Biofuels and Food Security: Implications of an Accelerated Biofuels Production

Biofuels development has received increased attention in recent times as a means to mitigate climate change, alleviate global energy concerns and foster rural development. Its perceived importance in these three areas has seen biofuels feature prominently on the international agenda. Nevertheless, the rapid growth of biofuels production has raised many concerns among experts worldwide, in particular with regard to sustainability issues and the threat posed to food security. The UN Secretary General, in his opening remarks to the High-level Segment of the 16th session of the UN Commission on Sustainable Development, stated that: "We need to ensure that policies promoting biofuels are consistent with maintaining food security and achieving sustainable development goals." Aware of a lack of integrated scientific analysis, OFID has commissioned this study, Biofuels and Food Security, which has been prepared by the renowned International Institute for Applied Systems Analysis (IIASA). This seminal research work assesses the impact on developing countries of wide-scale production and use of biofuels, in terms of both sustainable agriculture and food security. The unique feature of this study is that its quantified findings are derived from a scenario approach based on a peer reviewed modelling framework, which has contributed to the work of many scientific fora such as the Intergovernmental Panel on Climate Change (IPCC), and the United Nations (Climate Change and Agricultural Vulnerability, World Summit on Sustainable Development, Johannesburg). One of the key conclusions of the study is that an accelerated growth of first-generation biofuels production is threatening the availability of adequate food supplies for humans, by diverting land, water and other resources away from food and feed crops. Meanwhile, the "green" contribution of biofuels is seen as deceptive, with mainly second-generation biofuels appearing to offer interesting prospects. Sustainability issues (social, economic and environmental), the impact on land use, as well as many risk aspects are amongst the key issues tackled in the research. With the publication of this study, OFID seeks to uphold its time-honored tradition of promoting debate on issues of special interest to developing countries, including the OFID/OPEC Member States

Biofuels and Food Security

Biofuels development has received increased attention in recent times as a means to mitigate climate change, alleviate global energy concerns and foster rural development. Its perceived importance in these three areas has seen biofuels feature prominently on the international agenda. Nevertheless, the rapid growth of biofuels production has raised many concerns among experts worldwide, in particular with regard to sustainability issues and the threat posed to food security. The UN Secretary General, in his opening remarks to the High-level Segment of the 16th session of the UN Commission on Sustainable Development, stated that: "We need to ensure that policies promoting biofuels are consistent with maintaining food security and achieving sustainable development goals." Aware of a lack of integrated scientific analysis, OFID has commissioned this study, Biofuels and Food Security, which has been prepared by the renowned International Institute for Applied Systems Analysis (IIASA). This seminal research work assesses the impact on developing countries of wide-scale production and use of biofuels, in terms of both sustainable agriculture and food security. The unique feature of this study is that its quantified findings are derived from a scenario approach based on a peer reviewed modelling framework, which has contributed to the work of many scientific fora such as the Intergovernmental Panel on Climate Change (IPCC), and the United Nations (Climate Change and Agricultural Vulnerability, World Summit on Sustainable Development, Johannesburg). One of the key conclusions of the study is that an accelerated growth of first-generation biofuels production is threatening the availability of adequate food supplies for humans, by diverting land, water and other resources away from food and feed crops. Meanwhile, the "green" contribution of biofuels is seen as deceptive, with mainly second-generation biofuels appearing to offer interesting prospects. Sustainability issues (social, economic and environmental), the impact on land use, as well as many risk aspects are amongst the key issues tackled in the research. With the publication of this study, OFID seeks to uphold its time-honored tradition of promoting debate on issues of special interest to developing countries, including the OFID/OPEC Member States

Integrated modeling approach to the analysis of food security and sustainable rural developments: Ukrainian case study

In Ukraine, the growth of intensive agricultural enterprises with a focus on fast profits contributes considerably to food insecurity and increasing socio-economic and environmental risks. Ukraine has important natural and labor resources for effective rural development. For example, more than 50% of food production is still managed in small and medium farms despite the difficulties associated with economic instabilities and the lack of proper policy support. The main issue for the agro-policy nowadays is to use these resources in a sustainable way enforcing robust long term development of rural communities and agriculture. In this paper, we introduce a stochastic geographically explicit model for designing forward looking policies regarding robust resources allocation and composition of agricultural production enhancing food security and rural development. In particular, we investigate the role of investments into rural facilities to stabilize and enhance the performance of the agrofood sector in view of uncertainties and incomplete information. The security goals are introduced in the form of multidimensional risk indicators

Changes in empowerment and anxiety of patients and parents during genetic counselling for epilepsy

Genetic testing and counselling are increasingly important in epilepsy care, aiming at finding a diagnosis, understanding aetiology and improving treatment and outcome. The psychological impact of genetic counselling from patients' or parents & rsquo; perspectives is, however, unknown. We studied the counseleereported outcome of genetic counselling before and after genetic testing for epilepsy by evaluating empowerment - a key outcome goal of counselling reflecting cognitive, decisional and behavioural control, emotional regulation and hope - and anxiety. We asked patients or their parents (for those (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of European Paediatric Neurology Society. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Positive experiences of healthcare professionals with a mainstreaming approach of germline genetic testing for women with ovarian cancer

According to current guidelines, all women with epithelial ovarian cancer are eligible for genetic testing for BRCA germline pathogenic variants. Unfortunately, not all affected women are tested. We evaluated the acceptability and feasibility for non-genetic healthcare professionals to incorporate germline genetic testing into their daily practice. We developed and implemented a mainstreaming pathway, including a training module, in collaboration with various healthcare professionals and patient organizations. Healthcare professionals from 4 different hospitals were invited to participate. After completing the training module, gynecologic oncologists, gynecologists with a subspecialty training in oncology, and nurse specialists discussed and ordered genetic testing themselves. They received a questionnaire before completing the training module and 6 months after working according to the new pathway. We assessed healthcare professionals' attitudes, perceived knowledge, and self-efficacy, along with the feasibility of this new mainstream workflow in clinical practice, and evaluated the use and content of the training module. The participation rate for completing the training module was 90% (N = 19/21). At baseline and after 6 months, healthcare professionals had a positive attitude, high perceived knowledge and high self-efficacy toward discussing and ordering genetic testing. Knowledge had increased significantly after 6 months. The training module was rated with an average of 8.1 out of 10 and was considered useful. The majority of healthcare professionals (9/15) was able to discuss a genetic test in five to 10 min. After completion of a training module, non-genetic healthcare professionals feel motivated and competent to discuss and order genetic testing themselves

Surgical Oncologists and Nurses in Breast Cancer Care are Ready to Provide Pre-Test Genetic Counseling

Background: Pre-test genetic counseling for patients with breast cancer is increasingly being provided by nongenetic healthcare professionals. We evaluated the attitudes, knowledge, and self-efficacy of surgeons, oncologists, and nurses regarding mainstream genetic testing and the feasibility to incorporate pre-test genetic counseling into routine care. Methods: We offered an online training to healthcare professionals from 13 hospitals and implemented a mainstream genetic testing pathway in 11/13 (85%) hospitals. Questionnaires were sent before (T0) and 6 months after (T1) completing the training. Those who did not complete the training received a questionnaire to assess their motivations. Results: In 11 hospitals, 80 (65%) healthcare professionals completed the training, of whom 70 (88%) completed both questionnaires. The attitudes, (perceived) knowledge and self-efficacy of healthcare professionals were high both at baseline and 6 months after completing the training. After 6 months, their perceived knowledge about the advantages and disadvantages of a genetic test and implications for family members had significantly improved (p = 0.012 and p = 0.021, respectively). For the majority (89%), the time investment for pre-test genetic counseling was less than 15 min per patient and as expected or better. Healthcare professionals considered the total time investment feasible to incorporate mainstream genetic testing into their daily practice. The main barrier to complete the training was lack of time. The online training was considered useful, with a rating of 8/10. Conclusion: Surgical oncologists and nurses in breast cancer care feel well-equipped and motivated to provide pre-test genetic counseling after completion of an online training module

Hereditary cancer registries improve the care of patients with a genetic predisposition to cancer:contributions from the Dutch Lynch syndrome registry

The Dutch Hereditary Cancer Registry was established in 1985 with the support of the Ministry of Health (VWS). The aims of the registry are: (1) to promote the identification of families with hereditary cancer, (2) to encourage the participation in surveillance programs of individuals at high risk, (3) to ensure the continuity of lifelong surveillance examinations, and (4) to promote research, in particular the improvement of surveillance protocols. During its early days the registry provided assistance with family investigations and the collection of medical data, and recommended surveillance when a family fulfilled specific diagnostic criteria. Since 2000 the registry has focused on family follow-up, and ensuring the quality of surveillance programs and appropriate clinical management. Since its founding, the registry has identified over 10,000 high-risk individuals with a diverse array of hereditary cancer syndromes. All were encouraged to participate in prevention programmes. The registry has published a number of studies that evaluated the outcome of surveillance protocols for colorectal cancer (CRC) in Lynch syndrome, as well as in familial colorectal cancer. In 2006, evaluation of the effect of registration and colonoscopic surveillance on the mortality rate associated with colorectal cancer (CRC) showed that the policy led to a substantial decrease in the mortality rate associated with CRC. Following discovery of MMR gene defects, the first predictive model that could select families for genetic testing was published by the Leiden group. In addition, over the years the registry has produced many cancer risk studies that have helped to develop appropriate surveillance protocols. Hereditary cancer registries in general, and the Lynch syndrome registry in particular, play an important role in improving the clinical management of affected families.</p

Mainstream germline genetic testing for patients with epithelial ovarian cancer leads to higher testing rates and a reduction in genetics-related healthcare costs from a healthcare payer perspective

OBJECTIVE: Germline genetic testing is increasingly offered to patients with epithelial ovarian cancer by non-genetic healthcare professionals, so called mainstream genetic testing. The aim of this study was to evaluate the effect of implementing a mainstream genetic testing pathway on the percentage of newly diagnosed patients with epithelial ovarian cancer to whom genetic testing was offered and the genetics-related healthcare costs. METHODS: The possible care pathways for genetic counseling and testing and their associated costs were mapped. Patient files from all newly diagnosed patients with epithelial ovarian cancer before (March 2016 - September 2017) and after (April 2018 - December 2019) implementing our mainstream genetic testing pathway were analyzed. Based on this analysis, the percentage of newly diagnosed patients to whom genetic testing was offered was assessed and genetics-related healthcare costs were calculated using a healthcare payer perspective based on a Diagnosis-Related Group financing approach. RESULTS: Within six months after diagnosis, genetic testing was offered to 56% of patients before and to 70% of patients after implementation of our mainstream genetic testing pathway (p = 0.005). Genetics-related healthcare costs decreased from €3.511,29 per patient before implementation to €2.418,41 per patient after implementation of our mainstream genetic testing pathway (31% reduction, p = 0.000). CONCLUSION: This study shows that mainstream genetic testing leads to a significantly higher proportion of newly diagnosed patients with epithelial ovarian cancer being offered germline genetic testing. In addition, it significantly reduces genetics-related healthcare costs per patient

Patients’ experiences with pre-test genetic counseling provided by breast cancer healthcare professionals: Results from a large prospective multicenter study

Background: Pre-test genetic counseling of patients with breast cancer is increasingly being offered by non-genetic healthcare professionals. We aimed to evaluate the experiences of patients with breast cancer receiving pre-test genetic counseling from a non-genetic healthcare professional (i.e., surgeon or nurse). Methods: Patients who were diagnosed with breast cancer and received pre-test counseling from their surgeon or nurse (mainstream group), and patients who received pre-test counseling from a clinical geneticist (usual care group) were invited to participate in our multicenter study. Between September 2019 and December 2021, patients received a questionnaire after pre-test counseling (T0) and four weeks after receiving their test results (T1) to evaluate psychosocial outcomes, knowledge, discussed topics and satisfaction. Results: We included 191 patients in our mainstream and 183 patients in our usual care group and received, respectively 159 and 145 follow-up questionnaires. Levels of distress and decisional regret were comparable in both groups. Decisional conflict was higher in our mainstream group (p = 0.01), but only 7% had clinically relevant decisional conflict (vs 2% in usual care group). The possible implications of a genetic test on (secondary) breast or ovarian cancer risks were less frequently discussed in our mainstream group (p = 0.03 and p = 0.000, respectively). In both groups knowledge about genetics was comparable, satisfaction was high and the majority of patients in both groups preferred to give both verbal and written consent for genetic testing. Conclusion: Mainstreamed genetic care provides sufficient information for the majority of breast cancer patients to decide about genetic testing with minimal distress