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Back to basics: Gaps in baseline data call for revisiting an environmental education program in the SAVA region, Madagascar.

ABSTRACT: Environmental education programs are critically important for raising awareness about global and local environmental concerns, by providing the knowledge, tools, and means for young and old generations to cope with current challenges. Of the greatest importance is the implementation of environmental education programs in biodiversity hotspots where environmental crises are high and resources to fund mitigation programs are low. Madagascar is one such priority hotspot, featuring intensive wildlife-human conflicts due to shrinking natural environments. The Duke Lemur Center-SAVA Conservation Initiative has been conducting environmental education activities in the SAVA region, northeastern Madagascar, since 2011. These activities have been aimed at increasing awareness of local and global environmental issues and at stimulating the involvement of local school students. Our initiatives have predominantly supported teacher trainings to provide teachers with environmental education content, examples, and recommendations on how to integrate activities into their regular curricula, commonly referred to as a "cascade approach". Due to logistical hurdles, including high teacher turnover rates, however, these interventions have not been monitored to assess their efficacy. Thus, to better inform current and future interventions, we designed and implemented classroom-based surveys to gather baseline data on the basic knowledge of SAVA students and their perceptions of the environment. We identify informational gaps in surveyed schools, including those located in large towns vs. villages, and those with trained vs. untrained teachers. Based on these results, we make recommendations for future environmental education efforts in the region, including activities that could address real-life environmental problems and decision-making solutions.

SUBMITTER: Blanco MB

PROVIDER: S-EPMC7173847 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Back to basics: Gaps in baseline data call for revisiting an environmental education program in the SAVA region, Madagascar.

Blanco Marina B MB Rudman Alexie N AN Greene Lydia K LK Razafindrainibe Fusiane F Andrianandrasana Lanto L Welch Charles C

PloS one 20200421 4

Environmental education programs are critically important for raising awareness about global and local environmental concerns, by providing the knowledge, tools, and means for young and old generations to cope with current challenges. Of the greatest importance is the implementation of environmental education programs in biodiversity hotspots where environmental crises are high and resources to fund mitigation programs are low. Madagascar is one such priority hotspot, featuring intensive wildlif ...[more]

PMID: 32315367

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Project description:INTRODUCTION:Measles elimination depends on the successful deployment of measles containing vaccine. Vaccination programs often depend on a combination of routine and non-routine services, including supplementary immunization activities (SIAs) and vaccination weeks (VWs), that both aim to vaccinate all eligible children regardless of vaccination history or natural infection. Madagascar has used a combination of these activities to improve measles coverage. However, ongoing massive measles outbreak suggests that the country was in a "honeymoon" period and that coverage achieved needs to be re-evaluated. Although healthcare access is expected to vary seasonally in low resources settings, little evidence exists to quantify temporal fluctuations in routine vaccination, and interactions with other immunization activities. METHODS:We used three data sources: national administrative data on measles vaccine delivery from 2013 to 2016, digitized vaccination cards from 49 health centers in 6 health districts, and a survey of health workers. Data were analyzed using linear regressions, analysis of variance, and t-tests. FINDINGS:From 2013 to 2016, the footprint of SIAs and VWs is apparent, with more doses distributed during the relevant timeframes. Routine vaccination decreases in subsequent months, suggesting that additional activities may be interfering with routine services. The majority of missed vaccination opportunities occur during the rainy season. Health facility organization and shortage of vaccine contributed to vaccination gaps. Children born in June were the least likely to be vaccinated on time. DISCUSSION:Evidence that routine vaccination coverage varies over the year and is diminished by other activities suggests that maintaining routine vaccination during SIAs and VWs is a key direction for strengthening immunization programs, ensuring population immunity and avoiding future outbreaks. FUNDING:Wellcome Trust Fund, Burroughs Wellcome Fund, Gates Foundation, National Institutes of Health.

Project description:BackgroundExercise and education is recommended as first-line treatment by evidence-based, international guidelines for low back pain (LBP). Despite consensus regarding the treatment, there is a gap between guidelines and what is offered to patients. Digital LBP treatments are an emerging way of delivering first-line treatment.ObjectiveThe aim of this study is to evaluate outcomes after participation in a 3-month digitally delivered treatment program for individuals with subacute or chronic LBP.MethodsWe analyzed data from 2593 consecutively recruited participants in a digitally delivered treatment program, available via the national health care system in Sweden. The program consists of video-instructed and progressive adaptable exercises, education through text lessons, and a chat and video function connecting participants with a personal physiotherapist. The primary outcome was mean change and proportion reaching a minimal clinically important change (MCIC) for LBP (2 points or 30% decrease) assessed with the numerical rating scale (average pain during the past week, discrete boxes, 0-10, best to worst). Secondary outcomes were mean change and proportion reaching MCIC (10 points or 30%) in disability, assessed with the Oswestry Disability Index (ODI; 0-100, best to worst) and a question on patient acceptable symptom state (PASS).ResultsThe mean participant age was 63 years, 73.85% (1915/2593) were female, 54.72% (1419/2593) had higher education, 50.56% (1311/2593) were retired, and the mean BMI was 26.5 kg/m2. Participants completed on average 84% of the prescribed exercises and lessons, with an adherence of ≥80% in 69.26% (1796/2593) and ≥90% in 50.13% (1300/2593) of the participants. Mean reduction in pain from baseline to 3 months was 1.7 (95% CI -1.8 to -1.6), corresponding to a 35% relative change. MCIC was reached by 58.50% (1517/2593) of participants. ODI decreased 4 points (95% CI -4.5 to -3.7), and 36.48% (946/2593) reached an MCIC. A change from no to yes in PASS was seen in 30.35% (787/2593) of participants. Multivariable analysis showed positive associations between reaching an MCIC in pain and high baseline pain (odds ratio [OR] 1.9, 95% CI 1.6-2.1), adherence (OR 1.5, 95% CI 1.3-1.8), and motivation (OR 1.2, 95% CI 1.0-1.5), while we found negative associations for wish for surgery (OR 0.6, 95% CI 0.5-0.9) and pain in other joints (OR 0.9, 95% CI 0.7-0.9). We found no associations between sociodemographic characteristics and pain reduction.ConclusionsParticipants in this digitally delivered treatment for LBP had reduced pain at 3-month follow-up, and 58.50% (1517/2593) reported an MCIC in pain. Our findings suggest that digital treatment programs can reduce pain at clinically important levels for people with high adherence to treatment but that those with such severe LBP problems that they wish to undergo surgery may benefit from additional support.Trial registrationClinicalTrials.gov NCT05226156; https://clinicaltrials.gov/ct2/show/NCT05226156.

Dataset Information

Back to basics: Gaps in baseline data call for revisiting an environmental education program in the SAVA region, Madagascar.

Publications

Back to basics: Gaps in baseline data call for revisiting an environmental education program in the SAVA region, Madagascar.

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