More than Maize, Bananas, and Coffee: The Inter- and Intraspecific Diversity of Edible Plants of the Huastec Mayan Landscape Mosaics in Mexico1.

More than Maize, Bananas, and Coffee: The Inter- and Intraspecific Edible Plant Diversity in Huastec Mayan Landscape Mosaics in Mexico. Global emergencies such as biodiversity loss and climate crisis urge us to identify and mainstream crop genetic resources in complex indigenous farming systems to understand their role as genetic reservoirs and identify synergies in productive landscapes between development, conservation, and food security. We aimed to characterize the inter- and intraspecific diversity of food plants of the Tének (or Huastec) in Mexico and their distribution within and between the different land-use systems along a tropical altitudinal gradient. Tének farmers manage a highly diverse and dynamic food biota in swidden maize fields, agroforestry systems, and home gardens. Even with a small sample size, our study provides a complete analysis of the food crop diversity in the research area. The Tének cultivate a high number of 347 registered species and variants, most of them at medium altitude. Intraspecific diversity dominates (69%). All land-use systems of the agroecosystem complex serve as a specific pool for plant genetic resources, and there is a low similarity between and within systems and localities, especially at the intraspecific level. The proportion of rare and unique food plants is high. We recommend an agroecosystem approach and prioritization for conservation as well as other efforts related to the in situ crop genetic capital. Supplementary Information: The online version contains supplementary material available at 10.1007/s12231-021-09520-9.

Más que maíces, plátanos y café: La diversidad inter e intraespecífica de plantas comestibles en los mosaicos de paisaje de los mayas huastecos en México. Las emergencias globales como la pérdida de biodiversidad y la crisis climática obligan a identificar y a reconocer los recursos fitogenéticos en los sistemas complejos agrícolas indígenas, para comprender su papel como reservorios genéticos e identificar sinergias en los paisajes productivos entre el desarrollo, la conservación y la seguridad alimentaria. El objetivo fue caracterizar la diversidad inter e intraespecífica de plantas alimenticias de los Tének (o Huastecos) en México y su distribución dentro y entre los diferentes sistemas agrícolas a lo largo de un gradiente altitudinal. Los agricultores Tének manejan una biota alimentaria muy diversa y dinámica en milpas, sistemas agroforestales y huertos familiares. Aun con el tamaño de muestra pequeño en este estudio, se proporciona un análisis completo de la diversidad de cultivos alimentarios en el área de estudio. Los Tének cultivan un elevado número de 347 especies y variantes registradas, la mayoría de ellas en la altitud mediana. La diversidad intraespecífica (69%) es dominante. Todos los sistemas de manejo del complejo agroecosistémico sirven como reserva específica de recursos fitogenéticos, y existe una baja similitud entre y dentro de los sistemas y localidades, especialmente en el nivel intraespecífico. La proporción de plantas alimenticias raras y únicas es alta. Se recomienda un enfoque agroecosistémico y de priorización para la conservación y otros esfuerzos relacionados con el capital genético de cultivos in situ.

Shared care for diabetes: supporting communication between primary and secondary care.

OBJECTIVE: To assess the effects on information exchange of electronic communication between physicians co-treating diabetic patients. DESIGN: Comparison of traditional paper-based communication for reporting and electronic communication. SETTING: General practitioners and an internal medicine outpatient clinic of an urban public hospital. SUBJECTS: A total of 275 diabetic patients, and the 32 general practitioners and one internal medicine consultant who cared for them. INTERVENTION: An electronic communication network, linking up the computer-based patient records of the physicians, thus enabling electronic data interchange. MAIN OUTCOME MEASURES: Number of letters sent and received per year by the general practitioners, the number of diabetes-related parameters (e.g. results of laboratory tests) in the patient records, and HBA1C levels. RESULTS: INTERVENTION GPs received more messages per year (1.6 per patient) than control GPs (0.5 per patient, P<0.05). Significant higher availability (P<0.05) was achieved for data on HBA1C levels, fructosamine levels, blood pressure measurements, cholesterol levels, triglyceride levels and weight measurements. INTERVENTION patients showed a slight but significant decrease of HBA1C levels in the second semester of 1994 (from 7.0 to 6.8, P = 0.03), control patients also showed a slightly decreased group mean, but this change was not significant (from 6.6 to 6.5, P = 0.52). The magnitudes of these mean differences, however, were not significantly different (intervention group: 0.21; control group: 0.12, P = 0.68). CONCLUSIONS: The electronic communication network for exchanging consultation outcomes significantly increased frequency of communication and the availability of data to the general practitioner on diagnostic procedures performed in the hospital, thus providing more complete information about the care that patients are receiving. A large-scale experiment over a longer period of time is needed to assess the effects of improved communication on quality of care.

Shared care for diabetes: supporting communication between primary and secondary care.

As health care becomes more complex, interest in the benefits of coordination of care has increased. Especially patients that are being treated jointly by more than one physician (shared care), are vulnerable to adverse effects resulting from inadequate coordination and communication. We describe a study in which care providers support shared care by using computer-based patient records for data storage, and structured electronic data interchange (EDI) as a means of communication. The study showed that the electronic communication network for exchanging consultation outcomes significantly increased frequency of communication and the availability of data to the general practitioner on diagnostic procedures performed in the hospital, thus providing more complete information about the care that patients are receiving.

Coordinating shared care using electronic data interchange.

Shared care is the situation in which physicians jointly treat the same patient. Shared care may occur with elderly patients suffering from several health problems, patients with chronic disorders such as diabetes, mellitus, obstructive pulmonary diseases, or cardiological disorders. For a number of health problems, including diabetes, shared care protocols have been developed involving division of tasks between health care providers from different disciplines [1]. Optimal communication is considered to be a vital aspect of shared care, both from medical and cost-effectiveness points of view, but at the same time communication forms the bottleneck as physicians often lack time to comply with the protocol [2]. At present, new technologies are emerging that hold the promise of improving communication between health care providers. One such technology is Electronic Data Interchange (EDI), defined as "the replacement of paper documents by standard electronic messages conveyed from one computer to another without manual intervention" [3]. In Europe, the ISO syntax standard EDIFACT has been adopted as the standard for defining EDI-messages [4]. In The Netherlands, coordination of the standardization of health care messages is performed by a national organization. At present, several standardized messages are available for a variety of purposes. One is a message for data exchange between physicians; in this message, however, only physician-patient- and hospital-identifying data are structured, and all medical data is transferred as free text. Consequently, using this message, the receiving system is unable to integrate the data into the computer-based patient record. In order to support shared care, a message is needed that can also transfer the structure of the data in a computer-based record in order to allow integration of records from multiple sources. Therefore, we developed a new message, called MEDEUR, that is designed for integrated patient data exchange between computer-based patient records. The message can contain both administrative and medical data and can be used for transmission of a complete medical record, or sections of it. Our departments are working on a project in which general practitioners and specialists use their own electronic medical record system for storing data of jointly treated patients. In addition, the participating physicians use the MEDEUR message standard in communicating about these patients. The use of EDI enables physicians to transmit patient data electronically to another physician's computer system. The receiving physician can store the data automatically in his electronic medical record without having to re-type the data. We will demonstrate the electronic data interchange functionality of the general practitioner's information system, ELIAS, and the integrated composing and storing of electronic messages. We will also discuss several system design issues.

A standardized message for supporting shared care.

As health care becomes more complex, interest in the benefits of coordination of care has increased. Especially patients that are being treated jointly by more than one physician (shared care), are vulnerable to adverse effects resulting from inadequate coordination and communication. We describe a study in which care providers support shared care by using computer-based patient records for data storage, and structured electronic data interchange as a means of communication. In this study, we are aiming at the development and implementation of protocols for shared care.