Innovation in natural resource management

International agricultural research is expanding beyond the development of annual crop technologies for individual farms to the development of longer-tern natural resource management techniques for entire landscapes. But technologies of practices with a long lag time between investment and returns are unlikely to be adopted by farmers unless they have secure rights to the underlying resources (property rights). Similarly, technologies that span multiple farms are unlikely to be adopted unless neighbors and groups work together (collective action). But little is know about the way property rights and collective action in developing countries mediate the adoption of technologies by farmers and groups. This statement offers suggestions for promoting sustainable natural resource management.

Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial

Objective: The HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management. Design: Unmasked randomised controlled trial with automated ascertainment of primary endpoint. Setting: 76 general practices in the United Kingdom. Participants: 622 people with treated but poorly controlled hypertension (>140/90 mm Hg) and access to the internet. Interventions: Participants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines. Main outcome measures: The primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values. Results: After one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of −3.4 mm Hg (95% confidence interval −6.1 to −0.8 mm Hg) and a mean difference in diastolic blood pressure of −0.5 mm Hg (−1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction. Conclusions: The HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded. Trial registration: ISRCTN13790648

Strategies for poverty alleviation and sustainable resource management in the fragile lands of Sub-Saharan Africa

Partial contents: Workshop summary / Anna Knox McCulloch [IFPRI staff], Suresh Babu [IFPRI staff], Tidiane Ngaido [IFPRI staff] -- Growth, poverty alleviation, and the environment in the fragile lands of Sub-Saharan Africa / Suresh Babu and Peter Hazell [IFPRI staff] -- Spatial aspects of the design and targeting of development strategies for fragile lands / Stanley Wood [IFPRI staff] ... [et al.] -- The impact of policy reforms and trade liberalization on fragile lands in Sub-Saharan Africa / Awudu Abdulai and Peter Hazell -- Strategies for sustainable agricultural development in the East African highlands / John Pender [IFPRI staff] ... [et al.] -- Property rights institutions for the development of fragile lands / Anna Knox McCulloch and Peter Hazell -- Dambo Irrigation systems: indigenous water management for food security in Zimbabwe / Ruth Meinzen-Dick [IFPRI staff] and Godswill Makombe.Non-PRIFPRI5; GRP5EPTD; COM326 p. : ill., tables ; 21 cm