Project description:The global food system must meet the increasing demand for food, fiber, and energy while reducing environmental impacts. The UN Food System Summit (UNFSS) has made a clear call to action for a global food systems transformation. We argue that three major discrepancies remain, potentially delaying the urgent implementation of the call to action. First, Nature-based Solutions (NbS) are not sufficiently focused on agriculture, leading to funding allocation issues. Second, a mismatch of agroecology with technology innovations may slow scaling agroecological farming. Lastly, agricultural diversification must move beyond organic landscapes and into conventional agriculture. As a solution, principles of NbS should be clear on agricultural integration. Moreover, stakeholder awareness must increase that agroecology does not necessarily conflict with agricultural technologies. Future agricultural models must apply measures such as agricultural diversification in conjunction with technology innovations to then ascertain an overall timely and successful implementation of the UNFSS call to action.
Project description:This paper suggests and tests a psychological model of environmental art perception and subsequent support for climate change policies. The model is based on findings from art perception and environmental psychology, which indicate that the response of the viewer to the artwork is (1) first an emotional reaction, which can be positive and/or negative. The emotional activation leads to (2) evaluation of the perceived quality of the artwork. This forms the first impression of the artwork the viewer gets, which then triggers (3) reflections on the artwork that are finally related to support for climate policies. The model test uses data collected at the ArtCOP21 that accompanied the 21st UN climate summit in Paris. At 37 connected events, the research team collected 883 audience responses with a brief quantitative paper-pencil questionnaire. The data were analyzed using a multilevel-structural equation modeling approach. Results support the suggested theoretical model. Moreover, the effect of reflections on the artwork on support for climate policies is moderated by environmental attitudes, meaning the lower the environmental attitudes, the higher the effect of reflections on policy support. Finally, artwork features like color, size, displaying something personal, etc., could be identified that had a significant relation to differences on the artwork level regarding the first impression of the artwork and the reflections elicited. The study shows that being confronted with climate change-related artwork relates at least in the short run to increased climate policy support, which is mostly channeled through an emotional activation with following cognitive processing. Features of the artwork relate to how strongly and which emotions are activated.
Project description:At present, our ability to comprehend the dynamics of food systems and the consequences of their rapid 'transformations' is limited. In this paper, we propose to address this gap by exploring the interactions between the sustainability of food systems and a set of key drivers at the global scale. For this we compile a metric of 12 key drivers of food system from a globally-representative set of low, middle, and high-income countries and analyze the relationships between these drivers and a composite index that integrates the four key dimensions of food system sustainability, namely: food security & nutrition, environment, social, and economic dimensions. The two metrics highlight the important data gap that characterizes national systems' statistics-in particular in relation to transformation, transport, retail and distribution. Spearman correlations and Principal Component Analysis are then used to explore associations between levels of sustainability and drivers. With the exception of one economic driver (trade flows in merchandise and services), the majority of the statistically significant correlations found between food system sustainability and drivers appear to be negative. The fact that most of these negative drivers are closely related to the global demographic transition that is currently affecting the world population highlights the magnitude of the challenges ahead. This analysis is the first one that provides quantitative evidence at the global scale about correlations between the four dimensions of sustainability of our food systems and specific drivers.
Project description:BackgroundThe Breast Health Global Initiative (BHGI) established a series of resource-stratified, evidence-based guidelines to address breast cancer control in the context of available resources. Here, the authors describe methodologies and health system prerequisites to support the translation and implementation of these guidelines into practice.MethodsIn October 2018, the BHGI convened the Sixth Global Summit on Improving Breast Healthcare Through Resource-Stratified Phased Implementation. The purpose of the summit was to define a stepwise methodology (phased implementation) for guiding the translation of resource-appropriate breast cancer control guidelines into real-world practice. Three expert consensus panels developed stepwise, resource-appropriate recommendations for implementing these guidelines in low-income and middle-income countries as well as underserved communities in high-income countries. Each panel focused on 1 of 3 specific aspects of breast cancer care: 1) early detection, 2) treatment, and 3) health system strengthening.ResultsKey findings from the summit and subsequent article preparation included the identification of phased-implementation prerequisites that were explored during consensus debates. These core issues and concepts are key components for implementing breast health care that consider real-world resource constraints. Communication and engagement across all levels of care is vital to any effectively operating health care system, including effective communication with ministries of health and of finance, to demonstrate needs, outcomes, and cost benefits.ConclusionsUnderserved communities at all economic levels require effective strategies to deploy scarce resources to ensure access to timely, effective, and affordable health care. Systematically strategic approaches translating guidelines into practice are needed to build health system capacity to meet the current and anticipated global breast cancer burden.
Project description:The discipline of cardio-oncology has expanded at a remarkable pace. Recent developments and challenges to clinicians who practice cardio-oncology were presented at the Global Cardio-Oncology Summit on October 3 to 4, 2019, in São Paulo, Brazil. Here, we present the top 10 priorities for our field that were discussed at the meeting, and also detail a potential path forward to address these challenges. Defining robust predictors of cardiotoxicity, clarifying the role of cardioprotection, managing and preventing thromboembolism, improving hematopoietic stem cell transplant outcomes, personalizing cardiac interventions, building the cardio-oncology community, detecting and treating cardiovascular events associated with immunotherapy, understanding tyrosine kinase inhibitor cardiotoxicity, and enhancing survivorship care are all priorities for the field. The path forward requires a commitment to research, education, and excellence in clinical care to improve our patients' lives.
Project description:La febbre è una causa frequente di visita al ritorno da un viaggio in un paese tropicale. Il punto chiave è interrogare il paziente circa i dettagli del suo viaggio e caratterizzare al meglio i segni clinici, tra cui la febbre. Le principali cause di febbre al ritorno da un viaggio in un paese tropicale sono la malaria, le infezioni gastrointestinali, le infezioni respiratorie e urinarie e le patologie cutanee. È fondamentale e urgente escludere la malaria, a prescindere dai sintomi associati. Le altre possibili eziologie devono essere considerate in funzione del ritardo di comparsa della febbre rispetto al tempo di incubazione, dei segni associati e dei risultati degli esami di laboratorio iniziali. Infine, non si deve trascurare un’infezione comunitaria o cosmopolita a potenziale evolutivo grave.
Project description:Las enfermedades más frecuentes al regresar de un viaje al extranjero son las infecciones gastrointestinales, las enfermedades febriles y los problemas dermatológicos. La evaluación de un niño febril al regreso de un viaje es clínica: verificación de los antecedentes y las vacunaciones, búsqueda de otros casos en contacto, signos funcionales y físicos, y características del viaje. Unas pruebas complementarias de rutina completan a menudo la evaluación para una orientación sindrómica. Si bien las causas de fiebre son, sobre todo, cosmopolitas, la gravedad de la enfermedad exótica obliga a buscarlas prioritariamente. El paludismo debe sospecharse ante una fiebre procedente de África subsahariana. El diagnóstico se basa en la asociación de un frotis sanguíneo y una prueba sensible (gota gruesa, reacción en cadena de la polimerasa [PCR]) o una prueba de diagnóstico rápido (para Plasmodiumfalciparum). Los criterios clínico-biológicos de gravedad son esenciales para orientar y tratar al paciente. En caso de acceso no complicado por P. falciparum, el tratamiento se basa en un tratamiento combinado a base de artemisinina (ACT), arteméter-lumefantrina o artenimol-piperaquina. Los accesos graves se tratan con artesunato intravenoso, seguido de ACT oral. Dengue, chikungunya e infección por virus Zika tienen características clínicas comunes (fiebre-erupción-artralgias, tratamiento sintomático). En caso de dengue, conviene controlar la aparición de signos de alerta, que podrían hacer temer una evolución negativa. El chikungunya es grave en caso de transmisión en el parto, con un riesgo de encefalitis neonatal. En el niño, el Zika es asintomático o poco sintomático. Pero, en caso de infección durante el embarazo, el riesgo es el de una embriofetopatía. El diagnóstico de estas arbovirosis se basa en la PCR en la fase aguda y en la serología secundariamente. La sintomatología de la fiebre tifoidea es poco específica, lo cual justifica la práctica de hemocultivos sistemáticos ante una fiebre tras un viaje. Su tratamiento se basa en las cefalosporinas de tercera generación o el ciprofloxacino, pero las resistencias aumentan. En suma, la diversidad de las etiologías de una fiebre al regreso de un viaje y la potencial gravedad de las infecciones importadas imponen una reflexión sobre el proceso de tratamiento de estos pacientes, en especial en lo referente al riesgo de fiebre hemorrágica.