Access to global wheat reserves determines country-level vulnerability to conflict-induced Ukrainian wheat supply disruption.

The Russia-Ukraine conflict reduced global wheat supplies, yet the food security implications vary across countries. We identify a 39% decrease in Ukrainian wheat exports in 2022 resulting in >70% import losses in some of the countries most vulnerable to these disruptions, with substantial impacts felt in Egypt, Oman, Saudi Arabia, Libya, Mauritania, Yemen and Lebanon. Differential impacts are a function of access to capital and international trade, suggesting the need for policy measures to defuse the impending food crisis.

Patient attitudes and preferences about expanded noninvasive prenatal testing.

Noninvasive prenatal testing (NIPT) using cell-free DNA (cfDNA) is typically carried out to screen for common fetal chromosomal anomalies, with the option to screen for a wider range of chromosomal changes (expanded NIPT) becoming increasingly available. However, little is known about pregnant patients' attitudes and preferences regarding expanded NIPT. To address this gap, we surveyed general-risk patients having first-tier cfDNA screening at a private prenatal clinic on their expectations for expanded NIPT.

Global food systems transitions have enabled affordable diets but had less favourable outcomes for nutrition, environmental health, inclusion and equity.

Over the past 50 years, food systems worldwide have shifted from predominantly rural to industrialized and consolidated systems, with impacts on diets, nutrition and health, livelihoods, and environmental sustainability. We explore the potential for sustainable and equitable food system transformation (ideal state of change) by comparing countries at different stages of food system transition (changes) using food system typologies. Historically, incomes have risen faster than food prices as countries have industrialized, enabling a simultaneous increase in the supply and affordability of many nutritious foods.

SARS-CoV-2 mRNA-based vaccines in the Aicardi Goutières Syndrome.

Aicardi Goutières Syndrome (AGS) is an autoinflammatory disorder resulting in sustained interferon activation through defects in nucleic acid modification and sensing pathways. Thus, mRNA-based vaccination used against SARS-CoV-2, raise disease-specific safety concerns. To assess interferon signaling, we tested mRNA SARS-CoV-2 vaccines in AGS whole blood samples.

Do not transform food systems on the backs of the rural poor.

Even prior to COVID, there was a considerable push for food system transformation to achieve better nutrition and health as well as environmental and climate change outcomes. Recent years have seen a large number of high visibility and influential publications on food system transformation. Literature is emerging questioning the utility and scope of these analyses, particularly in terms of trade-offs among multiple objectives.

Prevalence of self-reported memory problems in adults with type 2 diabetes mellitus and cancer in the USA.

Purpose: To determine the prevalence of memory problems in individuals with or without a history of DM and cancer and assess possible compounding effects of these diseases on self-reported memory problems (SRMP).

Methods: We used data from the 2009-2018 National Health and Nutrition Examination Survey. We conducted logistic regression analyses to determine the associations among DM, cancer, and SRMP, adjusting for age, sex, race/ethnicity, education, and poverty level.

Towards food systems transformation-five paradigm shifts for healthy, inclusive and sustainable food systems.

Food systems must serve different societal, public health and individual nutrition, and environmental objectives and therefore face numerous challenges. Considering the integrated performances of food systems, this paper highlights five fundamental paradigm shifts that are required to overcome trade-offs and build synergies between health and nutrition, inclusive livelihoods, environmental sustainability and food system resilience. We focus on the challenges to raise policy ambitions, to harmonize production and consumption goals, to improve connectivity between them, to strengthen food system performance and to anchor the governance of food systems in inclusive policies and participatory institutions.

The household and individual-level productive impacts of cash transfer programs in Sub-Saharan Africa.

Silvio Daidone is a economist and Benjamin Davis is a Strategic Program Leader, both with the Food and Agriculture Organization of the United Nations, Rome, Italy. Sudhanshu Handa is a professor at the University of North Carolina at Chapel Hill. Paul Winters is the Associate Vice-President of the Strategy and Knowledge Department, International Fund for Agricultural Development, Rome, Italy.

The exclusion from welfare benefits: Resentment and survey attrition in a randomized controlled trial in Mexico.

Public policy programs must often impose limits on who may be eligible for benefits. Despite research on the impact of exclusion in developed countries, there is little evidence on how people react to being excluded from benefits in developing societies. Utilizing repeated waves of data from an experimental evaluation of Mexico's foundational PROGRESA antipoverty program, we examine the impact of exclusion and distinguish two separate forms.

Improving patient-centered communication while using an electronic health record: Report from a curriculum evaluation.

Introduction: Researchers and clinicians are concerned about the impact of electronic health record use and patient-centered communication. Training about patient-centered clinical communication skills with the electronic health record may help clinicians adapt and remain patient-centered.

Methods: We developed an interactive workshop eliciting challenges and opportunities of working with the electronic health record in clinical practice, introduction of specific patient-centered behaviors and mindful practice techniques, and video demonstrating contrasts in common behavior and "better practices.

Aneuploidy screening by non-invasive prenatal testing in twin pregnancy.

Objectives: To describe our experience with non-invasive prenatal testing (NIPT) in twin pregnancy.

Methods: Two sets of maternal blood samples from twin pregnancies were analyzed at our laboratory using NIPT: 115 stored samples from pregnancies with known outcome (Clinical Study A) and 487 prospectively collected samples for which outcomes were requested from providers (Clinical Study B). NIPT was used to screen for the presence of fetal aneuploidy on chromosomes 13, 18, 21, X and Y in all cases, and results were compared with outcomes when known.

Do Lung Cancer Eligibility Criteria Align with Risk among Blacks and Hispanics?

Background: Black patients have higher lung cancer risk despite lower pack years of smoking. We assessed lung cancer risk by race, ethnicity, and sex among a nationally representative population eligible for lung cancer screening based on Medicare criteria.

Methods: We used data from the National Health and Nutrition Examination Survey, 2007-2012 to assess lung cancer risk by sex, race and ethnicity among persons satisfying Medicare age and pack-year smoking eligibility criteria for lung cancer screening.

Assessing Health Literacy in Deaf American Sign Language Users.

Communication and language barriers isolate Deaf American Sign Language (ASL) users from mass media, health care messages, and health care communication, which, when coupled with social marginalization, places them at a high risk for inadequate health literacy. Our objectives were to translate, adapt, and develop an accessible health literacy instrument in ASL and to assess the prevalence and correlates of inadequate health literacy among Deaf ASL users and hearing English speakers using a cross-sectional design. A total of 405 participants (166 Deaf and 239 hearing) were enrolled in the study.

Effect of patient navigation on satisfaction with cancer-related care.

Purpose: Despite growing popularity of patient navigation (PN) as a means to improve cancer care quality and reduce cancer-related disparities, there are few well-designed controlled trials assessing the impact of PN on patient outcomes like satisfaction with care. The present controlled study examined effect of PN on satisfaction with cancer-related care.

Methods: Patients who presented with a symptom or abnormal screening test (n = 1788) or definitive diagnosis (n = 445) of breast, cervical, colorectal, or prostate cancer from eight Patient Navigator Research Program sites were included in one of two groups: intervention (PN) or comparison (usual care or usual care plus cancer educational materials).

Preliminary validation of a scale to measure patient perceived similarity to their navigator.

Objective: A central premise in deployment of community health workers (CHW) is that CHWs share key characteristics with their patients. We sought to develop a scale to measure this construct called the Perceived Navigator Similarity (PNS) questionnaire.

Methods: We adopted items from a similarly developed scale, patient perceived similarity to their physicians, and examined its psychometric properties among 51 patients who were navigated for cancer care by a CHW.

Emergency Department utilization among Deaf American Sign Language users.

Background: Deaf American Sign Language (ASL) users comprise a linguistic minority population with poor health care access due to communication barriers and low health literacy. Potentially, these health care barriers could increase Emergency Department (ED) use.

Objective: To compare ED use between deaf and non-deaf patients.

Process Evaluation of Practice-based Diabetes Prevention Programs: What Are the Implementation Challenges?

Purpose: The purpose of this report is to describe lessons learned about the feasibility of recruitment and implementation of low-income adults with prediabetes in primary care clinics into diabetes prevention programs.

Methods: Mixed methods process evaluation of a pragmatic 2-group pilot comparative effectiveness study of a community-developed Healthy Living Program (HLP) and a Diabetes Prevention Program (DPP) with 58 adults.

Results: Of the total (n = 1215) assessed for eligibility, 7% (n = 92) were randomized, 58 completed the baseline assessment, and 31 completed the intervention.

Cash transfer programme, productive activities and labour supply: Evidence from randomized experiment in Kenya.

This paper reports analysis of the impact of Kenya's Cash Transfer for Orphans and Vulnerable Children Programme on the household decisions on productive activities using data from a randomized experimental design. Results show that the programme had a positive and significant impact on food consumption coming from home production, accumulation of productive assets, especially on the ownership of small livestock and on formation of nonfarm enterprise, especially for females. The programme has provided more flexibility to families in terms of labour allocation decisions, particularly for those who are geographically isolated.

Improving breast and colon cancer screening rates: a comparison of letters, automated phone calls, or both.

Purpose: Low-cost interventions to improve cancer screening among primary care patients are needed. The comparative effectiveness of personalized letters, automated telephone calls, and both on breast cancer (BC) and colorectal cancer (CRC) screening is not known.

Methods: A pragmatic, randomized, controlled trial was conducted in 2011 to 2012.

Do clinicians recommend aspirin to patients for primary prevention of cardiovascular disease?

Background: The United States Preventive Services Task Force (USPSTF) released updated guidelines in 2009 recommending aspirin to prevent myocardial infarction among at-risk men and stroke among at-risk women.

Objective: Our aim was to examine clinician aspirin recommendation among eligible persons based on cardiovascular risk scores and USPSTF cutoffs.

Design: We used across-sectional analysis of a current nationally representative sample.

Impact of patient navigation on timely cancer care: the Patient Navigation Research Program.

Background: Patient navigation is a promising intervention to address cancer disparities but requires a multisite controlled trial to assess its effectiveness.

Methods: The Patient Navigation Research Program compared patient navigation with usual care on time to diagnosis or treatment for participants with breast, cervical, colorectal, or prostate screening abnormalities and/or cancers between 2007 and 2010. Patient navigators developed individualized strategies to address barriers to care, with the focus on preventing delays in care.