Pub Date : 2024-06-03DOI: 10.1038/s41562-024-01888-7
Joscha Gretzinger, Felicitas Schmitt, Angela Mötsch, Selina Carlhoff, Thiseas Christos Lamnidis, Yilei Huang, Harald Ringbauer, Corina Knipper, Michael Francken, Franziska Mandt, Leif Hansen, Cäcilia Freund, Cosimo Posth, Hannes Rathmann, Katerina Harvati, Günther Wieland, Lena Granehäll, Frank Maixner, Albert Zink, Wolfram Schier, Dirk Krausse, Johannes Krause, Stephan Schiffels
The early Iron Age (800 to 450 BCE) in France, Germany and Switzerland, known as the ‘West-Hallstattkreis’, stands out as featuring the earliest evidence for supra-regional organization north of the Alps. Often referred to as ‘early Celtic’, suggesting tentative connections to later cultural phenomena, its societal and population structure remain enigmatic. Here we present genomic and isotope data from 31 individuals from this context in southern Germany, dating between 616 and 200 BCE. We identify multiple biologically related groups spanning three elite burials as far as 100 km apart, supported by trans-regional individual mobility inferred from isotope data. These include a close biological relationship between two of the richest burial mounds of the Hallstatt culture. Bayesian modelling points to an avuncular relationship between the two individuals, which may suggest a practice of matrilineal dynastic succession in early Celtic elites. We show that their ancestry is shared on a broad geographic scale from Iberia throughout Central-Eastern Europe, undergoing a decline after the late Iron Age (450 BCE to ~50 CE). Gretzinger et al. examine genetic evidence from 31 Iron Age individuals in southern Germany and find that this early Celtic society probably had a dynastic system of matrilineal inheritance, with a network of well-connected elites covering a broad territory.
{"title":"Evidence for dynastic succession among early Celtic elites in Central Europe","authors":"Joscha Gretzinger, Felicitas Schmitt, Angela Mötsch, Selina Carlhoff, Thiseas Christos Lamnidis, Yilei Huang, Harald Ringbauer, Corina Knipper, Michael Francken, Franziska Mandt, Leif Hansen, Cäcilia Freund, Cosimo Posth, Hannes Rathmann, Katerina Harvati, Günther Wieland, Lena Granehäll, Frank Maixner, Albert Zink, Wolfram Schier, Dirk Krausse, Johannes Krause, Stephan Schiffels","doi":"10.1038/s41562-024-01888-7","DOIUrl":"10.1038/s41562-024-01888-7","url":null,"abstract":"The early Iron Age (800 to 450 BCE) in France, Germany and Switzerland, known as the ‘West-Hallstattkreis’, stands out as featuring the earliest evidence for supra-regional organization north of the Alps. Often referred to as ‘early Celtic’, suggesting tentative connections to later cultural phenomena, its societal and population structure remain enigmatic. Here we present genomic and isotope data from 31 individuals from this context in southern Germany, dating between 616 and 200 BCE. We identify multiple biologically related groups spanning three elite burials as far as 100 km apart, supported by trans-regional individual mobility inferred from isotope data. These include a close biological relationship between two of the richest burial mounds of the Hallstatt culture. Bayesian modelling points to an avuncular relationship between the two individuals, which may suggest a practice of matrilineal dynastic succession in early Celtic elites. We show that their ancestry is shared on a broad geographic scale from Iberia throughout Central-Eastern Europe, undergoing a decline after the late Iron Age (450 BCE to ~50 CE). Gretzinger et al. examine genetic evidence from 31 Iron Age individuals in southern Germany and find that this early Celtic society probably had a dynastic system of matrilineal inheritance, with a network of well-connected elites covering a broad territory.","PeriodicalId":19074,"journal":{"name":"Nature Human Behaviour","volume":null,"pages":null},"PeriodicalIF":21.4,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41562-024-01888-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141235934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-03DOI: 10.1038/s41562-024-01893-w
Central Africa is home to the greatest number of hunter-gatherers remaining in the world, but the origins of their culture remain unclear. We compiled a dataset of Central African hunter-gatherer musical instruments, subsistence tools, specialized vocabulary and genome-wide single-nucleotide polymorphism data, which revealed ancient networks of cultural and linguistic exchange that spanned thousands of kilometres.
{"title":"Musical instruments, tools, language and genetic data reveal ancient hunter-gatherer networks","authors":"","doi":"10.1038/s41562-024-01893-w","DOIUrl":"10.1038/s41562-024-01893-w","url":null,"abstract":"Central Africa is home to the greatest number of hunter-gatherers remaining in the world, but the origins of their culture remain unclear. We compiled a dataset of Central African hunter-gatherer musical instruments, subsistence tools, specialized vocabulary and genome-wide single-nucleotide polymorphism data, which revealed ancient networks of cultural and linguistic exchange that spanned thousands of kilometres.","PeriodicalId":19074,"journal":{"name":"Nature Human Behaviour","volume":null,"pages":null},"PeriodicalIF":21.4,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141235926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-30DOI: 10.1038/s41562-024-01900-0
Damage to a specific part of the brain in the frontal cortex reveals its necessity in effortful actions that help other people. These findings could have implications for understanding and treating disorders of social behaviour.
{"title":"How brain damage affects our willingness to help others","authors":"","doi":"10.1038/s41562-024-01900-0","DOIUrl":"10.1038/s41562-024-01900-0","url":null,"abstract":"Damage to a specific part of the brain in the frontal cortex reveals its necessity in effortful actions that help other people. These findings could have implications for understanding and treating disorders of social behaviour.","PeriodicalId":19074,"journal":{"name":"Nature Human Behaviour","volume":null,"pages":null},"PeriodicalIF":21.4,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141177399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-29DOI: 10.1038/s41562-024-01901-z
Pierre Vassiliadis, Elena Beanato, Traian Popa, Fabienne Windel, Takuya Morishita, Esra Neufeld, Julie Duque, Gerard Derosiere, Maximilian J. Wessel, Friedhelm C. Hummel
Reinforcement feedback can improve motor learning, but the underlying brain mechanisms remain underexplored. In particular, the causal contribution of specific patterns of oscillatory activity within the human striatum is unknown. To address this question, we exploited a recently developed non-invasive deep brain stimulation technique called transcranial temporal interference stimulation (tTIS) during reinforcement motor learning with concurrent neuroimaging, in a randomized, sham-controlled, double-blind study. Striatal tTIS applied at 80 Hz, but not at 20 Hz, abolished the benefits of reinforcement on motor learning. This effect was related to a selective modulation of neural activity within the striatum. Moreover, 80 Hz, but not 20 Hz, tTIS increased the neuromodulatory influence of the striatum on frontal areas involved in reinforcement motor learning. These results show that tTIS can non-invasively and selectively modulate a striatal mechanism involved in reinforcement learning, expanding our tools for the study of causal relationships between deep brain structures and human behaviour. Vassiliadis et al. use transcranial temporal interference stimulation—a non-invasive deep brain stimulation technique—to show that stimulation of the striatum applied at 80 Hz disrupts the ability to learn from reinforcement feedback.
{"title":"Non-invasive stimulation of the human striatum disrupts reinforcement learning of motor skills","authors":"Pierre Vassiliadis, Elena Beanato, Traian Popa, Fabienne Windel, Takuya Morishita, Esra Neufeld, Julie Duque, Gerard Derosiere, Maximilian J. Wessel, Friedhelm C. Hummel","doi":"10.1038/s41562-024-01901-z","DOIUrl":"10.1038/s41562-024-01901-z","url":null,"abstract":"Reinforcement feedback can improve motor learning, but the underlying brain mechanisms remain underexplored. In particular, the causal contribution of specific patterns of oscillatory activity within the human striatum is unknown. To address this question, we exploited a recently developed non-invasive deep brain stimulation technique called transcranial temporal interference stimulation (tTIS) during reinforcement motor learning with concurrent neuroimaging, in a randomized, sham-controlled, double-blind study. Striatal tTIS applied at 80 Hz, but not at 20 Hz, abolished the benefits of reinforcement on motor learning. This effect was related to a selective modulation of neural activity within the striatum. Moreover, 80 Hz, but not 20 Hz, tTIS increased the neuromodulatory influence of the striatum on frontal areas involved in reinforcement motor learning. These results show that tTIS can non-invasively and selectively modulate a striatal mechanism involved in reinforcement learning, expanding our tools for the study of causal relationships between deep brain structures and human behaviour. Vassiliadis et al. use transcranial temporal interference stimulation—a non-invasive deep brain stimulation technique—to show that stimulation of the striatum applied at 80 Hz disrupts the ability to learn from reinforcement feedback.","PeriodicalId":19074,"journal":{"name":"Nature Human Behaviour","volume":null,"pages":null},"PeriodicalIF":21.4,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41562-024-01901-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141165341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-27DOI: 10.1038/s41562-024-01887-8
Mauricio González-Forero
Brain size tripled in the human lineage over four million years, but why this occurred remains uncertain. Here, to study what caused this brain expansion, I mathematically model the evolutionary and developmental (evo-devo) dynamics of hominin brain size. The model recovers (1) the evolution of brain and body sizes of seven hominin species starting from brain and body sizes of the australopithecine scale, (2) the evolution of the hominin brain–body allometry and (3) major patterns of human development and evolution. I show that the brain expansion recovered is not caused by direct selection for brain size but by its genetic correlation with developmentally late preovulatory ovarian follicles. This correlation is generated over development if individuals experience a challenging ecology and seemingly cumulative culture, among other conditions. These findings show that the evolution of exceptionally adaptive traits may not be primarily caused by selection for them but by developmental constraints that divert selection. A mathematical model of the evolution and development of hominin brain size suggests that the evolution of a larger brain size in humans may have been driven by changes in developmental constraints rather than selection for brain size.
{"title":"Evolutionary–developmental (evo-devo) dynamics of hominin brain size","authors":"Mauricio González-Forero","doi":"10.1038/s41562-024-01887-8","DOIUrl":"10.1038/s41562-024-01887-8","url":null,"abstract":"Brain size tripled in the human lineage over four million years, but why this occurred remains uncertain. Here, to study what caused this brain expansion, I mathematically model the evolutionary and developmental (evo-devo) dynamics of hominin brain size. The model recovers (1) the evolution of brain and body sizes of seven hominin species starting from brain and body sizes of the australopithecine scale, (2) the evolution of the hominin brain–body allometry and (3) major patterns of human development and evolution. I show that the brain expansion recovered is not caused by direct selection for brain size but by its genetic correlation with developmentally late preovulatory ovarian follicles. This correlation is generated over development if individuals experience a challenging ecology and seemingly cumulative culture, among other conditions. These findings show that the evolution of exceptionally adaptive traits may not be primarily caused by selection for them but by developmental constraints that divert selection. A mathematical model of the evolution and development of hominin brain size suggests that the evolution of a larger brain size in humans may have been driven by changes in developmental constraints rather than selection for brain size.","PeriodicalId":19074,"journal":{"name":"Nature Human Behaviour","volume":null,"pages":null},"PeriodicalIF":21.4,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41562-024-01887-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141156726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-27DOI: 10.1038/s41562-024-01891-y
Cecilia Padilla-Iglesias, Javier Blanco-Portillo, Bogdan Pricop, Alexander G. Ioannidis, Balthasar Bickel, Andrea Manica, Lucio Vinicius, Andrea Bamberg Migliano
Human evolutionary history in Central Africa reflects a deep history of population connectivity. However, Central African hunter-gatherers (CAHGs) currently speak languages acquired from their neighbouring farmers. Hence it remains unclear which aspects of CAHG cultural diversity results from long-term evolution preceding agriculture and which reflect borrowing from farmers. On the basis of musical instruments, foraging tools, specialized vocabulary and genome-wide data from ten CAHG populations, we reveal evidence of large-scale cultural interconnectivity among CAHGs before and after the Bantu expansion. We also show that the distribution of hunter-gatherer musical instruments correlates with the oldest genomic segments in our sample predating farming. Music-related words are widely shared between western and eastern groups and likely precede the borrowing of Bantu languages. In contrast, subsistence tools are less frequently exchanged and may result from adaptation to local ecologies. We conclude that CAHG material culture and specialized lexicon reflect a long evolutionary history in Central Africa. Genome-wide analyses reveal a deep history of musical instruments and specialized vocabulary among Central African hunter-gatherers and the long-term cultural interconnectivity of these groups before and after the Bantu expansion.
{"title":"Deep history of cultural and linguistic evolution among Central African hunter-gatherers","authors":"Cecilia Padilla-Iglesias, Javier Blanco-Portillo, Bogdan Pricop, Alexander G. Ioannidis, Balthasar Bickel, Andrea Manica, Lucio Vinicius, Andrea Bamberg Migliano","doi":"10.1038/s41562-024-01891-y","DOIUrl":"10.1038/s41562-024-01891-y","url":null,"abstract":"Human evolutionary history in Central Africa reflects a deep history of population connectivity. However, Central African hunter-gatherers (CAHGs) currently speak languages acquired from their neighbouring farmers. Hence it remains unclear which aspects of CAHG cultural diversity results from long-term evolution preceding agriculture and which reflect borrowing from farmers. On the basis of musical instruments, foraging tools, specialized vocabulary and genome-wide data from ten CAHG populations, we reveal evidence of large-scale cultural interconnectivity among CAHGs before and after the Bantu expansion. We also show that the distribution of hunter-gatherer musical instruments correlates with the oldest genomic segments in our sample predating farming. Music-related words are widely shared between western and eastern groups and likely precede the borrowing of Bantu languages. In contrast, subsistence tools are less frequently exchanged and may result from adaptation to local ecologies. We conclude that CAHG material culture and specialized lexicon reflect a long evolutionary history in Central Africa. Genome-wide analyses reveal a deep history of musical instruments and specialized vocabulary among Central African hunter-gatherers and the long-term cultural interconnectivity of these groups before and after the Bantu expansion.","PeriodicalId":19074,"journal":{"name":"Nature Human Behaviour","volume":null,"pages":null},"PeriodicalIF":21.4,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41562-024-01891-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141156708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-27DOI: 10.1038/s41562-024-01899-4
Patricia L. Lockwood, Jo Cutler, Daniel Drew, Ayat Abdurahman, Deva Sanjeeva Jeyaretna, Matthew A. J. Apps, Masud Husain, Sanjay G. Manohar
Ventromedial prefrontal cortex (vmPFC) is vital for decision-making. Functional neuroimaging links vmPFC to processing rewards and effort, while parallel work suggests vmPFC involvement in prosocial behaviour. However, the necessity of vmPFC for these functions is unknown. Patients with rare focal vmPFC lesions (n = 25), patients with lesions elsewhere (n = 15) and healthy controls (n = 40) chose between rest and exerting effort to earn rewards for themselves or another person. vmPFC damage decreased prosociality across behavioural and computational measures. vmPFC patients earned less, discounted rewards by effort more, and exerted less force when another person benefited, compared to both control groups. Voxel-based lesion mapping revealed dissociations between vmPFC subregions. While medial damage led to antisocial behaviour, lateral damage increased prosocial behaviour relative to patients with damage elsewhere. vmPFC patients also showed reduced effort sensitivity overall, but reward sensitivity was limited to specific subregions. These results reveal multiple causal contributions of vmPFC to prosocial behaviour, effort and reward. By combining advanced mathematical modelling with data from a rare sample of patients with brain damage, the authors show that a specific part of the brain in the ventromedial prefrontal cortex is associated with putting in effort to help other people.
{"title":"Human ventromedial prefrontal cortex is necessary for prosocial motivation","authors":"Patricia L. Lockwood, Jo Cutler, Daniel Drew, Ayat Abdurahman, Deva Sanjeeva Jeyaretna, Matthew A. J. Apps, Masud Husain, Sanjay G. Manohar","doi":"10.1038/s41562-024-01899-4","DOIUrl":"10.1038/s41562-024-01899-4","url":null,"abstract":"Ventromedial prefrontal cortex (vmPFC) is vital for decision-making. Functional neuroimaging links vmPFC to processing rewards and effort, while parallel work suggests vmPFC involvement in prosocial behaviour. However, the necessity of vmPFC for these functions is unknown. Patients with rare focal vmPFC lesions (n = 25), patients with lesions elsewhere (n = 15) and healthy controls (n = 40) chose between rest and exerting effort to earn rewards for themselves or another person. vmPFC damage decreased prosociality across behavioural and computational measures. vmPFC patients earned less, discounted rewards by effort more, and exerted less force when another person benefited, compared to both control groups. Voxel-based lesion mapping revealed dissociations between vmPFC subregions. While medial damage led to antisocial behaviour, lateral damage increased prosocial behaviour relative to patients with damage elsewhere. vmPFC patients also showed reduced effort sensitivity overall, but reward sensitivity was limited to specific subregions. These results reveal multiple causal contributions of vmPFC to prosocial behaviour, effort and reward. By combining advanced mathematical modelling with data from a rare sample of patients with brain damage, the authors show that a specific part of the brain in the ventromedial prefrontal cortex is associated with putting in effort to help other people.","PeriodicalId":19074,"journal":{"name":"Nature Human Behaviour","volume":null,"pages":null},"PeriodicalIF":21.4,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41562-024-01899-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141156730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-27DOI: 10.1038/s41562-024-01906-8
Marlen Z. Gonzalez, Marissa A. Rice
Behavioural scientists want to see more consideration of context — so why are they not using tools derived from ecology, the science of all life in context? We invite behavioural scientists to align the science of human behaviour with that of behavioural ecology.
{"title":"Behavioural sciences need behavioural ecology","authors":"Marlen Z. Gonzalez, Marissa A. Rice","doi":"10.1038/s41562-024-01906-8","DOIUrl":"10.1038/s41562-024-01906-8","url":null,"abstract":"Behavioural scientists want to see more consideration of context — so why are they not using tools derived from ecology, the science of all life in context? We invite behavioural scientists to align the science of human behaviour with that of behavioural ecology.","PeriodicalId":19074,"journal":{"name":"Nature Human Behaviour","volume":null,"pages":null},"PeriodicalIF":21.4,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141156691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-24DOI: 10.1038/s41562-024-01889-6
Kevin H. Wilson, Rebecca A. Johnson, Chrysanthi Hatzimasoura, Robert P. Holman, Ryan T. Moore, David Yokum
To better connect non-emergent 911 callers to appropriate care, Washington, DC, routed low-acuity callers to nurses. Nurses could provide non-emergent transportation to a health centre, recommend self-care or return callers to the traditional 911 system. Over about one year, 6,053 callers were randomized (1:1) to receive a business-as-usual response (ncontrol = 3,023) or further triage (ntreatment = 3,030). We report on seven of nine outcomes, which were pre-registered ( https://osf.io/xderw ). The proportion of calls resulting in an ambulance dispatch dropped from 97% to 56% (β = −1.216 (−1.324, −1.108), P < 0.001), and those resulting in an ambulance transport dropped from 73% to 45% (β = −3.376 (−3.615, −3.137), P < 0.001). Among those callers who were Medicaid beneficiaries, within 24 hours, the proportion of calls resulting in an emergency department visit for issues classified as non-emergent or primary care physician (PCP) treatable dropped from 29.5% to 25.1% (β = −0.230 (−0.391, −0.069), P < 0.001), and the proportion resulting in the caller visiting a PCP rose from 2.5% to 8.2% (β = 1.252 (0.889, 1.615), P < 0.001). Over the longer time span of six months, we failed to detect evidence of impacts on emergency department visits, PCP visits or Medicaid expenditures. From a safety perspective, 13 callers randomized to treatment were eventually diagnosed with a time-sensitive illness, all of whom were quickly triaged to an ambulance response. These short-term effects suggest that nurse-led triage of non-emergent calls can safely connect callers to more appropriate, timely care. A randomized controlled trial of a nurse-led 911 triage programme in Washington, DC, by Wilson et al. finds that the programme improves the use of ambulance services and helps connect non-emergency callers with primary care.
{"title":"A randomized controlled trial evaluating the effects of nurse-led triage of 911 calls","authors":"Kevin H. Wilson, Rebecca A. Johnson, Chrysanthi Hatzimasoura, Robert P. Holman, Ryan T. Moore, David Yokum","doi":"10.1038/s41562-024-01889-6","DOIUrl":"10.1038/s41562-024-01889-6","url":null,"abstract":"To better connect non-emergent 911 callers to appropriate care, Washington, DC, routed low-acuity callers to nurses. Nurses could provide non-emergent transportation to a health centre, recommend self-care or return callers to the traditional 911 system. Over about one year, 6,053 callers were randomized (1:1) to receive a business-as-usual response (ncontrol = 3,023) or further triage (ntreatment = 3,030). We report on seven of nine outcomes, which were pre-registered ( https://osf.io/xderw ). The proportion of calls resulting in an ambulance dispatch dropped from 97% to 56% (β = −1.216 (−1.324, −1.108), P < 0.001), and those resulting in an ambulance transport dropped from 73% to 45% (β = −3.376 (−3.615, −3.137), P < 0.001). Among those callers who were Medicaid beneficiaries, within 24 hours, the proportion of calls resulting in an emergency department visit for issues classified as non-emergent or primary care physician (PCP) treatable dropped from 29.5% to 25.1% (β = −0.230 (−0.391, −0.069), P < 0.001), and the proportion resulting in the caller visiting a PCP rose from 2.5% to 8.2% (β = 1.252 (0.889, 1.615), P < 0.001). Over the longer time span of six months, we failed to detect evidence of impacts on emergency department visits, PCP visits or Medicaid expenditures. From a safety perspective, 13 callers randomized to treatment were eventually diagnosed with a time-sensitive illness, all of whom were quickly triaged to an ambulance response. These short-term effects suggest that nurse-led triage of non-emergent calls can safely connect callers to more appropriate, timely care. A randomized controlled trial of a nurse-led 911 triage programme in Washington, DC, by Wilson et al. finds that the programme improves the use of ambulance services and helps connect non-emergency callers with primary care.","PeriodicalId":19074,"journal":{"name":"Nature Human Behaviour","volume":null,"pages":null},"PeriodicalIF":21.4,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-24DOI: 10.1038/s41562-024-01875-y
Debadayita Raha, Katherine Sian Davies-Vollum, Sarah L. Hemstock, Isaac Boateng, Mohammed Tariqul Islam, Charles A. E. Pierce
Coastal communities across the globe are faced with multifaceted, interconnected challenges with competing environmental, social and economic needs. In rural coastal communities of the Global South, the challenges presented by climate change are complicated by those related to development, resource management and sustainable livelihoods. The rapid growth of such coastal communities exacerbates these challenges and reinforces the need for effective and sustainable governance. Such governance requires a move from top-down approaches to human-centred approaches. Human-centred coastal governance engages multiple stakeholders and combines multidisciplinary knowledge, participatory approaches, co-creation of solutions and multi-institutional partnerships. Here we present case studies from coastal communities in Vanuatu, Ghana and Bangladesh. These illustrate several of the complex challenges facing such communities and the collaborative and empowering strategies that have been used to meet them. Based on these case studies, we present a transdisciplinary framework to inform the co-creation of coastal management strategies that meet interconnected human and environmental needs. Coastal communities are growing rapidly and face the challenge of climate change with its implications for resource and livelihood sustainability. Raha et al. advocate for collaboration and co-creation of solutions to mitigate these urgent issues.
{"title":"We need collaboration and co-creation to address challenges facing coastal communities","authors":"Debadayita Raha, Katherine Sian Davies-Vollum, Sarah L. Hemstock, Isaac Boateng, Mohammed Tariqul Islam, Charles A. E. Pierce","doi":"10.1038/s41562-024-01875-y","DOIUrl":"10.1038/s41562-024-01875-y","url":null,"abstract":"Coastal communities across the globe are faced with multifaceted, interconnected challenges with competing environmental, social and economic needs. In rural coastal communities of the Global South, the challenges presented by climate change are complicated by those related to development, resource management and sustainable livelihoods. The rapid growth of such coastal communities exacerbates these challenges and reinforces the need for effective and sustainable governance. Such governance requires a move from top-down approaches to human-centred approaches. Human-centred coastal governance engages multiple stakeholders and combines multidisciplinary knowledge, participatory approaches, co-creation of solutions and multi-institutional partnerships. Here we present case studies from coastal communities in Vanuatu, Ghana and Bangladesh. These illustrate several of the complex challenges facing such communities and the collaborative and empowering strategies that have been used to meet them. Based on these case studies, we present a transdisciplinary framework to inform the co-creation of coastal management strategies that meet interconnected human and environmental needs. Coastal communities are growing rapidly and face the challenge of climate change with its implications for resource and livelihood sustainability. Raha et al. advocate for collaboration and co-creation of solutions to mitigate these urgent issues.","PeriodicalId":19074,"journal":{"name":"Nature Human Behaviour","volume":null,"pages":null},"PeriodicalIF":29.9,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141091921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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