Catalysing learning for development and climate change: an exploration of social learning and social differentiation in CGIAR

There is convergence between current theory and practice in global environmental change research and development communities on the importance of approaches that aim to ‘engage and embed’, i.e. engage diverse and relevant actors in knowledge creation and embed scientific information into societal contexts. Social learning has emerged as a way to both approach and characterise innovative ways of doing this. Defined here as “a change in understanding that goes beyond the individual to become situated within wider social units or communities of practice through social interactions between actors within social networks” (Reed et al. 2010), a social learning approach situates scientific research as just one form of specialised knowledge amidst other contextual knowledge. Co-learning – by bringing diverse knowledge and social worlds together to exchange needs, values and norms – is considered necessary for addressing complex, wicked problems and for building decision processes and adaptive structures that help navigate uncertain futures. Including socially differentiated groups into processes of knowledge creation and decision- making may fundamentally alter what questions are asked, how changes in practices are framed and how to break down systemic patterns of vulnerability and marginalisation. This paper investigates the synergies (and trade-offs) associated with integrating socially differentiated stakeholders and/or groups – the poor, women, elderly, youth and indigenous – into social learning processes aimed at addressing poverty reduction, livelihood development and longer term resilience. An exploratory scan of CGIAR identifies projects that engage socially differentiated groups in processes of social learning. Cases were characterised for their treatment of i) the particular context, including rationale for the engagement of socially differentiated groups, ii) the design of engagement interfaces, iii) the type of learning loops occurring, iv) particular channels that contributed to learning across networks and, where applicable, v) the outcomes and lessons from the learning process. The findings suggest that diverse forms of social differentiation and learning are occurring across many of CGIAR’s fifteen research centres. This is in part due to institutional reform that has put an increasing emphasis on gender strategies and monitored development outcomes. A more explicit recognition of the role and ‘added value’ that social learning research approaches have can enhance its visibility and ultimately the effectiveness of CGIAR’s vast research partnerships

Coffee Under Pressure

Describes experiences of: CIAT, Oxfam, Catholic Relief Services with Workshops, NetworksContext: Vulnerability of farmers equals vulnerability of supply chain. Inclusive management involves those that contribute to growing, selling and changing strategies. Crop modelling under different climate conditions requires knowledge of who’s growing, selling and involved in the supply chain. It also requires an analysis of who the beneficiaries of the value chain are and who will be adversely affected by changes in climate and in practice in order to identify appropriate adaptation strategies. Gender analysis is critical. Interface: Researchers and stakeholders such as farmers, extensionists, local governments, and ministers are brought together in workshops to discuss history, crop types and harvesting methods and climate change perceptions. Strategies such as visual questionnaires, maps, and models of 20-year crop/climate projections are used to engage and discuss how resources change over time. Learning: Knowledge and networks from collaborative teams are leveraged in order to mobilize practical tools, systems and practices that build adaptive capacity among the poor and among women. Young people understand much faster about climate change. Youth and women are more engaged in participatory workshops. Interactive approaches feed information back into more relevant crop/climate models. Channel: Working with intermediaries such as Oxfam has contributed to ways of integrating gender-sensitive methods into the research process. The collaboration has provided Oxfam with CIAT’s relevant crop/climate expertise and information, and providing an avenue for research to be disseminated more broadly. Engaging with global food companies has typically included Corporate Social Responsibility departments. There is a recognized need that corporate buyers need to be brought into the collaborations in order to mainstream sustainable supply chains more broadly. A gender expert within CIAT is facilitating learning about the need for differentiated gender components in research. Agronomists are paying attention and using this resource now that the need has been identified within the institution. Outcome: Learning that women play a significant role in the supply chain but do not get shares of revenue leads to new research questions about what varieties and practices contribute to more visible and greater involvement. Oxfam included post-harvest facilities in the supply chain, formalizing women’s involvement in the supply chain and ability to generate income. Funding is viewed as a primary barrier to longer term learning cycles and for building continuous partnerships and trust over time. CIAT is working collaboratively with supply chain stakeholders and making links with large development NGOs, to use one part (approx. 8%) of their funding for relevant scientific research that applies to local development projects. Where possible, it is expected that sampling design and the innovative methodologies developed can then be rolled out across extensive NGO networks, including Oxfam and Catholic Relief Services

Barriers and facilitators to physical activity in second-generation British Indian women:a qualitative study

Aim To understand the barriers to and motivations for physical activity among second-generation British Indian women. Subject Approximately 50% of British South Asians are UK-born, and this group is increasing as the second-generation also have children. Previous research into the barriers to and facilitators for physical activity has focused on migrant, first-generation populations. Qualitative research is needed to understand a) how we might further reduce the gap in physical activity levels between White British women and British Indian women and b) the different approaches that may be required for different generations. Methods Applying a socioecological model to take into account the wider social and physical contexts, we conducted semi-structured interviews with 28 Indian women living in Manchester, England. Interviews with first-generation British Indian women were also included to provide a comparator. Interviews were audio-recorded, transcribed, thematically coded and analysed using a grounded theory approach. Results Ways of socialising, concerns over appearance while being physically active, safety concerns and prioritising educational attainment in adolescence were all described as barriers to physical activity in second-generation British Indian women. Facilitators for physical activity included acknowledging the importance of taking time out for oneself; religious beliefs and religious groups promoting activity; being prompted by family illness; positive messages in both the media and while at school, and having local facilities to use. Conclusions Barriers to physical activity in second-generation Indian women were very similar to those already reported for White British women. Public health measures aimed at women in the general population may also positively affect second-generation Indian women. First-generation Indian women, second-generation children and Muslim women may respond better to culturally tailored interventions

Development of a conceptual framework to underpin a health‑related quality of life outcome measure in paediatric chronic fatigue syndrome/myalgic encephalopathy (CFS/ME):prioritisation through card ranking

PURPOSE: Chronic fatigue syndrome (CFS)/myalgic encephalopathy (ME) is relatively common in children and is disabling at an important time in their development. This study aimed to develop a conceptual framework of paediatric CFS/ME using the patient-perspective to ensure that the content of a new outcome measure includes the outcomes most important to young people. METHODS: We developed a child-centred interactive card ranking exercise that included health-related quality of life (HRQoL) outcomes identified from a previous review of the literature as well as qualitative work. Adolescents and their parents selected and ranked the outcomes most important to them and discussed each outcome in further detail. Adolescents were purposively sampled from a single specialist paediatric CFS/ME service in England. Interviews were audio recorded and transcribed verbatim, and thematic framework analysis was used to develop the final conceptual framework. RESULTS: We interviewed 43 participants in which there are 21 adolescents, 12-17 years of age with mild-moderate CFS/ME and their parents (20 mothers and 2 fathers). 'Symptoms', 'tiredness', 'payback and crashing' and 'activities and hobbies' were ranked most important to improve by both children and parents. Children ranked 'school' higher than parents and parents ranked 'mood' higher than children. A youth- specific CFS/ME conceptual framework of HRQoL was produced that included 4 outcome domains and 11 subdomains: sleep, tiredness, problems concentrating, individual symptoms, fluctuation and payback, daily and general activities, participation in school, leisure and social life, mood, anxiety and self-esteem. CONCLUSIONS: An interactive card ranking exercise worked well for adolescents aged 12-17 to elicit the most important outcomes to them and explore each domain in further detail. We developed a final conceptual framework of HRQoL that forms the basis of a new paediatric patient-reported outcome measure (PROM) in CFS/ME. KEYWORDS: Adolescents; Chronic fatigue syndrome/myalgic encephalopathy (CFS/ME); Conceptual framework; Health-related quality of life (HRQoL); Patient-reported outcome measure (PROM); Qualitativ

Project Reach: Implementation of Evidence-Based Psychotherapy Within Integrated Healthcare for Hurricane Harvey Affected Individuals

Project Reach was established to deliver evidence-based mental healthcare services to children and adults affected by Hurricane Harvey and its aftermath. Through Project Reach, an innovative multi-component assessment and treatment service is utilized to identify and treat in integrated healthcare settings both children and adults exhibiting significant behavioral health concerns in Houston. The aim is to provide sustainable, integrated mental health services through primary care and school-based settings to post-Harvey affected individuals whose emotional needs remain unmet. This paper describes the design and implementation of Project Reach as well as special considerations for implementation. The overall goal of Project Reach is to form a platform for expanding integrated services for those affected by Harvey that will maximize behavioral health outcomes while reducing cost and improving access

Developing and pretesting a new Patient Reported Outcome Measure for Paediatric Chronic Fatigue Syndrome/ Myalgic Encephalopathy (CFS/ME):Cognitive interviews with children

Background There is a lack of patient derived, child specific outcome measures to capture what health outcomes are important to children with Chronic Fatigue Syndrome/ Myalgic Encephalopathy (CFS/ME). We developed a new Patient Reported Outcome Measure (PROM) for paediatric CFS/ME through qualitative research with children. This study aimed to pre-test the new measure through cognitive interviews with children with CFS/ME. Methods Cognitive interviews were undertaken in children’s homes or over Skype. The Three-Step Test-Interview (TSTI) method was used to assess the quality of the draft PROM with children with CFS/ME to identify problems with initial content and design and test modifications over subsequent interview rounds. Children were purposively sampled from a single specialist paediatric CFS/ME service in England. Results Twenty-four children and their parents took part. They felt the new measure captured issues relevant to their condition and preferred it to the generic measures they completed in clinical assessment. Changes were made to item content and phrasing, timeframe and response options and tested through three rounds of interviews. Conclusions Cognitive interviews identified problems with the draft PROM, enabling us to make changes and then confirm acceptability in children aged 11–18. Further cognitive interviews are required with children 8–10 years old to examine the acceptability and content validity and provide evidence for age related cut offs of the new PROM to meet FDA standards. This study demonstrates the content validity of the new measure as relevant and acceptable for children with CFS/ME. The next stage is to undertake a psychometric evaluation to support the reduction of items, confirm the structure of the PROM and provide evidence of the data quality, reliability and validity

Advanced Processing of Food Waste Based Digestate for Mitigating Nitrogen Losses in a Winter Wheat Crop

The anaerobic digestion of food waste converts waste products into ‘green’ energy. Additionally, the secondary product from this process is a nutrient-rich digestate, which could provide a viable alternative to synthetically-produced fertilisers. However, like fertilisers, digestate applied to agricultural land can be susceptible to both ammonia (NH3) and nitrous oxide (N2O) losses, having negative environmental impacts, and reducing the amount of N available for crop uptake. Our main aim was to assess potential methods for mitigating N losses from digestate applied to a winter wheat crop and subsequent impact on yield. Plot trials were conducted at two UK sites, England (North Wyke-NW) and Wales (Henfaes-HF), to assess NH3 and N2O losses, yield and N offtake following a single band-spread digestate application. Treatments examined were digestate (D), acidified-digestate (AD), digestate with the nitrification inhibitor DMPP (D+NI), AD with DMPP (AD+NI), and a zero-N control (C). Determination of N losses was conducted using wind tunnels for NH3, and static manual and automatic chambers for N2O. The N offtake in both grain and straw was also measured. Ammonium nitrate (NH4NO3) fertiliser N response plots (from 75 to 300 kg N ha−1) were included to compare yields with the organic N source. Cumulative NH3-N losses were 27.6 % from D and D+NI plots and 1.5 % for AD and AD+NI of the total N applied, a significant reduction of 95 % with acidification. Cumulative N2O losses varied between 0.13 and 0.35 % of the total N applied and were reduced by 50 % with the use of DMPP. Grain yields for the digestate treatments were 7.52 – 9.21 and 7.23 – 9.23 t DM ha−1 at HF and NW, respectively. Yields were greater from the plots receiving acidified‐digestate relative to the non-acidified treatments but the differences were not significant. The yields (as a function of the N applied with each treatment) obtained for the digestate treatments ranged between 84.2 % (D+NI) and 103.6 % (D) of the yields produced by the same N rate from an inorganic source at HF. Advanced processing of digestate reduced N losses providing an environmentally sound option for N-management

Predicting the future of ALS: the impact of demographic change and potential new treatments on the prevalence of ALS in the United Kingdom, 2020-2116

OBJECTIVE To model the effects of demographic change under various scenarios of possible future treatment developments in ALS. METHODS Patients diagnosed with ALS at the King's College Hospital Motor Nerve Clinic between 2004 and 2017, and living within the London boroughs of Lambeth, Southwark, and Lewisham (LSL), were included as incident cases. We also ascertained incident cases from the Canterbury region over the same period. Future incidence of ALS was estimated by applying the calculated age- and sex-specific incidence rates to the UK population projections from 2020 to 2116. The number of prevalent cases for each future year was estimated based on an established method. Assuming constant incidence, we modelled four possible future prevalence scenarios by altering the median disease duration for varying subsets of the population, to represent the impact of new treatments. RESULTS The total number of people newly diagnosed with ALS per year in the UK is projected to rise from a baseline of 1415 UK cases in 2010 to 1701 in 2020 and 2635 in 2116. Overall prevalence of ALS was predicted to increase from 8.58 per 100,000 persons in 2020 to 9.67 per 100,000 persons in 2116. Halting disease progression in patients with C9orf72 mutations would yield the greatest impact of the modelled treatment scenarios, increasing prevalence in the year 2066 from a baseline of 9.50 per 100,000 persons to 15.68 per 100,000 persons. CONCLUSIONS Future developments in treatment would combine with the effects of demographic change to result in more people living longer with ALS