Stories of Change: Covid-19 Responses for Equity

Covid-19 Responses for Equity (CORE) was a three-year, CA$25m rapid research initiative that brought together 20 research projects to understand the socioeconomic impacts of the pandemic, improve existing responses, and generate better policy options for recovery. The research, funded by the Canadian International Development Research Centre (IDRC), took place across 42 countries in Africa, Asia, Latin America and the Middle East. The Institute of Development Studies (IDS) supported CORE to maximise the learning generated across the research portfolio and deepen engagement with governments, civil society, and the scientific community. This publication celebrates the impact of that research, and highlights Stories of Change from seven of the CORE projects that successfully influenced policy, practice, and understandings of the crisis. Collectively, these individual case studies provide a narrative about the nature of research impact in emergencies and the implications for the design and delivery of future rapid response research initiatives. There are clear lessons around the importance of organisational reputation, and the value of co-designing research with decision makers whilst simultaneously taking a critical position. Every story here emphasises the need to understand political context and to explore the trade-offs between research rigour and the timeliness of evidence. Above all, they illustrate the value of flexible funding arrangements that enable local teams to respond to fast-moving crises. These stories demonstrate unequivocally the value of locally led research responses to emergencies with the right international flow of resources and support. CORE’s research teams were well-placed to bring together communities, civil society organisations, and governments to create a space for vulnerable and marginalised groups to discuss their lived experiences of the pandemic and bring these perspectives into policy conversations. Their success hinged on their hyper-local knowledge and their unswerving focus on providing real-time evidence to advocate for the wellbeing of affected communities

Les récupérateur·trice·s de déchets font partie de la solution à la gestion des déchets solides au Sénégal

Waste pickers from the Bokk Diom organisation, working at Dakar’s Mbeubeuss landfill – in Senegal’s capital city –, continued to provide essential waste management services throughout the Covid-19 pandemic, contributing to public health, reducing environmental harm, and mitigating greenhouse gases. As with many, their incomes were impacted by the pandemic, especially those of women. However, the greatest threat to their incomes and livelihoods is the transformation of the waste management system, a process which they are excluded from. Drawing on research carried out with Women in Informal Employment: Globalizing and Organizing (WIEGO) during the pandemic, Bokk Diom was able to advocate on behalf of waste pickers and obtain pledges of inclusion in solid waste management (SWM) from national authorities. Bokk Diom and WIEGO are continuing in their efforts to attain a just transition for waste pickers.Les récupérateur·trice·s de déchets de l’organisation Bokk Diom travaillant à la décharge de Mbeubeuss de Dakar, dans la capital du Sénégal, ont fourni des services essentiels de gestion des déchets pendant la pandémie de la Covid-19, contribuant à la santé publique, la réduction des impacts environnementaux et à l’atténuation des gaz à effet de serre. Comme pour beaucoup, leurs revenus ont été affectés par la pandémie, en particulier pour les femmes. Mais la plus grande menace pour leurs revenus et leurs moyens de subsistance est la transformation du système de gestion des déchets, qui ne les inclut pas. En s’appuyant sur les résultats de la recherche menée avec Femmes dans l’Emploi Informel : Globalisation et Organisation (WIEGO) pendant la pandémie, Bokk Diom a été capable de plaider en faveur des récupérateur·trice·s et obtenir des autorités nationales des promesses d’inclusion dans la gestion des déchets solides (GDS). Bokk Diom et WIEGO continuent avec leurs efforts pour aboutir à une transition juste pour les récupérateur·trice·s.International Development Research Centre (IDRC

Manifestaciones hepatobiliares en pacientes con enfermedad inflamatoria crónica intestinal Hepatobiliary manifestations in patients with chronic inflammatory bowel disease

Es frecuente que en pacientes con enfermedad inflamatoria intestinal se observen cambios analíticos o clínicos que indican la existencia de una enfermedad hepatobiliar. La frecuencia de estos hallazgos oscila entre 11-49 % en colitis ulcerosa y entre 15-30 % en enfermedad de Crohn. En algunos casos, estas alteraciones se observan desde el primer momento en que se estudia a los pacientes, otras surgen en el curso de la enfermedad. Se realizó un estudio descriptivo observacional retrospectivo donde se incluyó 180 pacientes con enfermedad inflamatoria intestinal, que se atienden en el Instituto de Gastroenterología, de ellos con manifestaciones hepatobiliares, 17 pacientes (9,4 %), 12 colitis ulcerosa y 5 Crohn. Las variables estudiadas fueron: sexo, edad, años de evolución según tipo de enfermedad inflamatoria, tipo de manifestación hepatobiliar, síntomas clínicos, estudio de enzimas hepáticas y hallazgos ultrasonográficos. Se concluyó que existe predominio de pacientes con colitis ulcerosa. Predominó el sexo femenino en la colitis ulcerosa; el Crohn no tuvo variaciones significativas. La edad estuvo comprendida entre 30 y 49 años. La manifestación hepatobiliar más frecuente en el Crohn fue la hepatopatía de etiología no filiada y en la colitis ulcerosa la colangitis esclerosante primaria. El síntoma clínico que predominó en ambos grupos fue la astenia, y en la colitis ulcerosa también predominó el prurito e íctero. Con respecto a las enzimas bioquímicas predominó la hipertransaminasemia, y por ultrasonido el aspecto granular y aumento de la ecogenicidad hepática.It is common for patients with inflammatory bowel disease to present analytical or clinical changes pointing to the presence of hepatobiliary disease. The frequency of such findings ranges between 11-49 % in ulcerous colitis and between 15-30 % in Crohn's disease. In some cases, the alterations are found when the patient is first examined, while in others they emerge during the course of the disease. An observational retrospective descriptive study was conducted of 180 patients with inflammatory bowel disease cared for at the Institute of Gastroenterology. Hepatobiliary manifestations were found in 17 patients (9.4 %): 12 with ulcerous colitis and 5 with Crohn's disease. The variables studied were sex, age, years of evolution by type of inflammatory disease, type of hepatobiliary manifestation, clinical symptoms, study of hepatic enzymes and ultrasonographic findings. There was a predominance of patients with ulcerous colitis. Female sex prevailed in ulcerous colitis. No significant differences were found in Crohn's disease. Age ranged between 30-49. The most common hepatobiliary manifestations were liver disease of unknown etiology in Crohn's disease and primary sclerosing cholangitis in ulcerous colitis. The prevailing clinical symptom in both groups was asthenia. Pruritus and jaundice were also predominant in ulcerous colitis. With respect to biochemical enzymes, there was a predominance of hypertransaminasemia. Ultrasonographically, a granular aspect and increased hepatic echogenicity were the prevailing features

Effects of bingeing on fat during adolescence on the reinforcing effects of cocaine in adult male mice.

Binge eating is a specific form of overeating characterized by intermittent excessive eating. In addition to altering the neurobiological reward system, several studies have highlighted that consumption of palatable food increases vulnerability to drug use. The aim of the present study was to evaluate the effects of a high-fat diet consumed in a binge pattern during adolescence on the reinforcing effects of cocaine. After 40 days of binge-eating for 2 h, three days a week (PND 29-69), the reinforcing effects of cocaine on conditioning place preference and intravenous self-administration paradigm were evaluated in adolescent male mice. Circulating leptin and ghrelin levels and the effects of bingeing on fat on CB1 mu opioid receptor (MOr) and ghrelin receptor (GHSR) gene expression in the Nucleus Accumbens (NAcc) and Ventral Tegmental Area (VTA) were also assessed. Our results showed a significant escalation in the consumption of a high-fat diet between the first and last week. High-fat binge (HFB) animals were more sensitive to the reinforcing effects of a subthreshold dose of cocaine in the paradigms assayed, and animals under fat withdrawal were more vulnerable to the reinstatement of conditioned place preference. HFB mice also showed enhanced cocaine self-administration. After fat withdrawal, exposure to a new fat binge reinstated cocaine seeking. Although HFB did not modify leptin levels, a decrease in plasmatic ghrelin was observed. Moreover, this pattern of fatty diet resulted in a reduction of MOr and CB1 gene expression in the NAcc and an increase in GHSR expression in the VTA. We propose that bingeing on fat during adolescence induces long-lasting changes in the brain through the sensitization of brain reward circuits, which predisposes individuals to seek cocaine during adulthood.This study was supported by the Spanish Ministry of Economy and Innovation and FEDER (SAF2013-41761-R; PSI2014-51847-R;and PSI2011-24762), Spanish Ministry of Health, Social Affairs and Equality (PNSD 2014-020 and 2014-I007); Instituto de Salud Carlos III, Red de Trastornos Adictivos (RTA) (RD12/0028/0005, RD12/0028/0019 and RD12/0028/0024) and Union Europea, Fondos FEDER “una manera de hacer Europa”. Generalitat Valenciana, PROMETEOII/2014/063 and Generalitat de Catalunya (2014SGR34)

Infective Endocarditis After Transcatheter Versus Surgical Aortic Valve Replacement

Abstract Background Scarce data are available comparing infective endocarditis (IE) following surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). This study aimed to compare the clinical presentation, microbiological profile, management, and outcomes of IE after SAVR versus TAVR. Methods Data were collected from the “Infectious Endocarditis after TAVR International” (enrollment from 2005 to 2020) and the “International Collaboration on Endocarditis” (enrollment from 2000 to 2012) registries. Only patients with an IE affecting the aortic valve prosthesis were included. A 1:1 paired matching approach was used to compare patients with TAVR and SAVR. Results A total of 1688 patients were included. Of them, 602 (35.7%) had a surgical bioprosthesis (SB), 666 (39.5%) a mechanical prosthesis, 70 (4.2%) a homograft, and 350 (20.7%) a transcatheter heart valve. In the SAVR versus TAVR matched population, the rate of new moderate or severe aortic regurgitation was higher in the SB group (43.4% vs 13.5%; P < .001), and fewer vegetations were diagnosed in the SB group (62.5% vs 82%; P < .001). Patients with an SB had a higher rate of perivalvular extension (47.9% vs 27%; P < .001) and Staphylococcus aureus was less common in this group (13.4% vs 22%; P = .033). Despite a higher rate of surgery in patients with SB (44.4% vs 27.3%; P < .001), 1-year mortality was similar (SB: 46.5%; TAVR: 44.8%; log-rank P = .697). Conclusions Clinical presentation, type of causative microorganism, and treatment differed between patients with an IE located on SB compared with TAVR. Despite these differences, both groups exhibited high and similar mortality at 1-year follow-up