Outcome measurement in functional neurological disorder: a systematic review and recommendations.

OBJECTIVES: We aimed to identify existing outcome measures for functional neurological disorder (FND), to inform the development of recommendations and to guide future research on FND outcomes. METHODS: A systematic review was conducted to identify existing FND-specific outcome measures and the most common measurement domains and measures in previous treatment studies. Searches of Embase, MEDLINE and PsycINFO were conducted between January 1965 and June 2019. The findings were discussed during two international meetings of the FND-Core Outcome Measures group. RESULTS: Five FND-specific measures were identified-three clinician-rated and two patient-rated-but their measurement properties have not been rigorously evaluated. No single measure was identified for use across the range of FND symptoms in adults. Across randomised controlled trials (k=40) and observational treatment studies (k=40), outcome measures most often assessed core FND symptom change. Other domains measured commonly were additional physical and psychological symptoms, life impact (ie, quality of life, disability and general functioning) and health economics/cost-utility (eg, healthcare resource use and quality-adjusted life years). CONCLUSIONS: There are few well-validated FND-specific outcome measures. Thus, at present, we recommend that existing outcome measures, known to be reliable, valid and responsive in FND or closely related populations, are used to capture key outcome domains. Increased consistency in outcome measurement will facilitate comparison of treatment effects across FND symptom types and treatment modalities. Future work needs to more rigorously validate outcome measures used in this population

Research and innovation as a catalyst for food system transformation

Background: Food systems are associated with severe and persistent problems worldwide. Governance approaches aiming to foster sustainable transformation of food systems face several challenges due to the complex nature of food systems. Scope and approach: In this commentary we argue that addressing these governance challenges requires the development and adoption of novel research and innovation (R&I) approaches that will provide evidence to inform food system transformation and will serve as catalysts for change. We first elaborate on the complexity of food systems (transformation) and stress the need to move beyond traditional linear R&I approaches to be able to respond to persistent problems that affect food systems. Though integrated transdisciplinary approaches are promising, current R&I systems do not sufficiently support such endeavors. As such, we argue, we need strategies that trigger a double transformation - of food systems and of their R&I systems. Key Findings and Conclusions: Seizing the opportunities to transform R&I systems has implications for how research is done - pointing to the need for competence development among researchers, policy makers and society in general - and requires specific governance interventions that stimulate a systemic approach. Such interventions should foster transdisciplinary and transformative research agendas that stimulate portfolios of projects that will reinforce one another, and stimulate innovative experiments to shape conditions for systemic change. In short, a thorough rethinking of the role of R&I as well as how it is funded is a crucial step towards the development of the integrative policies that are necessary to engender systemic change - in the food system and beyond

Research and Innovation Supporting the Farm to Fork Strategy of the European Commission

The EU Think Tank (as part of the FIT4FOOD2030 Coordination andSupport Action) strongly supports the development of the Farm toFork Strategy as a key component of the European Green Deal,recognising the need to transform the food system as a whole

A Systems Approach to Research and Innovation for Food System Transformation

This policy brief of the European Union (EU) Think Tank – part of the FIT4FOOD2030 Coordination and Support Action (CSA) of the FOOD 2030 initiative – is a response and contribution to growing pleas for a ‘systems approach’ to transform food systems for Food and Nutrition Security (FNS) for present and future generations. This policy brief specifically focusses on the necessity of the adoption of a systems approach to Research and Innovation (R&I) in order to foster the transformation of food systems

Key Research and Innovation Questions on Engaging Consumers in the Delivery of FOOD 2030

Food system transformation requires major changes in food consumption practices. Consumers could play central roles to stimulate these changes, which needs to be fully recognized. Multi-stakeholder R&I efforts should focus more on the interactions between individual, contextual and policy factors influencing consumption patterns, with specific attention to the dynamic character of food environments. Consumers should be empowered and engaged in decision making, through co-design, co-creation, co-implementation and co-assessment