Comprehensive physiological and genomic characterization of a potential probiotic strain, Lactiplantibacillus plantarum ILSF15, isolated from the gut of tribes of Odisha, India.

Characterizing probiotic features of organisms isolated from diverse environments can lead to the discovery of novel strains with promising functional features and health attributes. The present study attempts to characterize a novel probiotic strain isolated from the gut of the tribal population of Odisha, India. Based on 16S rRNA-based phylogeny, the strain was identified as a species of the Lactiplantibacillus genus and was named Lactiplantibacillus plantarum strain ILSF15. The current investigation focuses on elucidating this strain's genetic and physiological properties associated with probiotic attributes such as biosafety risk, host adaptation/survival traits, and beneficial functional features. The novel strain was observed, in vitro, exhibiting features such as acid/bile tolerance, adhesion to the host enteric epithelial cells, cholesterol assimilation, and pathogen exclusion, indicating its ability to survive the harsh environment of the human GIT and resist the growth of harmful microorganisms. Additionally, the L. plantarum ILSF15 strain was found to harbor genes associated with the metabolism and synthesis of various bioactive molecules, including amino acids, carbohydrates, lipids, and vitamins, highlighting the organism's ability to efficiently utilize diverse resources and contribute to the host's nutrition and health. Several genes involved in host adaptation/survival strategies and host-microbe interactions were also identified from the ILSF15 genome. Moreover, L. plantarum strains, in general, were found to have an open pangenome characterized by high genetic diversity and the absence of specific lineages associated with particular habitats, signifying its versatile nature and potential applications in probiotic and functional food industries.

The Role of Community Engagement in Successful Recruitment of Research Participants During the COVID-19 Pandemic.

Background: Our research team was in the process of recruiting American Indian and Alaska Native (AIAN) women for a community-based intervention to prevent alcohol-exposed pregnancy when the COVID-19 pandemic began. Safety measures adopted at the tribal, state, and national level required us to rethink and revise study protocols. We followed the principles of community-based participatory research, especially community engagement. The goal of this article is to report the recommendations from local AIAN field staff and the community advisory board that enabled us to exceed our prepandemic recruitment goal. Methods: First, we developed a list of major adaptations and mapped each one onto our recruitment timeline to assess its effect on subsequent enrollment. Second, we surveyed the two AIAN field staff who led recruitment and an administrative staffer at the study site and conducted a qualitative analysis of their responses. Results: Our revised project timeline presents the major adaptations that led to our successful recruitment, as verified by qualitative data from field staff. These adaptations included expanding our social media presence, expanding recruitment to a nearby urban site, implementing a "refer a friend" program, and recruiting through local media outlets. Most important was having local AIAN staff who cultivated a nonjudgmental space for potential participants to talk about sensitive topics. Discussion: We not only met our prepandemic recruitment goal but exceeded it by 16.6%. The input of our community advisory board and the efforts of community-based staff were essential in achieving success during the unprecedented conditions of the COVID-19 pandemic.

Investigating linguistic and genetic shifts in East Indian tribal groups.

South Asia is home to almost a quarter of the world's total population and is home to significant ethnolinguistic diversity. Previous studies of linguistic and genetic affiliations of Indian populations suggest that the formation of these distinct groups was a protracted and complex phenomenon involving multiple waves of migration, cultural assimilation, and genetic admixture. The evolutionary processes of migration, mixing and merging of populations thus impact the culture and linguistic diversity of different groups, some of which may retain their linguistic affinities despite genetic admixture with other groups, or vice versa. Our study examines the relationship of genetic and linguistic affinities between Austroasiatic and Indo-European speakers in adjacent geographical regions of Eastern India. We analyzed 224 mitogenomes and 0.65 million SNP genotypes from 40 unrelated individuals belonging to the Bathudi, Bhumij, Ho, and Mahali ethnic groups from the Eastern Indian state of Odisha. These four groups are speakers of Austroasiatic languages who have adopted elements from Indo-European languages spoken in neighbouring regions. Our results suggest that these groups have the greatest maternal genetic affinity with other Austroasiatic-speaking groups in India. Allele frequency-based analyses, genome-wide SNPs, haplotype-based methods and IBD sharing further support the genetic similarity of these East Indian groups to Austroasiatic speakers of South Asia rather than regional populations speaking Indo-European and Dravidian languages. Our study shows that these populations experienced linguistic mixing, likely due to industrialization and modernization that brought them into close cultural contact with neighbouring Indo-European-speaking groups. However, linguistic change in these groups is not reflected in genetic mixing in these populations, as they appear to maintain strict genetic boundaries while simultaneously experiencing cultural mixing.

Upholding Tribal Sovereignty in Federal, State, and Local Emergency Vaccine Distribution Plans.

Cross jurisdictional collaboration efforts and emergency vaccine plans that are consistent with Tribal sovereignty are essential to public health emergency preparedness. The widespread adoption of clearly written federal, state, and local vaccine plans that address fundamental assumptions in vaccine distribution to Tribal nations is imperative for future pandemic response.

Disparity by caste and tribe: Understanding women's empowerment and health outcomes in India.

AIM: Women's empowerment status varies greatly in India according to caste, class, ethnicity and region. This paper aims to investigate the caste/tribe disparity in women's empowerment by region, the main correlates of each domain of empowerment, and the association of women's empowerment with nutritional and health care access outcomes, specifically anaemia, menstrual hygiene, and institutional delivery. METHODOLOGY: Using National Family Health Survey-5 (2019-2021) data, we have created a modified survey-based women's empowerment index (SWPER) using principal component analysis with Oblique varimax rotation. The first four components are interpreted as an attitude to violence, freedom of movement, decision-making power and social independence. Several multivariate regression models were used to understand the factor associated with empowerment and the association of women's empowerment with different health outcomes. RESULTS: The results indicate that women from the forward castes are the most empowered in most domains except decision-making. However, after controlling other background variables, the forward castes women are found to be the most empowered in attitude to violence, whereas Scheduled Castes and Scheduled Tribes women were found to be the most empowered women in decision-making. With regards to social independence, deprived castes women are more empowered than the forward castes women. The likelihood of empowerment in social independence domain increases with increasing wealth. There are wide regional variations in empowerment level between different social groups. Caste/tribe identity plays a significant role in determining health outcomes in India. Among all empowerment domains, social independence emerges as the most significant associated factor with improved health across all caste/tribe groups. CONCLUSION: The path to women's empowerment in India must recognize the intersectionality of caste/tribe identities, and address regional disparities. Social independence emerges as a critical determinant across all caste/tribe groups for improving health. Measures should be taken to empower women through the underlying factors of social independence.

Sickle cell disease in Indian tribal population: Findings of a multi-centre Indian SCD registry.

BACKGROUND: Sickle cell disease (SCD) registries provide crucial real-world data on demographics, epidemiology, healthcare, patient outcomes, and treatment efficacy. This paper presents findings from the Indian SCD Registry (ISCDR) on clinical manifestations, crisis episodes, disease management, and healthcare utilization in patients with SCD from 12 primary health centres (PHCs) in six tribal districts of India. METHODS: The ISCDR was introduced along with a three-tier screening process. Its Android-based application incorporates two electronic case report forms for patient data collection over one year. This paper presents a year's data from the ISCDR's 324 patients with SCD. RESULTS: Patients with SCD, aged one to 65 years, exhibited varied clinical manifestations. Most patients (85.2 %) were unaware of their SCD status before enrolling in ISCDR. Moderate to severe anaemia was prevalent (66.05 % and 30.56 %, respectively). Pain was a common complaint (80.86 %; CI: 76.17-85.00), while symptoms of stroke included sudden severe headaches (34.57 %; CI: 29.40-40.02). Common splenic sequestration symptoms included stomach pain (42.90 %; CI: 37.44-48.49) and abdominal tenderness (13.27 %; CI: 9.77-17.46), as a sign. Healthcare utilization was high, with 96.30 % receiving treatment and 83.64 % consuming hydroxyurea. Hospitalization occurred for 38.27 % (CI: 32.95-43.81), and 12.04 % (CI: 8.70-16.09) had blood transfusion during last year. CONCLUSIONS: ISCDR serves as a dynamic digital database on SCD epidemiology, clinical aspects, treatment and healthcare utilization. Notably, many patients lacked prior awareness of their SCD status, underscoring the need for improved awareness and care management. Integrating the registry into the national programme can streamline treatment implementation, prioritize management approaches, and optimize individual benefits.

Assessing NESTROFT as a preliminary screening tool for thalassemia in the Malayali tribes of Dharmapuri district, Tamil Nadu, India.

Background: Mutations affecting transcription, translation, or beta-globin stability, among other stages of beta-globin production, cause beta-thalassemia. Methods: Beta-thalassemia results in a high red blood cell count with a low mean corpuscular volume (60-70fl) and mean corpuscular hemoglobin (19-23pg), and Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT) is recommended for mass screening of populations. Among tribals in Dharmapuri district, this cross-sectional analysis evaluated the efficacy of RBC and NESTROFT against HPLC, regarded as the gold standard, in a study involving 484 subjects. Results: Findings indicated that out of the 484 samples, 73 tested positive for the beta-thalassemia trait through HPLC. The NESTROFT test demonstrated 87% sensitivity, 98.5% specificity, a positive predictive value of 99.3%, and a negative predictive value of 73.3%. In the multivariate analysis, NESTROFT and hemoglobin showed high significance with P values of 0.003 and 0.000, respectively. Conclusion: NESTROFT's high sensitivity is particularly noteworthy due to the absence of research among the Malayali tribes in the Dharmapuri district. Adoption of this preliminary test shows promise in detecting the disease at the local level, providing important information for early detection, especially considering the sizeable tribal population.

Wealth and education-related inequalities in the utilisation of reproductive, maternal, newborn, and child health interventions within scheduled tribes in India: an analysis of Odisha and Jharkhand.

BACKGROUND: The utilisation of Reproductive, Maternal, Newborn and Child Health (RMNCH) services remains lower among the Scheduled Tribes (ST) in India than among the rest of the country's population. The tribal population's poorest and least-educated households are further denied access to RMNCH care due to the intersection of their social status, wealth, and education levels. The study analyses the wealth- and education-related inequalities in the utilisation of RMNCH services within the ST population in Odisha and Jharkhand. METHODOLOGY: We have constructed two summary measures, namely, the Co-coverage indicator and a modified Composite Coverage Index (CC), to determine wealth- and education-related inequalities in the utilisation of RMNCH indicators within the ST population in Odisha and Jharkhand. The absolute and relative inequalities with respect to wealth and education within the ST population are estimated by employing the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII). RESULTS: The results of the study highlight that access to RMNCH services is easier for women who are better educated and belong to wealthier households. The SII and RII values in the co-coverage indicator and modified CCI exhibit an increase in wealth-related inequalities in Odisha between NFHS-4 (2015-16) and NFHS-5 (2019-21) whereas in Jharkhand, the wealth- and education-related absolute and relative inequalities present a reduction between 2016 and 2021. Among the indicators, utilisation of vaccination was high, while the uptake of Antenatal Care Centre Visits and Vitamin A supplementation should be improved. INTERPRETATION: The study results underscore the urgent need of targeted policies and interventions to address the inequalities in accessing RMNCH services among ST communities. A multi-dimensional approach that considers the socioeconomic, cultural and geographical factors affecting healthcare should be adopted while formulating health policies to reduce inequalities in access to healthcare.

Community-based early detection of oral precancerous lesion, accessibility and utilization of oral healthcare services among Irular tribes residing at union territory of Pondicherry.

Background: The present study was conducted to estimate the prevalence of oral carcinoma and precancerous lesion, oral healthcare seeking behaviour and identify accessible areas of tobacco cessation centres and oral healthcare facilities among Irular adult tribes residing in Pondicherry. Objectives: 1. To estimate the prevalence of oral carcinomas and precancerous lesion by using toluidine blue solution. 2. To determine their oral healthcare seeking behaviour in terms of utilizing oral healthcare facilities. 3. To identify accessible tobacco cessation centres and oral healthcare centres for prevention of oral cancer. Materials and Methods: A cross-sectional study is designed to identify oral carcinomas, oral health-care seeking behaviour among Irular tribes of Pondicherry. 1% toluidine blue solution prepared for detection of oral precancerous lesion. Data was collected using a questionnaire and clinical examination. The collected data was subjected to statistical analysis. Results: Out of 587 study population, oral mucosal lesion among the study population was 46 (7.8%) leukoplakia and 18 (3.1%) candidiasis. Positive health seeking behaviour 24 (41.7%) was observed. Conclusion: The study concluded that low prevalence of oral precancerous lesion and oral healthcare seeking behaviour is poor.

Prevalence of hemoglobinopathies among Malayali tribes of Jawadhu hills, Tiruvannamalai district, Tamil Nadu, India: a community-based cross-sectional study.

BACKGROUND: Hemoglobin (Hb), a red pigment of red blood cells (RBCs), carries oxygen from the lungs to different organs of the body and transports carbon dioxide back to the lungs. Any fault present in the Hb structure leads to undesirable functional effects of the RBCs, such as sickle cell anemia (SCA), thalassemia, etc. Hemoglobinopathies affect around 7% of people in both developed and developing countries globally. The aim of the present study was to determine the prevalence and carrier frequencies of hemoglobinopathies including SCA, thalassemia, and other abnormal Hb variants among Malayali tribes in the Jawadhu hills of Tiruvannamalai district, Tamil Nadu, India. METHODS: A community-based cross-sectional study was carried out among 443 Malayali tribes inhabiting the Jawadhu hills of Tiruvannamalai district from July 2022 to September 2022. The RBC indices were analyzed using an automated 5-part hematology analyzer (Mindray, BC-5150) and hemoglobin fractions were done using the HPLC system (Bio-Rad, D-10) following standard protocols. FINDINGS: A total of 443 participants were screened, out of whom 14.67% had an abnormal Hb fraction, 83.30% were identified as normal, and 2.03% were borderline. Notably, the study revealed a prevalence of 0.68% for the α-thalassemia trait and 13.99% for the ß-thalassemia trait. INTERPRETATION: Haemoglobinopathies, specifically the ß-thalassemia trait, were most prevalent among the Malayali tribal population of Tamil Nadu residing in the Jawadhu hills of Tiruvannamalai district. Hence, we need special attention for creating awareness, increasing hemoglobinopathies screening programs, and improving the importance of tribal health conditions by the government and non-governmental organizations (NGOs) for the betterment of the ethnic tribes.

Prevalence and Associated Risk Factors of Hypertension Among Tribal Population Aged 15-49 in India: Evidence from National Family Health Survey, 2019-2021.

BACKGROUND: Approximately 10% of non-communicable diseases (NCDs) can be attributed to hypertension. The prevalence of hypertension is steadily increasing among urban, rural, and tribal populations alike. There has been a growing incidence of hypertension within underprivileged groups; however, there is a scarcity of research focusing on the risks of hypertension within Indian tribes. The current study aimed to estimate the pooled prevalence of hypertension among tribes and the risk factors of hypertension. METHODS: This study uses data from the fifth phase of the National Family Health Survey (NFHS-5) in India, covering 2,843,917 individuals in 636,699 households. A total of 69,176 individuals belonging to tribal communities aged between 15 and 49, encompassing both males and females, have been incorporated into our study. The study utilized bivariate and multivariable binary logistic regression analyses, which were conducted using the R statistical software. RESULTS: Among 69,176 tribal populations between 15 and 49 years, the overall prevalence of hypertension was 12.54% (8676/69176; 95% CI, 12.29%, 12.79%). The prevalence of hypertension among males was 16.4% and 12.07% among females. Age, gender, education, marital status, smoking, and alcohol consumption were found to be the significant predictors of hypertension among tribes. CONCLUSION: The rising prevalence and potential dangers of hypertension within Indian tribes highlight their epidemiological transition burdened by significant cardiometabolic health concerns, necessitating prompt and ongoing monitoring and surveillance.

Oral Healthcare Utilization Factors Shaping the Perceived Oral Health Outcome Among Gond Tribes of Chhattisgarh: A Cross-Sectional Study Based on Andersen's Behavioral Model.

INTRODUCTION: The Gonds are a highly ancient and expansive tribal community, ranking among the largest in the world. A review of the literature has suggested that they are more vulnerable to oral diseases and are less inclined to utilize oral health services due to the comprehensive approach that considers the socioeconomic, cultural, and structural factors affecting the Gond community's access to oral health services. Tribal health requires action in the health sector. Utilization is an essential marker of the health status of any population and is necessary to bridge the gap between tribes and the wider portion of the community. Hence, this study was conducted among the Gond tribes of Chhattisgarh to evaluate the oral healthcare utilization factors shaping the perceived oral health outcome using Andersen's behavior model. MATERIALS AND METHODS: This cross-sectional study was carried out among 400 Gond tribes residing in villages of Chhattisgarh. Data was collected through a standardized questionnaire, adapted from Andersen's behavioral model of healthcare utilization during house-to-house survey. The questionnaire included predisposing, enabling, perceived, and evaluated need factors. Oral health status for evaluated need was assessed using the World Health Organization (WHO) Oral Health Assessment form (1997), and the perceived oral health outcome was measured using Oral Health Impact Profile-14 (OHIP-14). Results were computed using descriptive statistics, chi-square test, and one-way analysis of variance (ANOVA). Multivariate analysis was done using binomial logistic regression. RESULTS: The dental visit in the past one year was only 14%. The findings of logistic regression revealed that the perceived oral health outcome was significantly associated with age, occupation, and positive belief in the efficacy of dentist, perceived need, and presence of dental caries. CONCLUSION: The findings of the present study support Andersen's behavioral model and suggest that there is an interrelationship of predisposing characters, predisposing health beliefs, and enabling need factors that determine the likelihood of use of services, which in turn determines the good or bad oral health outcome.

Corrigendum: The maternal U1 haplogroup in the Koraga tribe as a correlate of their North Dravidian linguistic affinity.

[This corrects the article DOI: 10.3389/fgene.2023.1303628.].

Oral health status and behaviour among Kanikkaran tribes of Mundandhurai Hills in Tirunelveli district, Tamil Nadu.

Background: Kanikkaran are semi-nomadic tribes inhabiting Mundandhurai hills in Tamil Nadu. Their traditional method of maintaining oral health, seclusion, ignorance, and limited access to dental resources has led to their poor oral health situation. Thus, the present study is designed to assess the oral health status of the Kanikkaran tribals residing in Mundandhurai Hill of Tirunelveli district. Methods: A cross-sectional epidemiological study was conducted among 907 Kanikkaran tribes in Mundandhurai hills. Mundandhurai Hills in Ambasamudram taluk of Tirunelveli district was selected by convenience method. World Health Organization (WHO) oral health assessment form and its self-oral health assessment form (2013) were used. Descriptive and inferential statistics were performed using SPSS version 23.0. Result: There is a significant negative moderate correlation between age and dental caries (r = -0.752). There is a significantly high risk among tribes with the primary school of education and agriculture as an occupation for periodontal disease (OR = 3.48), premalignant lesion (OR = 2.52), and non-carious dental lesions (OR = 3.14). Males with primary school education and agriculture as occupation had a significantly higher consumption of sugar and use of tobacco (p < 0.05). Conclusion: Primary school of education with agriculture/labor as occupation had a high prevalence of DMFT, periodontitis, premalignant, and non-carious dental lesions. The results of the present study punctuate the necessity of raising awareness of the significance of good oral health through education and implementation of necessary dental services in Kanikkaran tribes.

Maternal healthcare seeking and determinants of adequate antenatal care and institutional childbirth among Indian tribes: A cross-sectional study from nine districts.

OBJECTIVE: To report the utilisation of maternal healthcare services and factors associated with adequate antenatal care and institutional childbirths among mothers in the tribal communities from nine districts in India. METHODS: Cross-sectional data were collected from 2636 tribal women who had a childbirth experience in the past 12 months. Socio-demographic, maternal healthcare services and health system-related details were collected. Multiple logistic regression analyses were done to identify factors associated with adequate antenatal care (receiving at least four antenatal care visits, the first visit being in the first trimester and receiving a minimum of 100 iron-folic acid tablets) and institutional childbirth (mother giving birth in a health facility). RESULTS: Only 23% of the mothers received adequate antenatal care. 82% were institutional childbirths. The logistic regression revealed that particularly vulnerable tribal groups (PVTGs), those lacking all-weather roads, and women of advanced age were at risk of inadequate antenatal care. Mother's education, health worker's home visits during pregnancy and reception of advice on antenatal care were significantly associated with the reception of adequate antenatal care. Having all-weather roads, and education of the mother and head of the household were positively associated with institutional childbirths, whereas PVTGs, children of birth order three or above, and working mothers were more likely to give childbirth at home. CONCLUSION: PVTGs are at risk of foregoing adequate antenatal care and are more likely to give childbirth at home. Having all-weather roads is a strong correlate of adequate maternal care. Outreach activities by the health workers are to be strengthened as they are positively and significantly associated with the reception of adequate antenatal care. Investing in education and other social determinants and addressing certain socio-cultural practices is important to improve maternal health.

Tracing the Disparity Between Healthcare Policy-Based Infrastructure and Health Belief-Lead Practices: a Narrative Review on Indigenous Populations of India.

Most Indian tribes have limited access to healthcare facilities and rely heavily on traditional healing practices. This narrative review aimed to identify the disparities in the implementation of healthcare services and in accessing and availing these services by the indigenous population in India. We also have tried to throw light on the plausibility in strengthening the efficiency and efficacy of the public health system, by utilizing the available resources to its maximum potential, so that there will be a measurable outcome in the health status of these populations in India, coherently with the relevant sustainable development goals (SDG). The evidence from published literatures supports the fact that the disparity exists in the health status of indigenous populations in India as compared to the general populations. It emphasizes the need to address the key determinants such as the lack of knowledge, traditional healing practices and poor utilization of healthcare services provided to them. Various factors such as accessibility to healthcare resources, traditional healing practices, lack of awareness regarding healthcare services and schemes provided by the government, insufficient data regarding their issues and challenges and cultural and language barriers worsen the health status of indigenous people. However, our review reiterates that a well-structured and sustainable policy with reframed infrastructure and administration of healthcare system might bring a positive change in the health status of indigenous population in India.

Assessment of Prevalence of Hypertension and its Risk Factors among Adult Tribal Population Residing in Lohandiguda Block of Bastar District of Chhattisgarh.

Background: Hypertension is known as the silent killer. It comprehends the top rank in non-infectious disease amongst adults; accountable for the deaths every year across the world. It is essential to consider the individual impact of risk factors and their impact on hypertension. This study thus elicited the socio-demographic characteristics, the prevalence of hypertension and associated risk factors, and its impact on adults with hypertension. To estimate the hypertension prevalence and its associated risk factors among adult tribal populations aged 25-60 years residing in Lohandiguda block of Bastar district of Chhattisgarh. Material and Methods: A community-based cross-sectional analytical study was used and the setting was done at the field practice area under the three primary health centers of Lohandiguda block, Bastar district of Chhattisgarh. It was carried out among 330 adult tribes residing for ≥1 year in the present locality. Data was collected by door-to-door visits through pre-designed, pretested, semi-structured questionnaire via face-to-face interview method and anthropometric measurement was done by using standard guidelines. The sampling method was multistage sampling. IBM SPSS STATISTICS-20.0 (IBM Corp., Armonk, NY, USA) software. Results: The overall prevalence of pre-hypertension and hypertension among tribal subjects was 34.9% and 47.3%, respectively. Of total hypertensive 27.3% were having stage-1 hypertension, 13.9% were having stage-2 hypertension and 6.0% were already diagnosed cases. Risk factors found in multivariate analysis are occupation (unemployed 0.012), frequency of smokeless tobacco used per day (0.,017) and central obesity (0.000). Conclusions: As hypertension is a multi-factorial disease the study found strong predictors like occupation, frequency of smokeless tobacco per day and having central obesity with significant difference.

Using Geospatial Data and Random Forest To Predict PFAS Contamination in Fish Tissue in the Columbia River Basin, United States.

Decision makers in the Columbia River Basin (CRB) are currently challenged with identifying and characterizing the extent of per- and polyfluoroalkyl substances (PFAS) contamination and human exposure to PFAS. This work aims to develop and pilot a methodology to help decision makers target and prioritize sampling investigations and identify contaminated natural resources. Here we use random forest models to predict ∑PFAS in fish tissue; understanding PFAS levels in fish is particularly important in the CRB because fish can be a major component of tribal and indigenous people diet. Geospatial data, including land cover and distances to known or potential PFAS sources and industries, were leveraged as predictors for modeling. Models were developed and evaluated for Washington state and Oregon using limited available empirical data. Mapped predictions show several areas where detectable concentrations of PFAS in fish tissue are predicted to occur, but prior sampling has not yet confirmed. Variable importance is analyzed to identify potentially important sources of PFAS in fish in this region. The cost-effective methodologies demonstrated here can help address sparsity of existing PFAS occurrence data in environmental media in this and other regions while also giving insights into potentially important drivers and sources of PFAS in fish.

Evaluation of a depression care model for the hill tribes: a family and community-based participatory research.

BACKGROUND: Even though, there is a particularly high prevalence of depression among individuals from the hill tribes in northern Thailand, they are unable to receive appropriate intervention due to cultural, transportation, communication, and legal barriers. Using community-based participatory research (CBPR), a depression care model was developed for the hill tribe population. The effectiveness of this model was examined using questionnaires, observations, focus groups, and in-depth interviews. METHODS: Participants include people with depression (n = 17) who were chosen based on their mild to moderately severe depression scores on the Patient Health Questionnaire 9-item (PHQ-9 scores of 5-19) and their caregivers (n = 5). The in-depth interview was conducted to distinguish the selected participants into two groups. The first group, the self-help group program, consisted of 12 participants endorsing negative thoughts about themselves and inappropriate problems solving. The second group, the family camp program, had ten participants, including five patients with family-related issues and their family members. Subjects separately participated in either the self-help or the family groups over three weeks. They completed the PHQ-9 at the beginning and end of the intervention. Questionnaires, observations, focus groups, and in-depth interviews were used to evaluate the effectiveness of the model. Content analysis was used to examine the qualitative data. Wilcoxon signed-rank test was used to analyze the changes in the severity of depression before and after participation in the intervention. RESULTS: The depression scores on the PHQ-9 of 12 participants improved significantly (11.92 ± 1.08 vs. 3.08 ± 0.51; p = 0.002) following participation in the self-help group. Increased self-esteem and improved interpersonal relationships were reported by participants in the self-help group program during interviews. There was no significant difference in the depression scores of 10 participating in the family camp program (6.00 ± 3.83 to 5.30 ± 3.56; p = 0.161). CONCLUSION: A model for depression care was tested in a hill tribe community, and its effectiveness was clearly observed. The developed model can be applied to other hill tribe communities in northern Thailand to improve depression care.