dialysis education but had not started dialysis or recently started dialysis within the past 6 months. METHODOLOGY: Serial qualitative interviews were undertaken to explore the decision-making processes and subsequent treatment experiences of patients with ESKD.Analytical approach: A framework method guided the iterative process of analysis. Decision-making codes were generated within NVivo software and then compared with the body of the interviews. RESULTS: Interviews were undertaken with 17 participants. We observed that decision-making was often a fluid process, rather than occurring at a single point in time, and was heavily influenced by perceptions of oneself as becoming old, social circumstances, life events and health status. LIMITATIONS: This study focuses on participants' experiences of decision-making about treatment and does not include perspectives of their nephrologists or other members of the nephrology team. CONCLUSIONS: Older patients often delay dialysis as an act of self-efficacy. They often do not commit to a dialysis decision following predialysis education. Delaying decision-making and initiating dialysis were common. This was not seen by participants as a final decision about therapy. Predialysis care and education should be different for older patients, who will delay decision-making until the time of facing obvious uraemic symptoms, threatening blood tests or paternalistic guidance from their nephrologist. TRIAL REGISTRATION NUMBER: Australasian Clinical Trials Registry ACTRN 12611000024943; results.