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3.
Am J Clin Nutr ; 112(3): 721-769, 2020 09 01.
Article in English | MEDLINE | ID: covidwho-657560

ABSTRACT

BACKGROUND: The US faces remarkable food and nutrition challenges. A new federal effort to strengthen and coordinate nutrition research could rapidly generate the evidence base needed to address these multiple national challenges. However, the relevant characteristics of such an effort have been uncertain. OBJECTIVES: Our aim was to provide an objective, informative summary of 1) the mounting diet-related health burdens facing our nation and corresponding economic, health equity, national security, and sustainability implications; 2) the current federal nutrition research landscape and existing mechanisms for its coordination; 3) the opportunities for and potential impact of new fundamental, clinical, public health, food and agricultural, and translational scientific discoveries; and 4) the various options for further strengthening and coordinating federal nutrition research, including corresponding advantages, disadvantages, and potential executive and legislative considerations. METHODS: We reviewed government and other published documents on federal nutrition research; held various discussions with expert groups, advocacy organizations, and scientific societies; and held in-person or phone meetings with >50 federal staff in executive and legislative roles, as well as with a variety of other stakeholders in academic, industry, and nongovernment organizations. RESULTS: Stark national nutrition challenges were identified. More Americans are sick than are healthy, largely from rising diet-related illnesses. These conditions create tremendous strains on productivity, health care costs, health disparities, government budgets, US economic competitiveness, and military readiness. The coronavirus disease 2019 (COVID-19) outbreak has further laid bare these strains, including food insecurity, major diet-related comorbidities for poor outcomes from COVID-19 such as diabetes, hypertension, and obesity, and insufficient surveillance on and coordination of our food system. More than 10 federal departments and agencies currently invest in critical nutrition research, yet with relatively flat investments over several decades. Coordination also remains suboptimal, documented by multiple governmental reports over 50 years. Greater harmonization and expansion of federal investment in nutrition science, not a silo-ing or rearrangement of existing investments, has tremendous potential to generate new discoveries to improve and sustain the health of all Americans. Two identified key strategies to achieve this were as follows: 1) a new authority for robust cross-governmental coordination of nutrition research and other nutrition-related policy and 2) strengthened authority, investment, and coordination for nutrition research within the NIH. These strategies were found to be complementary, together catalyzing important new science, partnerships, coordination, and returns on investment. Additional complementary actions to accelerate federal nutrition research were identified at the USDA. CONCLUSIONS: The need and opportunities for strengthened federal nutrition research are clear, with specific identified options to help create the new leadership, strategic planning, coordination, and investment the nation requires to address the multiple nutrition-related challenges and grasp the opportunities before us.


Subject(s)
Coronavirus Infections/complications , Nutrition Disorders/complications , Nutritional Physiological Phenomena , Pneumonia, Viral/complications , Research/standards , Cost of Illness , Health Care Costs , Healthcare Disparities/economics , Humans , Military Personnel , National Institutes of Health (U.S.)/economics , Nutrition Disorders/economics , Nutrition Disorders/epidemiology , Pandemics , United States/epidemiology , United States Department of Agriculture/economics , United States Dept. of Health and Human Services/economics
8.
Healthc Policy ; 16(1): 112-124, 2020 08.
Article in English | MEDLINE | ID: covidwho-722914

ABSTRACT

To inform Canada's research response to COVID-19, the Canadian Institutes of Health Research's Institute of Health Services and Policy Research (IHSPR) conducted a rapid-cycle priority identification process. Seven COVID-19 priorities for health services and policy research were identified: system adaptation and organization of care; resource allocation decision-making and ethics; rapid synthesis and comparative policy analysis of the COVID-19 response and outcomes; healthcare workforce; virtual care; long-term consequences of the pandemic; and public and patient engagement. Three additional cross-cutting themes were identified: supporting the health of Indigenous Peoples and vulnerable populations, data and digital infrastructure, and learning health systems and knowledge platforms. IHSPR hopes these research priorities will contribute to the broader ecosystem for collective research investment and action.


Subject(s)
Coronavirus Infections/prevention & control , Delivery of Health Care/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Research , Canada/epidemiology , Coronavirus Infections/epidemiology , Health Policy , Health Services Research , Humans , Pneumonia, Viral/epidemiology
10.
J Cell Sci ; 133(15)2020 08 14.
Article in English | MEDLINE | ID: covidwho-721359

ABSTRACT

The COVID-19 pandemic has disrupted traditional modes of scientific communication. In-person conferences and seminars have been cancelled and most scientists around the world have been confined to their homes. Although challenging, this situation has presented an opportunity to adopt new ways to communicate science and build scientific relationships within a digital environment, thereby reducing the environmental impact and increasing the inclusivity of scientific events. As a group of researchers who have recently created online seminar series for our respective research communities, we have come together to share our experiences and insights. Only a few weeks into this process, and often learning 'on the job', we have collectively encountered different problems and solutions. Here, we share our advice on formats and tools, security concerns, spreading the word to your community and creating a diverse, inclusive and collegial space online. We hope our experience will help others launch their own online initiatives, helping to shape the future of scientific communication as we move past the current crisis.


Subject(s)
Congresses as Topic , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Science , Virtual Reality , Computer Security , Humans , Online Social Networking , Research
11.
Cell ; 181(6): 1189-1193, 2020 06 11.
Article in English | MEDLINE | ID: covidwho-720440

ABSTRACT

Researchers around the globe have been mounting, accelerating, and redeploying efforts across disciplines and organizations to tackle the SARS-CoV-2 outbreak. However, humankind continues to be afflicted by numerous other devastating diseases in increasing numbers. Here, we outline considerations and opportunities toward striking a good balance between maintaining and redefining research priorities.


Subject(s)
Biomedical Research , Coronavirus Infections , Pandemics , Pneumonia, Viral , Biomedical Research/economics , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/prevention & control , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/prevention & control , Data Science/instrumentation , Data Science/methods , Delivery of Health Care , Humans , Inventions , Metabolic Diseases/diagnosis , Metabolic Diseases/drug therapy , Metabolic Diseases/prevention & control , Neoplasms/diagnosis , Neoplasms/drug therapy , Neoplasms/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/drug therapy , Pneumonia, Viral/prevention & control , Research
12.
Am J Public Health ; 110(9): 1369-1370, 2020 09.
Article in English | MEDLINE | ID: covidwho-713833
14.
Matern Child Health J ; 24(9): 1093-1098, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-706005

ABSTRACT

The coronavirus 2019 (COVID-19) pandemic and related policies have led to an unequal distribution of morbidity and mortality in the U.S. For Black women and birthing people, endemic vulnerabilities and disparities may exacerbate deleterious COVID-19 impacts. Historical and ongoing macro-level policies and forces over time have induced disproportionately higher rates of maternal morbidity and mortality among Black women and birthing people, and contemporary macroeconomic and healthcare policies and factors continue to hold particular consequence. These factors induce detrimental psychological, health, and behavioral responses that contribute to maternal health disparities. The COVID-19 pandemic is likely to disproportionately impact Black women and birthing people, as policy responses have failed to account for the their unique socioeconomic and healthcare contexts. The resulting consequences may form a 'vicious cycle', with upstream impacts that exacerbate upstream macro-level policies and forces that can further perpetuate the clustering of maternal morbidity and mortality in this population. Understanding the impacts of COVID-19 among Black women and birthing people requires theoretical frameworks that can sufficiently conceptualize their multi-level, interacting, and dynamic nature. Thus, we advocate for the proliferation of syndemic perspectives to guide maternal disparities research and prevention during the COVID-19 pandemic. These perspectives can enable a holistic and nuanced understanding of the intersection of endemic and COVID-19-specific vulnerabilities and disparities experienced by Black women and birthing people. Syndemic-informed research can then lead to impactful multi-level prevention strategies that simultaneously tackle both endemic and COVID-19-specific factors and outcomes that lead to the clustering of vulnerabilities and disparities over time.


Subject(s)
African Continental Ancestry Group/statistics & numerical data , Coronavirus Infections/prevention & control , Coronavirus , Health Services Accessibility/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , African Americans/statistics & numerical data , Betacoronavirus , Comorbidity , Coronavirus Infections/epidemiology , Female , Health Status Disparities , Healthcare Disparities/ethnology , Humans , Maternal Health , Maternal Mortality , Morbidity , Pneumonia, Viral/epidemiology , Population Surveillance , Research , Socioeconomic Factors , Syndemic , United States/epidemiology
15.
HIV Med ; 21(8): 536-540, 2020 09.
Article in English | MEDLINE | ID: covidwho-707537

ABSTRACT

The unprecedented global scale of COVID-19 globally has triggered a race to discover interventions to reduce associated morbidity and mortality and rapid release of research findings prior to any degree of critical review. As with previous novel infection outbreaks, antiretrovirals are just one drug class that has been held up as a potential strategy for prophylaxis and treatment with scant evidence and risk of harm. Here we summarize the evidence for antiretrovirals to treat COVID-19 and, as a drug that has also been studied in HIV, hydroxychloroquine, and flag some of the pitfalls of using therapies that have not been evaluated robustly.


Subject(s)
Anti-Retroviral Agents/therapeutic use , Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Drug Repositioning , Pneumonia, Viral/drug therapy , Research/standards , Coronavirus Infections/prevention & control , Drug Combinations , Drug Repositioning/standards , Drug Repositioning/trends , Humans , Hydroxychloroquine/therapeutic use , Lopinavir/therapeutic use , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Research/trends , Ritonavir/therapeutic use , Tenofovir/therapeutic use , Time Factors
17.
BMJ Glob Health ; 5(7)2020 07.
Article in English | MEDLINE | ID: covidwho-690906

ABSTRACT

INTRODUCTION: In March 2020, the WHO released a Global Research Roadmap in an effort to coordinate and accelerate the global research response to combat COVID-19 based on deliberations of 400 experts across the world. Three months on, the disease and our understanding have both evolved significantly. As we now tackle a pandemic in very different contexts and with increased knowledge, we sought to build on the work of the WHO to gain a more current and global perspective on these initial priorities. METHODS: We undertook a mixed methods study seeking the views of the global research community to (1) assess which of the early WHO roadmap priorities are still most pressing; (2) understand whether they are still valid in different settings, regions or countries; and (3) identify any new emerging priorities. RESULTS: Thematic analysis of the significant body of combined data shows the WHO roadmap is globally relevant; however, new important priorities have emerged, in particular, pertinent to low and lower middle-income countries (less resourced countries), where health systems are under significant competing pressures. We also found a shift from prioritising vaccine and therapeutic development towards a focus on assessing the effectiveness, risks, benefits and trust in the variety of public health interventions and measures. Our findings also provide insight into temporal nature of these research priorities, highlighting the urgency of research that can only be undertaken within the period of virus transmission, as well as other important research questions but which can be answered outside the transmission period. Both types of studies are key to help combat this pandemic but also importantly to ensure we are better prepared for the future. CONCLUSION: We hope these findings will help guide decision-making across the broad research system including the multilateral partners, research funders, public health practitioners, clinicians and civil society.


Subject(s)
Biomedical Research , Coronavirus Infections , Global Health , Pandemics , Pneumonia, Viral , Research , Betacoronavirus , Biomedical Research/methods , Biomedical Research/organization & administration , Biomedical Research/standards , Humans
20.
Matern Child Health J ; 24(9): 1093-1098, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-659750

ABSTRACT

The coronavirus 2019 (COVID-19) pandemic and related policies have led to an unequal distribution of morbidity and mortality in the U.S. For Black women and birthing people, endemic vulnerabilities and disparities may exacerbate deleterious COVID-19 impacts. Historical and ongoing macro-level policies and forces over time have induced disproportionately higher rates of maternal morbidity and mortality among Black women and birthing people, and contemporary macroeconomic and healthcare policies and factors continue to hold particular consequence. These factors induce detrimental psychological, health, and behavioral responses that contribute to maternal health disparities. The COVID-19 pandemic is likely to disproportionately impact Black women and birthing people, as policy responses have failed to account for the their unique socioeconomic and healthcare contexts. The resulting consequences may form a 'vicious cycle', with upstream impacts that exacerbate upstream macro-level policies and forces that can further perpetuate the clustering of maternal morbidity and mortality in this population. Understanding the impacts of COVID-19 among Black women and birthing people requires theoretical frameworks that can sufficiently conceptualize their multi-level, interacting, and dynamic nature. Thus, we advocate for the proliferation of syndemic perspectives to guide maternal disparities research and prevention during the COVID-19 pandemic. These perspectives can enable a holistic and nuanced understanding of the intersection of endemic and COVID-19-specific vulnerabilities and disparities experienced by Black women and birthing people. Syndemic-informed research can then lead to impactful multi-level prevention strategies that simultaneously tackle both endemic and COVID-19-specific factors and outcomes that lead to the clustering of vulnerabilities and disparities over time.


Subject(s)
African Continental Ancestry Group/statistics & numerical data , Coronavirus Infections/prevention & control , Coronavirus , Health Services Accessibility/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , African Americans/statistics & numerical data , Betacoronavirus , Comorbidity , Coronavirus Infections/epidemiology , Female , Health Status Disparities , Healthcare Disparities/ethnology , Humans , Maternal Health , Maternal Mortality , Morbidity , Pneumonia, Viral/epidemiology , Population Surveillance , Research , Socioeconomic Factors , Syndemic , United States/epidemiology
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