Caribbean Women's Health and Transnational Ethnobotany.

Caribbean Women's Health and Transnational Ethnobotany. Immigrants from the Dominican Republic (DR) and Haiti are among the top foreign-born communities in New York City (NYC). As people migrate to new countries, they bring their ethnomedical beliefs and practices, and adapt their plant pharmacopoeias. Haiti and the DR share a flora on the island of Hispaniola. In NYC, the flora is limited to what is available in the city. We selected plants for future laboratory research based on ethnobotanical data from two surveys among Dominicans in the DR and NYC, and a Haitian literature review. In both Dominican datasets, gynecological infections were the top women's health condition treated with plants. We identified 10 species for this purpose reported by Dominicans that are also known medicines in Haitian culture, although not yet documented for women's health. Plants for gynecological infections potentially cause dysbiosis of the vaginal microbiota, and may increase rather than prevent disease. There is a public health need to assess traditional medicines for their ability to inhibit pathogenic bacteria, while causing minimal disruption to the vaginal flora. Several species are known antibacterials, but remain to be tested for their efficacy. These results also provide a foundation for a planned ethnobotanical survey among NYC Haitian women. Supplementary Information: The online version contains supplementary material available at 10.1007/s12231-021-09526-3.

Haitian women in New York City use global food plants for women's health.

BACKGROUND: Despite the availability of mainstream biomedical healthcare in New York City (NYC), community-based ethnomedicine practices remain a low-cost, culturally relevant treatment for many immigrants. Previous urban ethnobotany research in NYC has established that several Caribbean communities continue using medicinal plants for women's health after immigration. This study sought to address to what extent: (1) NYC Haitian women continue using medicinal plants for women's health after migration; (2) their plants and the conditions treated were similar to those identified in an earlier survey with NYC immigrants from the Dominican Republic. METHODS: Through an ethnobotanical survey, 100 Haitian women living in NYC and born in Haiti were interviewed about their knowledge of medicinal plants for women's health conditions. Reported species were purchased based on local names in NYC Haitian stores and markets, vouchered, and identified. RESULTS: Nearly all Haitian women (97%) reported using medicinal plants while living in Haiti. Most Haitian women continued using medicinal plants after coming to the USA (83%). The 14% decrease, although significant (z = 3.3; p = 0.001), was mainly due to logistical difficulties with sourcing plants after recent immigration. Popular medicinal plant species reported were primarily global food plants, re-emphasizing the intertwined food-medicine relationship in Caribbean diasporas. Comparison with data from NYC Dominicans identified childbirth and puerperium, gynecological infections, and vaginal cleansing as priority Haitian women's health concerns treated with plants. CONCLUSION: Our findings support the global nature of Caribbean migrant plant pharmacopeia, predominantly centered around food plants and adapted to transnational urban settings. They underscore cultural diversity, dispelling the notion of one uniform traditional knowledge system labeled "Caribbean." The importance of preventative medicine for women's health, particularly the regular consumption of "healthy" foods or teas highlights the role food plants play in maintaining health without seeking treatment for a particular condition. Cross-cultural comparisons with other NYC Caribbean immigrants emphasize the importance of conducting ethnobotanical surveys to ground-truth plant use in the community. Such surveys can also identify culture-specific health priorities treated with these plants. Healthcare providers can leverage these insights to formulate culturally relevant and community-tailored healthcare strategies aligned with Haitian women's health beliefs and needs.

Fostering greater recognition of Caribbean traditional plant knowledge.

The Caribbean is a hotspot of biological and cultural diversity, manifested in traditional plant knowledge of Afrodescendant peoples and other ethnicities. To strengthen the visibility of this knowledge in research, education, and policy making, we propose an eight-step action plan centered on reciprocal relationships with Caribbean plant stewards, especially subsistence farmers.

Caribbean medicinal plant Argemone mexicana L.: Metabolomic analysis and in vitro effect on the vaginal microbiota.

ETHNOPHARMACOLOGICAL RELEVANCE: Medicinal plants are frequently used in Caribbean traditional medicine as low-cost, culturally relevant treatments for women's health concerns, such as gynecological infections. These plants are typically applied topically, potentially affecting both pathogenic bacteria (e.g., Gardnerella vaginalis) and beneficial vaginal microbes (Lactobacillus spp.). However, few studies have examined the impact of these plants on both beneficial and pathogenic vaginal bacteria. AIM OF THE STUDY: Argemone mexicana, available in New York City and commonly used to treat gynecological infections by immigrants from the Dominican Republic, was investigated for its chemical variation and effects on the vaginal microbiota. We hypothesized that variations in the bioactivity of Argemone mexicana on Gardnerella vaginalis and Lactobacillus spp. are due to differences in antimicrobial compounds across different preparations. MATERIALS AND METHODS: Untargeted and targeted metabolomic analysis using UPLC-qToF-MS and UPLC-TQD-MS were conducted on Argemone mexicana samples collected in New York City. Antimicrobial assays were used to assess the effects of Argemone mexicana samples on beneficial and pathogenic vaginal bacteria. ProGenesis QI and EZinfo were used for metabolomic analysis to link bioactivity with chemometric data. RESULTS: UPLC-qToF-MS and statistical analyses showed that chemical variation correlated with plant tissue type and processing (dry or fresh samples). These differences were evident in antimicrobial screenings, where active plant samples were antimicrobial against pathogenic bacteria only, with no effect on beneficial Lactobacillus. Known antimicrobial benzoquinone alkaloids, such as berberine, were partly responsible for the observed microbiological activity. Berberine exhibited similar inhibition patterns, reduced biofilm formation, and trended towards higher concentration in active samples. CONCLUSIONS: Extracts of Argemone mexicana, a plant used in Caribbean women's health, did not have an effect on beneficial vaginal microbes, but did inhibit pathogenic Gardnerella vaginalis. This antimicrobial activity correlated with the chemical variation of berberine and other related alkaloids across traditional preparations of Argemone mexicana. These results may be relevant for treating gynecological infections, not only with this plant, but other berberine-containing taxa.

Advancing ethnobiology for the ecological transition and a more inclusive and just world: a comprehensive framework for the next 20 years.

This opinion piece, written by ethnobiologists from different parts of the world, emphasizes the importance of ethnobiology research in advancing contemporary biology, natural resource management, biodiversity conservation, sustainable development, and, especially, contributing to the ecological transition and more just and inclusive world. To achieve these goals, it is essential to develop research and collaborate with social groups that live in close relationship with nature in research activities, such as Indigenous Peoples and Local Communities (IPLC), as well as Afro-descendants and other Marginalized, Minority or Minoritized Communities (AMMC). Ethnobiology can identify and provide locally appropriate solutions to local problems, enabling sustainable resource management at the landscape level. The text explores important aspects that need to be considered to guide the future of ethnobiology in the next 20 years, aiming to integrate and amplify previous discussions held in the discipline and identify points that demand ongoing attention. This paper highlights reflections from diverse researchers, emphasizing how ethnobiology can embrace different perspectives and employ rigorous analysis of complex phenomena toward effective policies and practices. This approach holds the potential to address the challenges the planet is currently facing in the coming decades.

Distribution and transmission of medicinal plant knowledge in the andean highlands: a case study from peru and bolivia.

This paper presents a study of patterns in the distribution and transmission of medicinal plant knowledge in rural Andean communities in Peru and Bolivia. Interviews and freelisting exercises were conducted with 18 households at each study site. The amount of medicinal plant knowledge of households was compared in relation to their socioeconomic characteristics. Cluster analysis was applied to identify households that possessed similar knowledge. The different modes of knowledge transmission were also assessed. Our study shows that while the amount of plant knowledge is determined by individual motivation and experience, the type of knowledge is influenced by the community of residence, age, migratory activity, and market integration. Plant knowledge was equally transmitted vertically and horizontally, which indicates that it is first acquired within the family but then undergoes transformations as a result of subsequent contacts with other knowledge sources, including age peers.

The use of medicinal plants by migrant people: adaptation, maintenance, and replacement.

Given the importance of studying the knowledge, beliefs, and practices of migrant communities to understand the dynamics of plant resource use, we reviewed the scientific literature concerning the use of medicinal plants by migrant populations engaged in international or long-distance migrations. We considered the importance of two processes: (1) adaptation to the new flora of the host country (i.e., substitution and incorporation of plants in the pharmacopoeia) and (2) continued use and acquisition of the original flora from migrants' home countries (i.e., importation, cultivation, and/or continued use of plants that grow in both host and home environments). We suggest that, depending on the specific context and conditions of migration, different processes that determine the use and/or selection of plants as herbal medicines may become predominant.

Understanding interdisciplinary perspectives of plant intelligence: Is it a matter of science, language, or subjectivity?

BACKGROUND: Evidence suggests that plants can behave intelligently by exhibiting the ability to learn, make associations between environmental cues, engage in complex decisions about resource acquisition, memorize, and adapt in flexible ways. However, plant intelligence is a disputed concept in the scientific community. Reasons for lack of consensus can be traced back to the history of Western philosophy, interpretation of terminology, and due to plants lacking neurons and a central nervous system. Plant intelligence thus constitutes a novel paradigm in the plant sciences. Therefore, the perspectives of scientists in plant-related disciplines need to be investigated in order to gain insight into the current state and future development of this concept. METHODS: This study analyzed opinions of plant intelligence held by scientists from different plant-related disciplines, including ethnobiology and other biological sciences, through an online questionnaire. RESULTS: Our findings show that respondents' personal belief systems and the frequency of taking into account other types of knowledge, such as traditional knowledge, in their own field(s) of study, were associated with their opinions of plant intelligence. Meanwhile, respondents' professional expertise, background (discipline), or familiarity with evidence provided on plant intelligence did not affect their opinions. CONCLUSIONS: This study emphasizes the influential role of scientists' own subjective beliefs. In response, two approaches could facilitate transdisciplinary understanding among scientists: (1) effective communication designed to foster change in agreement based on presented information; and (2) holding space for an interdisciplinary dialogue where scientists can express their own subjectivities and open new opportunities for collaboration.

Human impact on wild firewood species in the rural Andes community of Apillapampa, Bolivia.

Firewood is the basic fuel source in rural Bolivia. A study was conducted in an Andean village of subsistence farmers to investigate human impact on wild firewood species. A total of 114 different fuel species was inventoried during fieldtrips and transect sampling. Specific data on abundance and growth height of wild firewood species were collected in thirty-six transects of 50 ×2 m(2). Information on fuel uses of plants was obtained from 13 local Quechua key participants. To appraise the impact of fuel harvest, the extraction impact value (EIV) index was developed. This index takes into account local participants' appreciation of (1) decreasing plant abundance; (2) regeneration capacity of plants; (3) impact of root harvesting; and (4) quality of firewood. Results suggest that several (sub-)woody plant species are negatively affected by firewood harvesting. We found that anthropogenic pressure, expressed as EIV, covaried with density of firewood species, which could entail higher human pressure on more abundant and/or more accessible species. The apparent negative impact of anthropogenic pressure on populations of wild fuel species is corroborated by our finding that, in addition to altitude, several anthropogenic variables (i.e. site accessibility, cultivation of exotics and burning practices) explain part of the variation in height of firewood species in the surroundings of Apillapampa.

Taming the pandemic? The importance of homemade plant-based foods and beverages as community responses to COVID-19.

Household responses to COVID-19 in different corners of the world represent the primary health care that communities have relied on for preventing and mitigating symptoms. During a very complex and confusing time, in which public health services in multiple countries have been completely overwhelmed, and in some cases even collapsed, these first-line household responses have been quintessential for building physical, mental, and social resilience, and for improving individual and community health. This editorial discusses the outcomes of a rapid-response preliminary survey during the first phase of the pandemic among social and community contacts in five metropolises heavily affected by the COVID-19 health crisis (Wuhan, Milan, Madrid, New York, and Rio de Janeiro), and in twelve rural areas or countries initially less affected by the pandemic (Appalachia, Jamaica, Bolivia, Romania, Belarus, Lithuania, Poland, Georgia, Turkey, Pakistan, Cambodia, and South Africa). We summarized our perspectives as 17 case studies, observing that people have relied primarily on teas and spices ("food-medicines") and that there exist clear international plant favorites, popularized by various new media. Urban diasporas and rural households seem to have repurposed homemade plant-based remedies that they use in normal times for treating the flu and other respiratory symptoms or that they simply consider healthy foods. The most remarkable shift in many areas has been the increased consumption of ginger and garlic, followed by onion, turmeric, and lemon. Our preliminary inventory of food medicines serves as a baseline for future systematic ethnobotanical studies and aims to inspire in-depth research on how use patterns of plant-based foods and beverages, both "traditional" and "new", are changing during and after the COVID-19 pandemic. Our reflections in this editorial call attention to the importance of ethnobiology, ethnomedicine, and ethnogastronomy research into domestic health care strategies for improving community health.

Costus spicatus tea failed to improve diabetic progression in C57BLKS/J db/db mice, a model of type 2 diabetes mellitus.

AIM OF THE STUDY: Costus spicatus Sw. (Costaceae) is a prominent medicinal herb used by Dominicans in the Dominican Republic and the United States for the treatment of diabetes, a growing epidemic in the Hispanic community. An ethnobotanical survey of the Dominican community in New York City revealed the popular use of a tea from the insulina plant to treat hyperglycemia. Insulina was identified as Costus spicatus. We tested the ability of a tea made from the leaves of Costus spicatus to alter glucose homeostasis in C57BLKS/J (KS) db/db mice, a model of obesity-induced hyperglycemia with progressive beta cell depletion. MATERIALS AND METHODS: From 6 to 16 weeks of age, Experimental and Control animals (n=6/5) were given ad lib access to Costus spicatus tea or water, respectively. RESULTS: Weight gain and progression of hyperglycemia and insulinopenia between the Experimental and Control groups were statistically indistinguishable. There was no difference between groups in average fed or fasting glucose and insulin concentrations. Intraperitoneal (IP) insulin tolerance testing after the 10-week study period showed that Costus spicatus tea consumption did not alter insulin sensitivity. CONCLUSIONS: These data suggest that at the dose given, tea made from Costus spicatus leaves had no efficacy in the treatment of obesity-induced hyperglycemia. More investigation is needed to more fully explore dosages and the possible utility and biological activity of this common Dominican herbal remedy for the treatment of type 2 diabetes mellitus.

Susto etiology and treatment according to Bolivian Trinitario people: a "masters of the animal species" phenomenon.

This article addresses two concepts that are quite widespread among Latin American cultures: susto or "'fright sickness," and the "masters of the animal species" philosophy, whereby individual animal spirits are believed to be "owned" by species-specific spiritual masters. This is the first article to integrate both these aspects, drawing from ethnographic data from the Trinitario people in Bolivia collected through participant-observation and semistructured ethnobotanical interviews on medicinal plants. Although Trinitarios have a long history of agriculture, their worldview is still partly one of animistic hunter and fisherman societies. This worldview is reflected in Trinitario susto etiology and treatment. Susto is locally believed to originate through soul theft by a variety of masters of the animal species and landscape spirits. Treatment is partly based on the principle of similia similibus curantur or "like cures like" and magicoritual ceremonies, but ethnopharmacological preparations are also well known and frequently used.

Cross-cultural adaptation in urban ethnobotany: the Colombian folk pharmacopoeia in London.

AIM OF THE STUDY: To investigate traditional health care practices and changes in medicinal plant use among the growing Colombian community in London. MATERIALS AND METHODS: Ethnobotanical fieldwork consisted of qualitative, in-depth, semi-structured interviews with 23 Colombians living in London and botanical identification of 46 plant species actively used as herbal remedies. Subsequently, research data were compared with literature on ethnobotany and traditional herbal medicine in the home country, using a framework on cross-cultural adaptation, adjusted for the purpose of this study. RESULTS: Similarities and discrepancies between data and literature are interpreted as potential indicators of continuity and loss (or deculturation) of traditional remedies, respectively. Remedies used in London that are not corroborated by the literature suggest possible newly acquired uses. CONCLUSIONS: Cross-cultural adaptation related to health care practices is a multifaceted process. Persistence, loss and incorporation of remedies into the Colombian folk pharmacopoeia after migration are influenced by practical adaptation strategies as well as by symbolic-cultural motives of ethnic identity.

Identity in a medicine cabinet: Discursive positions of Andean migrants towards their use of herbal remedies in the United Kingdom.

This study explores different rationales for using herbal remedies among people from Andean descent in the United Kingdom, using positioning theory as a conceptual framework. By analysing processes of positioning in narratives about healthcare choices conducted with 40 Bolivian and Peruvian migrants in London (between 2005 and 2009), we examine in which ways talking about personal preferences for herbal medicine can be constitutive of one's health identity. The results reveal three distinct discursive repertoires that frame the use of herbal remedies either as a tradition, a health-conscious consumer choice, or as a coping strategy, each allowing specific health identity outcomes. An enhanced understanding of how people make sense of their use of traditional, plant-based medicines enables healthcare professionals to better assist patients in making meaningful decisions about their health. Through illustrating how treatment choices are discursively linked with identity, the present results debunk the tendency to perceive patients with a migration background as one homogenous group and thus urge for a patient centred approach.

A comparison of traditional healers' medicinal plant knowledge in the Bolivian Andes and Amazon.

Medicinal plant knowledge of two groups of traditional healers was thoroughly studied during a 2-year ethnobotanical survey in the Bolivian Andes (Quechua farmers from Apillapampa) and Amazon rainforest (Yuracaré-Trinitario slash-and-burn cultivators from Isiboro-Sécure National Park), respectively. Both areas represent ecologically and culturally diverse zones, differing in floristic diversity, physical accessibility to health care and degree of modernization, the latter evidenced by presence or intensity in use of modern services such as electricity, water distribution, and materials for house construction. It is generally believed that indigenous people have an impressive knowledge of useful plant species and that this knowledge reflects the plant wealth of their living environment. However, the present study shows that healers' knowledge of collected medicinal plants (expressed as percentage of plants known by name and use by the majority of healers) is higher in the Andean area characterised by a long history of anthropogenic activity, than in the biodiversity-rich rainforest (protected since 1965). Therefore, medicinal plant knowledge does not seem to depend on the level of plant diversity, degree of modernization or absence of Western health care infrastructure. Indeed, although Andean healers live in a floristically poorer environment, have adopted more modern services and have easier access to primary health care facilities, they are more knowledgeable about medicinal plants than rainforest healers who live isolated in an environment with considerable floristic/ecological variation and lack of Western health care. It is hypothesised that social factors underlying traditional medical practices (background of extensive family in traditional medicine) play an important role in transmission--and hence survival of knowledge on medicinal plants.

Medicinal plants used for menstrual disorders in Latin America, the Caribbean, sub-Saharan Africa, South and Southeast Asia and their uterine properties: a review.

ETHNOPHARMACOLOGICAL RELEVANCE: Menstrual disorders are generally not perceived as major health concerns by global health organizations, despite being disruptive to women׳s daily activities, particularly when access to sanitary facilities or analgesics is limited. Improving menstrual health requires access to safe and effective medication, but many women in Latin America, Africa or Asia prefer traditional medicine above modern remedies (such as contraceptives), as they can cause physical symptoms associated with fertility loss. Many medicinal plants are used for menstrual disorders, but few have been examined for their pharmacological activities related to traditional uses. Plants that have a smooth muscle-relaxant effect could ease menstrual cramps, but there are indications that dysmenorrhea in low-income countries is commonly treated with emmenagogues. This review aims to assess the most salient plants used to treat menstrual morbidity in Latin America and the Caribbean, sub-Saharan Africa, South and Southeast Asia, their uterine properties and adverse effects. To test whether plants used for painful menstruation could have uterine contracting properties, we recorded whether these species were also used to ease birth, induce menstruation, abortion or expel the afterbirth, as these suggest spasmogenic activities. MATERIALS AND METHODS: We reviewed the literature documenting traditional plant use in the study area for dysmenorrhea, regulating or inducing menstruation, uterine cleansing, uterine fibroids, expelling the placenta and lochia and for easing childbirth. Thirty genera (59 species) used in at least two continents or frequently throughout one continent, where shortlisted from the 90 most salient plant species emerging from our literature review. Using Medline, we searched for pharmacological properties and/or mechanisms of action relevant to their traditional uses of the shortlisted species. We searched VigiBase™, the WHO global individual case safety report database, on reported adverse drug reactions associated with these species. RESULTS: More than 2000 plant species are used for menstrual disorders in the study area. The most salient uses are to treat painful menstruation, induce or regulate menses, and induce abortion. Around half (29) of the 59 most salient species have been tested for their pharmacological effects, of which 48% act as uterine spasmolytics and 31% as uterine spasmogenics. Several frequently used species contain toxic constituents, which may put women and their unborn children at serious risk. VigiBase(TM) listed adverse drug reactions for 18 of these species, but few reports came from the study area. CONCLUSIONS: Research into the risks and benefits of medicinal plants for menstrual complaints should be given a higher priority in reproductive health programs that respect traditional knowledge and practices. Increased data collection is needed on adverse drug reactions among women using herbal medicines for reproductive health, especially in countries with limited reproductive health facilities.

Intercultural health and ethnobotany: how to improve healthcare for underserved and minority communities?

ETHNOPHARMACOLOGICAL RELEVANCE: The present conceptual review explores intercultural healthcare--defined as the integration of traditional medicine and biomedicine as complementary healthcare systems--in minority and underserved communities. This integration can take place at different levels: individuals (patients, healers, biomedical healthcare providers), institutions (health centers, hospitals) or society (government policy). BACKGROUND: Contemporary ethnobotany research of traditional medicine has primarily dealt with the botanical identification of plants commonly used by local communities, and the identification of health conditions treated with these plants, whereas ethnopharmacology has focused on the bioactivity of traditional remedies. On the other hand, medical anthropology seems to be the scholarship more involved with research into patients' healthcare-seeking itineraries and their interaction with traditional versus biomedical healthcare systems. The direct impact of these studies on public health of local communities can be contested. AIM OF THE REVIEW: To compare and discuss the body of scholarly work that deals with different aspects of traditional medicine in underserved and minority communities, and to reflect on how gaps identified in research can be bridged to help improve healthcare in these communities. KEY FINDINGS: The literature covers a broad range of information of relevance to intercultural healthcare. This information is fragmented across different scientific and clinical disciplines. A conceptual review of these studies identifies a clear need to devote more attention to ways in which research on traditional medicine can be more effectively applied to improve local public health in biomedical resource-poor settings, or in geographic areas that have disparities in access to healthcare. CONCLUSIONS: Scholars studying traditional medicine should prioritize a more interdisciplinary and applied perspective to their work in order to forge a more direct social impact on public health in local communities most in need of healthcare.

Evidence of the shifting baseline syndrome in ethnobotanical research.

BACKGROUND: The shifting baseline syndrome is a concept from ecology that can be analyzed in the context of ethnobotanical research. Evidence of shifting baseline syndrome can be found in studies dealing with intracultural variation of knowledge, when knowledge from different generations is compared and combined with information about changes in the environment and/or natural resources. METHODS: We reviewed 84 studies published between 1993 and 2012 that made comparisons of ethnobotanical knowledge according to different age classes. After analyzing these studies for evidence of the shifting baseline syndrome (lower knowledge levels in younger generations and mention of declining abundance of local natural resources), we searched within these studies for the use of the expressions "cultural erosion", "loss of knowledge", or "acculturation". RESULTS: The studies focused on different groups of plants (e.g. medicinal plants, foods, plants used for general purposes, or the uses of specific important species). More than half of all 84 studies (57%) mentioned a concern towards cultural erosion or knowledge loss; 54% of the studies showed evidence of the shifting baseline syndrome; and 37% of the studies did not provide any evidence of shifting baselines (intergenerational knowledge differences but no information available about the abundance of natural resources). DISCUSSION AND CONCLUSIONS: The general perception of knowledge loss among young people when comparing ethnobotanical repertoires among different age groups should be analyzed with caution. Changes in the landscape or in the abundance of plant resources may be associated with changes in ethnobotanical repertoires held by people of different age groups. Also, the relationship between the availability of resources and current plant use practices rely on a complexity of factors. Fluctuations in these variables can cause changes in the reference (baseline) of different generations and consequently be responsible for differences in intergenerational knowledge. Unraveling the complexity of changes in local knowledge systems in relation to environmental changes will allow the identification of more meaningful information for resource conservation.

Globalization and loss of plant knowledge: challenging the paradigm.

The erosion of cultural knowledge and traditions as a result of globalization and migration is a commonly reported phenomenon. We compared one type of cultural knowledge about medicinal plants (number of plants reported to treat thirty common health conditions) among Dominican laypersons who self-medicate with plants and live in rural or urban areas of the Dominican Republic (DR), and those who have moved to New York City (NYC). Many plants used as medicines were popular Dominican food plants. These plants were reported significantly more often by Dominicans living in NYC as compared to the DR, and this knowledge was not age-dependent. These results contradict the popular paradigm about loss of cultural plant knowledge and is the first study to report a statistically measurable increase in this type of knowledge associated with migration.