Infomediaries as complementary knowledge channels of climate-smart agriculture in the Philippines

Four key findings can be drawn from this scoping study: (1) all sites are situated in agricultural communities where rice is widely grown along with other crops; (2) almost all (99%) of the students surveyed are aware of climate change and its possible impacts on rice; (3) schools are rated as primary sources of information on CSA (Sig 2-tailed t=0.05) with the teachers as champions; and (4) instances of adoption of CSA practices have been documented. As regards the first finding, this means that this project, being focused on CSA, is rightly located. This is an important point as location specificity and relevance are among the key considerations for climate change adaptation initiatives to be successful. The second point takes this initiative to the next level as it informs that the direction must shift to how to translate awareness to tangible actions as stand-alone climate change awareness campaigns are inadequate to move people to action. The key, therefore, is to reflect on how platforms for youth engagement to serve as infomediaries on CSA can be optimized to yield the best results. The third finding establishes that efforts to engage the schools, with the teachers as champions, are leading to the right direction. Hence, the discourse should move to how the teachers can best be capacitated so they can address the “adaptation deficit” on CSA. The fourth finding is among the raison d ‘etre of this initiative. Albeit on a small scale, instances of adoption of some CSA practices have taken place. Hence, this initiative must now focus on investigating, which prompted the adoption so this can be massively replicated in other sites where these technologies seem fit

Mobilizing young people as climate-smart agriculture infomediaries: What do we know?

While efforts to adapt to the impacts of climate change have generally increased, the impression is that there is a negligible effort to include the vulnerable areas on the agenda. This paper seeks to fill in the gap by presenting an agricultural extension mechanism to tap high school students as information providers of climate-smart rice agriculture information in their rice-farming communities. This paper looks at the characteristics of the high school students who served as infomediaries as well as their information sources and perceptions on climate change; the best teaching media that can be used; and the infomediation pathways that can be drawn from this initiative. Two survey rounds, 2014 (n=) and 2015(n=), were used as data sources. Focus group discussions and interviews were also conducted. Chi-square tests were also employed. Data show that females are more likely to be infomediaries than males. Schools serve as the primary sources of information on climate change, and students generally equate climate change to extreme weather events such as drought. Various teaching media explored seem to be useful in various development contexts. Teachers are seen as the champions of this initiative. Hence, this initiative rests heavily on the extent of capacity enhancement that can be extended to the teachers so they are in a better position to train their students in the future

Optimal echocardiographic assessment of myocardial dysfunction for arrhythmic risk stratification in phospholamban mutation carriers

AIMS: Phospholamban (PLN) p.Arg14del mutation carriers are at risk of developing malignant ventricular arrhythmias (VAs) and/or heart failure. Currently, left ventricular ejection fraction (LVEF) plays an important role in risk assessment for VA in these individuals. We aimed to study the incremental prognostic value of left ventricular mechanical dispersion (LVMD) by echocardiographic deformation imaging for prediction of sustained VA in PLN p.Arg14del mutation carriers. METHODS AND RESULTS: We included 243 PLN p.Arg14del mutation carriers, which were classified into three groups according to the '45/45' rule: (i) normal left ventricular (LV) function, defined as preserved LVEF ≥45% with normal LVMD ≤45 ms (n = 139), (ii) mechanical LV dysfunction, defined as preserved LVEF ≥45% with abnormal LVMD >45 ms (n = 63), and (iii) overt LV dysfunction, defined as reduced LVEF <45% (n = 41). During a median follow-up of 3.3 (interquartile range 1.8-6.0) years, sustained VA occurred in 35 individuals. The negative predictive value of having normal LV function at baseline was 99% [95% confidence interval (CI): 92-100%] for developing sustained VA. The positive predictive value of mechanical LV dysfunction was 20% (95% CI: 15-27%). Mechanical LV dysfunction was an independent predictor of sustained VA in multivariable analysis [hazard ratio adjusted for VA history: 20.48 (95% CI: 2.57-162.84)]. CONCLUSION: LVMD has incremental prognostic value on top of LVEF in PLN p.Arg14del mutation carriers, particularly in those with preserved LVEF. The '45/45' rule is a practical approach to echocardiographic risk stratification in this challenging group of patients. This approach may also have added value in other diseases where LVEF deterioration is a relative late marker of myocardial dysfunction

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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What is the role of the placebo effect for pain relief in neurorehabilitation? Clinical implications from the Italian Consensus Conference on Pain in Neurorehabilitation

Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy