Addressing future food demand in The Gambia: can increased crop productivity and climate change adaptation close the supply-demand gap?

With rising demand for food and the threats posed by climate change, The Gambia faces significant challenges in ensuring sufficient and nutritious food for its population. To address these challenges, there is a need to increase domestic food production while limiting deforestation and land degradation. In this study, we modified the FABLE Calculator, a food and land-use system model, to focus on The Gambia to simulate scenarios for future food demand and increasing domestic food production. We considered the impacts of climate change on crops, the adoption of climate change adaptation techniques, as well as the potential of enhanced fertiliser use and irrigation to boost crop productivity, and assessed whether these measures would be sufficient to meet the projected increase in food demand. Our results indicate that domestic food production on existing cropland will not be sufficient to meet national food demand by 2050, leading to a significant supply-demand gap. However, investments in fertiliser availability and the development of sustainable irrigation infrastructure, coupled with climate change adaptation strategies like the adoption of climate-resilient crop varieties and optimised planting dates, could halve this gap. Addressing the remaining gap will require additional strategies, such as increasing imports, expanding cropland, or prioritising the production of domestic food crops over export crops. Given the critical role imports play in The Gambia's food supply, it is essential to ensure a robust flow of food imports by diversifying partners and addressing regional trade barriers. Our study highlights the urgent need for sustained investment and policy support to enhance domestic food production and food imports to secure sufficient and healthy food supplies amidst growing demand and climate change challenges. Supplementary Information: The online version contains supplementary material available at 10.1007/s12571-024-01444-1.

Changes in Climate Vulnerability and Projected Water Stress of The Gambia's Food Supply Between 1988 and 2018: Trading With Trade-Offs.

Background: The coexistence of under- and overnutrition is of increasing public health concern in The Gambia. Fruits, vegetables and pulses are essential to healthy and sustainable diets, preventing micronutrient deficiencies and non-communicable diseases, while cereals significantly contribute to energy intake. However, environmental changes are predicted to intensify, reducing future yields of these crops if agricultural productivity and resilience are not improved. The Gambia is highly climate-vulnerable and import-dependent, but the extent of its reliance on other climate-vulnerable countries for its supply of nutritionally important crops is currently unknown. Methods: We used United Nations Food and Agriculture Organization data, with novel origin-tracing algorithms applied, to analyse The Gambia's supply of cereals, fruits, vegetables and pulses between 1988 and 2018. The climate vulnerability of countries was assessed using Notre Dame Global Adaptation Initiative (ND-GAIN) index scores, and projected water stress (2040) assessed using World Resources Institute (WRI) scores. Multilevel generalized linear mixed-effects models were used to identify changes in the overall climate vulnerability and projected water stress of supply. Results: Between 1988 and 2018, The Gambia's supply of cereals, fruits, vegetables and pulses diversified, with the proportion domestically produced falling (Cereals: 61.4%-27.7%; Fruits: 93.0%-55.7%; Vegetables: 24.6%-16.3%; Pulses: 100.0%-76.0%). The weighted-average ND-GAIN scores improved (indicating less climate vulnerability) for supply of all crops except cereals, but the weighted-average WRI score for supply deteriorated (indicating increased projected water stress) for all crops except vegetables. When just considering imports, weighted-average ND-GAIN scores deteriorated for fruits and cereals while showing no significant change for other food groups, and the WRI score deteriorated for cereals only. Conclusions: Despite some notable improvements in the environmental vulnerability of The Gambia's supply of nutritionally important crops (particularly vegetables), considerable, and in some cases increasing, proportions of their supply are produced in countries that are vulnerable to climate change and future water stress. This may have implications for the availability, affordability, and hence consumption of these crops in The Gambia, ultimately exacerbating existing nutritional challenges. Exploring the options to strengthen supply resilience-such as altering trade patterns, agricultural techniques and diets-should be prioritized.

Sexual Safety for In-Patient Mental Health Care-The Democratic Diagnosis of Change.

This article discusses a co-produced qualitative understanding aimed at reducing the risk of sexual violence within mental health in-patient settings. It describes the first stages of testing a new approach which democratises organisational change as, people who use mental health services take the lead in partnership working with those who provide services. The article sets out 'TODAYICAN' (and its second-generation iteration, 'TODAYWECAN') as emerging approaches towards change. In particular, the article focusses upon the 'diagnose' component of the approach and reports findings from a mixed methods qualitative methodology. In doing so the article offers a conceptualisation of in-patient sexual safety in a mental health context drawn from the perspectives of people who use or provide in-patient services. The article also outlines where the consensus rests on what needs to change to make sexual safety an 'always event' whilst, critically analysing where the two groups differed in their views.

Assessment of novel tobacco heating product THP1.0. Part 6: A comparative in vitro study using contemporary screening approaches.

Cigarette smoking is a major risk factor for many adverse health conditions. Novel tobacco heating products (THPs) heat tobacco, reducing exposure to many of the harmful combustion toxicants in conventional cigarette emissions. In vitro studies have been employed to support the toxicological evaluation of chemicals and complex mixtures, including cigarette smoke. The use of automated robotics platforms for in vitro toxicological screening complements traditional testing approaches. Multiparametric toxicity and oxidative stress endpoints were used to assess in vitro biological responses elicited after exposure to total particulate matter (TPM) from two commercially available THPs, and the reference tobacco product 3R4F, in human bronchial epithelial cells. A luciferase-based reporter gene assay was used to assess antioxidant response element (ARE) transcriptional activation in stably transfected H292 cells after 6 and 24 h exposures. High-content screening was used to assess 10 endpoints normal human bronchial epithelial cells after 4 or 24 h exposures. 3R4F TPM stimulated significant increases in ARE activation (p < 0.005) and moderate activity in HCS cell-based assays compared to THP at comparable doses. THPs showed little or no activity in all assays. HCS techniques can extend safety assessments providing information quickly in the early stages of product innovation and development.

Risk of invasive meningococcal disease in university students in England and optimal strategies for protection using MenACWY vaccine.

PURPOSE: In August 2015, in response to increasing group W invasive meningococcal disease (IMD) nationally, a MenACWY vaccine programme was introduced in the UK for 13-18year olds. We reviewed the epidemiology of IMD in young adults and university-associated cases in England during 2014-15 academic year and assessed the potential impact of different immunisation strategies. METHODS: Public Health England national enhanced surveillance data were used to describe the epidemiology of IMD cases in 15-24year olds in England during 2014/15. Relative risks for IMD were calculated overall and by capsular group in students compared with non- student peers for 2014 and 2013 school leavers. Assuming stable future incidence and vaccine efficacy of 90% for five years, we estimated cases averted and numbers needed to vaccinate (NNV) for different MenACWY immunisation programmes: school-based adolescent, GP-based school leaver, and targeting freshers. RESULTS: Between July 2014 and June 2015, 112 IMD cases were diagnosed in those born between 01/09/1991 and 31/08/2001 (∼15 to 24year-olds). During the 2014/15 academic year (September to June), 49 IMD cases were reported among students attending English universities, including 22 among 2014 school leavers. In this cohort, the relative risk of IMD was higher among students compared to non-students for all capsular groups (RR 11.6; 95% CI 4.7-28.7) and for groups A/C/W/Y (RR 14.8; 95% CI, 4.3-51.5). A school-based programme could potentially have averted 14 cases in 2014/15 and 24 cases over five years with a lower NNV (18,000) than other programmes. CONCLUSIONS: University students, particularly first years entering direct from school, are at higher risk for IMD than non-students. With high vaccine coverage and timely completion, an adolescent school-based MenACWY programme has the greatest potential to prevent cases with the lowest NNV, but population impact through indirect (herd) protection could take longer.

A novel hybrid tobacco product that delivers a tobacco flavour note with vapour aerosol (Part 2): In vitro biological assessment and comparison with different tobacco-heating products.

This study assessed the toxicological and biological responses of aerosols from a novel hybrid tobacco product. Toxicological responses from the hybrid tobacco product were compared to those from a commercially available Tobacco Heating Product (c-THP), a prototype THP (p-THP) and a 3R4F reference cigarette, using in vitro test methods which were outlined as part of a framework to substantiate the risk reduction potential of novel tobacco and nicotine products. Exposure matrices used included total particulate matter (TPM), whole aerosol (WA), and aqueous aerosol extracts (AqE) obtained after machine-puffing the test products under the Health Canada Intense smoking regime. Levels of carbonyls and nicotine in these matrices were measured to understand the aerosol dosimetry of the products. The hybrid tobacco product tested negative across the in vitro assays including mutagenicity, genotoxicity, cytotoxicity, tumour promotion, oxidative stress and endothelial dysfunction. All the THPs tested demonstrated significantly reduced responses in these in vitro assays when compared to 3R4F. The findings suggest these products have the potential for reduced health risks. Further pre-clinical and clinical assessments are required to substantiate the risk reduction of these novel products at individual and population levels.

E-cigarette aerosols induce lower oxidative stress in vitro when compared to tobacco smoke.

Tobacco smoking is a risk factor for various diseases. The underlying cellular mechanisms are not fully characterized, but include oxidative stress, apoptosis, and necrosis. Electronic-cigarettes (e-cigarettes) have emerged as an alternative to and a possible means to reduce harm from tobacco smoking. E-cigarette vapor contains significantly lower levels of toxicants than cigarette smoke, but standardized methods to assess cellular responses to exposure are not well established. We investigated whether an in vitro model of the airway epithelium (human bronchial epithelial cells) and commercially available assays could differentiate cellular stress responses to aqueous aerosol extracts (AqE) generated from cigarette smoke and e-cigarette aerosols. After exposure to AqE concentrations of 0.063-0.500 puffs/mL, we measured the intracellular glutathione ratio (GSH:GSSG), intracellular generation of oxidant species, and activation of the nuclear factor erythroid-related factor 2 (Nrf2)-controlled antioxidant response elements (ARE) to characterize oxidative stress. Apoptotic and necrotic responses were characterized by increases in caspase 3/7 activity and reductions in viable cell protease activities. Concentration-dependent responses indicative of oxidative stress were obtained for all endpoints following exposure to cigarette smoke AqE: intracellular generation of oxidant species increased by up to 83%, GSH:GSSG reduced by 98.6% and transcriptional activation of ARE increased by up to 335%. Caspase 3/7 activity was increased by up to 37% and the viable cell population declined by up to 76%. No cellular stress responses were detected following exposure to e-cigarette AqE. The methods used were suitably sensitive to be employed for comparative studies of tobacco and nicotine products.

Temporal Variations of Water Productivity in Irrigated Corn: An Analysis of Factors Influencing Yield and Water Use across Central Nebraska.

Water Productivity (WP) of a crop defines the relationship between the economic or physical yield of the crop and its water use. With this concept it is possible to identify disproportionate water use or water-limited yield gaps and thereby support improvements in agricultural water management. However, too often important qualitative and quantitative environmental factors are not part of a WP analysis and therefore neglect the aspect of maintaining a sustainable agricultural system. In this study, we examine both the physical and economic WP in perspective with temporally changing environmental conditions. The physical WP analysis was performed by comparing simulated maximum attainable corn yields per unit of water using the crop model Hybrid-Maize with observed data from 2005 through 2013 from 108 farm plots in the Central Platte and the Tri Basin Natural Resource Districts of Nebraska. In order to expand the WP analysis on external factors influencing yields, a second model, Maize-N, was used to estimate optimal nitrogen (N)-fertilizer rate for specific fields in the study area. Finally, a vadose zone flow and transport model, HYDRUS-1D for simulating vertical nutrient transport in the soil, was used to estimate locations of nitrogen pulses in the soil profile. The comparison of simulated and observed data revealed that WP was not on an optimal level, mainly due to large amounts of irrigation used in the study area. The further analysis illustrated year-to-year variations of WP during the nine consecutive years, as well as the need to improve fertilizer management to favor WP and environmental quality. In addition, we addressed the negative influence of groundwater depletion on the economic WP through increasing pumping costs. In summary, this study demonstrated that involving temporal variations of WP as well as associated environmental and economic issues can represent a bigger picture of WP that can help to create incentives to sustainably improve agricultural production.

Examination of the use of human sera as an exposure agent for in vitro studies investigating the effects of cigarette smoking on cellular cardiovascular disease models.

In vitro models of smoking-related diseases and disease processes are valuable for mechanistic understanding and assessment of novel tobacco products. Many laboratories have used particulate phase or aqueous extracts of cigarette smoke as an exposure system for in vitro models. However, this may not be the most relevant method of exposing cells to smoke and its toxicants. Here we have examined the use of human serum as an exposure system. Cultured human umbilical vein endothelial cells were exposed in vitro to sera (50% dilution in culture media) from human volunteers (9 smokers; 10 non-smokers) for 20 h. Statistically-significant differential changes were detected in endothelial migration in an endothelial damage repair model, such that smokers' sera had an inhibitory effect on migration compared with sera from non-smokers (p<0.05). We further observed several statistically-significant differences in cardiovascular disease (CVD)-relevant gene expression between cells exposed to smokers' and non-smokers' sera, as well as differences in levels of cytokines secreted from endothelial cells. Our data demonstrate that human sera from smokers and non-smokers can differentially regulate endothelial function. We suggest that human serum provides a relevant exposure medium for in vitro studies assessing the impact of cigarette smoking on CVD risk potential.

Assessment of an in vitro model of lung epithelial cell stress responses.

The ability of cells to adapt and survive environmental and physiological stress relies on activation of cellular stress responses. These include anti-oxidant, inflammatory and apoptotic responses. These cellular responses are mediated by cell signalling pathways, including those controlled by the transcription factors Nrf2 (antioxidant response) and NF-?ß (inflammatory response). As part of a suite of in vitro models for the comparison of different nicotine delivery products, an in vitro lung cell stress response model has been developed. Human bronchial epithelial cells were exposed to positive controls or cigarette smoke aqueous extracts (CSEaq) from 3R4F and 1R5F reference cigarettes for 4hours. Cellular responses were then measured as oxidative, pro-inflammatory, apoptotic and necrotic endpoints. Cellular oxidative stress was characterised by measurement of the intracellular glutathione ratio, intracellular ROS production and activation of the Nrf2-controlled Anti-oxidative Response Elements (ARE). The inflammatory response of the cells was determined through quantification of secreted cytokines, IL-1a, IL-6 and IL-8. Apoptotic and necrotic responses were characterised by measurements of Caspase 3/7 activity and live-cell protease activity. Stably transfected luciferase reporter cell lines were utilised to quantify the transcriptional control of anti-oxidant and inflammatory pathways. All cell stress response endpoints were activated by exposure to positive controls or CSEaq. The observed concentration-dependent lowering of the glutathione ratio and increase in intracellular ROS generation corresponded with an increase in Nrf2 transcriptional activation of the ARE. It has been demonstrated that this model was able to distinguish between CSEaq from the two different reference cigarettes. We propose that this model may be suitably sensitive for biological comparisons of cigarettes against different nicotine delivery products.

Psychological aspects of bereavement in adults: preliminary development of the bereavement experiences index.

This study's aim was to produce a measure of the cognitive and affective impact of bereavement and to investigate the psychometric properties and potential utility of the measure. Using a mixed correlational and comparative design, the bereavement experiences of widows who had time to anticipate their partner's death were compared with those who had no such time. In the first stage of this two-stage study, seven widows completed semi-structured interviews regarding bereavement-related cognitions and affect. A set of bereavement-related statements was derived and formed the Bereavement Experiences Index (BEI). In the second stage, the BEI and a measure of psychological disturbance were administered to 20 additional widows. Unexpected bereavement led to greater psychological impact than expected loss although longer periods of expectation were positively correlated with higher levels of grief-related social dysfunction symptoms. This preliminary version of the BEI showed potential as a measure of grief responses with predictable links to psychological distress. The findings suggested a relationship between the time available to prepare for a loss and the development of psychological disturbance.

The DAS24: a short form of the Derriford Appearance Scale DAS59 to measure individual responses to living with problems of appearance.

OBJECTIVES: To develop a psychometrically robust and widely applicable short form of the Derriford Appearance Scale, (DAS59), which (1) will reliably and validly assess the distress and difficulties experienced in living with problems of appearance, (2) is acceptable to clinical and non-clinical populations, and (3) facilitates research and clinical decision-making through good standardization and sensitivity. DESIGN: Cross-sectional survey designs using clinical (out-patient and in-patient) and general population samples. METHOD: Twenty-five items were selected initially from the 59 items of the original DAS59. These were refined to 24 through item analyses and the scale was standardized on 535 patients with a range of problems of appearance and on a representative general population sample (N=1, 107). RESULTS: All 24 items contributed well to the total score and internal consistency was high (alpha=.92). Test-retest reliability (6 months) was good (0.82), and criterion validity, with the DAS59, was excellent (0.88). Good construct validity was demonstrated in differences between (1) patient and general population samples, (2) members of the general population concerned and not concerned about their appearance, and (3) in patterns of convergent and divergent correlations with a range of established scales. The general population data revealed widespread concerns about appearance. CONCLUSION: The DAS24 provides a widely applicable and acceptable short form of the original DAS59. It is psychometrically robust and discriminates well between patient groups, between clinical and non-clinical populations, and within the general population between those concerned, and those not concerned, about their appearance.