Agro-environmental project duration and effectiveness in South-east Asia

Considerable emphasis has been placed on developing technologies for agricultural sustainability. Many bilateral projects are working to achieve this outcome. A desk review was conducted to study the importance of project duration for the effectiveness of sustainable agricultural projects. Longer-duration projects were successful in addressing more holistic issues than short projects. However, funding agencies tend to fund shorter-duration projects, so projects become progressively shorter. At the same time, the number of projects implemented each year is increasing. Despite the decrease in total development assistance, increases in project numbers, particularly since 1986, appear to be at the cost of project duration. Short project duration was one of the most cited reasons for not completing essential dissemination activities for wider adoption, whereas longer- duration projects were usually considered more successful in addressing more holistic issues. It is difficult to produce tangible outputs from agricultural and soil conservation projects within five years. Considering the slow changes in the system and in agricultural and environmental sustainability, the authors suggest that project developers should be advised to plan for a minimum of 5–10 years, depending on the nature of activities. It is time for funding agencies to reconsider their tendency to fund shorter-duration projects

Vitamin K supplementation to improve vascular stiffness in CKD:The K4Kidneys randomized controlled trial

BACKGROUND:Vascular calcification, a risk factor for cardiovascular disease, is common among patients with CKD and is an independent contributor to increased vascular stiffness and vascular risk in this patient group. Vitamin K is a cofactor for proteins involved in prevention of vascular calcification. Whether or not vitamin K supplementation could improve arterial stiffness in patients with CKD is unknown. METHODS:To determine if vitamin K supplementation might improve arterial stiffness in patients in CKD, we conducted a parallel-group, double-blind, randomized trial in participants aged 18 or older with CKD stage 3b or 4 (eGFR 15-45 ml/min per 1.73 m2). We randomly assigned participants to receive 400 μg oral vitamin K2 or matching placebo once daily for a year. The primary outcome was the adjusted between-group difference in carotid-femoral pulse wave velocity at 12 months. Secondary outcomes included augmentation index, abdominal aortic calcification, BP, physical function, and blood markers of mineral metabolism and vascular health. We also updated a recently published meta-analysis of trials to include the findings of this study. RESULTS:We included 159 randomized participants in the modified intention-to-treat analysis, with 80 allocated to receive vitamin K and 79 to receive placebo. Mean age was 66 years, 62 (39%) were female, and 87 (55%) had CKD stage 4. We found no differences in pulse wave velocity at 12 months, augmentation index at 12 months, BP, B-type natriuretic peptide, or physical function. The updated meta-analysis showed no effect of vitamin K supplementation on vascular stiffness or vascular calcification measures. CONCLUSIONS:Vitamin K2 supplementation did not improve vascular stiffness or other measures of vascular health in this trial involving individuals with CKD. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER:Vitamin K therapy to improve vascular health in patients with chronic kidney disease, ISRCTN21444964 (www.isrctn.com)

The American Congress of Rehabilitation Medicine Diagnostic Criteria for Mild Traumatic Brain Injury

Objective: To develop new diagnostic criteria for mild traumatic brain injury (TBI) that are appropriate for use across the lifespan and in sports, civilian trauma, and military settings. Design: Rapid evidence reviews on 12 clinical questions and Delphi method for expert consensus. Participants: The Mild Traumatic Brain Injury Task Force of the American Congress of Rehabilitation Medicine Brain Injury Special Interest Group convened a Working Group of 17 members and an external interdisciplinary expert panel of 32 clinician-scientists. Public stakeholder feedback was analyzed from 68 individuals and 23 organizations. Results: The first 2 Delphi votes asked the expert panel to rate their agreement with both the diagnostic criteria for mild TBI and the supporting evidence statements. In the first round, 10 of 12 evidence statements reached consensus agreement. Revised evidence statements underwent a second round of expert panel voting, where consensus was achieved for all. For the diagnostic criteria, the final agreement rate, after the third vote, was 90.7%. Public stakeholder feedback was incorporated into the diagnostic criteria revision prior to the third expert panel vote. A terminology question was added to the third round of Delphi voting, where 30 of 32 (93.8%) expert panel members agreed that ‘the diagnostic label ‘concussion’ may be used interchangeably with ‘mild TBI’ when neuroimaging is normal or not clinically indicated.’ Conclusions: New diagnostic criteria for mild TBI were developed through an evidence review and expert consensus process. Having unified diagnostic criteria for mild TBI can improve the quality and consistency of mild TBI research and clinical care.</p

The American Congress of Rehabilitation Medicine Diagnostic Criteria for Mild Traumatic Brain Injury

Objective: To develop new diagnostic criteria for mild traumatic brain injury (TBI) that are appropriate for use across the lifespan and in sports, civilian trauma, and military settings. Design: Rapid evidence reviews on 12 clinical questions and Delphi method for expert consensus. Participants: The Mild Traumatic Brain Injury Task Force of the American Congress of Rehabilitation Medicine Brain Injury Special Interest Group convened a Working Group of 17 members and an external interdisciplinary expert panel of 32 clinician-scientists. Public stakeholder feedback was analyzed from 68 individuals and 23 organizations. Results: The first 2 Delphi votes asked the expert panel to rate their agreement with both the diagnostic criteria for mild TBI and the supporting evidence statements. In the first round, 10 of 12 evidence statements reached consensus agreement. Revised evidence statements underwent a second round of expert panel voting, where consensus was achieved for all. For the diagnostic criteria, the final agreement rate, after the third vote, was 90.7%. Public stakeholder feedback was incorporated into the diagnostic criteria revision prior to the third expert panel vote. A terminology question was added to the third round of Delphi voting, where 30 of 32 (93.8%) expert panel members agreed that ‘the diagnostic label ‘concussion’ may be used interchangeably with ‘mild TBI’ when neuroimaging is normal or not clinically indicated.’ Conclusions: New diagnostic criteria for mild TBI were developed through an evidence review and expert consensus process. Having unified diagnostic criteria for mild TBI can improve the quality and consistency of mild TBI research and clinical care.</p

The American Congress of Rehabilitation Medicine Diagnostic Criteria for Mild Traumatic Brain Injury

Objective: To develop new diagnostic criteria for mild traumatic brain injury (TBI) that are appropriate for use across the lifespan and in sports, civilian trauma, and military settings. Design: Rapid evidence reviews on 12 clinical questions and Delphi method for expert consensus. Participants: The Mild Traumatic Brain Injury Task Force of the American Congress of Rehabilitation Medicine Brain Injury Special Interest Group convened a Working Group of 17 members and an external interdisciplinary expert panel of 32 clinician-scientists. Public stakeholder feedback was analyzed from 68 individuals and 23 organizations. Results: The first 2 Delphi votes asked the expert panel to rate their agreement with both the diagnostic criteria for mild TBI and the supporting evidence statements. In the first round, 10 of 12 evidence statements reached consensus agreement. Revised evidence statements underwent a second round of expert panel voting, where consensus was achieved for all. For the diagnostic criteria, the final agreement rate, after the third vote, was 90.7%. Public stakeholder feedback was incorporated into the diagnostic criteria revision prior to the third expert panel vote. A terminology question was added to the third round of Delphi voting, where 30 of 32 (93.8%) expert panel members agreed that ‘the diagnostic label ‘concussion’ may be used interchangeably with ‘mild TBI’ when neuroimaging is normal or not clinically indicated.’ Conclusions: New diagnostic criteria for mild TBI were developed through an evidence review and expert consensus process. Having unified diagnostic criteria for mild TBI can improve the quality and consistency of mild TBI research and clinical care.</p

Factors influencing the effectiveness of an agro-environmental project in China

A case study identified the factors affecting farmers’ adoption of improved technologies extended by an agricultural development project in a rural village in Yunnan Province, China. Project effectiveness was influenced by: the success and appropriateness of recommended technologies and associated infrastructure development; the use of participatory approaches; material and advisory support to local stakeholders; clear explanations of project objectives to farmers; benefits for small landholders; land rights for farmers; farmers’ awareness and dissemination activities; and project duration. Farmers’ adoption of technologies should be a major criterion in evaluating project success

Lessons from Participatory Evaluation of Cropping Practices in Yunnan Province, China: Overview of the Effectiveness of Technologies and Issues Related to Technology Adoption

Increasing crop production, while maintaining sustainability, is a priority for agricultural development projects, particularly in developing countries. This study investigated the factors contributing to the effectiveness of agricultural development projects in improving the sustainability of cropping systems in a small upland watershed in south-west China. This involved a review of recent related projects and detailed evaluation of one project: the SHASEA Project. Farmers’ perceptions of several agricultural technologies are discussed, along with factors contributing to farmers’ adoption of these technologies. Local, national and international institutions need to adopt several strategies to improve project effectiveness and agro-environmental sustainability

Lessons from Participatory Evaluation of Cropping Practices in Yunnan Province, China: Overview of the Effectiveness of Technologies and Issues Related to Technology Adoption

Increasing crop production, while maintaining sustainability, is a priority for agricultural development projects, particularly in developing countries. This study investigated the factors contributing to the effectiveness of agricultural development projects in improving the sustainability of cropping systems in a small upland watershed in south-west China. This involved a review of recent related projects and detailed evaluation of one project: the SHASEA Project. Farmers’ perceptions of several agricultural technologies are discussed, along with factors contributing to farmers’ adoption of these technologies. Local, national and international institutions need to adopt several strategies to improve project effectiveness and agro-environmental sustainability.sustainable agriculture; technological effectiveness; technology adoption/adaptation

An evaluation of the introduction of modified cropping practices in Yunnan Province, China, using surveys of farmers' households

Problems associated with land degradation are serious in China. Sloping land in South China has experienced a decline in crop productivity by 30-60% due to soil erosion and it has been predicted that most topsoil will be lost within the next 100 years if current erosion rates continue. Considering these situations, an agro-environmental research and development project (Sustainable Highland Agriculture in South-East Asia – SHASEA) was conducted in a catchment in Yunnan Province, China, to address the objectives of increasing crop productivity in sustainable and environmentally-friendly ways. A range of cropping practices was developed and implemented in a rural upland catchment (Wang Jia). At the end of the project, farmers were surveyed to evaluate project effectiveness. All farmers from Wang Jia Catchment, who were involved in project implementation, were surveyed. A sample of farmers working in an adjacent catchment (not associated with the project) was surveyed for comparative purposes. Farmers had different perceptions of the cropping practices employed. Contour cultivation was preferred and likely to be adopted. Others practices such as straw mulching and intercropping were seen as less appropriate and unlikely to be adopted. Polythene mulch was recognized as effective, but likely to be adopted only if financial returns were favourable. The availability of relevant information had an important impact on the extent of technology testing by farmers and their willingness to adopt the practices in the future

An awareness-adoption matrix for strategic decision making in agricultural development projects: a case study in Yunnan Province, China

Significant achievements have been made in generating sustainable agricultural technologies in developing countries. Usually, these new technologies have been more effective in increasing production and productivity than existing technologies. However, many new technologies considered ‘effective’ have not been successful in alleviating the associated sustainability problems, due to poor adoption by targeted users. Success of any novel technical intervention should be judged on the basis of how widespread adoption is in the target area by targeted users. In this context, a case study identified the factors affecting farmers’ adoption of improved technologies extended by an agricultural development project in a rural Village in Yunnan Province, China. Initial adoption/adaptation of project technologies was influenced by farmers’ awareness of the technology. Farmers were more aware of polythene mulch, contour cultivation, intercropping and tree planting technologies than others. This led to a comparatively high initial uptake of polythene mulch, contour cultivation, sweet chestnut, and intercropping technologies. Farmers had inadequate knowledge about some Project technologies, the adoption of which was particularly low. This reveals the need for increasing farmers’ awareness about the rationale for Project technologies to achieve greater adoption/adaptation of project technologies by farmers over wider areas. Farmers’ testing of the technology leads to better adoption/adaptation compared to mere awareness. However, considerable time and resources are required for testing/trying technologies. This justifies the usefulness of comparatively quick and less resource demanding options for awareness creation. Development of effective cropping technologies is important for sustainable agricultural development. The success of any agricultural development project, especially in terms of improving sustainability, depends on how widely those improved technologies are adopted/adapted by farmers in the targeted region. Therefore, farmers’ adoption of technologies should be a key criterion for judging the success of any project. The awareness-adoption matrix is a useful tool to guide research and development projects to achieve expected adoption/adaptation of technologies. Use of the matrix helps identification of weak and strong aspects of research and development projects and thus assists strategic decision-making