The Open Burning of Plastic Wastes is an Urgent Global Health Issue.

The open burning of mixed wastes that contain plastics is a widespread practice across the globe, resulting in the release of gas emissions and ash residues that have toxic effects on human and environmental health. Although plastic pollution is under scrutiny as a pressing environmental concern, it is often conflated with plastic litter, and the contribution of the open burning of plastics to air, soil, and water pollution gets overlooked. Therefore, campaigns to raise awareness about plastic pollution often end up leading to increased open burning. Many countries or regions where open burning is prevalent have laws in place against the practice, but these are seldom effective. In this viewpoint, we direct attention to this critical but largely overlooked dimension of plastic pollution as an urgent global health issue. We also advocate interventions to raise awareness about the risks of open burning and emphasize the necessity of phasing out some particularly pernicious plastics in high-churn, single-use consumer applications.

Confident futures: Community-based organizations as first responders and agents of change in the face of the Covid-19 pandemic.

This comparative study of community organizations serving marginalized youth in New York City and Amsterdam utilized a novel ethnographic approach called reverse engineering to identify techniques for social change that are active in each organization, adaptable and translatable to other contexts. It found that youth-serving organizations led flexible responses to the crisis of COVID-19 as it affected those marginalized by race, immigrant status, housing instability, religion and gender. The organizations employed techniques that they had previously developed to cultivate youth well-being - among them connectivity, safe space, and creativity - to mount tailored responses to COVID-19 related crises. In New York City, these groups addressed crises of material survival resources (personal protective equipment, food, housing) whereas in Amsterdam, youth-serving organizations focused on social connections and emotional well-being as the government met more of participants' material needs.

The role of self-care interventions on men's health-seeking behaviours to advance their sexual and reproductive health and rights.

BACKGROUND: Self-care interventions are influencing people's access to, expectation and understanding of healthcare beyond formal health delivery systems. In doing so, self-care interventions could potentially improve health-seeking behaviours. While many men proactively engage in maintaining and promoting their health, the focus on men's health comes from the recognition, at least partially, that male socialization and social norms can induce men and boys to have a lower engagement in institutionalized public health entities and systems around their sexual and reproductive health and rights, that could impact negatively on themselves, their partners and children. MAIN TEXT: A research agenda could consider the ways that public health messaging and information on self care practices for sexual and reproductive health and rights could be tailored to reflect men's lived realities and experiences. Three examples of evidence-based self-care interventions related to sexual and reproductive health and rights that men can, and many do, engage in are briefly discussed: condom use, HIV self-testing and use of telemedicine and digital platforms for sexual health. We apply four core elements that contribute to health, including men's health (people-centred approaches, quality health systems, a safe and supportive enabling environment, and behaviour-change communication) to each intervention where further research can inform normative guidance. CONCLUSION: Engaging men and boys and facilitating their participation in self care can be an important policy intervention to advance global sexual and reproductive health and rights goals. The longstanding model of men neglecting or even sabotaging their wellbeing needs to be replaced by healthier lifestyles, which requires understanding how factors related to social support, social norms, power, academic performance or employability conditions, among others, influence men's engagement with health services and with their own self care practices.

Are psychotic-like experiences related to a discontinuation of cannabis consumption in young adults?

OBJECTIVE: To assess changes in cannabis use in young adults as a function of psychotic-like experiences. METHOD: Participants were initially recruited at age 14 in high schools for the longitudinal IMAGEN study. All measures presented here were assessed at follow-ups at age 19 and at age 22, respectively. Perceived stress was only assessed once at age 22. Ever users of cannabis (N = 552) gave qualitative and quantitative information on cannabis use and psychotic-like experiences using the Community Assessment of Psychic Experiences (CAPE). Of those, nearly all n = 549 reported to have experienced at least one psychotic experience of any form at age 19. RESULTS: Mean cannabis use increased from age 19 to 22 and age of first use of cannabis was positively associated with a change in cannabis use between the two time points. Change in cannabis use was not significantly associated with psychotic-like experiences at age 19 or 22. In exploratory analysis, we observed a positive association between perceived stress and the experience of psychotic experiences at age 22. CONCLUSION: Age of first use of cannabis influenced trajectories of young cannabis users with later onset leading to higher increase, whereas the frequency of psychotic-like experiences was not associated with a change in cannabis use. The observed association between perceived stress and psychotic-like experiences at age 22 emphasizes the importance of stress experiences in developing psychosis independent of cannabis use.

Keeping up with the times: skin-lightening practices among young men in the Philippines.

The desire for light(er) skin is widespread around the world and has been the subject of extensive critical scholarship. But far less attention has focused on skin-lightening practices among boys and men, even as historical and contemporary data show that it is both a long-standing and growing trend in many Asian countries. This study builds on a focused ethnography of young men's skin-lightening practices in two Philippine cities. Using Norbert Elias' notion of 'figurations', we look at how shifts in gender ideologies, socio-economic changes, processes of urbanisation and popular culture trends are reflected in these practices. We find that the pursuit of a whiter skin is not an individual project, but a mode of body modification which is enacted in figurations among male peers, between men and women, and between men and their employers and customers in a globalising economy. Overall, skin practices and preferences among young men in the Philippines are best understood in terms of changing notions of masculinity, the unchanging quest to look compatible (bagay) with one's peers, and the desire to keep up ever-changing trends.

Beyond health: medicines, food supplements, energetics and the commodification of self-performance in Maputo.

With an increasing range of products in global and local markets, more options are available for individuals to enhance their image and their (cognitive, social and physical) performance. These 'performance consumptions' relate to ideals of well-being and improvement, and are based on constructed desires, expectations and needs that go beyond the (often blurred) dichotomy of health and illness. Drawing from mixed-methods research in Maputo, Mozambique, this paper discusses individuals' use of medicines and other substances - pharmaceuticals, food supplements, traditional herbs, cosmetics and energy drinks - for managing different aspects of their everyday lives. Through an overview of the main consumption practices, we explore the underlying purposes and strategies of users, and the perceived legitimacy and risks involved when using a variety of products accessible through formal and informal exchange channels. From tiredness to sexual and aesthetic management, we show how the body becomes the locus of experimentation and investment to perform in accordance with socially expected roles, individual aspirations and everyday tasks. With insights from individuals' accounts in Maputo, we aim to add to discussions on pharmaceuticalisation of body management by showing how the emergence of new performance consumptions is articulated with the reconfiguration of more 'traditional' consumption practices.

Be your product: On youth, multilevel marketing, and nutritional cure-alls in Puerto Princesa, Philippines.

Young people in Puerto Princesa, the Philippines, are drawn to working as salespeople for AIM Global, a purveyor of the nutritional supplement C24/7. The company relies on multilevel marketing, in which sellers recruit other sellers, offering youth not only the chance to earn money but also educational discounts, access to bank cards, and an opportunity to develop do-it-yourself entrepreneurial skills. Trainers encourage sellers to capitalize on their intimate relations, to tailor the supplements to assuage aging clients' metabolic-health anxieties, and to use C24/7 themselves so that they can testify to its benefits. Such "sociometabolic" work is omnipresent in urban settings, where workers in beauty salons and gyms likewise promise to mitigate the material, bodily disturbances caused by toxic environments and precarious living conditions. [multilevel marketing, youth, sociometabolic labor, relational work, aspirations, nutritional supplements, metabolic health, ecology, Philippines].

Zoonotic Transmission of mcr-1 Colistin Resistance Gene from Small-Scale Poultry Farms, Vietnam.

We investigated the consequences of colistin use in backyard chicken farms in Vietnam by examining the prevalence of mcr-1 in fecal samples from chickens and humans. Detection of mcr-1-carrying bacteria in chicken samples was associated with colistin use and detection in human samples with exposure to mcr-1-positive chickens.

Coming of age, becoming obese: a cross-sectional analysis of obesity among adolescents and young adults in Malaysia.

BACKGROUND: Malaysians have become increasingly obese over recent years. The transition from adolescence to early adulthood is recognized as critical for the development of eating and activity habits. However, little obesity-related research focuses on this life stage. Drawing on data from a health and demographic surveillance site in Malaysia, this article describes obesity and overweight amongst adolescents and young adults in a multi-ethnic population. METHODS: Data were collected at the South East Asia Community Observatory (SEACO) in Segamat District, Johor. In this dynamic cohort of approximately 40,000 people, 5,475 were aged 16-35 in 2013-2014. The population consists of Malay, Chinese, Indian and Indigenous (Orang Asli) families in proportions that reflect the national ethnic diversity. Data were collected through health profiles (Body Mass Index [BMI] measurements in homes) and self-report questionnaires. RESULTS: Age and ethnicity were associated with overweight (BMI 25.0-29.9Kg/m2) and obesity (BMI ≥ 30Kg/m2). The prevalence of overweight was 12.8 % at ages 16-20 and 28.4 % at ages 31-35; obesity was 7.9 % and 20.9 % at the same age groups. The main ethnic groups also showed varied patterns of obesity and overweight at the different age groups with Chinese at lowest and Orang Asli at highest risk. Level of education, employment status, physical activity and frequency of eating out were poorly predictive of overweight and obesity. CONCLUSION: The pattern of overweight and obesity in the 16-35 age group further highlights this as a significant period for changes in health-related behaviours. Further longitudinal research is however needed to confirm the observed pattern and investigate causal factors.

Educated Guesses and Other Ways to Address the Pharmacological Uncertainty of Designer Drugs: An Exploratory Study of Experimentation Through an Online Drug Forum.

This study examines how experimentation with designer drugs is mediated by the Internet. We selected a popular drug forum that presents reports on self-experimentation with little or even completely unexplored designer drugs to examine: (1) how participants report their "trying out" of new compounds and (2) how participants reduce the pharmacological uncertainty associated with using these substances. Our methods included passive observation online, engaging more actively with the online community using an avatar, and off-line interviews with key interlocutors to validate our online findings. This article reflects on how forum participants experiment with designer drugs, their trust in suppliers and the testimonials of others, the use of ethno-scientific techniques that involve numerical weighing, "allergy dosing," and the use of standardized trip reports. We suggest that these techniques contribute to a sense of control in the face of the possible toxicity of unknown or little-known designer drugs. The online reporting of effects allows users to experience not only the thrill of a new kind of high but also connection with others in the self-experimenting drug community.

Anthropologists in Global Health Experiments.

Can global health experiments be part of more flexible systems of knowledge generation, where different bodies of knowledge come together to provide understanding not only of the outcomes of new interventions but also of the mechanisms through which they affect people's well-being and health? Building past work in which they tried to transform how global health experiments are carried out and inspired by the articles in this special issue, the authors of this commentary argue that strategic collaboration is needed to break the hegemony of randomized controlled trials in designing global health technologies. More open-ended experiments are possible if anthropologists team up with innovative researchers in biomedicine to develop new conceptual models and to adopt novel observational techniques and 'smart' trials that incorporate ethnography to unravel complex interactions between local biologies, attributes of health systems, social infrastructures, and users' everyday lives.

Access for all: contextualising HIV treatment as prevention in Swaziland.

This article explores how notions of the individual and population are evoked in two ongoing HIV treatment as prevention (TasP) implementation studies in Swaziland. By contrasting policy discourses with lived kinship experiences of people living with HIV, we seek to understand how TasP unfolds in the Swazi context. Data collection consisted of eight focus group discussions with people living with HIV who were members of support groups to examine their perspectives about TasP. In addition, 18 key informant interviews were conducted with study team members, national-level policy-makers and NGO representatives involved in the design of health communication messages about TasP in Swaziland. Thematic analysis was used to identify recurrent themes in transcripts and field notes. Policy-makers and people living with HIV actively resisted framing HIV treatment as a prevention technology but promoted it as (earlier) access to treatment for all. TasP was not conceptualised in terms of individual or societal benefits, which are characteristic of international public health debates; rather its locally situated meanings were embedded in kinship experiences, concerns about taking responsibility for one's own health and others, local biomedical knowledge about drug resistance, and secrecy. The findings from this study suggest that more attention is needed to understand how the global discourse of TasP becomes shaped in practice in different cultural contexts.

Prevalence and risk factors for carriage of antimicrobial-resistant Escherichia coli on household and small-scale chicken farms in the Mekong Delta of Vietnam.

OBJECTIVES: To describe the prevalence of antimicrobial resistance among commensal Escherichia coli isolates on household and small-scale chicken farms, common in southern Vietnam, and to investigate the association of antimicrobial resistance with farming practices and antimicrobial usage. METHODS: We collected data on farming and antimicrobial usage from 208 chicken farms. E. coli was isolated from boot swab samples using MacConkey agar (MA) and MA with ceftazidime, nalidixic acid or gentamicin. Isolates were tested for their susceptibility to 11 antimicrobials and for ESBL production. Risk factor analyses were carried out, using logistic regression, at both the bacterial population and farm levels. RESULTS: E. coli resistant to gentamicin, ciprofloxacin and third-generation cephalosporins was detected on 201 (96.6%), 191 (91.8%) and 77 (37.0%) of the farms, respectively. Of the 895 E. coli isolates, resistance to gentamicin, ciprofloxacin and third-generation cephalosporins was detected in 178 (19.9%), 291 (32.5%) and 29 (3.2%) of the isolates, respectively. Ciprofloxacin resistance was significantly associated with quinolone usage (OR = 2.26) and tetracycline usage (OR = 1.70). ESBL-producing E. coli were associated with farms containing fish ponds (OR = 4.82). CONCLUSIONS: Household and small farms showed frequent antimicrobial usage associated with a high prevalence of resistance to the most commonly used antimicrobials. Given the weak biocontainment, the high prevalence of resistant E. coli could represent a risk to the environment and to humans.