Emily Y. Cohen

Hypertension is a leading cause of premature mortality in Tanzania, but low trust and awareness of biomedical healthcare and prioritization of spiritual over physical health hinders uptake of care. Religious leaders are highly respected community members and are eager to collaborate with health professionals. Few community health worker training programs utilize evidence-based pedagogical recommendations in combination with theology specific to their students’ backgrounds. Our team of health research professionals and religious leaders developed a curriculum to teach local religious leaders to address and screen their communities for hypertension. We use a Community Based Participatory Research framework and evidence-based educational strategies (Kern’s framework for medical education, Bloom’s learning domains, and Knowles adult learning principles) to build a curriculum optimized to partner with religious leaders. Previously assessed attitudes toward and knowledge of hypertension in the community determined objectives and content, and religious leaders on the team determined appropriate religious aspects to incorporate. Through an evidence-based process, we hope to maximize efficacy of the intervention. Recognizing religious leaders as unique learners, we utilize well-tested educational theory and strategies to create a comprehensive curriculum prioritizing student input. The curriculum aligns with adult learning theories, is culturally tailored to meet the needs of the communities involved and equips religious leaders to promote blood pressure management through screening and lifestyle interventions. The curriculum addresses healthcare through a religious lens, fostering trust between healthcare professionals, patients, and religious leaders through interdisciplinary collaboration.

Glaucoma is the leading cause of irreversible blindness worldwide, with elevated intraocular pressure (IOP) as the only known modifiable risk factor. Trabecular meshwork (TM)-inducible myocilin (the MYOC gene) was the first to be identified and linked to juvenile and primary open-angle glaucoma. It has been suggested that mutations in the MYOC gene and the aggregation of mutant myocilin in the endoplasmic reticulum (ER) of TM may cause ER stress, resulting in a reduced outflow of aqueous humor and an increase in IOP. We selected 20 MYOC mutations with experimentally determined melting temperatures of mutated myocilin proteins. We included 40 published studies with at least one glaucoma patient with one of these 20 MYOC mutations and information on age at glaucoma diagnosis. Based on data from 458 patients, we found that a statistically significant but weak correlation was present between age and melting temperature based on various assumptions for age. We therefore conclude that genetic analysis of MYOC mutations alone cannot be used to accurately predict age at glaucoma diagnosis. However, it might be an important prognostic factor combined with other clinical factors for critical and early detection of glaucoma.