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Surveys of doctors suggest that they use placebos and placebo effects clinically to help patients. However, patients' views are not well-understood. We aimed to identify when and why placebo-prescribing in primary care might be acceptable and unacceptable to patients. A purposive diverse sample of 58 English-speaking adults (18 men; aged 19-80 years) participated in 11 focus groups. Vignettes describing doctors prescribing placebos in primary care were used to initiate discussions. Data were analyzed inductively. Participants discussed diverse harms and benefits of placebo-prescribing for individual patients, carers, healthcare providers, and society. Two perspectives on placebo-prescribing were identified. First, the \"consequentialist\" perspective focused on the potential for beneficial outcomes of placebo-prescribing. Here, some participants thought placebos are beneficial and should be used clinically; they often invoked the power of the mind or mind-body interactions. Others saw placebos as ineffective and therefore a waste of time and money. Second, the \"respecting autonomy\" perspective emphasized the harms caused by the deceptive processes thought necessary for placebo-prescribing. Here, participants judged placebo-prescribing unacceptable because placebo-prescribers deceive patients, thus a doctor who prescribes placebos cannot be trusted and patients' autonomy is compromised. They also saw placebo-responders as gullible, which deterred them from trying placebos themselves. Overall, the word \"placebo\" was often thought to imply \"ineffective\"; some participants suggested alternative carefully chosen language that could enable doctors to prescribe placebos without directly lying to patients. Negative views of placebos derive from beliefs that placebos do not work and/or that they require deception by the doctor. Positive views are pragmatic in that if placebos work then any associated processes (e.g. mechanisms, deception) are deemed unimportant. Public education about placebos and their effects is warranted and research to identify optimal ways of harnessing placebo effects in clinical practice is needed.

Global sweetpotato production is increasing due to its health benefits, including high levels of complex carbohydrates and bioactive compounds. To explore the genetic basis of carbohydrates and carotenoids, we conducted a genome-wide association study (GWAS) using diverse sweetpotato accessions, two decades of phenotypic data, and 252,975 dosage-based SNPs and INDELs. Our findings confirmed a negative correlation between dry matter and β-carotene and identified interconnected metabolic pathways regulating multiple traits. Notably, phytoene synthase, involved in carotene biosynthesis, was associated with dry matter. Other pathways linked to these traits include carbohydrate metabolism, cell wall modification, phosphate starvation, stress response, and flowering regulation. To evaluate the breeding potential of GWAS-assisted genomic prediction (GWABLUP), we found that the 500 top GWAS hits used for genomic prediction significantly enhanced predictive ability (PA) for six out of nine traits, improving PA by up to 6.7% to 15.9% compared to the Genomic Best Linear Unbiased Prediction (GBLUP), which utilized 41,551 and 500 markers, respectively. The best PA across traits ranged from 20.9% to 60.6%, with both additive and dominance effects playing an important role. Model selection, guided by resample model inclusion probability (RMIP), during GWABLUP and after each GWAS iteration typically yielded the highest PA. These results provide valuable insights for breeding strategies aimed at optimizing agronomic traits and addressing market demands for diverse value-added products.

Placebo groups are used in randomised clinical trials (RCTs) to control for placebo effects, which can be large. Participants in trials can misunderstand written information particularly regarding technical aspects of trial design such as randomisation; the adequacy of written information about placebos has not been explored. We aimed to identify what participants in major RCTs in the UK are told about placebos and their effects. We conducted a content analysis of 45 Participant Information Leaflets (PILs) using quantitative and qualitative methodologies. PILs were obtained from trials on a major registry of current UK clinical trials (the UKCRN database). Eligible leaflets were received from 44 non-commercial trials but only 1 commercial trial. The main limitation is the low response rate (13.5%), but characteristics of included trials were broadly representative of all non-commercial trials on the database. 84% of PILs were for trials with 50:50 randomisation ratios yet in almost every comparison the target treatments were prioritized over the placebos. Placebos were referred to significantly less frequently than target treatments (7 vs. 27 mentions, p<001) and were significantly less likely than target treatments to be described as triggering either beneficial effects (1 vs. 45, p<001) or adverse effects (4 vs. 39, p<001). 8 PILs (18%) explicitly stated that the placebo treatment was either undesirable or ineffective. PILs from recent high quality clinical trials emphasise the benefits and adverse effects of the target treatment, while largely ignoring the possible effects of the placebo. Thus they provide incomplete and at times inaccurate information about placebos. Trial participants should be more fully informed about the health changes that they might experience from a placebo. To do otherwise jeopardises informed consent and is inconsistent with not only the science of placebos but also the fundamental rationale underpinning placebo controlled trials.

ContextUnderstanding how the Northern Forest landscape has changed and is likely to change, both in terms of forest extent and forest configuration, has important implications for management.ObjectivesWe examined historical changes in forest pattern and extent to: (1) characterize recent forest cover change and potential drivers of that change, (2) identify areas vulnerable to future forest loss, (3) assess the impact of such loss on forest fragmentation, and (4) examine correlations between projected forest loss and socioeconomic variables to help inform future planning.MethodsWe developed a cellular automata model to simulate changes in forest land cover in the Northern Forest region from 2015 to 2075. The model was parameterized from observed historical trends (1985 to 2015) and correlating spatial variables using Bayesian Weights of Evidence. Using our model outputs, we identified areas most vulnerable to change, and impacts of these changes on forest fragmentation.ResultsThough we find an overall trend of decreasing forest area across the region, rates of change vary spatially and temporally, with an overall increase in forest cover between 2000 and 2015. Areas most attractive for development (e.g. high population density, low slope and elevation) were most likely to experience deforestation. Forest fragmentation increased during observed and simulated time steps, even during an observed period of net forest regeneration.ConclusionsForest loss and fragmentation due to development represent a formidable threat to the Northern Forest. Historical trends indicate that simply increasing forest extent is not sufficient to restore forest connectivity in the region.

Research has established that the burdens of externalities associated with industrial production are disproportionately borne by socially and politically vulnerable groups, and this is particularly true for farmworkers who are at high risk for environmental exposures and illnesses. The impacts of these risks are often compounded by farmworker communities’ social vulnerability. Yet, less is known about how the intersection of race, class, and gender can position some farmworkers to be at higher risk for particular types of oppressions. We extend the literature by analyzing the case of Black women farmworkers in Apopka, Florida, which was historically home to a large agricultural community. Drawing on the concept of critical environmental justice, we investigate the lived experiences of these women in the context of racialized, gendered, and economic oppressions during their time working on the farms. We use the case of Apopka to ask: (a) how the policies and socio-historical context of the agricultural industry in the American South contributed to injustices experienced by Black women farmworkers in Apopka, Florida; and (b) how race, gender, and class intersected and intersect to create and legitimize environmental injustices in the workplace for these farmworkers. Our data include semi-structured in-depth interviews, newspaper and media coverage, and archival materials. Our analysis advances work on critical environmental justice and intersectionality by mapping the relationship between structural and environmental intersectional oppressions for Black women farmworkers.

Catastrophic uncontrolled fires are a leading social-environmental challenge that now occur even in the humid tropics. In 2015 extensive Indonesian peatland fires commanded national and international attention and resulted in a ban on all burning in the country extending to traditional farmers practicing small-scale fire-based agriculture on mineral soils. However, the impacts of, and responses to the ban on these fire-dependent communities is not well understood. Understanding the mental models of communities exposed to environmental change and its corresponding policy responses can provide salient insights into the placebased experience of change to identify contested perceptions and serve to improve the distributional equity of associated impacts. We assessed the mental models of Dayak farmers in Kapuas Hulu, Kalimantan, in three distinct landscape contexts: i) oil palm (OP), ii) national park (NP), and iii) transition (T) sites. These locations enabled insights into how different contemporary landscape contexts and livelihood opportunities are related to experiences and coping strategies. We collected data using the Conceptual Content Cognitive Mapping approach in two communities in each landscape context (n = 24 participants per landscape), and 72 interviews in total. Results show that the NP and T sites were most similar, whilst the OP communities held distinct perceptions of fire. In addition to the agricultural value of fire, cultural and relational values are associated with fire use across sites and would be severed through fire prevention. Finally, we show that the burdens of the burn ban for farmers and forests were most pronounced in the NP and T sites where farmers are most reliant on traditional agriculture, have the fewest livelihood alternatives and least external support to fight uncontrolled fires.

Wild oyster populations are in decline globally, affecting communities of generational fishers and changing the cultural dynamics of coastal communities. Managers have employed a range of approaches to conserve and restore oyster populations and sustainable fisheries; yet there is little agreement among managers, scientists, and resource users regarding what constitutes success. This study uses a qualitative, mental models approach to compare understandings of management, perceptions of management success, and barriers to achieving successful management outcomes among three critical stakeholder groups: natural resource managers, oyster harvesters, and aquaculture farmers. We found similarities among the mental models of all three groups in the causes and consequences of the oyster fishery decline, but major differences in definitions of management, factors needed for successful management, and barriers to success. This study takes a more comprehensive look at the understandings of stakeholders than previous research by mapping the causes and effects, from the decline of the oyster fishery to expectations of future success. Managers can improve stakeholder investment in management projects by gaining a better understanding of the differing definitions of project success, stakeholder participation, and stakeholder understanding of the role of management.

Pathways of transmission of coronavirus (COVID‐19) disease in the human population are still emerging. However, empirical observations suggest that dense human settlements are the most adversely impacted, corroborating a broad consensus that human‐to‐human transmission is a key mechanism for the rapid spread of this disease. Here, using logistic regression techniques, estimates of threshold levels of population density were computed corresponding to the incidence (case counts) in the human population. Regions with population densities greater than 3,000 person per square mile in the United States have about 95% likelihood to report 43,380 number of average cumulative cases of COVID‐19. Since case numbers of COVID‐19 dynamically changed each day until 30 November 2020, ca. 4% of US counties were at 50% or higher probability to 38,232 number of COVID‐19 cases. While threshold on population density is not the sole indicator for predictability of coronavirus in human population, yet it is one of the key variables on understanding and rethinking human settlement in urban landscapes. Plain Language Summary Population density is certainly one of the key factors influencing the transmission of infectious diseases like COVID‐19. It is approximated that in continental United States, population density of 1,192 per square mile and higher presents 50% probability of getting 38,232 number of COVID‐19 cases. Key Points Based on data from the USA, the population density of 1,192 persons per square mile represented a 50% or higher probability of more than 38,000 COVID‐19 cumulative cases at county scale as of 30 November 2020 About 35 counties in the USA with population density greater or equal to 3,000 per square mile are at very high chances (95% or higher) of more than 43,000 cumulative cases at county scale as of 30 November 2020 Analysis shows the vulnerability of urban towns to respiratory infectious disease

Extant research on social movements has highlighted activists' discursive tactics to challenge the state, yet little analytical attention focuses on elite efforts to dominate the discourse arena through the deployment of oppositional frames. This paper analyzes elite oppositional framing surrounding the placement of a highway bypass in the Czech Republic. Our research examines how democratic states deploy oppositional frames and enlist elite countermovement support for their efforts to obstruct challenges. Using a range of data sources, we delineate the mechanisms used by these elite actors to vilify and stigmatize environmental activists, paving the way for more violent forms of public harassment. The concept we initiate, discursive obstruction, adds the critical dimension of power relations to analyses of both framing processes and discursive opportunity structures. We conclude by discussing the implications of our results for social movement research.

Background The COVID-19 pandemic led to an unprecedented relaxation of restrictions on take-home doses in opioid agonist treatment (OAT). We conducted a mixed methods systematic review to explore the impact of these changes on program effectiveness and client experiences in OAT. Methods The protocol for this review was registered in PROSPERO (CRD42022352310). From Aug.–Nov. 2022, we searched Medline, Embase, CINAHL, PsycInfo, Web of Science, Cochrane Register of Controlled Trials, and the grey literature. We included studies reporting quantitative measures of retention in treatment, illicit substance use, overdose, client health, quality of life, or treatment satisfaction or using qualitative methods to examine client experiences with take-home doses during the pandemic. We critically appraised studies using the Mixed Methods Appraisal Tool. We synthesized quantitative data using vote-counting by direction of effect and presented the results in harvest plots. Qualitative data were analyzed using thematic synthesis. We used a convergent segregated approach to integrate quantitative and qualitative findings. Results Forty studies were included. Most were from North America (23/40) or the United Kingdom (9/40). The quantitative synthesis was limited by potential for confounding, but suggested an association between take-home doses and increased retention in treatment. There was no evidence of an association between take-home doses and illicit substance use or overdose. Qualitative findings indicated that take-home doses reduced clients’ exposure to unregulated substances and stigma and minimized work/treatment conflicts. Though some clients reported challenges with managing their medication, the dominant narrative was one of appreciation, reduced anxiety, and a renewed sense of agency and identity. The integrated analysis suggested reduced treatment burden as an explanation for improved retention and revealed variation in individual relationships between take-home doses and illicit substance use. We identified a critical gap in quantitative measures of patient-important outcomes. Conclusion The relaxation of restrictions on take-home doses was associated with improved client experience and retention in OAT. We found no evidence of an association with illicit substance use or overdose, despite the expansion of take-home doses to previously ineligible groups. Including patient-important outcome measures in policy, program development, and treatment planning is essential to ensuring that decisions around take-home doses accurately reflect their value to clients.