Few studies of land-use/land-cover change provide an integrated assessment of the driving forces and consequences of that change, particularly in Africa. Our objectives were to determine how driving forces at different scales change over time, how these forces affect the dynamics and patterns of land use/land cover, and how land-use/land-cover change affects ecological properties at the landscape scale. To accomplish these objectives, we first developed a way to identify the causes and consequences of change at a landscape scale by integrating tools from ecology and the social sciences and then applied these methods to a case study in Ghibe Valley, southwestern Ethiopia. Maps of land-use/land-cover change were created from aerial photography and Landsat TM imagery for the period, 1957-1993. A method called 'ecological time lines' was developed to elicit landscape-scale explanations for changes from long-term residents. Cropland expanded at twice the speed recently (1987)(1988)(1989)(1990)(1991)(1992)(1993) than two decades ago (1957)(1958)(1959)(1960)(1961)(1962)(1963)(1964)(1965)(1966)(1967)(1968)(1969)(1970)(1971)(1972)(1973), but also contracted rapidly between 1973-1987. Rapid land-use/land cover change was caused by the combined effects of drought and migration, changes in settlement and land tenure policy, and changes in the severity of the livestock disease, trypanosomosis, which is transmitted by the tsetse fly. The scale of the causes and consequences of land-use/land-cover change varied from local to sub-national (regional) to international and the links between causes and consequences crossed scales. At the landscape scale, each cause affected the location and pattern of land use/land cover differently. The contraction of cropland increased grass biomass and cover, woody plant cover, the frequency and extent of savanna burning, and the abundance of wildlife. With recent control of the tsetse fly, these ecological changes are being reversed. These complex patterns are discussed in the context of scaling issues and current conceptual models of land-use/land-cover change.

Teaching about domestic violence and racism is a formidable task that requires the inclusion of material that challenges dominant ideologies about race and gender. A recent training for police officers about domestic violence and racism serves as a good example of how challenging the task can be. Drawing from this 1-day police training, from existing pedagogical literature, and from the authors' collective experiences teaching about these issues, the authors address challenges encountered and propose strategies to mitigate them. The authors propose a multilevel approach to implementing strategies to address these challenges, which includes ongoing involvement during three stages of the training.

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Successful control of tsetse (Glossina spp.)‐transmitted trypanosomiasis in the Ghibe Valley, Ethiopia, appears to have accelerated conversion of wooded grassland into cropland. Land conversion, in turn, may have fragmented wildlife habitat. Our objective was to assess the influence of the expansion of agricultural land‐use, brought about by tsetse control, on ecological properties by using bird species richness and composition as indicators of environmental impacts. We sampled bird species richness and composition (using Timed‐Species counts) and habitat structure (using field sampling and remote sensing) in four land cover/land‐use types in areas subjected to tsetse fly control and adjacent areas without control. At the height of the growing season bird species numbers and vegetative complexity were greater in the small‐holder, oxen‐plowed fields and riparian woodlands than in wooded grasslands or in large‐holder, tractor‐plowed fields. Species composition was highly dissimilar (40–70% dissimilarity) comparing among land‐use types, with many species found only in a single type. This implies that trypanosomiasis control that results in land conversion from wooded grasslands to small‐holder farming in this region may have no adverse impacts on bird species numbers but will alter composition. These results also suggest that moderate land‐use by humans (e.g., small‐holder field mosaics) increases habitat heterogeneity and bird species richness relative to high levels of use (e.g., tractor‐plowed fields). Tsetse control may be indirectly maintaining species richness in the valley by encouraging the differential spread of these small‐scale, heterogeneous farms in place of large‐scale, homogeneous farms. Nevertheless, if the extent of small‐holder farms significantly exceeds that of present levels, negative impacts on bird species richness and large shifts in species composition may occur.

Background Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with few treatment options. N-acetylcysteine (NAC) is a well-tolerated, inexpensive treatment with antioxidant and anti-fibrotic properties. The National Heart, Lung, and Blood Institute (NHLBI)-sponsored PANTHER (Prednisone Azathioprine and NAC therapy in IPF) trial confirmed the harmful effects of immunosuppression in IPF, and did not show a benefit to treatment with NAC. However, a post hoc analysis revealed a potential beneficial effect of NAC in a subgroup of individuals carrying a specific genetic variant, TOLLIP rs3750920 TT genotype, present in about 25% of patients with IPF. Here, we present the design and rationale for the Phase III, multi-center, randomized, double-blind, placebo-controlled Prospective Treatment Efficacy in IPF Using Genotype for NAC Selection (PRECISIONS) clinical trial. Methods The PRECISIONS trial will randomize 200 patients with IPF and the TOLLIP rs3750920 TT genotype 1:1 to oral N-acetylcysteine (600 mg tablets taken three times a day) or placebo for a 24-month duration. The primary endpoint is the composite of time to 10% relative decline in forced vital capacity (FVC), first respiratory hospitalization, lung transplantation, or death from any cause. Secondary endpoints include change in patient-reported outcome scores and proportion of participants with treatment-emergent adverse events. Biospecimens, including blood, buccal, and fecal will be collected longitudinally for future research purposes. Study participants will be offered enrollment in a home spirometry substudy, which explores time to 10% relative FVC decline measured at home, and its comparison with study visit FVC. Discussion The sentinel observation of a potential pharmacogenetic interaction between NAC and TOLLIP polymorphism highlights the urgent, unmet need for better, molecularly focused, and precise therapeutic strategies in IPF. The PRECISIONS clinical trial is the first study to use molecularly-focused techniques to identify patients with IPF most likely to benefit from treatment. PRECISIONS has the potential to shift the paradigm in how trials in this condition are designed and executed, and is the first step toward personalized medicine for patients with IPF. Trial Registration ClinicalTrials.gov identifier: NCT04300920. Registered March 9, 2020. https://clinicaltrials.gov/ct2/show/NCT04300920