Smallholder farmers rely on labor exchange to generate agricultural work when cash is rare and credit unavailable. Reciprocal altruism, biased by genetic kinship, has been implicated as the mechanism responsible for labor exchange; however, few empirical tests confirm this proposition. Competitive altruism could be operating if people differ in ability and use this information as a criterion for partnership selection. Labor exchange data are presented from a Dominican smallholder village over a 10-month period within the village's primary cash economic opportunity, bay oil production. Results indicate that competitive altruism better explains variation in labor exchange relationships and group size than reciprocal altruism and kinship, suggesting the presence of a biologic market for male exchange relationships. Bay oil laborers vary in altruistic behaviors, causing reputations for altruism to emerge. Men with reputations as high-quality altruists generate larger labor groups in bay oil production than do poor-quality ones. Larger groups induce bargaining wars, causing men to compete through altruistic acts, which allows high-quality individuals to discriminate potential partners for labor exchange relationships. Men with better reputations achieve more same-sex reciprocal partnerships but not a greater incidence of conjugal partnership, suggesting that male altruism is intra-but not intersexually selected.The world's population is mostly rural, poor, and agrarian (International Fund for Agricultural Development 2010). These smallholders rely on labor exchange as a strategy to generate income and assistance in times of need (Erasmus
Adults with serious mental illness and substance use disorders have elevated risk of mortality and higher healthcare costs compared to the general population. As these disparities have been linked to poor management of co-occurring chronic conditions in primary care, the behavioral health setting may be a preferred setting for routine medical screening and treatment. This qualitative study describes early stages of integrating care teams in emerging medical homes based in mental health and addiction treatment settings. Clinicians and staff from ten agencies engaged in the Behavioral Health Home Learning Collaborative participated in qualitative interviews exploring local definitions of "behavioral health home" and initial barriers and facilitators to integration. Facilitators included clear staff roles, flexible scheduling, and interdisciplinary huddles and staff trainings. Challenges included workforce, limited use of electronic health records, and differing professional cultures. Participants advocated for new workflows and payment structures to accommodate scheduling demands and holistic case management.
Background: Clinical guidelines recommend a personalized approach to mammography screening for women in their forties; however, methods to do so are lacking. An evidence-based mammography screening decision aid was developed as an electronic mobile application and evaluated in a before-after study. Methods: The decision aid (Mammopad) included modules on breast cancer, mammography, risk assessment, and priority setting about screening. Women aged 40-49 years who were patients of rural primary care clinics, had no major risk factors for breast cancer, and no mammography during the previous year were invited to use the decision aid. Twenty women participated in pretesting of the decision aid and 75 additional women completed the before-after study. The primary outcome was decisional conflict measured before and after using Mammopad. Secondary outcomes included decision self-efficacy and intention to begin or continue mammography screening. Differences comparing measures before versus after use were determined using Wilcoxon signed rank tests. Results: After using Mammopad, women reported reduced decisional conflict based on mean Decisional Conflict Scale scores overall (46.33 versus 8.33; Z = -7.225; p < 0.001) and on all subscales ( p < 0.001). Women also reported increased mean Decision Self-Efficacy Scale scores (79.67 versus 95.73; Z = 6.816, p < 0.001). Although 19% of women changed their screening intentions, this was not statistically significant. Conclusions: Women reported less conflict about their decisions for mammography screening, and felt more confident to make decisions after using Mammopad. This approach may help guide women through the decision making process to determine personalized screening choices that are appropriate for them.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with đź’™ for researchers
Part of the Research Solutions Family.