Mainstreaming nus for nutrition-sensitive agriculture: A holistic approach

Bioversity International and the International Fund for Agricultural Development (IFAD) have recently published an operational framework to guide practitioners on ways to mainstream neglected and underutilized species (NUS) into projects and investment programs with the aim of supporting nutrition-sensitive agriculture and resilient food production systems. This chapter presents the key elements of this framework and offers reflections on its implementation following Bioversity International’s innovative holistic value-chain approach, which, through interdisciplinary, bottom-up and gender-sensitive interventions, aims at strengthening the resilience of livelihoods as a whole, with special attention given to women, youth, Indigenous Peoples and other marginalized members of society. Actions meant to increase the use of NUS to strengthen the resilience of communities in the face of the recent COVID-19 pandemic are also proposed. © 2022 selection and editorial matter, Stefano Padulosi, E.D. Israel Oliver King, Danny Hunter and M.S. Swaminathan.

Multimodal surveillance of SARS-CoV-2 at a university enables development of a robust outbreak response framework.

BACKGROUND: Universities are vulnerable to infectious disease outbreaks, making them ideal environments to study transmission dynamics and evaluate mitigation and surveillance measures. Here, we analyze multimodal COVID-19-associated data collected during the 2020-2021 academic year at Colorado Mesa University and introduce a SARS-CoV-2 surveillance and response framework. METHODS: We analyzed epidemiological and sociobehavioral data (demographics, contact tracing, and WiFi-based co-location data) alongside pathogen surveillance data (wastewater and diagnostic testing, and viral genomic sequencing of wastewater and clinical specimens) to characterize outbreak dynamics and inform policy. We applied relative risk, multiple linear regression, and social network assortativity to identify attributes or behaviors associated with contracting SARS-CoV-2. To characterize SARS-CoV-2 transmission, we used viral sequencing, phylogenomic tools, and functional assays. FINDINGS: Athletes, particularly those on high-contact teams, had the highest risk of testing positive. On average, individuals who tested positive had more contacts and longer interaction durations than individuals who never tested positive. The distribution of contacts per individual was overdispersed, although not as overdispersed as the distribution of phylogenomic descendants. Corroboration via technical replicates was essential for identification of wastewater mutations. CONCLUSIONS: Based on our findings, we formulate a framework that combines tools into an integrated disease surveillance program that can be implemented in other congregate settings with limited resources. FUNDING: This work was supported by the National Science Foundation, the Hertz Foundation, the National Institutes of Health, the Centers for Disease Control and Prevention, the Massachusetts Consortium on Pathogen Readiness, the Howard Hughes Medical Institute, the Flu Lab, and the Audacious Project.

Effects of COVID-19 on Patients in Adult Ambulatory Psychiatry: Using Patient-Rated Outcome Measures and Telemedicine.

Introduction: To examine the effects of coronavirus disease 2019 (COVID-19) on patients in an academic psychiatric ambulatory clinic, data from a measurement-based care (MBC) system were analyzed to evaluate impacts on psychiatric functioning in patients using telemedicine. Psychiatric functioning was evaluated for psychological distress (brief adjustment scale [BASE]-6), depression (patient health questionnaire [PHQ]-9), and anxiety (generalized anxiety disorder [GAD]-7), including initial alcohol (U.S. alcohol use disorders identification test) and substance use (drug abuse screening test-10) screening. Methods: This observational study included MBC data collected from November 2019 to March 2021. Patient-Reported Outcome Measures (PROMs) were examined to determine changes in symptomatology over the course of treatment, as well as symptom changes resulting from the pandemic. Patients were included in analyses if they completed at least one PROM in the MBC system. Results: A total of 2,145 patients actively participated in the MBC system completing at least one PROM, with engagement ranging from 35.07% to 83.50% depending on demographic factors, where completion rates were significantly different for age, payor status, and diagnostic group. Average baseline scores for new patients varied for the GAD-7, PHQ-9, and BASE-6. Within-person improvements in mental health before and after the pandemic were statistically significant for anxiety, depression, and psychological adjustment. Discussion: MBC is a helpful tool in determining treatment progress for patients engaging in telemedicine. This study showed that patients who engaged in psychiatric services incorporating PROMs had improvements in mental health during the COVID-19 pandemic. Additional research is needed exploring whether PROMs might serve as a protective or facilitative factor for those with mental illness during a crisis when in-person visits are not possible.

New technologies in pediatric ophthalmology: a view from the inside

Purpose/Relevance: New technologies are rapidly emerging in all fields, especially in the COVID-19 era, including pediatric ophthalmology. These technologies are widely disseminated in diverse areas such as screening, diagnostics, treatment, device production, genetics, and artificial intelligence. Some provide low-cost, simple solutions to common problems, whereas others, are expensive and complex. The speakers will present several technologies, including retinal polarizing scanning for screening of amblyopia and traumatic brain injury, smart phone photo screening for amblyopia risk factors, artificial intelligence, optical coherence tomography angiography, handheld OCT, gene therapy, and eye tracking technology for diagnostics and treatment of amblyopia. Target Audience: Pediatric and comprehensive ophthalmologists, orthoptists, residents, and students. Current Practice: Technologies are rapidly evolving, making it difficult to stay updated and exposed to all the innovations. Some clinicians are eager to explore new concepts, some may have limited exposure, whereas others may refrain from utilizing up-and-coming new technologies. Best Practice: Understanding the limitations and benefits of new technologies and bringing basic scientific knowledge and better solutions to existing clinical challenges in order to fulfill unmet diagnostic and therapeutical needs. The presenters will summarize seven technologies, which will focus on providing affordable screening as well as high-volume and high-quality eye care and innovative technologies. Expected Outcomes: The audience will be exposed to an in-depth analysis of new technological modalities in screening, informatics, diagnostics, and treatment options in pediatric ophthalmology. Format: The workshop will include an overview of different clinically available technologies pertaining to pediatric ophthalmology. Each speaker, either an innovator or at the center of development or dissemination of these technologies, will provide a didactic lecture that will be followed by questions from the panel and audience, along with a discussion on the technologies' effectiveness and clinical relevance. Summary: In a rapidly changing world of technologies,and healthcare, this workshop will provide an overview of several existing innovations in pediatric ophthalmology.

The impact of age demographics on interpreting and applying population-wide infection fatality rates for COVID-19

The ongoing coronavirus disease 2019 (COVID-19) pandemic affects the Canadian Armed Forces (CAF) and its members in multiple ways. As the CAF manages its own healthcare system for its members, it must consider the impact of COVID-19 not only on the operational effectiveness of its workforce but also on its healthcare operations. Furthermore, given that the CAF has deployed task forces in support of other government departments, including into long-term care facilities that are experiencing outbreaks, it is important for the CAF to maintain situational awareness of the outbreak in the Canadian population generally. In providing analytical support to the CAF on these questions, we focused on establishing the applicability of estimates of COVID-19 infection fatality rates (IFRs) from the literature to the CAF and to the Canadian public. This paper explores how the age-dependent effects of COVID-19 must be taken into account when comparing estimates based on countries with very different age profiles, such as China and Italy. Furthermore, it explores how varying age structures within a country (e.g., within a subnational jurisdiction, or within a given working population) should affect how analysts apply estimates of IFR to scenarios involving those specific populations. Copyright: © 2021 Her Majesty the Queen in Right of Canada, Department of National Defence

The OARSI “joint effort initiative” repository of online osteoarthritis management programmes: an implementation rapid response during covid-19

Purpose: 1) To collate into a repository, best-evidence online osteoarthritis management programmes (OAMPS), and 2) facilitate their implementation, in the context of the COVID-19 pandemic.The Osteoarthritis Research Society International Joint Effort Initiative (OARSI JEI) is a collaboration between international researchers, clinicians and knowledge brokers with an interest in the implementation of OAMPS. OAMPs are defined by the OARSI JEI as “models of evidence-based, non-surgical care that have been implemented in a real world setting and include the following four components: personalised OA care;delivered as a package of care with longitudinal reassessment and progression;comprising two or more elements of the core non-surgical, non-pharmacological interventions (education, exercise and weight loss);with optional adjunct treatments as required (e.g. assistive devices and psychosocial support)”. In 2020, COVID-19 presented a major barrier to the clinical delivery of traditional “in-person” OAMPS. In response, the OARSI JEI implementation group sought to create a repository resource for healthcare professionals (HCPs) seeking to access and signpost patients with OA to online, high-quality OAMPS. The resource also provided access to online HCP training. Methods: An existing community of practice (OARSI JEI implementation group) with access to patient and public involvement, was utilised to create and share an evidence-informed online OAMP repository via social media and OARSI networks. The project involved 5 key stages. Online OAMPS resource investigation: International research, implementation and HCP experts from the JEI implementation group (n=32) were invited to send all online OAMP resources that they were aware of to the reviewers (LS, JQ). These were captured in a spreadsheet with data extracted on programme name;country of origin;whether the resource targeted patients or HCPs;access details relating to required technology, sign in and any access costs;weblink;brief programme content summary;OARSI expert advocating for the programme quality (including whether the content is evidence informed). Screening for repository inclusion: Two reviewers (JQ, LS) screened the resources received against inclusion criteria (matching the OAMP definition, remotely deliverable via the internet, OARSI expert endorsed). Disagreements were resolved through discussion. Creating the online OA repository resource: Academics (JQ, LS, KD) provided content and feedback for a knowledge broker (LC) to create a pdf repository containing included online OAMP information, weblinks and summary information in the form of an infographic. Rapid social media knowledge mobilisation: The repository resource was initially hosted on the Keele Impact Accelerator Unit website and shared on completion with existing OARSI member JEI networks via social media (Twitter)(LC). Owners of online OAMPS also promoted their own programmes via social media. Reflection and learning: Project method strengths and limitations were discussed, critiqued and captured during an OARSI JEI community of practice meeting. Results: The final OARSI online repository included 7 OAMPS and linked training resources. The online repository is available at: with ongoing plans for hosting on the OARSI website. Fig. 1 illustrates the repository cover and Fig. 2 is the infographic repository summary. A relative dearth of online OAMPS meeting our prespecified criteria were identified which included: ESCAPE pain;The Joint Academy;JIGSAW-E (for pharmacists and physiotherapists);PEAK: Join2Move;Osteoarthritis Management Healthy Weight for life. Only JIGSAW-E, PEAK and the Join2Move app were widely available free resources for HCPs at the early stage of the COVID-19 pandemic. All online OAMPs were in English except the Join2Move app which is in Dutch. Content details of the included online OAMPs and online OAMP HCP training packages are summarised in Table 1. The initial Twitter launch tweet sharing the repository infographic and repository link has had 5,679 impre sions and 334 engagements to date and has been shared globally. Reflections and limitations: There is an urgent requirement for more high-quality OAMPs to be freely available for remote delivery and in a wider range of languages. This has relevance both during the COVID pandemic and more generally for rural, geographically isolated populations and low- and middle-income countries. In reacting to an emergency, rapidly evolving, time-pressured clinical pandemic context, there was a tension in matching the highest quality methods for searching, evaluating and synthesising online OAMPs in the shortest possible time. For example, full systematic review methods were deemed inappropriate and the project was not explicitly informed a-priori by a protocol or knowledge mobilisation theory, however, members of the team had knowledge mobilisation expertise. It is possible that we did not identify all online OAMPs. For example, no online OAMPS from South America, Africa or Asia were identified which may, in part, be explained by the geographical representation within the community of practice, with participants mostly from Europe, North America and Australasia. It is acknowledged that the pragmatic and rapid OAMP resource identification, screening and knowledge mobilisation from this project does not guarantee implementation into clinical practice. The existence of the OARSI JEI implementation group facilitated the timely execution of this project whilst the use of social media allowed the repository to be shared rapidly with many stakeholders. Future plans include the hosting of the repository and future JEI work on the OARSI website (to increase resource access);the formal synthesis of knowledge mobilisation metrics relating to the online repository and included OAMPS, and;the ongoing review of repository content in the light of new OAMPS. Conclusions: The OARSI-endorsed JEI implementation group facilitated the creation of an online OAMP repository in response to the COVID-19 pandemic and need for remotely delivered care. There is a dearth of widely available and remotely deliverable OAMPs internationally. This is likely to present a significant barrier to the delivery of best OA care, especially during COVID-19. OARSI can have a key role in supporting the implementation of best OA care. There is a need to actively broaden the diversity and national representation within the JEI implementation group and increase patient and public involvement to best serve the international OA populations, particularly from low- and middle-income countries, it seeks to inform. [Formula presented] [Formula presented] [Formula presented]

From World War II to COVID-19: A Historical Perspective on the American Medical Supply Chain.

COVID-19 is the latest episode of shortages of critical medical supplies. Historically and to the present day, medical supplies have been sourced from single regions in the world, thus rendering the supply chain vulnerable to a myriad of harmful circumstances. We argue that shortages in medications related and unrelated to COVID have illustrated the need for the United States to diversify its medical supply sources before future pandemics, political crises, or natural disasters occur.