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Introduction: : Food insecurity and health are inextricably linked. Since 2008, Scotland has witnessed a proliferation of both food insecurity and emergency food provision. There is a recognised commitment from Scottish Government to 'end the need for food banks', however, the food aid landscape was 'turbo-charged' during COVID-19 leading to intense expansion and diversification of food-based projects, including the development of community food pantries (CFPs). These 'new' models are relatively under-researched, meaning we do not adequately understand their potential or realised impacts on food insecurity and health. This study aims to fill that gap. Methods: A qualitative methodology was used to collect and analyse data from in-depth interviews with 10 representatives from both operational and policy settings related to food insecurity in Scotland. In addition, we conducted an analysis of policy documentation from Scottish Government related to tackling food insecurity to understand how CFPs fit into its overall strategy to transition away from food bank use. Results: We found there were variations in conceptualisations of CFPs and how they operate, challenges related to addressing food insecurity at a community level and varied narratives around the role of community level interventions in tackling health inequalities. Choice and access to services were viewed as central components to the pantry model. However, there were significant challenges faced by CFPs, including territorialism, funding and food supply. Articulations of health were often multi-layered and complicated with strong recognition of the social determinants as well as acknowledgement of the limitations of tackling food insecurity and health inequalities solely at the community level. Conclusions: Despite a commitment to transition away from emergency food provision, CFPs in Scotland appear to face many of the same issues as food banks, particularly those which impact health. Urgent critique of their reliance on surplus food redistribution is required alongside investigation of how these 'new' models are experienced by the people who access them. Further expansion of these models should be viewed with caution and in the same vein as traditional emergency food provision: a symptom of, rather than a solution to, the problem of food insecurity. [ABSTRACT FROM AUTHOR]

Abstract Introduction : Food insecurity and health are inextricably linked. Since 2008, Scotland has witnessed a proliferation of both food insecurity and emergency food provision. There is a recognised commitment from Scottish Government to ‘end the need for food banks’, however, the food aid landscape was ‘turbo-charged’ during COVID-19 leading to intense expansion and diversification of food-based projects, including the development of community food pantries (CFPs). These ‘new’ models are relatively under-researched, meaning we do not adequately understand their potential or realised impacts on food insecurity and health. This study aims to fill that gap. Methods A qualitative methodology was used to collect and analyse data from in-depth interviews with 10 representatives from both operational and policy settings related to food insecurity in Scotland. In addition, we conducted an analysis of policy documentation from Scottish Government related to tackling food insecurity to understand how CFPs fit into its overall strategy to transition away from food bank use. Results We found there were variations in conceptualisations of CFPs and how they operate, challenges related to addressing food insecurity at a community level and varied narratives around the role of community level interventions in tackling health inequalities. Choice and access to services were viewed as central components to the pantry model. However, there were significant challenges faced by CFPs, including territorialism, funding and food supply. Articulations of health were often multi-layered and complicated with strong recognition of the social determinants as well as acknowledgement of the limitations of tackling food insecurity and health inequalities solely at the community level. Conclusions Despite a commitment to transition away from emergency food provision, CFPs in Scotland appear to face many of the same issues as food banks, particularly those which impact health. Urgent critique of their reliance on surplus food redistribution is required alongside investigation of how these ‘new’ models are experienced by the people who access them. Further expansion of these models should be viewed with caution and in the same vein as traditional emergency food provision: a symptom of, rather than a solution to, the problem of food insecurity.

Abstract Background As part of the fight against coronavirus disease, Nigeria received nearly 4 million doses of the COVID-19 vaccine via the COVID-19 Vaccines Global Access (COVAX) Facility, marking a historic step towards equitable global distribution of COVID-19 vaccines. Although evidence exists on COVID-19 hesitancy in Nigeria, yet, we are unaware of any study on the optimization of COVID-19 vaccination from the lenses of the mobile teams. Objective This study seeks to explore the perceptions and experiences of mobile teams in selected communities during the implementation of COVID-19 vaccination in Benue and Niger. Methods An exploratory approach was adopted, and the study was conducted in Niger and Benue states based on poor performance in COVID-19 vaccination. Focus Group Discussions (FDGs) were conducted among 12 mobile vaccination teams from 12 LGAs. The recorded discussions were transcribed and coded (inductively and deductively) using Dedoose software (v9.0). Four themes and seven sub-themes were generated from the participants’ responses. Results Seventy-two (72) health workers including vaccinators, validators, Electronic Management of Immunization Data (EMID) recorders, social mobilizers, and paper recorders participated in this study. Health workers’ perceptions and experiences were thematized using the health building blocks. The mobilization teams in Benue and Niger states perceived that their mobilization efforts contributed to improved coverage, increased accessibility, and reduced hesitancy among the community dwellers. Challenges reported by the teams were vaccine misconceptions, requests for incentives in exchange for vaccine uptake, poor network services, distance to communities, and vaccine stockout. Conclusion This study concluded that social mobilizers play key roles in vaccine uptake, especially at the community level. Their roles in creating awareness, sensitization, and bringing the vaccine closer to hard-to-reach communities contributed to the success attained in the fight against COVID-19 in both states.

Background: As part of the fight against coronavirus disease, Nigeria received nearly 4 million doses of the COVID-19 vaccine via the COVID-19 Vaccines Global Access (COVAX) Facility, marking a historic step towards equitable global distribution of COVID-19 vaccines. Although evidence exists on COVID-19 hesitancy in Nigeria, yet, we are unaware of any study on the optimization of COVID-19 vaccination from the lenses of the mobile teams. Objective: This study seeks to explore the perceptions and experiences of mobile teams in selected communities during the implementation of COVID-19 vaccination in Benue and Niger. Methods: An exploratory approach was adopted, and the study was conducted in Niger and Benue states based on poor performance in COVID-19 vaccination. Focus Group Discussions (FDGs) were conducted among 12 mobile vaccination teams from 12 LGAs. The recorded discussions were transcribed and coded (inductively and deductively) using Dedoose software (v9.0). Four themes and seven sub-themes were generated from the participants' responses. Results: Seventy-two (72) health workers including vaccinators, validators, Electronic Management of Immunization Data (EMID) recorders, social mobilizers, and paper recorders participated in this study. Health workers' perceptions and experiences were thematized using the health building blocks. The mobilization teams in Benue and Niger states perceived that their mobilization efforts contributed to improved coverage, increased accessibility, and reduced hesitancy among the community dwellers. Challenges reported by the teams were vaccine misconceptions, requests for incentives in exchange for vaccine uptake, poor network services, distance to communities, and vaccine stockout. Conclusion: This study concluded that social mobilizers play key roles in vaccine uptake, especially at the community level. Their roles in creating awareness, sensitization, and bringing the vaccine closer to hard-to-reach communities contributed to the success attained in the fight against COVID-19 in both states. [ABSTRACT FROM AUTHOR]

Nitrogen (N) deposition exhibits significant impacts on ecosystem functions and processes. Previous studies have indicated that N addition has an impact on the stoichiometry of plant leaf C:N:P ratios. However, few studies have focused on effects of N addition on belowground systems. This study aims to examine the impact of 7 years of N addition on above- and belowground C:N:P stoichiometry at plant community level in a temperate grassland located in Inner Mongolia. A 7-year field N addition experiment was conducted, which included six treatments: Cont: control; N1: 0.4 mol·m−2 N; N2: 0.8 mol·m−2 N; N3: 1.6 mol·m−2 N; N4: 2.8 mol·m−2 N; N5: 4 mol·m−2 N with six replicates. Above- and belowground plant biomass and C:N:P stoichiometry were measured and analyzed. Our results showed that N addition resulted in a reduction of aboveground C concentration, but an increase in aboveground N and P concentrations, with a decrease in C:N and C:P ratios and an increase in N:P ratio. Furthermore, the aboveground C, N, and P pools all exhibited an increase as a result of N addition. However, N addition did not have any significant effect on belowground C, N, P concentrations, ratios, pools, or stoichiometric characteristics in the soil layers of 0–10, 10–30, 30–50, and 50–100 cm. These results suggest that increasing levels of N deposition significantly alter the aboveground C:N:P stoichiometry at the plant community level, which may affect functions and processes in the grassland ecosystem, but have little effect on belowground C:N:P stoichiometry. [ABSTRACT FROM AUTHOR]

In rugby union (rugby), the tackle is the most frequent cause of concussion and thus a target for intervention to reduce concussion incidence. The aim of this study is to describe tackle characteristics and factors associated with illegal high tackles in amateur community-level rugby during a lowered (armpit level) tackle height law variation trial. Prospective observational cohort study. Video surveillance of a single season, four-league competition with coding of video data according to a predefined coding framework. Descriptive statistics of tackle detail and logistic regression was performed to analyse factors associated with high tackles. One hundred and eight matches with 14,679 tackles and a mean of 137 (± 30) tackles per match were analysed. High tackles (above armpit level) had significantly greater odds of occurring in the lower (2nd–4th) leagues (OR: 1.95; 95 % CI: 1.6–2.4; p < 0.001), front-on tackles (OR: 1.61; 95 % CI: 1.3–2.0; p < 0.001), arm tackles (OR: 1.65; 95 % CI: 1.3–2.1; p < 0.001), bent-at-waist ball carrier (OR: 1.93; 95 % CI: 1.6–2.4; p < 0.001), falling/diving ball carrier (OR: 2.21; 95 % CI: 1.6–3.1; p < 0.001), and an upright tackler (OR: 3.38; 95 % CI: 2.7–4.2; p < 0.001). A falling/diving tackler had significantly lower odds of being associated with a high tackle (OR: 0.44; 95 % CI: 0.3–0.6; p < 0.001). Overall mean tackles per match were similar to those of senior amateur and elite rugby. League, tackle type, tackle aspect, and player body positions were associated with high tackles. These findings reiterate the need for ongoing efforts to identify and implement mitigating strategies to reduce tackle-related injury risk. [ABSTRACT FROM AUTHOR]

Cyber-dating violence (cyber-DV) is a prevalent issue among adolescent girls that can have negative consequences including post-traumatic stress symptoms and suicidal ideations and attempts. In the aim to reduce its prevalence and impacts, researchers are increasingly relying on the identification of risk and protective factors associated with cyber-DV across multiple ecological contexts. The current study aimed to examine the influence of individual (e.g., dissociation), interpersonal (e.g., offline forms of dating violence) and community level (e.g., community support) factors associated with the cyber-DV victimization of adolescent girls. A sample of 456 adolescent girls (M = 16.17 years old, SD = 1.28) was recruited online to complete a survey. At the individual level, emotion dysregulation, dissociative symptoms, post-traumatic stress symptoms and resilience were measured. Offline forms of DV and a history of child sexual abuse were assessed at the interpersonal level. Finally, at the community level, community support, community resilience, neighborhood material and social disadvantage were evaluated. Results from a hierarchical logistic regression indicated that exposure to offline DV namely verbal-emotional DV, sexual DV, threats, as well as living in neighborhoods with lower levels of social disadvantage were significantly associated with an increased risk of cyber-DV victimization. Cyber-DV preventative intervention efforts should focus on incorporating cyber-DV specific modules and activities into offline DV prevention and intervention programs as to reduce the likelihood of adolescents suffering both forms of DV and their associated repercussions. [ABSTRACT FROM AUTHOR]

In ecological stoichiometry, the stoichiometry and spatial distribution of leaf carbon, nitrogen, and phosphorus are important research topics. Various studies have assessed leaf stoichiometry and its relationships with environmental factors at different scales. However, how the leaf carbon, nitrogen and phosphorus stoichiometric characteristics of the same vegetation type at the community level vary with environmental factors along a continuous altitudinal gradient remains poorly understood. In this paper, 13 sampling sites along an altitudinal gradient of 1,800--3,011 m in a typical temperate mountain meadow ecosystem on the southern slope of the Wutai Mountain in North China were sampled to explore the response of leaf carbon, nitrogen and phosphorus stoichiometric characteristics to altitude change using correlation analysis, and then quantified the contribution of driving factors using canonical correspondence analysis (CCA) and variation partitioning. We found that the community-level leaf stoichiometry of mountain meadows differed significantly at different altitudes, and an increase in altitude significantly decreased community-level leaf total nitrogen (LTN) and leaf total phosphorus (LTP); however, the leaf total carbon (LTC), CN, C-P, and N-P increased with an increase in altitude. Additionally, with increasing altitude, soil properties showed significant trends. Soil organic carbon (SOC), soil total nitrogen (STN), soil total phosphorus (STP), soil water content and soil electrical conductivity increased significantly, but soil temperature, soil bulk density and soil pH exhibited the opposite trend. Our results suggested that altitude, soil electrical conductivity and soil bulk density significantly influenced the changes in the leaf stoichiometric characteristics, explaining 75.5% of the total variation, and altitude had the greatest influence (36.6%). In the temperate mountains, altitude played a decisive role in affecting patterns of meadow plant nutrients and stoichiometry and was more important than soil in explaining leaf C-N-P stoichiometry variations. Our findings provide important references to understand the responses of plant stoichiometry to altitudinal gradients. [ABSTRACT FROM AUTHOR]

In ecological stoichiometry, the stoichiometry and spatial distribution of leaf carbon, nitrogen, and phosphorus are important research topics. Various studies have assessed leaf stoichiometry and its relationships with environmental factors at different scales. However, how the leaf carbon, nitrogen and phosphorus stoichiometric characteristics of the same vegetation type at the community level vary with environmental factors along a continuous altitudinal gradient remains poorly understood. In this paper, 13 sampling sites along an altitudinal gradient of 1,800—3,011 m in a typical temperate mountain meadow ecosystem on the southern slope of the Wutai Mountain in North China were sampled to explore the response of leaf carbon, nitrogen and phosphorus stoichiometric characteristics to altitude change using correlation analysis, and then quantified the contribution of driving factors using canonical correspondence analysis (CCA) and variation partitioning. We found that the community-level leaf stoichiometry of mountain meadows differed significantly at different altitudes, and an increase in altitude significantly decreased community-level leaf total nitrogen (LTN) and leaf total phosphorus (LTP); however, the leaf total carbon (LTC), C∶N, C∶P, and N∶P increased with an increase in altitude. Additionally, with increasing altitude, soil properties showed significant trends. Soil organic carbon (SOC), soil total nitrogen (STN), soil total phosphorus (STP), soil water content and soil electrical conductivity increased significantly, but soil temperature, soil bulk density and soil pH exhibited the opposite trend. Our results suggested that altitude, soil electrical conductivity and soil bulk density significantly influenced the changes in the leaf stoichiometric characteristics, explaining 75.5% of the total variation, and altitude had the greatest influence (36.6%). In the temperate mountains, altitude played a decisive role in affecting patterns of meadow plant nutrients and stoichiometry and was more important than soil in explaining leaf C∶N∶P stoichiometry variations. Our findings provide important references to understand the responses of plant stoichiometry to altitudinal gradients.

The analysis of wetland patterns and their driving mechanisms is the research focus of discussion in wetland ecology. In this study, we tried to analyse the spatial differentiation patterns of community and landscape levels dominated by hydro‐ecological processes. The spatial differentiation patterns of landscape patterns and their driving mechanisms were explored in focus. This study was based on 30‐year land cover data of Baiyangdian Wetland Nature Reserve in North China Plain, China, constructing an ecological response relationship matrix between inundation frequency and vegetation cover frequency for the spatial divide at the community and landscape level. By constructing a landscape index set and analysing the index set using clustering, non‐metric multidimensional scale analysis, discriminant and redundancy analysis, we finally obtained the differentiation characteristics of wetland landscape patterns and their driving mechanisms. The spatial differentiation of community levels along the water level gradient showed a banded distribution pattern of submerged‐floating‐emerge to meadow shrubs, but the stability of the hydrological regime dominated the spatial differentiation of landscape levels. Wetland landscapes along the stability gradient of the hydrological regime were divided into stable and fluctuating zones. The stable zone had the landscape pattern characteristics of low fragmentation, simple and regular shape and high numbers of different patch types; the landscape pattern of the fluctuating zone was characterized by a high fragmentation and complex shape, with a small number of different patch types and a non‐uniform distribution. The analysis of the driving mechanism showed that the stability of the hydrological regime was the only reason for the formation of the landscape pattern of the stable zone. The combined effect of human‐dominated and natural‐supplemented effects jointly drove the formation of the landscape pattern of the fluctuating zone. The influence of human on the landscape pattern of the fluctuating zone showed a trend of spatial expansion from high areas to shallow water areas. The combination of traditional landscape indices and aquatic ecological processes characterized the spatial differentiation of wetland landscape patterns, and also verified the feasibility of this method. This study was a successful example of conducting ecological process‐oriented landscape level spatial differentiation analysis. The results of the study are intended to provide recommendations for the rational and effective use and precise conservation of wetland plant and animal resources and the restoration of wetland ecosystems. [ABSTRACT FROM AUTHOR]

● Agricultural innovation is a coevolution process of hardware, software and orgware. ● Innovation intermediaries is important for the coevolution process of agricultural innovation. ● The roles of STBs have evolved from a knowledge broker to a broader innovation intermediary at the village level. ● Facilitating orgware is more effective than enabling software in promoting farmers' adoption of improved tillage practice. ● Collaboration between individual STBs is needed to support the coevolution process of innovation at a larger scale. Agricultural innovation can be described as a coevolutionary process of technological innovation, symbolic change, and social or institutional innovation, which relies on the interactions and collaboration between multiple stakeholders. This view emphasizes the significance of innovation intermediaries in supporting the coevolution process of innovation. Many studies have provided evidence on how innovation intermediaries play roles in supporting the coevolution innovation process at a broader innovation system level. However, little emphasis has been given to the role of innovation intermediaries in supporting the coevolution process of innovation at the community level in rural China. To address this research gap, this paper offers a case study of a novel type of innovation support intervention designed to promote technical change at the community level, the Science and Technology Backyard (STB). The paper focuses on the efforts of a specific STB in Wangzhuang village to promote innovation in tillage methods in wheat production. The aims was to examine the role of this newly emerging innovation support intervention in supporting the coevolution process of innovation at the community level, and compare the outcome of the coevolution process in the village with an STB to that in villages without an STB. Innovation journey analysis is applied to understand the evolved intermediation roles in the innovation process, and multivariate regression analysis is employed to assess the outcome of the coevolution process in villages with and without an STB. The findings suggest that the roles of STBs have evolved from knowledge brokers to systemic innovation intermediaries that facilitate the coevolution process of innovation inside an STB village. It has led to a higher adoption rate of improved technology, a better enabling environment for learning, and more effective institutional support in STB villages than in non-STB villages. However, the effect of support provided by a single STB on the coevolution process outside the community was limited. This finding points to a need for collaboration mechanisms and for connecting single STBs to support the coevolution process of innovation at a larger scale.

Birds constitute one of the most important seed dispersal agents globally, especially in the tropics. The feeding preferences of frugivorous birds are, therefore, potentially of great ecological importance. A number of laboratory‐based and observational studies have attempted to ascertain the preferences of certain bird species for certain fruit traits. However, little attention has been paid to community‐wide preferences of frugivorous birds and the impact this may have on fruit traits on a broader scale. Here, we used artificial fruits of different colors and sizes to investigate community‐wide fruit trait preferences of birds at three sites along an elevational gradient in Papua New Guinea. We recorded attack rates on artificial fruits as visible impressions made by a bird's beak during a feeding attempt. We also measured the colors and sizes of real fruits at each site, and the gape widths of frugivorous birds, allowing for comparisons between bird feeding preferences and bird and fruit traits. Regardless of elevation, red and purple fruits were universally preferred to green and attacked at similar rates to one another, despite strong elevational patterns in real fruit color. However, elevation had a significant effect on fruit size preferences. A weak, non‐significant preference for large fruits was recorded at 700 m, while medium fruits were strongly preferred at 1700 m and small fruits at 2700 m. These patterns mirror those of both real fruit size and frugivorous bird gape width along the gradient, suggesting the potential for selective pressure of birds on fruit size at different elevations. [ABSTRACT FROM AUTHOR]

Abstract Birds constitute one of the most important seed dispersal agents globally, especially in the tropics. The feeding preferences of frugivorous birds are, therefore, potentially of great ecological importance. A number of laboratory‐based and observational studies have attempted to ascertain the preferences of certain bird species for certain fruit traits. However, little attention has been paid to community‐wide preferences of frugivorous birds and the impact this may have on fruit traits on a broader scale. Here, we used artificial fruits of different colors and sizes to investigate community‐wide fruit trait preferences of birds at three sites along an elevational gradient in Papua New Guinea. We recorded attack rates on artificial fruits as visible impressions made by a bird's beak during a feeding attempt. We also measured the colors and sizes of real fruits at each site, and the gape widths of frugivorous birds, allowing for comparisons between bird feeding preferences and bird and fruit traits. Regardless of elevation, red and purple fruits were universally preferred to green and attacked at similar rates to one another, despite strong elevational patterns in real fruit color. However, elevation had a significant effect on fruit size preferences. A weak, non‐significant preference for large fruits was recorded at 700 m, while medium fruits were strongly preferred at 1700 m and small fruits at 2700 m. These patterns mirror those of both real fruit size and frugivorous bird gape width along the gradient, suggesting the potential for selective pressure of birds on fruit size at different elevations.

Chandler and Lalonde broadened the scope of inquiry in suicide research by providing theoretical grounding and empirical support for the role of community, culture, and history in understanding Indigenous youth suicide and reimagining its prevention. Their work pushed the field to consider the intersectional process of individual and collective meaning-making in prevention of Indigenous suicide, together with the central role culture plays in bringing coherence to this process over time. Their innovation shifted the research focus to include the shared histories, contexts, and structures of meaning that shape individual lives and behaviors. We describe here a new generation of research extending their pathbreaking line of inquiry. Recent work aims to identify complex associations between community-level structures and suicidal behavior by collaborating with Alaska Native people from rural communities to describe how community protective factors function as preventative resources in their daily lives. Community engagement and knowledge co-production created a measure of community protection from suicide. Structured interviews with rural Alaska Native community members allowed use of this measure to produce relevant, accessible, and actionable knowledge. Ongoing investigations next seek to describe their mechanisms in shaping young people's lives through a multilevel, mixed-methods community-based study linking community-level protection to protection and well-being of individual youth. These efforts to understand the multiple culture-specific and culturally mediated pathways by which communities build on their strengths, resources, and practices to support Indigenous young people's development and reduce suicide risk are inspired by and expand on Chandler and Lalonde's remarkable legacy.

Abstract Background Maternal anemia continues as a global public health concern particularly in developing countries including Ethiopia. It is associated with an increased risk of maternal death, obstetric complications, preterm birth, and low birth weight. Even though maternal anemia is the commonest problem in Ethiopia, there is limited evidence on the spatial distribution and determinants of iron supplementation. Therefore, this study aimed to investigate the spatial distribution and determinants of iron supplementation among pregnant women in Ethiopia. Method A secondary data analysis was conducted based on the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total weighted sample of 7589 women was included for analysis. For the spatial analysis; ArcGIS version 10.6, and SaT Scan version 9.6 statistical software were employed to explore the spatial distribution, and to identify significant hotspot areas of iron supplementation in Ethiopia. For the determinant factors, multilevel logistic regression analysis was fitted to identify significant individual and community level determinants of iron supplementation. Deviance, Median Odds Ratio (MOR), and Intra-class Correlation Coefficient (ICC) were used for model comparison and for assessing model fitness. Variables with a p-value of less than 0.2 in the bivariable analysis were considered in the multivariable multilevel analysis. In the multivariable multilevel analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to declare significant determinants of iron supplementation. Results The spatial distribution of iron supplementation was significantly varied across the country with Global Moran’s index value of 0.3 (p

Abstract Background Prior studies have shown that contraceptive use reduces maternal mortality independently of other maternal health services. The present study took advantage of geographically detailed Indonesian data to study the interplay between contraceptive use and other risk and protective factors for maternal mortality at the community level, a level of analysis where the protective effects of family planning can be best understood. Methods Data from the 2015 Intercensal Population Survey (SUPAS) and the 2014 Village Potential Survey (PODES) were used to construct a series of census block-level variables measuring key risk and protective factors for maternal mortality. The relationships between these factors and maternal mortality, measured via natural log-transformation of past five-year maternal mortality ratios in each of the 40,748 census blocks were assessed via log-linear regressions. Results Higher community maternal mortality ratios were associated with lower community contraceptive prevalence, higher percentage of parity four-plus births, higher proportion of poor households, lower population density of hospitals, higher density of traditional birth attendants (TBA), and residence outside of Java-Bali. For every percentage point increase in CPR, community maternal mortality ratios were lower by 7.0 points (95% CI = 0.9, 14.3). Community-level household wealth was the strongest predictor of maternal mortality. Conclusions Community contraceptive prevalence made a significant contribution to reducing maternal mortality net of other risk and protective factors during 2010–2015. Increased health system responsiveness to the needs of pregnant women and reductions in socioeconomic and geographic disparities in maternal health services will be needed for Indonesia to reach the 2030 SDG maternal mortality goal.

Conservative survival strategy of plants growing in harsh karst habitats is observed from the view of plant functional traits, such as morphological traits and ecological stoichiometry. However, whether the plant communities in karst forests with high species turnover adopt a conservative strategy remains undetermined. This study comprehensively investigated the characteristics of functional traits of dominant plant species in four forests (i.e. Platycarya strobilacea, Quercus fabri, Quercus variabilis, and Pinus massoniana forests) in a trough‐valley karst watershed in Northern Guizhou Province, Southwestern China to explore the adaptation strategy of karst forests at the community level. At the organ and the species levels, traits differed among species, and the leaf and the bark morphological traits and root C:N:P ecological stoichiometry presented large interspecific variations. At the community level, the P. massoniana forest presented the lowest specific root length and dry matter content and tissue density of roots, branch, twig, and bark; the Q. fabri and the Q. variabilis forests displayed low specific leaf area and high dry matter content and tissue density of roots, branch, and twig; and the Platycarya strobilacea forest exhibited high specific leaf area. The P. massoniana forest was subjected to N and P colimitation, and the three other broad‐leaved forests were limited by P supply. The community‐weighted means rather than the arithmetic means of traits were preferential to represent the trait characteristics at the community level. From the view of plant functional traits at the community level, karst forests develop multiple functional traits like low specific leaf area, high dry matter content and tissue density of leaf, roots, branch, and twig, and decrease N and P investments in leaf for a conservative survival strategy to adapt to harsh habitats. [ABSTRACT FROM AUTHOR]

Rainwater harvesting is the method of collection, store and use of rainwater where ever it falls. Tropical climatic conditions will receive extreme precipitation, i.e. in form of rain. Water stress and scarcity is happening around the world especially in urban areas as the demand is more because of density of population. As the infrastructure of basic needs at urban areas are almost up to the level, the paved areas will be present in most of the areas. The gap between supply and demand is varying much essentially in urban areas. Thus, the rainwater harvesting at plot level as well as at community level is becoming very much essential so as to minimize the gap between demand and supply. The harvested water lead to supplement the main supply of water and lessens the pressure on main source of water for the existing urban settlement. The present paper deals with the frame work for sustainable rainwater harvesting at a town level. The paper deals with correlating the selected eight study pockets in Guntur town, Andhra Pradesh, India by making the grouping of plots based on the area of the plots with regard to dwelling units related to occupants. The correlation analysis directed to establish strong relation between different study pockets with respect to LPCDs to workout settlement level Sustainable harvestable rainwater frame work with due consideration to density of population, slope, topography and meteorological parameters etc. [ABSTRACT FROM AUTHOR]

This article examines how and why marketization of policing may occur in a historically state-centred policing context in the absence of governmental policy promoting privatization and marketization. In Sweden, a community-level marketization is increasingly becoming the new norm. It is a result of a political mobilization by the private security industry, characterized by an association of private security with the public interest in safety, an absence of national political decision-making, and pragmatic local initiatives to increase public safety, but it results in the dispersion of political decision-making that fails to ensure democratic governance of policing and security provision. [ABSTRACT FROM AUTHOR]

Abstract Background The Democratic Republic of the Congo adopted the strategy of using, at the community level, a dose of rectal artesunate as a pre-referral treatment for severe malaria amongst children under 5 years who could not quickly reach a health care facility and take oral medication. However, the adherence to referral advice after the integration of this strategy and the acceptability of the strategy were unknown. Methods To assess adherence by the mothers/caretakers of children under 5 years to referral advice provided by the community health workers after pre-referral treatment of severe malaria with rectal artesunate, the authors conducted a noninferiority community trial with a pre- and post-intervention design in 63 (pre-intervention) and 51 (post-intervention) community care sites in 4 provinces (Kasaï-Oriental, Kasaï-Central, Lomami, Lualaba) from August 2014 through June 2016. The pre- and post-intervention surveys targets 387 mothers of children under 5 years and 63 community health workers and 346 mothers and 41 community health workers, respectively. A 15% margin was considered for noninferiority analyses due to the expected decrease in adherence to referral advice after the introduction of the new intervention. Results The mothers acknowledged that the rectal route was often used (60.7%), and medicines given rectally were considered more effective (63.6%) and easy to administer (69.7%). The acceptability of pre-referral rectal artesunate was relatively high: 79.4% (95% CI 75.4–83.3) among mothers, 90.3% (95% CI 82.3–96.8) among community health workers, and 97.8% (95% CI 93.3–100) among nurses. Adherence to referral advice at post-intervention [84.3% (95% CI 80.6–88.1)] was non-inferior to pre-intervention adherence [94.1% (95% CI 91.7–96.4)]. Conclusions The integration of pre-referral rectal artesunate for severe malaria into the community care site in the DR Congo is feasible and acceptable. It positively affected adherence to referral advice. However, more health education is needed for parents of children under 5 years and community health workers.

The aim of this study is to differentiate old-field plant communities along the abandonment time and/or environmental gradient in the landscape surrounded villages with established Czech settlers in Romanian Banat area conserving traditional agriculture, and to identify site factors which cause plant diversity of particular vegetation types. Study area: Wider territory centered by the village Sfânta Elena, southern Romania ((44°40’ N; 21°43’ E). Methods: We collected 97 phytosociological relevés covered the same number of old-fields in the area and the following habitat parameters were measured: soil pH, available phosphorus, total carbon and nitrogen, Heat Load Index. Software TURBOVEG / JUICE was used to collect and elaborate the data set of relevés. Old-field vegetation was classified into five basic plant communities using TWINSPAN (all the botanical material includes 291 plant species). For each community, we detected diagnostic species according to their fidelity index. The presence of mowing, grazing or burning was registered for recorded stands. Ecological preferences of each community were examined using one-way analysis of variance (ANOVA). Vegetation-environment relationships were analysed using ordination method – Cannonical correspondence analysis (CCA) in CANOCO for Windows (version 4.5) to find the main variability gradients within the dataset. Scatter plot relationships between variables were constructed. Main results and conclusions: Dependence of number of species (alpha diversity) on the abandoned field’s age exhibits an unimodal shape of this relationship with the maximum peak of species diversity in plant stands aged approximately 13 years. The most importnat ecological factors and/or type of management in the relationship to the old-field plant composition show the following significance order: available phosphorus content in the soil (P), total nitrogen content in the soil (N), presence of burning, length of abandonment (old-field age), carbon/nitrogen ratio in the soil (C/N). Other parameters (grazing, mowing, zero management) do not demonstrate effective impact according to our dataset and seem to be equal to the absence of burning.

Background: Maternal anemia continues as a global public health concern particularly in developing countries including Ethiopia. It is associated with an increased risk of maternal death, obstetric complications, preterm birth, and low birth weight. Even though maternal anemia is the commonest problem in Ethiopia, there is limited evidence on the spatial distribution and determinants of iron supplementation. Therefore, this study aimed to investigate the spatial distribution and determinants of iron supplementation among pregnant women in Ethiopia.Method: A secondary data analysis was conducted based on the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total weighted sample of 7589 women was included for analysis. For the spatial analysis; ArcGIS version 10.6, and SaT Scan version 9.6 statistical software were employed to explore the spatial distribution, and to identify significant hotspot areas of iron supplementation in Ethiopia. For the determinant factors, multilevel logistic regression analysis was fitted to identify significant individual and community level determinants of iron supplementation. Deviance, Median Odds Ratio (MOR), and Intra-class Correlation Coefficient (ICC) were used for model comparison and for assessing model fitness. Variables with a p-value of less than 0.2 in the bivariable analysis were considered in the multivariable multilevel analysis. In the multivariable multilevel analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to declare significant determinants of iron supplementation.Results: The spatial distribution of iron supplementation was significantly varied across the country with Global Moran's index value of 0.3 (p < 0.001). The SaTScan analysis identified a total of 271 significant clusters, of these 89 clusters were primary clusters located in the Southwest Somali and Central Oromia regions (LLR = 66.69, P < 0.001, RR = 1.35). ANC visit (AOR = 3.66, 95%CI: 3.21, 417), community education [AOR = 1.31, 95%CI, 1.07, 1.59), media exposure (AOR = 1.33, 95%CI: 1.15, 1.53), distance to health facility (AOR = 1.32, 95%CI: 1.16, 1.50), region and household wealth index were statistically significant determinant factors of iron supplementation.Conclusion: Iron supplementation among pregnant women were significantly varied across the country. Therefore, the finding of this study could help to design effective public health interventions targeting areas with low iron supplementation and maternal health services should be delivered in all areas of our country. Besides, public health programs should enhance iron supplementation through promoting ANC visits, media exposure, and giving special emphasis to marginalized and remote areas. [ABSTRACT FROM AUTHOR]

Herbaceous synusia is an important component of shrub community/ecosystem in the Junggar Desert and contributes a large proportion of net primary productivity in spring and early summer. Soil in the Junggar Desert is seriously deficient in nitrogen (N), but herbaceous plants possess high N concentration and N:P (phosphorous) ratio at the individual and interspecies levels; however, the community-level leaf stoichiometric characteristics of herbaceous synusia, spatial distribution patterns, and the driving factors at the regional scale remain unclear. In this study, 79 sampling plots were set up across the entire Junggar Desert. Foliar samples were collected by whole-plant harvesting method in each sampling plot, and the status of foliar carbon (C), N, and P concentrations, stoichiometric ratios, interrelationships, spatial patterns, and influencing factors were systematically analyzed. Results showed that the average contents of foliar C, N, and P in herbaceous synusia were 331.47, 25.85, and 1.54 mg g−1, respectively, and foliar C:N, C:P, and N:P were 13.76, 225.91, and 17.30, respectively. In contrast to most terrestrial ecosystems and global vegetation, herbaceous synusia was characterized by low C, C:N, and C:P and high N and N:P. Foliar C, N, and P were linearly and allometrically correlated with one another significantly. The foliar N–C, P–C, and N–P scaling exponents were 1.987, 1.770, and 1.122, respectively, thus the order of accumulation rates of foliar C, N, and P was N > P > C. Foliar C, N, C:N, and N:P presented significant differences among different soil habitats and shrub communities. Foliar stoichiometric traits showed obvious and different spatial heterogeneity at the regional scale. Multi-environmental factors jointly influenced foliar stoichiometric traits, and climate and geographical factors presented greater impact than soil. In conclusion, the foliar C:N:P stoichiometric traits might be the unique and inherent property of desert herbaceous species in this study area formed by long-term adaptation to the arid and barren environments in Central Asia, and this finding should be fully considered in regional ecological conservation and management.

Abstract Background Social capital is a multilevel construct impacting health. Community level social capital, beyond the neighborhood, has received relatively less attention. Moreover, the measurement of community level social capital has tended to make use of aggregated individual data, rather than observable community characteristics. Methods Herein, metropolitan religious adherence, as an observable community-level measure of social capital, is used. We match it to city of residence for 2826 women in the Fragile Families Childhood Wellbeing Study (a cohort study) who have lived continuously in that city during a nine-year period. Using ordered logistic regression with clustered standard errors to account for area effects, we look at the relationship between metropolitan religious adherence and self-rated health, while controlling for lagged individual, neighborhood, and socioeconomic factors, as well as individual level religious attendance. Results Religious adherence at the community level is positive and statistically significant; every 1% increase in area religiosity corresponds to a 1.2% increase in the odds of good health. Conclusions These findings shed light on a possible pathway by which social capital may improve health, perhaps acting as a stress buffer or through spillover effects of reciprocity generated by exposure to religion.

This study was carried out across the six geopolitical zones to assess knowledge and health seeking behaviors of Nigerians during the first wave of COVID-19 pandemic lockdown in order to understand the seemingly low cases of COVID-19 in Nigeria. Structured and pretested short questionnaires were employed to obtain information electronically and physically across the six geopolitical zones on socio-demographic characteristics of participants; the knowledge of participants on COVID-19 disease; availability and accessibility to testing and isolation centers in the communities, attitudes and health seeking behaviors. A total of 1023 respondents; 705 (68.9%) males and 318 (31.1%) females across the six geopolitical zones in Nigeria participated in this study with 477(46.6%) within the 26-45 years age category, and 6(0.6%) above 66 years. A total of 985(96.3%) had heard about COVID-19 at the time of survey while a total of 859(84.0%) of the respondents were aware of the presence of COVID-19 laboratory testing centers. Across the geopolitical zones, majority of the respondents 487(47.6%) claimed there are no routine testing for COVID-19 at their community level, while 303 (29.6%) affirmed otherwise and 216(21.1%) did not know if there were routine testing going on or not. On health seeking behaviors across the country, majority of the respondents 558(54.5%) affirmed they would visit the hospital as the first point of contact if the opportunity presented itself, 244(23.9%) claimed they would call the NCDC toll line, 2(0.2%) said they would use prayers, while 1(0.1%) respectively claimed they would use home management strategies through visiting chemist stores and checking the internet for solutions. Findings from this study confirm that there is very high awareness of the COVID-19 disease across the country, and limited number of testing centers at the community level. The implications include the possibility of unreported COVID-19 cases in the cities as well as in the communities. [ABSTRACT FROM AUTHOR]

Background: Prior studies have shown that contraceptive use reduces maternal mortality independently of other maternal health services. The present study took advantage of geographically detailed Indonesian data to study the interplay between contraceptive use and other risk and protective factors for maternal mortality at the community level, a level of analysis where the protective effects of family planning can be best understood. Methods: Data from the 2015 Intercensal Population Survey (SUPAS) and the 2014 Village Potential Survey (PODES) were used to construct a series of census block-level variables measuring key risk and protective factors for maternal mortality. The relationships between these factors and maternal mortality, measured via natural log-transformation of past five-year maternal mortality ratios in each of the 40,748 census blocks were assessed via log-linear regressions. Results: Higher community maternal mortality ratios were associated with lower community contraceptive prevalence, higher percentage of parity four-plus births, higher proportion of poor households, lower population density of hospitals, higher density of traditional birth attendants (TBA), and residence outside of Java-Bali. For every percentage point increase in CPR, community maternal mortality ratios were lower by 7.0 points (95% CI = 0.9, 14.3). Community-level household wealth was the strongest predictor of maternal mortality. Conclusions: Community contraceptive prevalence made a significant contribution to reducing maternal mortality net of other risk and protective factors during 2010–2015. Increased health system responsiveness to the needs of pregnant women and reductions in socioeconomic and geographic disparities in maternal health services will be needed for Indonesia to reach the 2030 SDG maternal mortality goal. [ABSTRACT FROM AUTHOR]

Summary: The continuing nitrogen (N) deposition observed worldwide alters ecosystem nutrient cycling and ecosystem functioning. Litter decomposition is a key process contributing to these changes, but the numerous mechanisms for altered decomposition remain poorly identified.We assessed these different mechanisms with a decomposition experiment using litter from four abundant species (Achnatherum sibiricum, Agropyron cristatum, Leymus chinensis and Stipa grandis) and litter mixtures representing treatment‐specific community composition in a semi‐arid grassland under long‐term simulation of six different rates of N deposition.Decomposition increased consistently with increasing rates of N addition in all litter types. Higher soil manganese (Mn) availability, which apparently was a consequence of N addition‐induced lower soil pH, was the most important factor for faster decomposition. Soil C : N ratios were lower with N addition that subsequently led to markedly higher bacterial to fungal ratios, which also stimulated litter decomposition.Several factors contributed jointly to higher rates of litter decomposition in response to N deposition. Shifts in plant species composition and litter quality played a minor role compared to N‐driven reductions in soil pH and C : N, which increased soil Mn availability and altered microbial community structure. The soil‐driven effect on decomposition reported here may have long‐lasting impacts on nutrient cycling, soil organic matter dynamics and ecosystem functioning. [ABSTRACT FROM AUTHOR]

Interaction between animals and plants is an important way to maintain terrestrial biodiversity and ecosystem function, but little is known about the structure of reciprocal networks between fruit plants and frugivore birds in urban habitats. To explore the characteristics of the plant–frugivore network and network roles of species, we observed the fruit ripening phenology of 21 species of fruit plants and the interactions between these plants and 39 species of frugivore birds during the whole year in a large urban park. Then, we assessed the characteristics of the total plant–frugivore and seasonal networks, and analyzed the network roles of species and the relationship between their network roles and ecological traits. Fruit ripened mainly in autumn and winter, and interaction connections in the two seasons contributed 39.68% and 44.83% to the total network, respectively. The specialization (H2′), connectance (C), nestedness, and interaction evenness (eH2) of the network were lower in autumn and winter, while the interaction diversity was higher. Compared with the networks (N = 1000) generated by the null model, the observed network exhibited higher nestedness and interaction diversity (E2) and lower specialization (H2′), connectance (C), and interaction evenness (eH2). A correlation analysis combining ecological traits and network roles showed that plants with black fruit had higher effective partners and partner diversity, while other traits of plants and birds were not significantly correlated with their network parameters. The important plants (N = 6) and birds (N = 3) contributed to 71.78% and 67.55% of the total network connection, they were mainly evergreen plants with black and red drupes and omnivorous generalist birds with medium and large sizes. Our research highlighted the seasonal differences in urban plant–frugivore network and the value of important species in maintaining network structures and providing ecosystem services.

Climate change alters precipitation regimes world‐wide and is regarded as a major threat for pollinators and pollination services. Yet, not much is known on how wetter as well as drier conditions affect food resources for pollinators and pollinator attraction in a multi‐species community context. It is unclear how community shifts under changed hydrological conditions might affect pollinators.This mesocosm study addresses existing research gaps by investigating effects of drought, wetness and temporary flooding on floral resources and pollinator attraction within a plant community, initially including nine insect‐pollinated and six wind‐pollinated species. Floral resources were assessed over three growing seasons. I monitored community descriptors (percentage of herbs and herbaceous species richness, presence of flowering insect‐pollinated individuals), floral traits (flower height, size and weight, floral sugar content of one key species) and proxies for plant fitness (pollinator attraction, seed and flower weight of one key species).Wetness and especially dryness decreased the species richness and biomass proportion of insect‐pollinated herbaceous species and flowering herbaceous plant individuals occurred less frequently. Permanent wetness decreased the floral sugar content of the key species Trifolium pratense. Wet, temporary flooded and especially dry communities were visited by pollinators less often. Active pollinators spent less time within wet and flooded communities, while not at all visiting dry communities. Seed and flower weight of the obligate xenogamous T. pratense in flooded and dry communities decreased, indicating negative consequences for plant fitness caused by a lack of pollination.Synthesis. While dryness had negative effects for floral resources both in terms of community descriptors and floral traits, negative effects of wetness and temporary flooding were mostly caused by a decrease of insect‐pollinated herbaceous species. The study thus indicates that shifts in plant community composition are decisive for a predictive understanding of plant–pollinator interactions under environmental change, but these have been neglected in past research. Changing precipitation patterns will adversely affect floral resources and pollinator attraction in agriculturally used temperate grassland, which might have widespread negative consequences for pollination services and food security in the coming decades. [ABSTRACT FROM AUTHOR]

Background: The Democratic Republic of the Congo adopted the strategy of using, at the community level, a dose of rectal artesunate as a pre-referral treatment for severe malaria amongst children under 5 years who could not quickly reach a health care facility and take oral medication. However, the adherence to referral advice after the integration of this strategy and the acceptability of the strategy were unknown. Methods: To assess adherence by the mothers/caretakers of children under 5 years to referral advice provided by the community health workers after pre-referral treatment of severe malaria with rectal artesunate, the authors conducted a noninferiority community trial with a pre- and post-intervention design in 63 (pre-intervention) and 51 (post-intervention) community care sites in 4 provinces (Kasaï-Oriental, Kasaï-Central, Lomami, Lualaba) from August 2014 through June 2016. The pre- and post-intervention surveys targets 387 mothers of children under 5 years and 63 community health workers and 346 mothers and 41 community health workers, respectively. A 15% margin was considered for noninferiority analyses due to the expected decrease in adherence to referral advice after the introduction of the new intervention. Results: The mothers acknowledged that the rectal route was often used (60.7%), and medicines given rectally were considered more effective (63.6%) and easy to administer (69.7%). The acceptability of pre-referral rectal artesunate was relatively high: 79.4% (95% CI 75.4–83.3) among mothers, 90.3% (95% CI 82.3–96.8) among community health workers, and 97.8% (95% CI 93.3–100) among nurses. Adherence to referral advice at post-intervention [84.3% (95% CI 80.6–88.1)] was non-inferior to pre-intervention adherence [94.1% (95% CI 91.7–96.4)]. Conclusions: The integration of pre-referral rectal artesunate for severe malaria into the community care site in the DR Congo is feasible and acceptable. It positively affected adherence to referral advice. However, more health education is needed for parents of children under 5 years and community health workers. [ABSTRACT FROM AUTHOR]

Nitrogen pollution, especially ammonia, and its impacts on aquatic ecosystems are always hot topics worldwide. Evaluating the toxicity effect of ammonia on aquatic organisms is the essential basis for nitrogen management. Benthic macroinvertebrates are widely used to evaluate ammonia toxicity based on acute and chronic lab tests. In comparison, responses of macroinvertebrates under field and controlled conditions were rarely studied. To explore the effect of ammonia on macroinvertebrate assemblages and the underlying mechanisms under field conditions, a 5-year fertilization experiment was conducted in 5 quasi-natural ponds located in the Yangtze River floodplain. One control (TN0, no artificial ammonia loading) and four treatments (TN2, TN10, TN20, TN100; ordered by artificial ammonia loading from low to high) were set. The results showed that (1) species number of macroinvertebrates differed little among the ponds, while total density and biomass were positively correlated with unionized ammonia concentration (NH 3), indicating that increased ammonia loading had no adverse impact on macroinvertebrate abundance; (2) all ponds were dominated by gathering collectors and the biomass was higher in the ponds with higher ammonia loading resulting from the more phytoplankton promoted by ammonia loading and improved internal phosphorus release; (3) the biomass of predators also increased with the increasing NH 3 which may be due to the bottom-up effect through their prey; (4) some species, such as Limnodrilus hoffmeisteri , survived and were dominant species in the ponds with higher NH 3 compared with 96 h median lethal concentration from acute lab test. The results suggested that higher ammonia loading increased macroinvertebrate abundance, mainly contributed by gathering collectors and predators. Unlike previous acute and chronic lab tests, macroinvertebrates showed extremely high tolerance to NH 3 in field conditions. This study supported that ammonia toxicity to aquatic organisms was scale-dependent and should be evaluated at multiple scales. Diagram depicting the response of benthic macroinvertebrates assemblages to ammonia loading and the underlying mechanisms in quasi-natural ponds. [Display omitted] • Higher ammonia loading had no impact to the species richness of macroinvertebrates. • Ammonia increased macroinvertebrate abundance due to abundant food resources. • The increased macroinvertebrates were composed mainly of collectors and predators. • Ammonia toxicity to macroinvertebrates was scale-dependent. • Ammonia showed weaker toxicity to macroinvertebrates in field scale than in lab. [ABSTRACT FROM AUTHOR]

Background: We developed and validated an instrument to measure community-level social capital based on data derived from older community dwellers in Japan. Methods: We used cross-sectional data from the Japan Gerontological Evaluation Study, a nationwide survey involving 123,760 functionally independent older people nested within 702 communities (i.e., school districts). We conducted exploratory and confirmatory factor analyses on survey items to determine the items in a multi-dimensional scale to measure community social capital. Internal consistency was checked with Cronbach's alpha. Convergent construct validity was assessed via correlating the scale with health outcomes. Results: From 53 candidate variables, 11 community-level variables were extracted: participation in volunteer groups, sports groups, hobby activities, study or cultural groups, and activities for teaching specific skills; trust, norms of reciprocity, and attachment to one's community; received emotional support; provided emotional support; and received instrumental support. Using factor analysis, these variables were determined to belong to three sub-scales: civic participation (eigenvalue = 3.317, α = 0.797), social cohesion (eigenvalue = 2.633, α = 0.853), and reciprocity (eigenvalue = 1.424, α = 0.732). Confirmatory factor analysis indicated the goodness of fit of this model. Multilevel Poisson regression analysis revealed that civic participation score was robustly associated with individual subjective health (Self-Rated Health: prevalence ratio [PR] 0.96; 95% confidence interval [CI], 0.94–0.98; Geriatric Depression Scale [GDS]: PR 0.95; 95% CI, 0.93–0.97). Reciprocity score was also associated with individual GDS (PR 0.98; 95% CI, 0.96–1.00). Social cohesion score was not consistently associated with individual health indicators. Conclusions: Our scale for measuring social capital at the community level might be useful for future studies of older community dwellers.

Abstract Background Correct knowledge about Tuberculosis (TB) is essential for appropriate healthcare seeking behaviour and to accessing diagnosis and treatment services timely. There are several factors influencing knowledge about TB. The present study was conducted to assess the change in community knowledge of Tuberculosis (TB) and its association with respondent’s socio-demographic characteristics in two serial knowledge-attitude-practice surveys. Methods Community level interventions including community meetings with youth groups, village health committees and self-help groups and through mass media activities were undertaken to create awareness and knowledge about TB and service availability. Increase in knowledge on TB and its association with respondent’s socio-demographic characteristics was assessed by two serial KAP surveys in 2010–2011 (baseline) and 2012–2013 (midline) in 30 districts of India. Correct knowledge of TB was assessed by using lead questions and scores were assigned. The composite score was dichotomized into two groups (score 0–6, poor TB knowledge and score 7–13, good TB knowledge). Results In baseline and midline survey, 4562 and 4808 individuals were interviewed. The correct knowledge about TB; cough ≥2 weeks, transmission through air, 6–8 months treatment duration, and free treatment increased by 7 % (p-value

Objective: Distrust in vaccination is a public health concern. In responding to vaccination distrust, the psychosocial context it occurs in needs to be accounted for. But this psychosocial context is insufficiently understood. We examined how Australians' attitudes to childhood vaccination relate to broader psychosocial characteristics pertaining to two key areas: health and government.Design: 4370 Australians were surveyed and divided into five vaccine attitude groups. Logistic univariable and multivariable regression analyses were used to compare differences in psychosocial characteristics between these groups.Results: Multivariate analysis showed that, compared to groups with positive vaccine attitudes, groups with negative attitudes were more informed, engaged and independent health consumers, with greater adherence to complementary medicine, but lower belief in holistic health. They had higher distrust in the mainstream healthcare system, higher conspiracist ideation, and were more likely to vote for minor political parties. They were more likely to be male, religious, have children, and self-report better health.Conclusions: This research revealed HOW profiles of psychosocial characteristics differed between each of the five attitudes to childhood vaccines.Practice Implications: These findings are useful for tailoring communications about vaccination-related concerns. They also show that more granular classification and measurement of vaccine attitudes may be useful. [ABSTRACT FROM AUTHOR]