Establishing Agro-Enterprises towards Inclusive Development: The Case of Nueva Segovia Consortium of Cooperatives in the Philippines

This study analyzed the case of a local cooperative in the Philippines engaged in agro-enterprise development (AED). It aimed to gather microlevel insight on AED’s contribution to inclusive development, in the context of inclusive agri-business. The researchers profiled the AED initiatives of the Nueva Segovia Consortium of Cooperatives (NSCC), determined the challenges in implementing these initiatives, and analyzed the perceived impacts of the initiatives on the beneficiaries in relation to inclusive development. Data were gathered through key informant interview, focus group discussion, and review of project documents. Based on NSCC’s experience, key informants perceive that the AED initiatives have led to material, cognitive, perceptual, and relational change in its beneficiaries. These resulted from continuous capacity building and directly linking farmers to modern value chains through agro-enterprise development. The changes contribute to empowering the member farmers thereby promoting inclusive development at the local level. The key challenges faced by NSCC are related to production and the policy and institutional landscape for agro-enterprise development. Addressing these challenges, as well as capacitating the agro-enterprises to implement post-production value-adding activities, can maximize the gains towards inclusive development. In-depth studies on the impacts of agro-enterprises on beneficiaries are recommended to further substantiate the potential of agro-enterprise development to promote inclusiveness

I Foro de Ministras y Viceministras de Agricultura de las Américas “Las Mujeres al frente de la Transformación de los Sistemas Agroalimentarios”

Moderadora: Karla Iberia Sánchez.El objetivo del Foro es resaltar el papel de las mujeres que, desde el nivel más alto de la función pública, trabajan por el desarrollo sostenible de los sistemas agroalimentarios, generando un espacio de diálogo e intercambio de información en el que se compartirán valiosas experiencias de gestión

Effect of Metformin and Lifestyle Interventions on Mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study

ObjectiveTo determine whether metformin or lifestyle modification can lower rates of all-cause and cause-specific mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study.Research design and methodsFrom 1996 to 1999, 3,234 adults at high risk for type 2 diabetes were randomized to an intensive lifestyle intervention, masked metformin, or placebo. Placebo and lifestyle interventions stopped in 2001, and a modified lifestyle program was offered to everyone, but unmasked study metformin continued in those originally randomized. Causes of deaths through 31 December 2018 were adjudicated by blinded reviews. All-cause and cause-specific mortality hazard ratios (HRs) were estimated from Cox proportional hazards regression models and Fine-Gray models, respectively.ResultsOver a median of 21 years (interquartile range 20-21), 453 participants died. Cancer was the leading cause of death (n = 170), followed by cardiovascular disease (n = 131). Compared with placebo, metformin did not influence mortality from all causes (HR 0.99 [95% CI 0.79, 1.25]), cancer (HR 1.04 [95% CI 0.72, 1.52]), or cardiovascular disease (HR 1.08 [95% CI 0.70, 1.66]). Similarly, lifestyle modification did not impact all-cause (HR 1.02 [95% CI 0.81, 1.28]), cancer (HR 1.07 [95% CI 0.74, 1.55]), or cardiovascular disease (HR 1.18 [95% CI 0.77, 1.81]) mortality. Analyses adjusted for diabetes status and duration, BMI, cumulative glycemic exposure, and cardiovascular risks yielded results similar to those for all-cause mortality.ConclusionsCancer was the leading cause of mortality among adults at high risk for type 2 diabetes. Although metformin and lifestyle modification prevented diabetes, neither strategy reduced all-cause, cancer, or cardiovascular mortality rates

Risk of COVID-19 after natural infection or vaccinationResearch in context

Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health