Indigenizing CBPR: Evaluation of a Community-Based and Participatory Research Process Implementation of the Elluam Tungiinun (Towards Wellness) Program in Alaska

The process that community based participatory research (CBPR) implementation takes in indigenous community contexts has serious implications for health intervention outcomes and sustainability. An evaluation of the Elluam Tungiinun (Towards Wellness) Project aimed to explore the experience of a Yup'ik Alaska Native community engaged within a CBPR process and describe the effects of CBPR process implementation from an indigenous community member perspective. CBPR is acknowledged as an effective strategy for engaging American Indian and Alaska Native communities in research process, but we still know very little about the experience from a local, community member perspective. What are the perceived outcomes of participation in CBPR from a local, community member perspective? Qualitative methods were used to elicit community member perspectives of participation in a CBPR process engaged with one Yup'ik community in southwest Alaska. Results focus on community member perceptions of CBPR implementation, involvement in the process and partnership, ownership of the project with outcomes observed and perceived at the community, family and individual levels, and challenges. A discussion of findings demonstrates how ownership of the intervention arose from a translational and indigenizing process initiated by the community that was supported and enhanced through the implementation of CBPR. Community member perspectives of their participation in the research reveal important process points that stand to contribute meaningfully to implementation science for interventions developed by and for indigenous and other minority and culturally diverse peoples.     

Collaborative Measurement Development as a Tool in CBPR: Measurement Development and Adaptation within the Cultures of Communities

This paper describes the processes we engaged into develop a measurement protocol used to assess the outcomes in a community based suicide and alcohol abuse prevention project with two Alaska Native communities. While the literature on community-based participatory research (CBPR) is substantial regarding the importance of collaborations, few studies have reported on this collaboration in the process of developing measures to assess CBPR projects. We first tell a story of the processes around the standard issues of doing cross-cultural work on measurement development related to areas of equivalence. A second story is provided that highlights how community differences within the same cultural group can affect both the process and content of culturally relevant measurement selection, adaptation, and development.     

Working memory retrieval differences between medial temporal lobe epilepsy patients and controls: A three memory layer approach

Multi-store models of working memory (WM) have given way to more dynamic approaches that conceive WM as an activated subset of long-term memory (LTM). The resulting framework considers that memory representations are governed by a hierarchy of accessibility. The activated part of LTM holds representations in a heightened state of activation, some of which can reach a state of immediate accessibility according to task demands. Recent neuroimaging studies have studied the neural basis of retrieval information with different states of accessibility. It was found that the medial temporal lobe (MTL) was involved in retrieving information within immediate access store and outside this privileged zone. In the current study we further explored the contribution of MTL to WM retrieval by analyzing the consequences of MTL damage to this process considering the state of accessibility of memory representations. The performance of a group of epilepsy patients with left hippocampal sclerosis in a 12-item recognition task was compared with that of a healthy control group. We adopted an embedded model of WM that distinguishes three components: the activated LTM, the region of direct access, and a single-item focus of attention. Groups did not differ when retrieving information from single-item focus, but patients were less accurate retrieving information outside focal attention, either items from LTM or items expected to be in the WM range. Analyses focused on items held in the direct access buffer showed that consequences of MTL damage were modulated by the level of accessibility of memory representations, producing a reduced capacity.     

Corruption as a global hindrance to promoting ethics,integrity, and sustainable development in Tanzania: the role of the anti-corruption agency

Corruption is the single greatest challenge that erodes and defeats efforts made by many nations, especially in the developing world, towards sustainable development and towards the promotion and strengthening of democratic institutions and values. This article lays out international norms of ethics and integrity, reflected also in Tanzanian norms. It argues that strategic decision is imperative and a ‘Good Governance Architecture' is meant to provide a working solution to curb unethical behaviour, corruption, and the culture of impunity. This working solution – which involves economic and institutional reforms, prevention strategies, enforcement, political will, transparency, accountability, popular participation, the rule of law, and the democratic space – goes further towards the root cause of the problem than legal norms do.     

Influences on anger in German urban cyclists

Previous research shows that anger and aggression among road users lead to maladjusted driving and a higher risk of accidents. Especially cyclists as vulnerable road users have a high risk of being injured if they are involved in accidents. This paper examines reasons for cycling anger in two studies. The first study aimed at identifying anger provoking events. Seventy-three cyclists were invited to discuss anger provoking events in a focus group setting. These events were rated regarding their anger intensity, clustered within focus groups, and aggregated across all groups. The first study revealed 208 unique cycling anger provoking events of varying anger intensity that were summarized in six clusters. The second study aimed at validating these anger provoking events, the ratings, and the clusters. Here, 129 participants were asked to complete a four-time point diary study (over the course of ten days), in which they registered all anger provoking events that they experienced while cycling. The results of this study validated most of the anger provoking events of the first study. Both studies show that most anger provoking events are related to conflicts between cyclists with other road users like car drivers and pedestrians. Moreover, conflicts with car drivers seem to cause stronger anger among cyclists than conflicts with other cyclists or pedestrians. Implications for further research and the planning of road infrastructure are discussed.     

Relating Coalition Capacity to the Adoption of Science-Based Prevention in Communities: Evidence from a Randomized Trial of Communities That Care

Coalition‐based efforts that use a science‐based approach to prevention can improve the wellbeing of community youth. This study measured several coalition capacities that are hypothesized to facilitate the adoption of a science‐based approach to prevention in communities. Using data from 12 coalitions participating in a community‐randomized trial of the prevention strategy Communities That Care (CTC), this paper describes select measurement properties of five salient coalition capacities (member substantive knowledge of prevention, member acquisition of new skills, member attitudes toward CTC, organizational linkages, and influence on organizations), as reported by coalition members, and examines the degree to which these capacities facilitated the community leader reports of the community‐wide adoption of a science‐based approach to prevention. Findings indicated that the five coalition capacities could be reliably measured using coalition member reports. Meta‐regression analyses found that CTC had a greater impact on the adoption of a science‐based prevention approach in 12 matched pairs of control and CTC communities where the CTC coalition had greater member (new skill acquisition) and organizational capacities (organizational linkages).     

A cognitive behavioral workshop for subclinical obsessions and compulsions

The present study investigates the effectiveness of a 3-h cognitive behavioral workshop for individuals, ages 18-22, with subclinical obsessions and compulsions. It was hypothesized that, compared to individuals in an assessment-only waitlist group (n = 42), individuals assigned to the workshop group (n = 43) would experience a significant decrease in obsessive-compulsive (OC) symptomatology, comorbidity, and thought action fusion endorsement at 1-month and 5-month follow-up assessments. An additional outcome of interest was the number of incident cases of obsessive-compulsive disorder (OCD) over the course of the study. The results indicated that the workshop group reported a significantly fewer number of OC symptoms at 5-month follow-up and endorsed significantly less thought action fusion at both follow-up points. However, there were no differences between groups in severity of OC symptoms and number of comorbid diagnoses endorsed. Only one incident case of OCD was observed during the study, from a participant in the waitlist group. These results are discussed in reference to treatment of subclinical anxiety symptoms.     

Professionalizing the Practice of Public Policy in the Prevention of Violence

The State of the Science Conference Statement on “Preventing Violence and Related Health-Risking Social Behaviors in Adolescents” accurately summarizes the state of knowledge regarding risk factors for violence and intervention efficacy. The Statement missed an opportunity, however, to move the field of prevention practice and policy forward by advocating for more systematic, central review of preventive interventions through a new federal regulatory body, such as an “FDA for Preventive Interventions.” This body would provide review of evidence-based programs and aid decision-making in funding. As a complement to this body, decision-makers also need guidelines in evidence-based practice in ambiguous circumstances, which characterize much of the reality of public policy. Therefore, this new regulatory body should be accompanied by guidelines for evidence-based practice in intervention and policy. Finally, in order to move forward both of these concepts, a National Academy of Sciences Panel should convene to deliberate how these concepts can be implemented.     

The effects of mindfulness-based cognitive therapy on recurrence of depressive episodes, mental health and quality of life: A randomized controlled study

Depression is characterized by a large risk of relapse/recurrence. Mindfulness-based cognitive therapy (MBCT) is a recent non-drug psychotherapeutic intervention to prevent future depressive relapse/recurrence in remitted/recovered depressed patients. In this randomized controlled trial, the authors investigated the effects of MBCT on the relapse in depression and the time to first relapse since study participation, as well as on several mood states and the quality of life of the patients. 106 recovered depressed patients with a history of at least 3 depressive episodes continued either with their treatment as usual (TAU) or received MBCT in addition to TAU. The efficacy of MBCT was assessed over a study period of 56 weeks. At the end of the study period relapse/recurrence was significantly reduced and the time until first relapse increased in the MBCT plus TAU condition in comparison with TAU alone. The MBCT plus TAU group also showed a significant reduction in both short and longer-term depressive mood and better mood states and quality of the life. For patients with a history of at least three depressive episodes who are not acutely depressed, MBCT, added to TAU, may play an important role in the domain of relapse prevention in depression.