Assistance Program Research Articles

O-013 Population pharmacokinetics of follitropin delta during ovarian stimulation

Abstract Study question Which patient characteristics affect serum follicle stimulating hormone (FSH) concentrations in women undergoing ovarian stimulation (OS) with follitropin delta, a human cell line derived FSH? Summary answer Body weight is the main determinant of serum FSH concentrations during OS. Renal function, race, ethnicity, hepatic function and age have at most small influence. What is known already The pharmacokinetics of FSH have been studied in dedicated studies with serial blood sampling, typically conducted in healthy subjects. Such studies are designed to provide detailed pharmacokinetic profile information but lack the statistical power for identifying individual patient characteristics affecting FSH exposure. Population pharmacokinetic modelling enables evaluating the influence of patient characteristics based on few FSH measurements per patient if data from many patients are available. Study design, size, duration Serum FSH concentrations were assessed by immunoassay in seven randomized, controlled, blinded, multicentre trials of follitropin delta in women undergoing an assisted reproductive technology program. The trials were conducted in the United States, Canada, Europe, Brazil, and Asia. In all, 2,721 women treated with follitropin delta contributed to the evaluation with 6,952 FSH measurements. Participants/materials, setting, methods FSH concentrations were described with a pre-specified one-compartment population pharmacokinetic model. The key model parameters were the apparent total clearance (CL/F) of follitropin delta, the interindividual variability in CL/F and the effects of baseline values of body weight, age, race, ethnicity, renal and hepatic function on CL/F. Renal function was assessed using the estimated glomerular filtration rate (eGFR) and hepatic function by alanine transaminase (ALT) and bilirubin levels. Main results and the role of chance Area under the FSH concentration-time curve during a dosing interval (AUC) was derived from dose and CL/F. Body weight had the most pronounced effect on AUC, both in terms of effect magnitude and statistical significance. AUC was 1.28-fold higher (90% confidence limits: 1.25; 1.30) in women with a body weight of 47 kg (5th percentile) compared to women with a median body weight of 62 kg. The effect estimates of eGFR, Asian race and Black race on CL/F were within the bioequivalence limits of 0.80 and 1.25, but with 90% confidence limits not including a value of 1. The effect of Black race was estimated to be a 1.19 fold (90% confidence limits: 1.12; 1.26) higher AUC, as compared to White race. Despite this, the individual estimates of AUC were close to identical comparing these patient populations (mean (SD) relative to a typical study participant: 1.00 (0.25) and 0.97 (0.23), respectively). This is likely due to the mean body weight being higher in Black trial participants compared to White trial participants (78.3 kg compared to 68.2 kg). The effects of age, ethnicity and the hepatic function markers ALT and bilirubin were well within the bioequivalence range of 0.80 – 1.25. Limitations, reasons for caution Potential effects of subject characteristics on PK parameters such as subcutaneous absorption rate or volume of distribution could not be evaluated due to the number of serum FSH concentration measurements available per patient. Wider implications of the findings After follitropin delta administration, serum FSH concentrations are inversely related to body weight; this may be helpful for determining whether there is a need to consider body weight when selecting dose. Trial registration number NCT01426386, NCT02309671, NCT01956110, NCT03228680, NCT03296527, NCT03740737, NCT03738618, NCT03809429

P-414 Evaluation of small non-coding RNAs in uterine fluid in the diagnosis of endometrial receptivity in assisted reproductive technology programs

Abstract Study question To analyze endometrial receptivity in patients undergoing frozen-thawed embryo transfer (FET) based on the expression of small non-coding RNAs (sncRNAs): microRNAs and piwiRNAs. Summary answer According to our studies, the expression of sncRNAs in uterine aspirate may become an additional non-invasive and effective way to determine endometrial receptivity. What is known already Today, infertility remains an important medical and social problem. According to statistics, the effectiveness of ART programs remains at the level of 30-40%. Violation of the implantation mechanism is associated with a shift in the “implantation window” period and endometrial receptivity. Therefore, the search for an ideal marker of endometrial receptivity is a priority. Studying the expression of sncRNAs in endometrial secretions or uterine aspirate may become a potential marker of endometrial receptivity. Study design, size, duration The study included 102 infertile couples with women aged from 23 to 40 years. The patients were divided into two groups depending on the preparation of the endometrium for the FET: group 1 - 42 patients with natural cycle (NC); group 2 - 60 patients with hormone replacement therapy (HRT). SncRNAs were assessed in uterine aspiration on the day of FET. Participants/materials, setting, methods Uterine fluid was carried out in a volume of 5 to 50 μl with noninvasive technique. Next, the material was sent to the laboratory of applied transcriptomics for identification of sncRNAs. Quantitative assessment of sncRNAs in the endometrial secretion on the day of FET was carried out by deep sequencing on the NextSeq 500/550 platform (Illumina). Main results and the role of chance Logistic regression models were constructed for predicting pregnancy and endometrial receptivity based on the expression profiles of microRNAs and piwiRNAs in uterine aspirate, which are with 95% sensitivity and 74% specificity in the case of a combination of miR-34c-5p, miR-363–3p, miR-1180–3p, miR-361–3p, miR-183–5p (AUC = 0.91, p < 0.001) or with 74% sensitivity and 87% specificity in the case of a combination of molecules piR_004152, piR_020541, piR_001318, piR_014923, piR_017716 (AUC = 0.81, p < 0.001) determine the readiness of the endometrium for embryo implantation in the FET. In the NC and HRT groups, statistically significant differences were established between patients who became pregnant and patients with a negative result of the ART program in terms of baseline progesterone levels (p < 0.001). In the HRT group, positive correlations were revealed between endometrial thickness on the day of embryo transfer and the baseline level of progesterone (p = 0.04, r = 0.28). Limitations, reasons for caution The study was limited in sample size of patients and requires further randomized studies. Wider implications of the findings For the first time, a test system has been developed for assessing endometrial receptivity based on the expression of sncRNAs in patients both in the NC and in the HRT during the FET. It was found that increased initial progesterone levels correlate with positive outcomes of ART programs. Trial registration number not applicable

P-049 Identification of human spermatozoa with zona pellucida-binding ability using deep learning

Abstract Study question Can a deep learning model be used for identification of fertilization-competent human spermatozoa based on their distinctive morphological features? Summary answer Our results validated the clinical significance of image analysis of sperm morphology using deep learning to identify high-quality spermatozoa with zona pellucida (ZP)-binding ability. What is known already Sperm morphology is manually evaluated as part of the conventional semen analysis in clinical settings. However, the clinical predictive power of sperm morphology remains debatable due to its lack of association with the fertilization potential of spermatozoa. Human zona pellucida (ZP)-binding ability is a measurable, independent sperm parameter associated with in vitro fertilization (IVF) and pregnancy outcome. Supervised deep learning is an advanced branch to systematically identify the underlying relationship between the input images and designated output. A well-trained model with high generalization ability can generate plausible predictions for unseen images collected under the same condition as the training datasets. Study design, size, duration Human spermatozoa and oocytes were obtained with written consents from the donors attending our assisted reproduction program. Acrosome intact, ZP-bound spermatozoa were recovered after 30 min of gamete coincubation. Unbound spermatozoa were collected from clinical samples of spermatozoa with defective ZP-binding ability leading to fertilization failure following conventional insemination. Sperm images of infertile men (n = 165) with fertilization rates including 0-40% (low), 41-70% (intermediate) and 71-100% (high) following conventional insemination were collected for validation. Participants/materials, setting, methods Diff-Quik stained images of spermatozoa were processed by the K-means clustering algorithm to generate grey-scaled images of individual sperm heads. All sperm images of clinical samples were subjected an additional image conversion step using Cycle Generative Adversarial Network (CycleGAN) to ensure that their microenvironments are similar to those of the laboratory samples. A VGG 13 model was fine-tuned to classify a total of 1,083 images of ZP-bound and unbound spermatozoa over 50 epochs. Main results and the role of chance The newly fine-tuned VGG-13 model demonstrated excellent performance in classifying the ZP-bound and unbound spermatozoa, as reflected by the high sensitivity of 97.6%, specificity of 96.0%, and accuracy of 96.4%. It had a high discriminative power to distinguish between ZP-bound and unbound spermatozoa with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.992. Saliency maps indicated that the model focused on the sperm head and mid-pieces in all images, with a primary emphasis on the anterior regions (43.0%±5.0%). The model was further validated on a vast collection of over 40,000 sperm images collected from the aforementioned fertilization groups. Our results revealed that the high fertilization rate group had a significantly higher percentage of predicted ZP-binding ability than the low fertilization rate group, as determined by the model (16.8%±7.2 vs. 3.2%±1.4; p < 0.05). By analyzing sperm images from infertile men (n = 113) in the high and low fertilization rates groups, a clinical threshold of 4.8% was identified using ROS curve (AUC:0.970) and Youden’s index, which can be used to distinguish between ZP-bound and unbound spermatozoa of clinical samples with a specificity of 93.8% and a sensitivity of 90.9%. Limitations, reasons for caution Our deep learning model is only applicable to diff-quik stained images of spermatozoa captured at high magnification. Further investigation is needed to examine its classification performance on images captured by different platforms and settings, ensuring consistent and reliable prediction accuracy regardless of varying degrees of image quality. Wider implications of the findings Our newly fine-tuned model can be used to evaluate sperm fertilizing potential, irrespective of the parameters evaluated in conventional semen analysis and to identify normospermic patients with defective ZP-binding ability who may benefit from intracytoplasmic sperm injection (ICSI) to improve their fertilization outcome. Trial registration number not applicable

P-099 The development of a novel sperm washing medium, enriched with serotonin as the active constituent, with the objective of enhancing sperm motility and viability

Abstract Study question Is it possible to develop a novel product that increases the success rate of treating male infertility through assisted reproductive techniques? Summary answer Sperm washing media, aiming to improve sperm quality, enhance sperm motility, and generally support male reproductive health in the field of assisted reproductive techniques. What is known already Infertility impacts 15% of all couples globally, with 50% of infertility cases attributed solely to male factors. Reduced semen motility is identified as a primary factor directly associated with infertility. The utilization of supplementation to enhance overall sperm quality has gained increasing popularity worldwide. The sperm preparation process in Assisted Reproductive Technology (ART) is crucial for successful fertilization, with sperm washing mediums playing a critical role in enhancing efficiency. Sperm-washing media is a specialized solution utilized in assisted reproductive technologies such as intrauterine insemination and in vitro fertilization to remove the seminal fluid and debris for sperm to undergo capacitation. Study design, size, duration In this study, 200 normozoospermic men were included, and their semen samples were analyzed over an 18-month period following the guidelines outlined by the World Health Organization (2010) to assess the efficacy of serotonin, selenium, zinc, L-Carnitine, and Coenzyme Q10 supplementation on sperm motility, viability, ROS and DNA damage. Participants/materials, setting, methods Sperm samples obtained from 200 volunteer men undergoing infertility assessments were subdivided into three samples.The sperm samples underwent preparation using the swim-up technique. The study involved the examination of samples in three distinct washing media: (1) Origio, (2) Irvine Scientific, (3) a prototype (serotonin, selenium, zinc, L-carnitine, and Coenzyme Q10). Each medium was analyzed for motility, apoptosis, reactive oxygen species (ROS), and DNA damage. Main results and the role of chance It is found that mean basal total sperm counts are 38 million. After sperm washing, mean total sperm counts of Origio®, Irvine® and Prototype are 15 million respectively (p > 0.05). As total progressive motility is % 40 before washing, it is increased to 62%,56% and 64% after washing with Origio®, Irvine® and Prototype, respectively (p > 0.05). Annexin V staining is used for detection of apoptosis in sperm samples. On average, early apoptosis over the total sperm count(TSC) per subgroups are 34.67% for Prototype, 33.17% for Origio® and 30.96% for Irvine®, whereas late apoptosis ratios are found significantly lower in Prototype compared to Origio and Irvine; 8.7%, 28.26% and 27.74%, respectively. Ratio of necrosis over TSC per subgroups is 3.15% for Prototype, 13.49% for Origio® and 18.78% for Irvine® whereas viability ratios are as 53.48%, 25.08%, 22.52%, respectively.(p < 0.05). ROS levels in semen after washing are significantly lower for Prototype (5.9%, 10.29%, and 18.22%, Prototype, Origio® and Irvine®, respectively) (p < 0.05). Limitations, reasons for caution Semen samples from males aged 28 to 45, who are unable to conceive, do not smoke, and have not undergone any surgical interventions, are collected from patients after a sexual abstinence period of 3-4 days. Wider implications of the findings We propose that our serotonin-activated washing media for sperm preparation can serve as a suitable choice for selecting high-quality sperm in assisted reproductive technology programs. These molecules may enhance the success of assisted reproduction techniques when present in sperm preparation media. Trial registration number SerotoneX

Police mental health in small and rural areas of Pennsylvania

PurposeThe nature of policework is uniquely challenging to officers’ mental health, producing detrimental outcomes such as higher rates of suicide, substance abuse and divorce compared to other occupations. This is especially true in small and rural police departments, where officers often have broader responsibilities and cover a larger geographic area than their counterparts who work in large urban departments. Given the limited resources available to small and rural police, the purpose of this study is to explore the mental health services available to officers in small and rural police departments.Design/methodology/approachWe used a mixed methods approach. First, we surveyed 349 small and rural Pennsylvania police chiefs about the mental health services in their department. Of these chiefs, 53 participated in subsequent in-depth qualitative interviews about officer awareness of the mental health services available to them, what resources they thought would be helpful to officers and what barriers exist to prevent officers from seeking help.FindingsQuantitative results indicated that 22% of small and rural police departments had no mental health programs available to officers; Critical Incident Stress Management and Employee Assistance Programs were most commonly available. Budget size and the presence of a union influenced whether a department had mental health programs available to officers. Qualitative interviews found that although most departments provided some mental health services, officers were unlikely to use them. Chiefs expressed a need for improved services that officers might be more likely to use.Practical implicationsGiven the lack of resources available in small and rural police departments and the lack of adoption of some resources, we recommend peer assistance, general wellness programs and telehealth as feasible options for officer mental health.Originality/valueSmall and rural police comprise the bulk of policing in the USA, yet remain understudied. This study focuses on small and rural police.

A Spatial Perspective on Environmental Justice: The Link Between Gerrymandering, Toxic Waste Facilities, and the Supplemental Nutrition Assistance Program in the Midwest, United States

A Spatial Perspective on Environmental Justice: The Link Between Gerrymandering, Toxic Waste Facilities, and the Supplemental Nutrition Assistance Program in the Midwest, United States

Understanding Barriers to Guideline-Concordant Treatment in Foregut Cancer: From Data to Solutions

BackgroundA large proportion of patients with foregut cancers do not receive guideline-concordant treatment (GCT). This study sought to understand underlying barriers to GCT through a root cause analysis approach.MethodsA single-institution retrospective review of 498 patients with foregut (gastric, pancreatic, and hepatobiliary) adenocarcinoma from 2018 to 2022 was performed. Guideline-concordant treatment was defined based on National Comprehensive Cancer Network guidelines. The Ishikawa cause and effect model was used to establish main contributing factors to non-GCT.ResultsOverall, 34% did not receive GCT. Root causes of non-GCT included Patient, Physician, Institutional Environment and Broader System-related factors. In decreasing order of frequency, the following contributed to non-GCT: receipt of incomplete therapy (N = 28, 16.5%), deconditioning on chemotherapy (N = 26, 15.3%), delays in care because of patient resource constraints followed by loss to follow-up (N = 19, 11.2%), physician factors (N = 19, 11.2%), no documentation of treatment plan after referral to oncologic expertise (N = 19, 11.2%), loss to follow-up before oncology referral (N = 17, 10%), nonreferral to medical oncologic expertise (N = 16, 9.4%), nonreferral to surgical oncology in patients with resectable disease (N = 15, 8.8%), and complications preventing completion of treatment (N = 11, 6.5%). Non-GCT often was a function of multiple intersecting patient, physician, and institutional factors.ConclusionsA substantial percentage of patients with foregut cancer do not receive GCT. Solutions that may improve receipt of GCT include development of automated systems to improve patient follow-up; institutional prioritization of resources to enhance staffing; financial counseling and assistance programs; and development and integration of structured prehabilitation programs into cancer treatment pathways.

Understanding the Dynamic and Episodic Nature of Technostressors and Their Effects on Cyberdeviance: A Daily Field Investigation

From a management perspective, our results first reveal the detrimental impacts of daily technostressors on the functioning of an organization and its employees. Managers should be cognizant of these consequences and create a relaxing work environment or design tools to reduce technostressors. Managers can institute more daily breaks and ensure that employees have autonomy over when to take breaks and what they do during their break time. We also encourage executives to avoid using information and communication technologies to technologically invade the lives and personal time of employees in the evening after work. Second, to reduce the incidence of daily cyberdeviance, managers should offer assistance programs to their employees to teach them how to control or manage their emotional and cognitive resources and to better cope with techno-overload and techno-invasion. Third, the moderating effect of technology self-efficacy suggests that there are added benefits to selecting and training employees with high technology self-efficacy, as doing so not only helps employees to cope with techno-overload but also enables them to regulate their immediate emotions rather than engage in daily cyberdeviance at work.

Influence of social determinants of health and adversity on computerized neurocognitive assessment

Introduction: Social determinants of health and adversity, including poverty, maltreatment, and neighborhood deprivation, are individual-level factors that may significantly affect baseline neurocognitive testing and management that have yet to be thoroughly explored within the computerized neurocognitive assessment.Objectives: Examine individual-level experiences of poverty, abuse, neighborhood deprivation, and social mobility on computerized cognitive testing.Methods: The sample included 3,845 student-athletes who completed a baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and were enrolled in the Child-Household Integrated Longitudinal Data database. Multivariable linear regressions were used to assess independent variables of Supplemental Nutrition Assistance Program enrollment, abuse or neglect cases, Area Deprivation Index scores, and other demographic factors on four baseline ImPACT composite scores: verbal and visual memory, visuomotor, and reaction time.Results: Individual-level factors of persistent poverty and neighborhood deprivation were associated with lower composite scores; however, upward social mobility was not significantly associated with cognitive performance. The effects of mother’s race on computerized cognitive testing performance were attenuated when accounting for measures of adversity.Conclusion: Findings highlight the importance of social determinants of health in computerized neurocognitive testing to ensure more culturally sensitive and precise understanding of athletic baselines.

Employee assistance program for players in the Chinese Professional Baseball League

Employee Assistance Programs (EAP) offer services that assist in the management of problems faced by employees. EAP can assist in addressing employee-related issues in various workplaces, including the problems faced by professional baseball players. The purpose of this study is to develop the framework for a suitable EAP for the players of the Chinese Professional Baseball League (CPBL). This study chose the modified Delphi method to develop the EAP for players of the CPBL. The selection of members of the expert panel was based on their expertise in human resource management, counseling, EAP, and sports management, as well as retired professional baseball players. The two rounds of nine-week survey were conducted to collect the opinions of the panel experts. The results indicated that EAP for CPBL players fall into four categories: EAP about work, which can help players pursue their career development; EAP about health, which can help players maintain their physical and mental health; EAP about family life, which can help improve the quality of life of players and their families; and other EAP, which can be used to establish communication channels with the teams. There are a total of 40 EAP items developed in this study.

Impact of Socioeconomic Status on Patient Adherence in Managing Renal Masses.

Previous literature suggests socioeconomic status and racial disparities impact management decisions for patients with small renal masses. We aim to build upon these findings and examine how these modalities impact patient adherence to their management plan. This retrospective study analyzed our Kidney Tumor Program database (n = 1476) containing patients from 2000 to 2020. Socioeconomic status was estimated using 2 modalities: Area Deprivation Index and household income. Patients were then evaluated for differences in adherence, nonadherence, and loss to follow-up. Adherent patients completed all recommended appointments within 6 months of their initial follow-up. Nonadherent patients did not complete all recommended appointments within 6 months of their originally scheduled follow-up but eventually did. Patients lost to follow-up were recommended to follow up but never did. Patient adherence was not significantly different across sex or primary treatment method but differed with respect to race/ethnicity. Black patients were significantly more likely to be nonadherent (P = .021) and lost to follow-up (P = .008). After adjusting for race/ethnicity, Area Deprivation Index and income bracket were significantly associated with adherence and loss to follow-up. Patients with a high socioeconomic status had significantly higher rates of adherence (ADI, quartile [Q] 1 vs Q4, P = .038; income, >$120,000 vs $30,000-$59,999, P < .003) and decreased loss to follow-up (ADI, Q1 vs Q4, P = .03; income, >$120,000 vs $30,000-$59,999, P = .002). Our results demonstrate that Black race and low socioeconomic status are associated with decreased adherence and increased loss to follow-up. Possible strategies to target these disparities include financial assistance programming, social determinants of health screening, and nurse navigator programs.

Fruit and Vegetable Intake Among US Children Aged 1–5 Years Old and Associations With Food Assistance Program Participation and Food Sufficiency, 2021–2022

Fruit and Vegetable Intake Among US Children Aged 1–5 Years Old and Associations With Food Assistance Program Participation and Food Sufficiency, 2021–2022

Fruit and Vegetable Intake and Supplemental Nutrition Assistance Program Participation Status Among Older Adults Living in Rhode Island

Fruit and Vegetable Intake and Supplemental Nutrition Assistance Program Participation Status Among Older Adults Living in Rhode Island

Impact of Food Insecurity and Community and Federal Food Assistance Program Usage on Experiencing a Negative Health Condition Among Latinx Individuals in the NC High Country

Impact of Food Insecurity and Community and Federal Food Assistance Program Usage on Experiencing a Negative Health Condition Among Latinx Individuals in the NC High Country

The Effectiveness of Fisherman Community Empowerment Programs Through Fisheries Actor Business Cards

This study aims to determine the effectiveness of the Fisherman Community Empowerment Program through Fisheries Actor Business Cards in Landolia Village, Ranteangin District, North Kolaka Regency. This type of research was conducted with qualitative research methods, data collected from primary data and secondary data. Primary data sourced from interviews with informants totaling 11 people and from observations. As for secondary data by collecting data through literature studies and other supporting literature. The data analysis technique used is qualitative data analysis using data collection, data reduction, data presentation, and drawing conclusions put forward by Miles and Hubberman. Based on the results of the study indicate that the effectiveness of the Fisher Community Empowerment Program through the Fisheries Actor Business Card (KUSUKA) Landolia Village, Ranteangin District, North Kolaka Regency through 4 indicators to measure the effectiveness of the program, namely: 1) the accuracy of the program targets, the effectiveness of the Fisherman Community Empowerment Program through the Kusuka Card in the village. Landolia, Ranteangin District, North Kolaka Regency has not been effective because the target accuracy indicator has not been effective because the target achievement is less than all program targets, 2) Program socialization on program socialization indicators in the fishermen community empowerment program through Kusuka is still not effective because of the low interest of the community to participate in socialization. 3) program objectives, with the Kusuka program for fishermen groups in Landolia Village, it is said to be quite effective because it really helps the community in meeting their daily needs. 4) Program Monitoring Based on the explanation above, the authors conducted further searches and saw data on the members of the fishing group who received the assistance provided through the Kusuka program, which is still not considered effective because not all members of the fishermen use the assistance programs properly.

Employee Assistance Programs for Indigenous People in the Workplace

According to a survey regarding indigenous employment, in Taiwan, a high proportion of indigenous people are engaged in construction work compared with the overall population. However, among indigenous construction workers, 56.15% have received no occupational safety or health training, and 9.39% have encountered occupational accidents in their workplaces. Therefore, this study aimed to develop employee assistance programs (EAPs) for indigenous workers in Taiwan by focusing on three dimensions—namely work, life, and health—and by establishing corresponding implementation paths for these EAPs. A modified Delphi method was adopted to screen EAP measures for the workplaces of indigenous workers, and a formal evaluation followed. Subsequently, the analytic hierarchy process was employed to calculate the overall weights among the factors in order to discern the relative importance of each factor in achieving the target goal or to resolve target problems and establish an order of priority. The results indicated that health was the most important of the three dimensions of indigenous EAPs, followed by the life dimension and then the work dimension. Compared with previous studies regarding Han Taiwanese workers, mental health services in the health dimension were particularly important in the present study. Finally, regarding the health dimension, this study suggests developing mental health services that respect indigenous culture and therefore are appropriate for indigenous people, such as the establishment of drug and alcohol addiction support groups and mental health service systems. In addition, corresponding welfare measures can be offered to enhance people’s motivation to change.

NIH Applicant Assistance Program counteracts decades of underrepresentation in SBIR grant awardees.

NIH Applicant Assistance Program counteracts decades of underrepresentation in SBIR grant awardees.

Association between participation in the supplemental nutrition assistance program and perception of limited availability and choice of healthy foods.

Nutrition security encompasses stable and equitable access, availability, affordability, and utilization of healthy foods. To evaluate the relationship of two newly created dichotomous measures that represent aspects of nutrition security (i.e., perceived limited availability and healthfulness choice) with Supplemental Nutrition Assistance Program (SNAP) participation. Logistic regression models were run for each outcome separately with adjustment for age, income-to-poverty ratio, gender, education, race, and food security. Adults using social services (e.g., food pantries) were enrolled (N = 402) in this cross-sectional analysis. SNAP participants (61.7%) were not different from non-SNAP participants in perceiving limited availability (aOR [95% CI]: 1.21 [0.75, 1.95]) or limited ability to choose (aOR [95% CI]: 0.69 [0.43, 1.12]) healthy foods. Both SNAP and non-SNAP participants with low socioeconomic status report limited availability of healthy foods in their environment and a limited ability to choose healthy foods.

A Review on Scaling Up Successful Agricultural Extension Techniques for Global Benefit

Agricultural extension services are important for enhancing agricultural productivity, food security, and rural development. Examination of future and research needs highlights the significance of innovative approaches and emerging technologies, such as digital agriculture, precision farming, artificial intelligence, blockchain technology, and biotechnology, in transforming extension services. These technologies offer the potential to optimize resource use, increase yields, and improve supply chain transparency. Comprehensive impact assessments, including randomized controlled trials and mixed-methods approaches, are essential for evaluating the effectiveness of extension programs and understanding their long-term impacts on productivity, food security, and livelihoods. Supportive policy development and advocacy efforts are crucial for creating an enabling environment that promotes innovation, collaboration, and sustainable practices. This includes establishing regulatory frameworks, providing financial incentives, and integrating extension services into national development plans. Cross-disciplinary research and international collaboration are key to addressing the complex challenges facing agriculture, fostering the exchange of knowledge and best practices, and enhancing the capacity of national extension systems. Interdisciplinary research teams and systems thinking approaches can provide comprehensive solutions to agricultural challenges, while international research networks and development assistance programs can facilitate the transfer of appropriate technologies and practices. South-South cooperation offers additional opportunities for knowledge exchange and technology transfer between developing countries. By addressing these future directions and research needs, agricultural extension services can effectively contribute to sustainable agricultural development, improved livelihoods for farmers, and greater resilience to climate change. This approach will ensure that extension services remain responsive to the evolving challenges and opportunities in the agricultural sector, ultimately promoting global food security and economic growth.

Reflections on government‐led social assistance programmes under Zimbabwe's National Social Protection Policy Framework: A social contract lens

AbstractSocial protection has gained global recognition for its role in addressing poverty, yet delivering social protection remains an intractable challenge for governments in the Global South. In this article, we assess the performance of government‐run social assistance in Zimbabwe. Our assessment begins in 2016 when the National Social Protection Policy Framework (NSPPF) was promulgated to maximize returns on social investments. Utilizing a systematic review approach, we collated literature published between 2016–2023. We find that despite adopting the NSPPF, social protection programming remains a challenge in Zimbabwe. We find that the disbursement of transfers to beneficiaries are delayed, benefits are misaligned with market forces due to inflation, most programmes are run without monitoring and evaluation structures, funding in the sector remains inadequate to reduce poverty and vulnerability, and no grievance and redress mechanisms exist. Our synthesis underscores the need for the refreshment of the social contract in Zimbabwe, a renewal of political will to finance social assistance programmes, engagement to transform policy into action, the expansion of the civic space to ensure citizens effectively participate in calling for social assistance, as well as concerted efforts towards harmonizing existing social assistance programmes. We highlight the need to embed social protection within a human rights‐based framework, and the need for robust monitoring frameworks along with predictable and dedicated financing.