Opportunities for Consistent and Holistic Metrics to Support Food Systems Transformation: A Summary of a Symposium Presented at Nutrition 2023.

There is an urgent need for global food systems transformation to realize a future where planetary health reaches its full potential. Paramount to this vision is the ability of stakeholders across sectors to understand how foods and dietary patterns impact food systems inclusive of all domains of sustainability-environmental, nutrition/health, economic and social. This article is a synopsis of presentations by 3 food systems experts to share the latest science in a session entitled "How do you measure sustainability? Opportunities for consistent and holistic metrics to support food systems transformation" at the American Society for Nutrition's 2023 annual conference. As summarized here, global population data showing widespread malnutrition underscore the important role of dietary diversity through a balance of plant- and animal-source foods to achieve nutritionally adequate diets and reduce risk of noncommunicable diseases. Yet, recent international audits of countries, companies, and organizations and their sustainability targets largely demonstrate an underrepresentation of robust nutrition/health metrics to support public nutrition and health progress. Addressing limitations in diet-sustainability modeling systems provides a viable opportunity to accurately reflect the important contributions and trade-offs of diets across all domains of sustainability to ultimately support evidence-based decision making in advancing healthy food systems.

Development and validation of an intervention for childhood trauma and exposure to violence in Vhembe District, South Africa.

Most strategies are implemented; however, South Africa needs to evaluate and develop trauma interventions. The study aims to develop, test and validate childhood trauma exposure intervention in the Vhembe district, Limpopo province. Donabedian's structure-process-outcome model will guide the study. The study will employ multiphase mixed methods with five phases. Phase 1 will be a thorough systematic evaluation of literature on childhood trauma and exposure to violence interventions to describe existing interventions. Phase 2, stage 1: Will explore the experiences of children exposed to trauma and violence regarding their experiences of the treatment they received, using semi-structured qualitative interviews. Non-probability purposeful sampling techniques will be used to select participants. The Thoyondou Victim Empowerment's database will select participants. The researchers will conduct semi-structured and unstructured interviews with youngsters exposed to violence and trauma. Stage 2 will be a qualitative study of trauma centre managers and personnel sampled from the contact record. IPA will analyze data. Phase 3 will conceptualize Phase 1 and the empirical phase into Donabedian's SPO framework for Phase 4. Phase 4 develops the intervention using Phase 3's conceptual framework and tests and validates it.

College students' satisfaction with online teaching during the COVID-19 pandemic: Evidence from Hubei Province, China.

To evaluate the performance of online teaching during the COVID-19 period, we collected 1886 survey data from college students in Hubei Province, China. The scoring rules of the Framework for Teaching were used to measure college students' satisfaction with online teaching, and an econometric model was constructed to empirically validate its dynamic influences. We found that college students' satisfaction with online teaching during the COVID-19 pandemic was lower than that with offline teaching. Online teaching satisfaction was significantly affected by variables of class size, proportion of online teaching, epidemic severity, college grade, network, course classification, major classification, and the teacher's age and skills. It was further found that as COVID-19 gradually dissipated, offline teaching should be resumed as soon as possible. These findings objectively evaluate the teaching performance of college students during the COVID-19 pandemic and can provide suggestions for optimizing online teaching during future emergencies.

Utilizing data platform management to implement "5W" analysis framework for preventing and controlling corruption in grassroots government.

In the era of information technology advancement, big data analysis has emerged as a crucial tool for government governance. Despite this, corruption remains a challenge at the grass-roots level, primarily attributed to information asymmetry. To enhance the efficacy of corruption prevention and control in grass-roots government, this study introduces the concept of data platform management and integrates it with the "5W" (Who, What, When, Where, Why) analysis framework. The research is motivated by the observation that existing studies on corruption prevention primarily concentrate on the formulation of laws and regulations, neglecting the potential improvement in actual effectiveness through the utilization of data platforms and analytical frameworks. The research employs methodologies grounded in the Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis framework, the Plan, Do, Check, Act (PDCA) cycle analysis framework, and the 5W analysis framework. Throughout the iterative process of implementing data platform management, various timeframes are established, and the impact of the three models is evaluated using indicators such as public participation and government satisfaction. The research reveals that the SWOT framework can formulate targeted strategies, the PDCA framework continuously optimizes work processes, and the 5W framework profoundly explores the root causes of corruption. The outcomes indicate a 10.76% increase in the public participation level score with the 5W model, rising from 71.67%, and a 23.24% increase in the governance efficiency score, reaching 66.12%. The SWOT model excels in case handling prescription and corruption reporting rate. The synergistic application of the three models demonstrates a positive impact. In conclusion, the amalgamation of data platform management and a multi-model approach effectively enhances the corruption prevention capabilities of grass-roots governments, offering insights for the establishment of transparent and efficient grass-roots governance.

Towards a new framework to assess agri-food value chains' sustainability - The case of chestnut value chain.

Food systems rely on natural resources for production causing their depletion. Sustainability assessment can encourage farms and agri-food companies to improve sustainability performances. Sustainability assessment frameworks and tools differ in their purposes, scope, methods of application, and required time for execution; however, most of them do not fit with value chains, or they do not cover all sustainability dimensions. Our objective is to propose a holistic framework to assess sustainability at agri-food value chains level. The proposed framework combines the Sustainability Assessment of Food and Agriculture systems (SAFA) (El Hage, 2012) [1] and The Agri-food Evaluation Framework (TEEB) [2]. It incorporates the concepts of Socio-Ecological Systems, Assemblage, and Social Practices. It integrates system dynamics by emphasising human and natural capital stocks and their users. We explain in detail the methodological steps we followed to construct and to apply this new framework to two case studies in Italy and France. The new framework was applied to real-life case studies and has shown its effectiveness and demonstrates its potential for widespread use in similar scenarios.

An intersectionality framework for identifying relevant covariates in health equity research.

Introduction: Health equity research uses impact evaluations to estimate the effectiveness of new interventions that aim to mitigate health inequities. Health inequities are influenced by many experiential factors and failure of research to account for such experiential factors and their potential interactions may jeopardize findings and lead to promoted methods that may unintentionally sustain or even worsen the targeted health inequity. Thus, it is imperative that health equity impact evaluations identify and include variables related to the circumstances, conditions, and experiences of the sample being studied in analyses. In this review, we promote intersectionality as a conceptual framework for brainstorming important yet often overlooked covariates in health equity related impact evaluations. Methods: We briefly review and define concepts and terminology relevant to health equity, then detail four domains of experiential factors that often intersect in ways that may obscure findings: Biological, Social, Environmental, and Economic. Results: We provide examples of the framework's application to lupus-related research and examples of covariates used in our own health equity impact evaluations with minority patients who have lupus. Discussion: Applying an intersectionality framework during covariate selection is an important component to actualizing precision prevention. While we do not provide an exhaustive list, our aim is to provide a springboard for brainstorming meaningful covariates for health equity evaluation that may further help unveil sustainable solutions to persisting health inequities.

Exploring Barriers to Accessing Adolescents Sexual and Reproductive Health Services in South Ethiopia Regional State: A Phenomenological Study Using Levesque's Framework.

Introduction: Evidence suggests that adolescents face multiple barriers to accessing Sexual and Reproductive Health (SRH) services. However, there remains a notable gap in the literature regarding the nuanced interplay between supply-side and demand-side barriers. Therefore, this study aimed to examine barriers to accessing SRH services in the Gamo Zone of South Ethiopia Regional State. Methods: A descriptive phenomenology study was conducted from September 04 to October 15, 2023. A total of seven Focus Group Discussions (FGDs), four with girls and three with boys, with a total of 75 adolescents, and ten Key informant interviews (KIIs)with healthcare providers participated in the study. A semi-structured interview guide was used to explore their lived experiences. All interviews and discussions were audio-recorded. To analyze and manage data framework analysis approach was applied using ATLAS Ti version 7 software. Results: The major barriers preventing adolescents from accessing SRH services are related to the interplay between supply and demand-side barriers across all five domains of the Levesque framework. Despite the high need for access to health care, lack of SRH literacy, lack of outreach activities, and integration of SRH information in health facilities often hampered adolescents' healthcare need. Additionally, fear of stigma from family and community, social norms, and lack of discussion of SRH issues hindered their ability to seek health care. Shortage of supplies and healthcare providers' behaviors further hindering adolescents' ability to access health care services. Furthermore, the limited involvement of adolescents in decision-making and the lack of effective coordination further complicate the appropriateness of services for adolescents. Conclusion: The finding of this study reveals that adolescents face multifaceted barriers. Therefore, there is a need for high-impact complex interventions, program and policy that address both supply and demand side barriers needs to give due intention to improve access to SRH services for adolescents.

Key Performance Indicators: A Framework for Allied Healthcare Educational Institutions.

Background: Performance evaluation in the allied healthcare education sector is complex, making it essential for policymakers and managers to approach it comprehensively and thoughtfully to understand their performance. Hence, the development and monitoring of Key Performance Indicators (KPIs) in this domain must be considered one of the key priorities for the policymakers in AHIs. Aim: This study aims to develop a framework for the AHIs to extract and profile the indicators, measure, and report the results appropriately. Methods: The authors adopted a general review of the literature approach to study the primary goals of the institutional KPI framework, emphasizing the need for benchmarking while implementing KPIs and how to track performance using a KPI dashboard. Results: The study provides the scope, relevant KPI categories, and a list of KPIs for evaluating the effectiveness of allied healthcare programs. The study findings also emphasized the need for benchmarking the KPIs and establishing a KPI dashboard while measuring and monitoring performance. Conclusion: KPIs are considered an invaluable tool that contributes immensely to the performance monitoring process of AHIs, irrespective of the specialties. This helps to identify and guide AHIs for developing KPIs and the associated minimum data set to measure organizational performance and monitor the quality of teaching and learning. In addition, the KPI framework reported in this study is a tool to assist performance monitoring that can subsequently contribute to the overall quality of AHIs.

Using the common-sense model of illness representations to explore individuals' experiences and perceptions of migraine and its management in the United Kingdom.

OBJECTIVES: Migraine is considered a chronic health condition that impacts both quality of life and psychological wellbeing. People with migraines use a range of management strategies, which include pharmacological and non-pharmacological treatments. The aim of this study was to explore individuals' experiences and perceptions of migraines and its treatment using the Common-Sense Model (CSM) of Illness Representations. METHODS: Semi-structured, one-to-one interviews were conducted with eleven individuals with a history of migraine to explore their experiences and perceptions of migraine and its treatment. Participants were recruited from across the United Kingdom via convenience sampling using social media advertisement. Interviews were recorded, transcribed verbatim, and qualitative data were analysed using theoretical framework analysis using the CSM. RESULTS: The three dimensions of the CSM were mapped on to the qualitative data. These were: (i) Cognitive representations of migraine, within five domains: (a) identity of migraine, (b) perceived causes, (c) perceived timeline, (d) perceived control/cure, and (e) perceived consequences; (ii) Emotional representations of migraine relating to (a) migraine specific emotions and (b) emotional representation of the impact of migraine; and (iii) Coping/self-management behaviours, namely (a) self-medicating behaviours and (b) care-seeking behaviours. No incongruous data were found; therefore, no further thematic analysis was required. CONCLUSION: This is the first study to apply the CSM to migraine for framework analysis of qualitative data in this way. The findings illustrate the emotional impact of migraine and the range of illness perceptions associated with appropriate self-management. The data will be used to design a questionnaire for quantitative studies to investigate the extent to which these perceptions are generalizable to the wider population of people who experience migraines.

Outcome measurement: Design of a social impact framework to measure shifts in the ecosystem for inclusion.

Children with disabilities need comprehensive intervention spanning health, education, and social systems from infancy through adulthood, with ongoing assessment of outcomes. While assistive technology is crucial, it must be complemented by inclusive learning options and other systemic interventions. Bronfenbrenner's Ecological Systems Theory guides this approach. A project in South Africa's Northern Cape Province utilized Acumen's Lean Data methodology for monitoring and evaluation. This methodology emphasizes rapid, technology-enabled data collection to inform stakeholders effectively. The project focused on disability awareness, referral systems, assistive technology provision, and early childhood development, adapting programs for various stakeholders and virtual delivery during COVID-19 lockdowns. Results underscored the interconnectedness of assistive technology with broader inclusion efforts and the importance of adaptability and continuous assessment. Further research is recommended to explore the project's role in fostering disability inclusion comprehensively. This ecosystemic approach highlights the necessity of holistic intervention and ongoing evaluation for sustainable social transformation and inclusion.

The roads to managed competition for mixed public-private health systems: a conceptual framework.

Health systems' insurance/funding can be organised in several ways. Some countries have adopted systems with a mixture of public-private involvement (e.g. Australia, Chile, Ireland, South Africa, New Zealand) which creates two-tier health systems, allowing consumers (groups) to have preferential access to the basic standard of care (e.g. skipping waiting times). The degree to which efficiency and equity are achieved in these types of systems is questioned. In this paper, we consider integration of the two tiers by means of a managed competition model, which underpins Social Health Insurance (SHI) systems. We elaborate a two-part conceptual framework, where, first, we review and update the existing pre-requisites for the model of managed competition to fit a broader definition of health systems, and second, we typologise possible roadmaps to achieve that model in terms of the insurance function, and focus on the consequences on providers and governance/stewardship.

A Highly Robust and Conducting Ultramicroporous 3D Fe(II)-Based Metal-Organic Framework for Efficient Energy Storage.

Exploitation of metal-organic framework (MOF) materials as active electrodes for energy storage or conversion is reasonably challenging owing to their poor robustness against various acidic/basic conditions and conventionally low electric conductivity. Keeping this in perspective, herein, a 3D ultramicroporous triazolate Fe-MOF (abbreviated as Fe-MET) is judiciously employed using cheap and commercially available starting materials. Fe-MET possesses ultra-stability against various chemical environments (pH-1 to pH-14 with varied organic solvents) and is highly electrically conductive (σ = 0.19 S m-1) in one fell swoop. By taking advantage of the properties mentioned above, Fe-MET electrodes give prominence to electrochemical capacitor (EC) performance by delivering an astounding gravimetric (304 F g-1) and areal (181 mF cm-2) capacitance at 0.5 A g-1 current density with exceptionally high cycling stability. Implementation of Fe-MET as an exclusive (by not using any conductive additives) EC electrode in solid-state energy storage devices outperforms most of the reported MOF-based EC materials and even surpasses certain porous carbon and graphene materials, showcasing superior capabilities and great promise compared to various other alternatives as energy storage materials.

Ultrasound Trigger Ce-Based MOF Nanoenzyme For Efficient Thrombolytic Therapy.

The inflammatory damage caused by thrombus formation and dissolution can increase the risk of thrombotic complications on top of cell death and organ dysfunction caused by thrombus itself. Therefore, a rapid and precise thrombolytic therapy strategy is in urgent need to effectively dissolve thrombus and resist oxidation simultaneously. In this study, Ce-UiO-66, a cerium-based metal-organic framework (Ce-MOF) with reactive oxygen species (ROS) scavenging properties, encapsulated by low-immunogenic mesenchymal stem cell membrane with inflammation-targeting properties, is used to construct a targeted nanomedicine Ce-UiO-CM. Ce-UiO-CM is applied in combination with external ultrasound stimulation for thrombolytic therapy in rat femoral artery. Ce-UiO-66 has abundant Ce (III)/Ce (IV) coupling sites that react with hydrogen peroxide (H2O2) to produce oxygen, exhibiting catalase (CAT) activity. The multi-cavity structure of Ce-UiO-66 can generate electron holes, and its pore channels can act as micro-reactors to further enhance its ROS scavenging capacity. Additionally, the porous structure of Ce-UiO-66 and the oxygen produced by its reaction with H2O2 may enhance the cavitation effects of ultrasound, thereby improving thrombolysis efficacy.

Photo-responsive Hydrogen-Bonded Molecular Networks Capable of Retaining Crystalline Periodicity after Isomerization.

The molecular conformation, crystalline morphology, and properties of photochromic organic crystals can be controlled through photoirradiation, making them promising candidates for functional organic materials. However, photochromic porous molecular crystals with a networked framework structure are rare due to the difficulty in maintaining space that allows for photo-induced molecular motion in the crystalline state. This study describes a photo-responsive single crystal based on hydrogen-bonded (H-bonded) network of dihydrodimethylbenzo[e]pyrene derivative 4BDHP. A crystal composed of H-bonded undulate layers, 4BDHP-2, underwent photoisomerization in the crystalline state due to loose stacking of the layers, resulting loss of crystallinity. Enantio-pure crystal (S,S)-4BDHP-2, on the other hand, allowed to reveal the structure of the photoisomerized crystal, in which the closed form (4BDHP) and open form (4CPD) were arranged alternately with keeping crystalline periodicity, although side reactions were also implied. The present proof-of-concept system of a photochromic framework that retains crystalline periodicity after photoisomerization may provide new light-driven porous functional materials.

The Association Between Perceived Discrimination, Age and Proportion of Lifetime in the United States Among Somali Immigrants: A Cross-Sectional Analysis.

Discrimination is detrimental to health. Little is known about perceived discrimination among Somali immigrants. We examined whether age or proportion of lifetime in the United States was associated with perceived discrimination among Somali immigrants. Guided by Intersectionality, we described a secondary analysis of Everyday Discrimination Scale (EDS) survey data from the Healthy Immigrant Community study. Younger participants ( ≤40 years) experienced more discrimination than older participants ( >40 years). Higher education, being male, and earning $20,000-$39,999 was associated with more perceived discrimination. These findings suggest that Somali immigrants who are younger, more formally educated, male, and/or earn $20,000-$39,000 report more discrimination than their counterparts. Possible explanations include exposure to discrimination outside the Somali community or more awareness about racism. Alternatively, the EDS may not capture the discrimination experienced by Somali women or older adults. Further research is needed to address the discrimination experienced by Somali immigrants. Clinical Trial Registration: NCT05136339, November 29,2021.

Toward Patient Centricity: Why Do Patients With Inflammatory Bowel Disease Participate in Pharmaceutical Clinical Trials? A Mixed-Methods Exploration of Study Participants.

Background: A better understanding of motivations to participate as well as recommendations to reduce barriers to enrollment may assist in design of future clinical trials. Methods: We developed a 32-item electronic questionnaire to explore motivations, experiences, and recommendations of inflammatory bowel disease patients, who had participated in pharmaceutical clinical trials in a tertiary center in Canada over the last decade. We employed a mixed-methods approach that integrates both quantitative and qualitative research methods. Results: We distributed a total of 69 e-mails with surveys and received 46 responses (66.6% response rate). Study participants were mostly male (27/46, 58.7%), non-Hispanic White (43/46, 93.5%), with a mean age of 45.5 years (SD 10.9). Most decided to participate in a clinical trial to benefit future patients (29/46, 63.0%). Half of the participants (23/46, 50.0%) reported they were worried about the possibility of receiving placebo, although the majority (29/46, 63.0%) understood they could improve on placebo. The most challenging aspect reported was the number and length of questionnaires (15/46, 32.6%), as well as the number of colonoscopies (14/46, 30.4%). Strategies recommended to increase enrollment were reduction of the chance of receiving placebo (20/46, 43.5%), facilitating inclusion of patients who have failed multiple therapies (20/46, 43.5%), allowing virtual visits (18/46, 39.1%), including subtypes of disease traditionally excluded from trials (16/46, 34.8%) and improving outreach to underrepresented populations (13/46, 28.3%). The vast majority (37/46, 80.4%) reported their experience of participation to be better than expected. Conclusions: These results should help inform the design of future clinical trials with a focus on patient-centricity.

A dual recognition-based strategy employing Ni-modified metal-organic framework for in situ screening of SIRT1 inhibitors from Chinese herbs.

Sirtuin1 (SIRT1), an NAD+-dependent histone deacetylase, plays a crucial role in regulating molecular signaling pathways. Recently, inhibition of SIRT1 rather than its activation shows the therapeutic potential for central nervous system disorder, however, the discovered SIRT1 inhibitors remains limited. In this work, a dual recognition-based strategy was developed to screen SIRT1 inhibitors from natural resources in situ. This approach utilized a Ni-modified metal-organic framework (Ni@Tyr@UiO-66-NH2) along with cell lysate containing an engineered His-tagged SIRT1 protein, eliminating the need for purified proteins, pure compounds, and protein immobilization. The high-performance Ni@Tyr@UiO-66-NH2 was synthesized by modifying the surface of UiO-66-NH2 with Ni2+ ions to specifically capture His-tagged SIRT1 while persevering its enzyme activity. By employing dual recognition, in which Ni@Tyr@UiO-66-NH2 recognized SIRT1 and SIRT1 recognized its ligands, the process of identifying SIRT1 inhibitors from complex matrix was vastly streamlined. The developed method allowed the efficient discovery of 16 natural SIRT1 inhibitors from Chinese herbs. Among them, 6 compounds were fully characterized, and suffruticosol A was found to have an excellent IC50 value of 0.95 ±â€¯0.12 µM. Overall, an innovative dual recognition-based strategy was proposed to efficiently identify SIRT1 inhibitors in this study, offering scientific clues for the development of drugs targeting CNS disorders.

Modulating 3d Charge State via Halogen Ions in Neighboring Molecules of Metal-Organic Frameworks for Improving Water Oxidation.

Modulating the coordination environment of the metal active center is an effective method to boost the catalytic performances of metal-organic frameworks (MOFs) for oxygen evolution reaction (OER). However, little attention has been paid to the halogen effects on the ligands engineering. Herein, a series of MOFs X─FeNi-MOFs (X = Br, Cl, and F) is constructed with different coordination microenvironments to optimize OER activity. Theoretical calculations reveal that with the increase in electronegativity of halogen ions in terephthalic acid molecular (TPA), the Bader charge of Ni atoms gets larger and the Ni-3d band center and O-2p bands move closer to the Fermi level. This indicates that an increase in ligand negativity of halogen ions in TPA can promote the adsorption ability of catalytic sites to oxygen-containing intermediates and reduce the activation barrier for OER. Experimental also demonstrates that F─FeNi-MOFs exhibit the highest catalytic activity with an ultralow overpotential of 218 mV at 10 mA cm-2, outperforming most otate-of-the-art Fe/Co/Ni-based MOFs catalysts, and the enhanced mass activity by seven times compared with that for the sample before ligands engineering. This work opens a new avenue for the realization of the modulation of NiFe─O bonding by halogen ion in TPA and improves the OER performance of MOFs.

CuO (111) Microcrystalline Evoked Indium-Organic Framework for Efficient Electroreduction of CO2 to Formate.

Electrochemical reduction of carbon dioxide (CO2RR) to formate is economically beneficial but suffers from poor selectivity and high overpotential. Herein, enriched microcrystalline copper oxide is introduced on the surface of indium-based metal-organic frameworks. Benefiting from the CuO (111) microcrystalline shell and formed catalytic active In-Cu interfaces, the obtained MIL-68(In)/CuO heterostructure display excellent CO2RR to formate with a Faradaic efficiency (FE) as high as 89.7% at low potential of only -0.7 V vs. RHE in a flow cell. Significantly, the membrane electrode assembly (MEA) cell based on MIL-68(In)/CuO exhibit a remarkable current density of 640.3 mA cm-2 at 3.1 V and can be stably operated for 180 h at 2.7 V with a current density of 200 mA cm-2. The ex/in situ electrochemical investigations reveal that the introduction of CuO increases the formation rate of the carbon dioxide reduction intermediate *HCOO- and inhibits the competitive hydrogen evolution reaction. This work not only provides an in-depth study of the mechanism of the CO2RR pathways on In/Cu composite catalyst but also offers an effective strategy for the interface design of electrocatalytic carbon dioxide reduction reaction.

Phosphine-incorporated Metal-Organic Framework for Palladium Catalyzed Heck Coupling Reaction.

As an emerging material with the potential to combine the high efficiency of homogeneous catalysts and high stability and recyclability of heterogeneous catalysts, metal-organic frameworks (MOFs) have been viewed as one of the candidates to produce catalysts of the next generation. Herein, we heterogenized the highly active mono(phosphine)-Pd complex on surface of UiO-66 MOF, as a catalyst for Suzuki and Heck cross coupling reactions. The successful immobilization of these Pd-monophosphine complexes on MOF surface to form UiO-66-PPh2-Pd was characterized and confirmed via comprehensive set of analytical methods. UiO-66-PPh2-Pd showed high activity and selectivity for both Suzuki and Heck Cross Coupling Reactions. This strategy enabled facile access to mono(phosphine) complexes which are challenging to design and require multistep synthesis in homogeneous systems, paving the way for future MOF catalysts applications by similar systems.