Diversity of underutilized vegetables and fruit in Sri Lanka: Prioritization for collection, conservation, genetic improvement, and promotion

Despite their crucial role in combating hunger, malnutrition, and poverty, many plant species cultivated as fruits, vegetables, roots, and tuber crops remain neglected and underutilized worldwide, and Sri Lanka is no exception. Integrating these crops into farming systems has the potential to create nutrient-dense, climate-resilient, and sustainable agricultural practices. The study titled "Diversity of underutilized vegetables and fruit in Sri Lanka: prioritization for collection, conservation, genetic improvement, and promotion" highlights the significance of underutilized vegetables and fruits in Sri Lanka's agricultural biodiversity. These often-overlooked crops possess unique nutritional and agronomic traits that could benefit both farmers and consumers. However, they have been overshadowed by more commonly cultivated species and varieties. To safeguard the genetic diversity and potential contributions of these underutilized crops to food security and nutrition, the study emphasizes the need for prioritizing their collection and conservation. Preserving their genetic resources enables researchers and farmers to access a broader range of traits, enhancing resilience to environmental challenges. Additionally, the research underscores the importance of genetic improvement efforts to boost the productivity and adaptability of underutilized vegetables and fruits. Breeding programs focused on priority species can lead to the development of new cultivars with desirable traits, such as increased yield, disease resistance, and improved nutritional content. Moreover, promoting underutilized crops is essential to raise awareness among consumers, retailers, and policymakers about their nutritional benefits and economic potential. By creating market demand and integrating these crops into agricultural systems, their sustainable cultivation and utilization become more viable. In summary, recognizing and prioritizing the diversity of underutilized vegetables and fruits in Sri Lanka is crucial. Through strategic collection, conservation, genetic improvement, and promotion efforts, these crops can significantly contribute to enhancing food security, preserving biodiversity, and supporting sustainable agricultural practices in the country

Competences of physiotherapists and nurses working with older adults in Sri Lanka: a need analysis exploratory study with students, academics and health professionals

Background & Aim: The population of Sri Lanka (SL) is rapidly aging, with a growing demand for healthcare professionals skilled in geriatric care. Nurses and physiotherapists play a crucial role in the management of the health and well-being of older adults. This survey aimed to identify the current resources and demands in the professional competences for physiotherapy and nursing professionals working with older adults in SL. Methods: An observational cross-sectional study was conducted among physiotherapists and nurses working in health care settings in SL, academic staff members involved in teaching, training and research, and final year physiotherapy and nursing undergraduates in selected state universities in SL. All the participants completed an online survey consisting of general socio-demographic information, professional and education-related information, knowledge, skills, and clinical and non-clinical competences required for older adult care. Results: Among the 189 respondents (mean age=32.44; SD=8.16 years), 145 (76.7%) were females, 113 (59.8%) were physiotherapists, and 76 (40.2%) were nurses. Of the total participants, 54 (28.6%) were academic staff members, 64 (33.9%) were final-year undergraduates and 71 (37.6%) were healthcare professionals (physiotherapists and nurses). Physiotherapists reported being less confident in “managing chronic pain in older adults” compared to nurses (p=0.03). “Active listening” (88%) and “respect for dignity and autonomy” (76.8%) were identified as more relevant aspects for health professionals under empathy in the care of older adults. “Communication barriers” (83.1%), “financial constraints” (66.7%) and “cultural sensitivity” (63.0%) were identified as challenges that healthcare professionals faced when working with older adults. Conclusions & Recommendations: The findings emphasize the importance of incorporating geriatric-specific training into the undergraduate education and professional development of healthcare providers, particularly nurses and physiotherapists. Policymakers, education and healthcare institutions should collaborate to develop structured training programs that address the identified competency gaps and promote the delivery of holistic and person-centred care for older adults.ei tietoa saavutettavuudest

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Factors Associated with Symptom Burden in Adults with Chronic Kidney Disease Undergoing Hemodialysis: A Prospective Study

People with end stage renal disease and undergoing hemodialysis experience a high symptom burden that impairs quality of life. This study aimed to assess the prevalence, dynamicity and determinants of symptom burden among middle-aged and older adult hemodialysis patients. A descriptive cross-sectional study together with a longitudinal assessment was used. A total of 118 and 102 hemodialysis patients were assessed at baseline and at a 6-month follow-up. Validated questionnaires were used to assess the symptom burden, stress, illness perception and social support. Multiple linear regression analysis was used to determine the factors associated with symptom burden. The median number of symptoms experienced was 21 (Interquartile Range (IQR); 18–23) and 19 (IQR; 13–22) at baseline and 6 months, respectively. Having elevated stress (β = 0.65, p ≤ 0.005) and illness perception (β = 0.21, p = 0.02) were significantly predicted symptom burden at baseline (F (4, 112) = 55.29, p &lt; 0.005, R2 = 0.664). Stress (β = 0.28, p = 0.003), illness perception (β = 0.2, p = 0.03), poor social support (β = −0.22, p = 0.01) and low body weight (β = −0.19, p = 0.03) were the determinants for symptom burden at 6 months (F (5, 93) = 4.85, p ≤ 0.005, R2 = 0.24). Elevated stress, illness perception level, poor social support and low post-dialysis body weight were found to be determinants for symptom burden. Attention should be given to psychosocial factors of hemodialysis patients while conducting assessment and delivering care to patients.</jats:p

Factors Associated with Symptom Burden in Adults with Chronic Kidney Disease Undergoing Hemodialysis: A Prospective Study

People with end stage renal disease and undergoing hemodialysis experience a high symptom burden that impairs quality of life. This study aimed to assess the prevalence, dynamicity and determinants of symptom burden among middle-aged and older adult hemodialysis patients. A descriptive cross-sectional study together with a longitudinal assessment was used. A total of 118 and 102 hemodialysis patients were assessed at baseline and at a 6-month follow-up. Validated questionnaires were used to assess the symptom burden, stress, illness perception and social support. Multiple linear regression analysis was used to determine the factors associated with symptom burden. The median number of symptoms experienced was 21 (Interquartile Range (IQR); 18&ndash;23) and 19 (IQR; 13&ndash;22) at baseline and 6 months, respectively. Having elevated stress (&beta; = 0.65, p &le; 0.005) and illness perception (&beta; = 0.21, p = 0.02) were significantly predicted symptom burden at baseline (F (4, 112) = 55.29, p &lt; 0.005, R2 = 0.664). Stress (&beta; = 0.28, p = 0.003), illness perception (&beta; = 0.2, p = 0.03), poor social support (&beta; = &minus;0.22, p = 0.01) and low body weight (&beta; = &minus;0.19, p = 0.03) were the determinants for symptom burden at 6 months (F (5, 93) = 4.85, p &le; 0.005, R2 = 0.24). Elevated stress, illness perception level, poor social support and low post-dialysis body weight were found to be determinants for symptom burden. Attention should be given to psychosocial factors of hemodialysis patients while conducting assessment and delivering care to patients

Recovery of cardiovascular testing in Asia during the COVID-19 pandemic: findings from the INCAPS COVID 2 study

Background Understanding pandemic-related reductions and subsequent recovery of cardiovascular testing in Asia is important for guiding regional public health efforts.Objectives This study sought to evaluate the recovery of cardiovascular testing in Asia 1 year into the COVID-19 pandemic.Methods In this subanalysis of a worldwide survey on the impact of COVID-19 on cardiovascular diagnostic care in April 2020 and April 2021, recovery of testing volume in Asia was compared among subregions, World Bank income groups and imaging modalities.Results Of 669 sites worldwide, 164 sites were in 33 Asian countries. Cardiovascular testing volumes in Asia decreased by 53% from March 2019 to April 2020, then recovered 96% of this decrease by April 2021, compared with 98% recovery in the rest of the world. Eastern Asia and Western and Central Asia reported recovery rates of 123% and 110%, compared with 50% and 80% recovery in Southern and South-eastern Asia. Testing volumes among high-income and upper-middle-income Asian countries recovered to 117% and 121% but remained depressed at 49% and 14% recovery in lower-middle and low-income countries, respectively. Stress ECG, stress echo and stress positron emission tomography studies experienced median reductions of 48%, 35% and 57% in testing volume between March 2019 and April 2021, while volumes of coronary artery calcium, coronary CT angiography and cardiac MR remained stable during this period.Conclusions The recovery of cardiovascular testing in Asia 1 year into the COVID-19 pandemic lagged in the Southern and South-eastern subregions, as well as in lower-income countries. Recovery favoured advanced cardiac imaging modalities over standard stress testing modalities

Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19

BACKGROUND The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures