A comparative national-level analysis of government food system resilience activities across four developed countries at varying stages of planning
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SUBMITTER: Lloyd J
PROVIDER: S-EPMC10865510 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:Aim:To identify factors associated with completion of Advance Care Planning (ACP) by patients seen in primary care in developed countries. We hypothesized that the quality of primary care is associated. Method:We analysed respondent reported individual and healthcare utilization factors associated with the completion of ACP activities from the 2014 Commonwealth Fund International Health Policy Survey of Older Adults in 11 Countries. The primary outcome is the combined number of ACP activities completed. ACP activities included discussion of treatment preferences, documentation of healthcare wishes, or documentation of a surrogate decision maker. A quality of primary care index was calculated. Results:Respondents averaged 69 years old. Most were women, graduated high school, rated their income as average or higher, and rated their health as good or better. A minority reported multimorbidity, accessed the emergency department or hospital, or were informal caregivers. Out of 25530 survey respondents, 13409 (53%) reported completion of any ACP activity; 11579 (45%) had discussed treatment preferences. Generalized linear mixed model results suggest that hospitalization (rate ratio [RR] 1.18), multimorbidity (RR 1.16), informal caregiving (RR 1.13), higher education level (RR 1.14), income (RR 1.05), access to higher quality primary care (RR 1.04) and ED visits (RR 1.04) were associated with higher rates of ACP activities. Male gender (RR 0.85) and higher perceived health status (RR 0.96) were associated with lower rates. Conclusions:In this international study, individuals with greater interaction with the healthcare system through hospitalization, multimorbidity, access to quality primary care and informal caregiving reported more ACP activities.
| S-EPMC5965096 | biostudies-literature
Project description:Food security is a global concern affecting even highly developed countries. Ongoing globalisation of food systems, characterised by trading interdependencies, means that agricultural production can be disrupted by climate change, affecting food availability. This study investigated Sweden's food security by identifying major food import categories and associated trade partners (using the World Integrated Trade System database) and vulnerability to frictions in trade deriving from climate change. Vulnerability was assessed through three indicators: exposure based on diversity of sources, dominance and direct trade from supplying countries; sensitivity, assessed using the Climate Risk Index, and adaptive capacity, assessed using the Fragile State Index. The results revealed that Sweden's grain imports may be most vulnerable, and animal products least vulnerable, to climate change. Management strategies based on this preliminary assessment can be developed by integrating climate vulnerability deriving from food trading into the 'Gravity' model, to improve prediction of trade flows.
| S-EPMC8847661 | biostudies-literature
Project description:ContextThe COVID-19 pandemic has been affecting health and economies across the world, although the nature of direct and indirect effects on Asian agrifood systems and food security has not yet been well understood.ObjectivesThis paper assesses the initial responses of major farming and food systems to COVID-19 in 25 Asian countries, and considers the implications for resilience, food and nutrition security and recovery policies by the governments.MethodsA conceptual systems model was specified including key pathways linking the direct and indirect effects of COVID-19 to the resilience and performance of the four principal Asian farming and food systems, viz, lowland rice based; irrigated wheat based; hill mixed; and dryland mixed systems. Based on this framework, a systematic survey of 2504 key informants (4% policy makers, 6% researchers or University staff, 6% extension workers, 65% farmers, and 19% others) in 20 Asian countries was conducted and the results assessed and analysed.Results and conclusionThe principal Asian farming and food systems were moderately resilient to COVID-19, reinforced by government policies in many countries that prioritized food availability and affordability. Rural livelihoods and food security were affected primarily because of disruptions to local labour markets (especially for off-farm work), farm produce markets (notably for perishable foods) and input supply chains (i.e., seeds and fertilisers). The overall effects on system performance were most severe in the irrigated wheat based system and least severe in the hill mixed system, associated in the latter case with greater resilience and diversification and less dependence on external inputs and long market chains. Farming and food systems' resilience and sustainability are critical considerations for recovery policies and programmes, especially in relation to economic performance that initially recovered more slowly than productivity, natural resources status and social capital. Overall, the resilience of Asian farming and food systems was strong because of inherent systems characteristics reinforced by public policies that prioritized staple food production and distribution as well as complementary welfare programmes. With the substantial risks to plant- and animal-sourced food supplies from future zoonoses and the institutional vulnerabilities revealed by COVID-19, efforts to improve resilience should be central to recovery programmes.SignificanceThis study was the first Asia-wide systems assessment of the effects of COVID-19 on agriculture and food systems, differentiating the effects of the pandemic across the four principal regional farming and food systems in the region.
| S-EPMC9584831 | biostudies-literature
Project description:Developing countries can generate effective solutions for today's global health challenges. This paper reviews relevant literature to construct the case for international cooperation, and in particular, developed-developing country partnerships. Standard database and web-based searches were conducted for publications in English between 1990 and 2010. Studies containing full or partial data relating to international cooperation between developed and developing countries were retained for further analysis. Of 227 articles retained through initial screening, 65 were included in the final analysis. The results were two-fold: some articles pointed to intangible benefits accrued by developed country partners, but the majority of information pointed to developing country innovations that can potentially inform health systems in developed countries. This information spanned all six WHO health system components. Ten key health areas where developed countries have the most to learn from the developing world were identified and include, rural health service delivery; skills substitution; decentralisation of management; creative problem-solving; education in communicable disease control; innovation in mobile phone use; low technology simulation training; local product manufacture; health financing; and social entrepreneurship. While there are no guarantees that innovations from developing country experiences can effectively transfer to developed countries, combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is virgin and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardized method for reporting partnership benefits is needed--this is perhaps the single most immediate need in planning for, and realizing, the full potential of international cooperation between developed and developing countries.
| S-EPMC3459713 | biostudies-literature
Project description:INTRODUCTION: Scurvy, while uncommon, still occurs in developed countries despite the widespread availability of vitamins and fortified foods. A vitamin C deficiency prevalence of 10 to 14% in adults was reported in the National Health and Nutrition Examination Survey (NHANES) in 1994. OBJECTIVE: We report the case of a 57-year-old male who presented with a combined vitamin C deficiency (scurvy) and a Zinc deficiency. INTERVENTIONS: He came to the emergency department complaining of a painful swollen ecchymotic leg and dyspnea. Prescriptions for narcotics did not relieve his symptoms. When a detailed dietary history was obtained, we added scurvy to the differential diagnosis. An extensive evaluation excluded trauma, coagulopathies, neoplasia, and vasculitides. MAIN RESULT: The combination of a classic skin biopsy and a low vitamin C level confirmed the diagnosis. CONCLUSION: This presentation illustrates the necessity of including scurvy in the differential diagnosis of ecchymoses and demonstrates specific populations at risk: single adults and the elderly with deficient diets.
| S-EPMC2517958 | biostudies-other
Project description:BackgroundResearch indicates that food parcels provided by food banks are nutritionally poor. Food insecurity and the use of food banks are both rising, with detrimental effects on the dietary intake and health of users. This mixed-method systematic review aims to investigate the current nutritional adequacy of pre-packaged food parcels and whether using food banks reduces the food insecurity and improves the dietary intake of their users.MethodsA mixed-method systematic literature review, restricted to articles published from 2015, was conducted using eight electronic databases, four grey literature databases and eight relevant websites. Quantitative findings, investigating the nutritional quality of food parcels and/or their impact on dietary intake or food insecurity, were presented narratively. Qualitative findings reporting the views of food bank users regarding food from food banks underwent thematic synthesis. These independent syntheses were integrated using configurative analysis and presented narratively.ResultsOf 2189 articles, 11 quantitative and 10 qualitative were included. Food parcels were inconsistent at meeting nutritional requirements and often failed to meet individual needs, including cultural and health preferences. Using food banks improved food security and dietary quality of users, allowing otherwise unachievable access to food. However, food insecurity remained, and is explained by limited food variety, quality and choice. The mixed-method findings support interventions to ensure consistent, adequate nutrition at food banks, including catering for individual needs.ConclusionsFood banks are a lifeline for those severely food insecure. However when used alone, food banks struggle to eliminate the heightened food insecurity of their users. Efforts to improve the nutritional quality of food parcels could improve the experiences and diet-related outcomes of those requiring food banks.
| S-EPMC9790279 | biostudies-literature
Project description:Mammals have evolved sex-specific adaptations to reduce energy usage in times of food scarcity. These adaptations are well described for peripheral tissue, though much less is known about how the energy-expensive brain adapts to food restriction, and how such adaptations differ across the sexes. Here, we examined how food restriction impacts energy usage and function in the primary visual cortex (V1) of adult male and female mice. Molecular analysis and RNA sequencing revealed that food restriction modulated canonical, energy-regulating pathways including oxidative phosphorylation, AMP-activated protein kinase (AMPK) and mammalian target of rapamycin (mTOR) signalling, significantly in males but not in females V1. Moreover, we found that in contrast to males, food restriction in females non-significantly affected V1 ATP usage and visual coding precision (assessed by orientation selectivity). Decreased serum leptin is necessary for triggering energy-saving changes in male mouse V1 during food restriction. Consistent with this result, we found a significant decrease of serum leptin in food-restricted males but no significant change in food-restricted females. Collectively, our findings demonstrate that cortical function and energy usage in female mice are more resilient to food restriction than in males. The neocortex, therefore, contributes to sex-specific, energy-saving adaptations in response to metabolic challenge.
2023-10-09 | GSE233435 | GEO
Project description:BackgroundNew medicines have become available for the treatment of drug-resistant tuberculosis (DR-TB) and are introduced in sub-Saharan Africa (SSA) by the national TB programs (NTPs) through special access schemes. Pharmacovigilance is typically the task of national medicines regulatory agencies (NMRAs), but the active drug safety monitoring and management (aDSM) recommended for the new TB medicines and regimens was introduced through the NTPs. We assessed the strengths and challenges of pharmacovigilance systems in Eswatini, Ethiopia, Nigeria and Tanzania, focusing on their capacity to monitor safety of medicines registered and not registered by the NMRAs for the treatment of DR-TB.MethodsAssessment visits were conducted to all four countries by a multidisciplinary team. We used a pharmacovigilance indicator tool derived from existing tools, interviewed key stakeholders, and visited health facilities where DR-TB patients were treated with new medicines. Assessment results were verified with the local NMRAs and NTPs.ResultsMost countries have enabling laws, regulations and guidelines for the conduct of pharmacovigilance by the NMRAs. The relative success of NTP-NMRA collaboration is much influenced by interpersonal relationships between staff. Division of roles and responsibilities is not always clear and leads to duplication and unfulfilled tasks (e.g. causality assessment). The introduction of aDSM has increased awareness among DR-TB healthcare providers.ConclusionaDSM has created awareness about the importance of pharmacovigilance among NTPs. In the future, a push for conducting pharmacovigilance through public health programs seems useful, but this needs to coincide with increased collaboration with between public health programs and NMRAs with clear formulation of roles and responsibilities.
| S-EPMC8499544 | biostudies-literature
Project description:We use 2012 data on economically developed countries from the International Social Survey Program to examine variation in "cultural norms" (at the world region and country levels) and "attitudes" (at the individual level) regarding the appropriate roles of family members and formal providers in both the provision and financing of assistance with daily activities at home. Our analysis has two parts: (1) a descriptive analysis of differences in cultural norms by world region and country (N = 25 countries) and (2) a multilevel multinomial logistic regression analysis of the importance of country-level factors in explaining individuals' elder support attitudes (N = 21 countries). In the descriptive analysis, we find substantial variation in cultural norms both between world regions and between countries within all world regions except for the Nordic countries. The multilevel regression analysis points to the importance of two sets of country-level factors-"macrostructural factors" and "cultural-contextual factors"-in explaining individuals' elder support attitudes. With regard to macrostructural factors, we find, consistent with our hypotheses, greater support for "publicly financed formal assistance" (i.e., the financing of formal assistance is supported by public funds) in countries with higher spending on services. The effects of the cultural-contextual factors are mostly consistent with our hypotheses and suggest the importance of taking into account the wider religious and political context in explaining individuals' elder support attitudes. We conclude with a discussion of the social scientific and social policy implications of our findings.
| S-EPMC7040143 | biostudies-literature
Project description:We document trends in food security up to one full year after the onset of the COVID-19 pandemic in four African countries. Using household-level data collected by the World Bank, we highlight differences over time amid the pandemic, between rural and urban areas, and between female-headed and male-headed households within Burkina Faso, Ethiopia, Malawi, and Nigeria. We first observe a sharp increase in food insecurity during the early months of the pandemic with a subsequent gradual decline. Next, we find that food insecurity has increased more in rural areas than in urban areas relative to pre-pandemic data within each of these countries. Finally, we do not find a systematic difference in changes in food insecurity between female-headed and male-headed households. These trends complement previous microeconomic analysis studying short-term changes in food security associated with the pandemic and existing macroeconomic projections.
| S-EPMC9234064 | biostudies-literature