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Dementia research lacks appropriate representation of diverse groups who often face substantial adversity and greater risk of dementia. Current research participants are primarily well-resourced, non-Hispanic White, cisgender adults who live close to academic medical centers where much of the research is based. Consequently, the field faces a knowledge gap about Alzheimer's-related risk factors in those other groups. The Alzheimer's Association hosted a virtual conference on June 14-16, 2021, supported in part by the National Institute on Aging (R13 AG072859-01), focused on health disparities. The conference was held entirely online and consisted of 2 days of core programming and a day of focused meetings centered on American Indian and Alaska Natives and on LGBTQIA+ populations. Over 1300 registrants attended discussions focused on the structural and systemic inequities experienced across diverse groups, as well as ways to investigate and address these inequities., (© 2024 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Introduction: American Indian and Alaska Natives serve in the military at one of the highest rates of all racial and ethnic groups. For Veterans, the already significant healthcare disparities Natives experience are aggravated by barriers to accessing care, care navigation, and coordination of health care within the Veterans Health Administration (VHA) between the VHA and tribal health systems. To mitigate these barriers, the VHA is developing a patient navigation program designed specifically for rural Native Veterans. We describe formative work aimed at understanding and addressing barriers to VHA care from the perspective of rural Native Veterans and those who facilitate their care., Methods: Thirty-four individuals participated in semi-structured interviews (22 Veterans, 6 family members, and 6 Veteran advocates) drawn from 9 tribal communities across the US., Results: Participants described many barriers to using the VHA, including perceptions of care scarcity, long travel distances to the VHA, high travel costs, and bureaucratic barriers including poor customer service, scheduling issues, and long waits for appointments. Many Veterans preferred IHS/tribal health care over the VHA due to its proximity, simplicity, ease of use, and quality., Conclusion: Rural Native Veterans must see a clear benefit to using the VHA given the many obstacles to its use. Veteran recommendations for addressing barriers to VHA care within a navigation program include assistance enrolling in, scheduling, and navigating VHA systems; paperwork assistance; cost reimbursement; and care coordination with the IHS/tribal health care., (© 2024. W. Montague Cobb-NMA Health Institute.)

Aligning crop production with conservation initiatives has long been a topic of debate, with agricultural intensification threatening biodiversity across the globe. Shade-grown coffee allows farmers to preserve biodiversity by providing viable habitat, but its conservation value remains unclear. In this meta-analysis, we screened existing literature using the PRISMA protocol to compare the effect of three shade intensities on species diversity and individual abundance: sun, low shade (LS) and high shade (HS). Furthermore, we examine differences between taxa, within taxa and between regions to establish which species benefit most from shade and whether these benefits vary dependent on geographical location. Out of 1889 studies, we included 69 studies in the analysis, and performed random-effects meta-analyses and meta-regressions. Overall, we found that species diversity was significantly higher in HS when compared to sun and LS, and species diversity in LS tended to be higher than in sun. In each treatment, the species diversity of birds was higher in the higher shade treatment, i.e., HS and LS. In addition, mammal and epiphyte species diversity was higher in HS when compared to LS. Similarly, studies from Latin America showed significantly higher species diversity and abundance in shaded farms when compared to sun farms. Studies conducted in Africa detailed the opposite relationship, with abundance being significantly higher in less shaded systems, highlighting that land-use strategies must be region-specific. Moving forward, strategies to conserve biodiversity within coffee farms should: 1) account for region-specific variables; 2) end further encroachment; 3) maintain connectivity; and 4) optimise yield through prioritising faunal and floral diversity., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: The treatment of non-small cell lung cancer (NSCLC) has evolved dramatically with the approval of immuno-oncology (IO) and targeted therapies (TTs). Insights on the patient experience with these therapies and their impacts are lacking. Health-related social media has been increasingly used by patients to share their disease and treatment experiences, thus representing a valuable source of real-world data to understand the patient's voice and uncover potential unmet needs., Objective: This study aimed to describe the experiences of patients with NSCLC as reported in discussions posted on lung cancer-specific social media with respect to their disease symptoms and associated impacts., Methods: Publicly available posts (2010-2019) were extracted from selected lung cancer- or NSCLC-specific websites. Social media users (patients and caregivers posting on these websites) were stratified by metastatic- and adjuvant-eligible subgroups and treatment received using natural language processing (NLP) and machine learning methods. Automated identification of symptoms was conducted using NLP. Qualitative data analysis (QDA) was conducted on random samples of posts mentioning pain-related, fatigue-related, respiratory-related, or infection-related symptoms to capture the patient experience with these and associated impacts., Results: Overall, 1724 users (50,390 posts) and 574 users (4531 posts) were included in the metastatic group and adjuvant group, respectively. Among users in the metastatic group, pain, discomfort, and fatigue were the most commonly mentioned symptoms (49.7% and 39.6%, respectively), and in the QDA (258 posts from 134 users), the most frequent impacts related to physical impairments, sleep, and eating habits. Among users in the adjuvant group, pain, discomfort, and respiratory symptoms were the most commonly mentioned (44.8% and 23.9%, respectively), and impacts identified in the QDA (154 posts from 92 users) were mostly related to physical functioning., Conclusions: Findings from this exploratory observational analysis of social media among patients and caregivers informed the lived experience of NSCLC in the era of novel therapies, shedding light on most reported symptoms and their impacts. These findings can be used to inform future research on NSCLC treatment development and patient management., (©Alison Booth, Stephanie Manson, Sonia Halhol, Evie Merinopoulou, Mireia Raluy-Callado, Asha Hareendran, Stefanie Knoll. Originally published in JMIR Cancer (https://cancer.jmir.org), 12.07.2023.)

As road infrastructure networks rapidly expand globally, especially in the tropics, previously continuous habitats are being fragmented, resulting in more frequent wildlife-vehicle collisions (WVC). Primates are widespread throughout many sub-/tropical countries, and as their habitats are fragmented, they are increasingly at risk of WVC. We created the Global Primate Roadkill Database (GPRD), the largest available standardized database of primate roadkill incidents. We obtained data from published papers, un-published and citizen science databases, anecdotal reports, news reports, and social media posts. Here, we describe the collection methods for the GPRD and present the most up-to-date version of the database in full. For each primate roadkill incident, we recorded the species killed, the exact location, and the year and month the roadkill was observed. At the time of publication, the GPRD includes 2862 individual primate roadkill records from 41 countries. As primates range in more than twice as many countries, the absence of data from these countries is not necessarily indicative of a lack of primate vehicular collisions. Given the value of these data for addressing both local and global research questions, we encourage conservationists and citizen scientists to contribute to the GPRD so that, together, we can better understand the impact road infrastructure has on primates and evaluate measures which may help mitigate risk-prone areas or species.

Purpose: Our study examined psychosocial risk and protective features affecting cardiovascular and mortality disparities in American Indians, including stress, anger, cynicism, trauma, depression, quality of life, and social support., Methods: The Strong Heart Family Study cohort recruited American Indian adults from 12 communities over 3 regions in 2001-2003 (N = 2786). Psychosocial measures included Cohen Perceived Stress, Spielberger Anger Expression, Cook-Medley cynicism subscale, symptoms of post-traumatic stress disorder, Centers for Epidemiologic Studies Depression scale, Short Form 12-a quality of life scale, and the Social Support and Social Undermining scale. Cardiovascular events and all-cause mortality were evaluated by surveillance and physician adjudication through 2017., Results: Participants were middle-aged, 40% male, with mean 12 years formal education. Depression symptoms were correlated with anger, cynicism, poor quality of life, isolation, criticism; better social support was correlated with lower cynicism, anger, and trauma. Adjusted time-to-event regressions found that depression, (poor) quality of life, and social isolation scores formed higher risk for mortality and cardiovascular events, and social support was associated with lower risk. Social support partially explained risk associations in causal mediation analyses., Conclusion: Altogether, our findings suggest that social support is associated with better mood and quality of life; and lower cynicism, stress, and disease risk-even when said risk may be increased by comorbidities. Future research should examine whether enhancing social support can prospectively reduce risk, as an efficient, cost-effective intervention opportunity that may be enacted at the community level., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

This paper addresses the challenge of sharing finer-scale Protected Health Information (PHI) while maintaining patient privacy by using regionalization to create higher resolution HIPAA-compliant geographical aggregations. We compare four regionalization approaches in terms of their fitness for analysis and display: max-p-regions, REDCAP, and self-organizing maps (SOM) variants of each. Each method is used to create a configuration of regions that aligns with census boundaries, optimizes intra-unit homogeneity, and maximizes the number of spatial units while meeting the minimum population threshold required for sharing PHI under HIPAA guidelines. The relative utility of each configuration was assessed with measures of model-fit, compactness, homogeneity, and resolution. Adding the SOM procedure to max-p-regions resulted in statistically significant improvements for nearly all assessment measures whereas the addition of SOM to REDCAP primarily degraded these measures. These differences can be attributed to the different impacts of SOM on top-down and bottom-up regionalization procedures. Overall, we recommend REDCAP which outperformed on most measures. The SOM variant of max-p-regions (MSOM) may also be recommended as it provided the highest resolution while maintaining suitable performance on all other measures.