Food Security & Civil Society

Findings from an in-depth qualitative investigation of Food Security with people from civil society organisations. A ‘boots on the ground’ perspective, which reveals the concerns about food security, and stakeholder evaluations of what they think needs to be done

Effectiveness of self-management interventions for long-term conditions in people experiencing socio-economic deprivation in high-income countries: a systematic review and meta-analysis

BACKGROUND: Long-term conditions (LTCs) are prevalent in socio-economically deprived populations. Self-management interventions can improve health outcomes, but socio-economically deprived groups have lower participation in them, with potentially lower effectiveness. This review explored whether self-management interventions delivered to people experiencing socio-economic deprivation improve outcomes. METHODS: We searched databases up to November 2022 for randomized trials. We screened, extracted data and assessed the quality of these studies using Cochrane Risk of Bias 2 (RoB2). We narratively synthesized all studies and performed a meta-analysis on eligible articles. We assessed the certainty of evidence using GRADE for articles included in the meta-analysis. RESULTS: The 51 studies included in this review had mixed findings. For the diabetes meta-analysis, there was a statistically significant pooled reduction in haemoglobin A1c (-0.29%). We had moderate certainty in the evidence. Thirty-eight of the study interventions had specific tailoring for socio-economically deprived populations, including adaptions for low literacy and financial incentives. Each intervention had an average of four self-management components. CONCLUSIONS: Self-management interventions for socio-economically deprived populations show promise, though more evidence is needed. Our review suggests that the number of self-management components may not be important. With the increasing emphasis on self-management, to avoid exacerbating health inequalities, interventions should include tailoring for socio-economically deprived individuals

Inclusion of Premenopausal Women in Breast Cancer Clinical Trials

BACKGROUND: Patients with premenopausal breast cancer (PMBC) have been historically excluded from some clinical trials because of the limitations of using endocrine therapy (ET) in this population. We analyzed breast cancer randomized clinical trials (RCTs) to determine the rates of and factors associated with inclusion of PMBC patients to provide a benchmark for PMBC inclusion in RCTs moving forward. METHODS: Using ClinicalTrials.Gov, we identified breast cancer phase III RCTs and extracted inclusion criteria and patient enrollment information. Multiple binary logistic regression modeling was used to assess trial-related factors that were associated with PMBC patient inclusion. RESULTS: Of 170 breast cancer RCTs identified, 131 (77.1%) included PMBC patients. Sixty-five (38.2%) trials analyzed patients with hormone-receptor-positive (HR+) and HER2-negative (HER2-) breast cancer, of which 31 (47.7%) allowed for enrollment of PMBC patients. Lower rates of PMBC inclusion were seen in trials that studied HR+/HER2-patients (47.7% PMBC inclusion in HR+/HER2-trials vs. 94.3% in non-HR+/HER2-trials, aOR 0.07 [95% CI: 0.02-0.19], p \u3c 0.001) and in trials that randomized or mandated ET (44.4% in ET trials vs. 83.2% in non-ET trials, aOR 0.21 [95% CI: 0.10-0.83], p = 0.02). Trials studying chemotherapy (CT) were associated with inclusion of PMBC patients (100% in CT trials vs. 70.5% in non-CT trials, a OR 14.02 [95% CI: 1.54-127.91], p = 0.01). All surgical and radiation therapy clinical trials allowed for the inclusion of PMBC patients in their eligibility criteria. CONCLUSIONS: Breast cancer clinical trials should carefully select their enrollment criteria and consider inclusion of premenopausal patients when appropriate

Computational Neuropsychiatry - Schizophrenia as a Cognitive Brain Network Disorder

Computational modeling of functional brain networks in fMRI data has advanced the understanding of higher cognitive function. It is hypothesized that functional networks mediating higher cognitive processes are disrupted in people with schizophrenia. In this article, we review studies that applied measures of functional and effective connectivity to fMRI data during cognitive tasks, in particular working memory fMRI studies. We provide a conceptual summary of the main findings in fMRI data and their relationship with neurotransmitter systems, which are known to be altered in individuals with schizophrenia. We consider possible developments in computational neuropsychiatry, which are likely to further our understanding of how key functional networks are altered in schizophrenia.Dr. Mortimer and Theresa Sackler FoundationRoyal Society (Great Britain) (Dorothy Hodgkin Fellowship

Strengthening the Resilience of Urban Retailers towards Flood Risks - A Case Study in the Riverbank Region of Kaohsiung City

[[abstract]]The urban environment is a complex system composed of the human-environment interactions within the physical-environmental system. It is constantly at the risk of the recurrent and prevalent flooding events in densely populated low land neighborhoods. Resilience is crucial to mitigating climate risks; this study ascertained the retail sector as the basic industry in Meinung with the Location Quotient (LQ) analysis; the interactive visualization tools supported and affirmed the retailers' concentration in the area most prone to flood risk. By conducting the semi-structured interviews for 15 key retailers, the study focused on the driver, pressure, state, impact, and response (DPSIR) framework to assess the knowledge, skills, and network capacity attained from climate change scenarios and flooding. The measurement of the level of resilience showed that retailers’ focus on strategic identification of potential weather-related risks and implementation of adaptation plans for each business's provision of services conformed to place-specificity criteria. The results indicated that (1) mal-adaptation of mitigation measures focus only on short-term objectives and overlook long-term and the overall resilience potential; (2) the appropriate tools for resilience strengthening assessment ascertained the perceived vulnerability; the mitigation relies on knowledge, skill and network capacity attained from previous experiences; (3) interactive visual tools provided an accurate mean, evaluation, and implementation of an integrative interface to guide and enhance the process of resilience strengthening; (4) resilience adaptability from local retailers built an effective way to mitigate flood risks. Finally, further research issues are identified with an effective resilience strengthening method against climate change.[[notice]]補正完