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Recognizing the critical role gender plays in food systems within West Africa, this review paper explores the contributions women make throughout the food value chain and the challenges they face in achieving food and nutrition security. A search across the databases; Hinari, Ovid MEDLINE, Scopus and Web of Science targeted peer-reviewed articles reporting on studies published between 2000 and 2023 in English or French and focused on women in West Africa. Data were extracted using a predefined form in Covidence and a narrative synthesis was used to summarize women's roles and challenges within food systems. Thematic analysis of 69 peer-reviewed articles out of a total of 9,789 screened revealed West African women as central figures in regional food systems. Beyond their well-documented roles in land preparation, planting, and harvesting, women actively engage in processing, distribution, marketing and household consumption of diverse food crops (fruits, vegetables, grains and tubers) across rural and urban agri-food systems. This multifaceted engagement extends far beyond production, demonstrably impacting key socio-economic and nutrition metrics including food security, food sovereignty, and sustainable livelihoods of countless communities across the region. Nonetheless, women are disproportionately affected by challenges such as unequal access to resources, limited decision-making power, and restrictive cultural norms and education. These factors hinder their participation in different activities within the food system. To address these gendered disparities and promote equitable food systems, targeted interventions are crucial. These interventions must prioritize education and training to equip women with knowledge, skills, and modern technology. Additionally, policy changes are necessary to promote equitable access to resources, financing and land ownership. Furthermore, dismantling discriminatory cultural norms and promoting gender equality are essential steps along with implementing infrastructure and technologies that address women's specific needs. By prioritizing women's empowerment through a combination of education, policy changes, technological upgrades, and collaborative efforts with stakeholders, West Africa can strive towards a more sustainable and equitable food system for all. Key words: food sovereignty, food rights, food systems, gender dynamics, West Africa, INTRODUCTION Achieving the 2030 Agenda for Sustainable Development Goals (SDGs) hinges on gender equality and women's empowerment, particularly regarding food security, nutrition and food sovereignty [1, 2]. Women are crucial [...]

In the United States, melioidosis is an emerging infectious disease caused by Burkholderia pseudomallei (1,2). In melioidosis-endemic areas, the bacterium causes pneumonia and fatal bacteremia with diverse mortality rates that [...]

Vectorborne diseases are a growing public health concern in the United States. Whereas bacterial pathogens are responsible for most infections, tickborne viruses represent an emerging and poorly understood threat (1). [...]

Oropouche virus (OROV; Orthobunyavirus oropoucheense) is a reemerging arbovirus belonging to the family Peribunyaviridae. The large (L), medium (M), and small (S) single-stranded, negative-sense RNA segments of the OROV genome [...]

Influenza A viruses are enzootic in swine populations worldwide. All swine influenza A viruses are 1 of 3 antigenic subtypes-H1N1, H1N2, and H3N2-and distinct differences in evolutionary patterns exist between [...]

Enhanced Recovery After Surgery (ERAS) programs were developed as evidence-based, multi-disciplinary interventions in all the perioperative phases to minimise the surgical stress response, reduce complications, and enhance outcomes. The results across various surgical procedures have been positive, with a reduction in medical complications, a reduction in length of hospital stay, and a reduction in care costs without increased re-admission rates. However, implementation for many institutions has not been easy and suboptimal at best. The robust and pervasive adoption of these programs should be based on effective change management, dynamic and engaged clinical leadership, adherence to the principles of continuous quality improvement programs, and the adoption of evidence-based and data-driven changes in pathway development and implementation. Rapid cycle, randomised/quasi-randomised quality improvement projects must be the core foundation of an ERAS program. Finally, research methodologies should focus on controlling for adherence to the core elements of the pathways and testing for the effectiveness of an individual intervention in a randomised controlled trial. Keywords: Enhanced recovery after surgery, machine learning, perioperative medicine, perioperative research, surgical complications, Author(s): Vijaya Gottumukkala (corresponding author) [1]; Girish P. Joshi [2] INTRODUCTION Enhanced recovery after surgery (ERAS) programs were introduced into the surgical practice over two decades ago as evidence-based, multi-disciplinary [...]

Each year, government contracting programs dole out tens of billions of dollars to businesses that meet certain racial criteria. For example, in 2023, the State of Wisconsin spent over $200 [...]

Problem Violence against women is a global health problem. Effectively preventing such violence requires locally adapted strategies. Approach The World Health Organization in Indonesia, in collaboration with United Nations (UN) Population Fund, UN Women, United Nations Children's Fund, United Nations Development Programme and Joint United Nations Programme on HIV/AIDS, launched capacity-building initiatives to introduce RESPECT as an evidence-based framework to address violence against women. The initiatives included stakeholder engagement, module development, sensitization training, a workshop and evaluation sessions. These sessions introduced RESPECT strategies to government officials, UN officers and community representatives, mapped best practices and developed action plans. Local setting Indonesia has a substantial burden of violence against women, despite numerous laws and policies to combat it. The 2021 Indonesian violence against women survey showed that 26.1% (3341/12 800) of women aged 15-64 years had experienced violence in their lifetime, with 8.7% (1114/12 800) experiencing violence in the past year. Relevant changes The initiatives to introduce RESPECT led to securing government support, and verbal commitment was given by the Director for the Protection of Women's Rights against Domestic Violence and Vulnerability to integrate RESPECT into the 2025-2029 National Development Plan and National Strategy for Reducing Violence Against Women. Lessons learnt RESPECT can be adapted to local contexts through customization and capacity-building and by ensuring initial government support, dedicated personnel, resource allocation and use of established relationships with key stakeholders. Improved research, monitoring and evaluation are vital to promote evidence-informed decision-making, together with community engagement and multistakeholder collaboration. The UN can facilitate these efforts. [phrase omitted] Probleme La violence a l'egard des femmes est un probleme de sante mondial. Lutter efficacement contre de telles violences necessite des strategies adaptees aux differents contextes locaux. Approche En collaboration avec le Fonds des Nations unies pour la population (FNUAP), l'ONU Femmes, le Fonds des Nations unies pour l'enfance, le Programme des Nations unies pour le developpement et le Programme commun des Nations Unies sur le VIH/sida, l'Organisation mondiale de la Sante en Indonesie a lance une serie d'initiatives de renforcement des capacites afin d'instaurer RESPECT, un cadre methodologique fonde sur des faits dont le but est de lutter contre les violences envers les femmes. Parmi ces initiatives figuraient l'implication des parties prenantes, le developpement de modules, une formation a la sensibilisation, un atelier et des sessions d'evaluation. Ces sessions ont servi a presenter les strategies RESPECT a des responsables du gouvernement, des fonctionnaires de l'ONU et des representants des communautes, a identifier les meilleures pratiques et a elaborer des plans d'action. Environnement local Malgre de nombreuses lois et politiques visant a lutter contre la violence envers les femmes, elle demeure un veritable fleau en Indonesie. Une enquete menee en 2021 dans le pays a montre que 26,1% (3341/12 800) des femmes agees de 15 a 64 ans avaient subi des violences au cours de leur vie, et que 8,7% (1114/12 800) y avaient ete confrontees au cours de l'annee ecoulee. Changements significatifs Les initiatives visant a mettre en place RESPECT ont permis d'assurer le soutien du gouvernement, tandis que le directeur charge de la protection des droits des femmes contre les violences domestiques et les facteurs de vulnerabilite s'est engage verbalement a integrer RESPECT dans le Plan national de developpement et la Strategie nationale de reduction de la violence a l'egard des femmes 2025-2029. Lecons tirees Le cadre methodologique RESPECT peut etre adapte aux differents contextes locaux par le biais de la personnalisation et du renforcement des capacites, mais aussi en veillant a obtenir l'appui initial du gouvernement, en disposant d'un personnel specialise, en attribuant des ressources et en utilisant les relations etablies avec les principales parties prenantes. Lamelioration de la recherche, du suivi et de l'evaluation est cruciale pour promouvoir des processus decisionnels etayes par des faits, tout comme l'implication des communautes et la collaboration multilaterale. LONU peut contribuer a ces efforts. [phrase omitted] Situacion La violencia contra las mujeres es un problema sanitario mundial. Para prevenirla de manera eficaz se necesitan estrategias adaptadas a las circunstancias locales. Enfoque La Organizacion Mundial de la Salud en Indonesia, en colaboracion con el Fondo de Poblacion de las Naciones Unidas (ONU), ONU Mujeres, el Fondo de las Naciones Unidas para la Infancia, el Programa de las Naciones Unidas para el Desarrollo y el Programa Conjunto de las Naciones Unidas sobre el VIH/SIDA, emprendio iniciativas de capacitacion para introducir RESPECT como marco basado en evidencias para abordar la violencia contra las mujeres. Las iniciativas incluyeron la participacion de las partes interesadas, el desarrollo de modulos, formacion de sensibilizacion, un taller y sesiones de evaluacion. En estas sesiones se presentaron las estrategias de RESPECT a funcionarios del gobierno, oficiales de las Naciones Unidas y representantes de la comunidad, se trazaron las mejores practicas y se desarrollaron planes de accion. Marco regional Indonesia tiene una carga considerable de violencia contra las mujeres, a pesar de las numerosas leyes y politicas para contrarrestarla. La encuesta sobre violencia contra las mujeres realizada en Indonesia en 2021 mostro que el 26,1% (3341/12 800) de las mujeres de entre 15 y 64 anos habian sufrido violencia a lo largo de su vida, y el 8,7% (1114/12 800) en el ultimo ano. Cambios importantes Las iniciativas para introducir RESPECT llevaron a conseguir el apoyo del gobierno. Ademas, el Director para la Proteccion de los derechos de la mujer contra la violencia domestica y la vulnerabilidad se comprometio verbalmente a integrar RESPECT en el Plan nacional de desarrollo 2025-2029 y en la Estrategia nacional para reducir la violencia contra la mujer. Lecciones aprendidas Se puede adaptar RESPECT a los contextos locales mediante la personalizacion y el desarrollo de capacidades, y garantizando el apoyo inicial del gobierno, la dedicacion de personal, la asignacion de recursos y el uso de las relaciones establecidas con las principales partes interesadas. La mejora de la investigacion, el seguimiento y la evaluacion son vitales para promover la toma de decisiones basada en evidencias, junto con la participacion de la comunidad y la colaboracion de multiples partes interesadas. La ONU puede facilitar estos esfuerzos., Introduction Violence against women is a global health problem rooted in gender inequality. (1) Preventing violence against women in Indonesia is a distinct challenge: despite the existence of laws and [...]

The normative role of the World Health Organization (WHO) involves creating evidence-based, principled guidelines to guide its Member States in making well-informed public health decisions. While these guidelines often need to be adapted to ensure contextual relevance, foster better implementation and adherence, adapting existing guidelines is more efficient than creating new ones. Here we describe the adaptation of the WHO coronavirus disease 2019 (COVID-19) living guideline on pharmacological interventions for the Caribbean using the grading of recommendations, assessment, development and evaluation (GRADE)-ADOLOPMENT method. The Caribbean Public Health Agency and the Pan American Health Organization led the effort, assembling a diverse panel of 16 experts from seven Caribbean countries and territories. The adaptation process, involving 15 steps, was guided by an experienced methodologist and included selecting relevant clinical questions and prioritizing them based on regional needs. The panel evaluated the latest WHO guidelines and integrated additional local data. They adjusted the direction and strength of several recommendations to better fit the Caribbean context, considering local values and preferences, resources, accessibility, feasibility and impact on health equity. Ultimately, we changed the direction of two recommendations and the strength of five, tailoring them to regional realities. This effort highlights the importance of adapting global guidelines to local settings, improving their applicability and effectiveness. The adaptation process also serves as a valuable opportunity for skill transfer and capacity-building in guideline development. Continued research is needed to assess the impact of these adaptations on health-care outcomes in the Caribbean. [phrase omitted] Le role normatif de l'Organisation mondiale de la sante (OMS) consiste a elaborer des lignes directrices fondees sur des donnees scientifiques et sur des principes afin d'aider ses Etats membres a prendre des decisions eclairees en matiere de sante publique. Bien qu'elles necessitent souvent des adaptations pour garantir leur pertinence par rapport a des contextes precis et pour favoriser une meilleure mise en oeuvre et adhesion, il est plus efficace d'adapter les lignes directrices existantes que d'en creer de nouvelles. La presente publication decrit l'adaptation de la ligne directrice evolutive de l'OMS sur les interventions pharmacologiques dans le cadre de la maladie a coronavirus (COVID-19) pour les Caraibes en appliquant la methodologie GRADE (classement des recommandations, de l'appreciation, du developpement et de l'evaluation)-ADOLOPMENT. LAgence de sante publique des Caraibes et l'Organisation panamericaine de la Sante ont dirige les travaux en reunissant un groupe diversifie de 16 experts issus de sept pays et territoires des Caraibes. Le processus d'adaptation, comptant 15 etapes et encadre par un methodologiste experimente, a consiste a selectionner des questions cliniques pertinentes et a les classer par ordre de priorite selon les besoins regionaux. Ce groupe a evalue les dernieres lignes directrices de l'OMS et a integre des donnees locales supplementaires. Il a ensuite ajuste l'orientation et le poids de plusieurs recommandations afin de mieux les adapter au contexte des Caraibes, en tenant compte des valeurs et des preferences locales, des ressources, de l'accessibilite, de la faisabilite et de l'impact sur l'equite en matiere de sante. En fin de compte, l'orientation de deux recommandations et le poids de cinq autres ont ete modifies, en les adaptant aux realites regionales. Cet effort souligne l'importance d'adapter des lignes directrices mondiales aux contextes locaux, afin d'en ameliorer l'applicabilite et l'efficacite. Le processus d'adaptation represente egalement une occasion precieuse de transfert de competences et de renforcement des capacites en matiere d'elaboration de lignes directrices. Des recherches continues s'imposent pour evaluer l'impact de ces adaptations sur les resultats des soins de sante dans les Caraibes. [phrase omitted] La funcion normativa de la Organizacion Mundial de la Salud (OMS) consiste en elaborar directrices basadas en pruebas y principios para orientar a sus Estados Miembros en la toma de decisiones de salud publica bien fundamentadas. Aunque con frecuencia es necesario adaptar estas directrices para garantizar su pertinencia contextual y fomentar una mejor implementacion y observancia, la adaptacion de directrices existentes es mas eficiente que la creacion de otras nuevas. Aqui describimos la adaptacion de la directriz vigente de la OMS sobre la enfermedad por coronavirus (COVID-19) relativa a las intervenciones farmacologicas para el Caribe utilizando el metodo de clasificacion de valoracion, elaboracion y evaluacion de las recomendaciones (GRADE)ADOLOPMENT. La Agencia de Salud Publica del Caribe y la Organizacion Panamericana de la Salud lideraron la iniciativa, que reunio a un variado grupo de 16 expertos de siete paises y territorios caribenos. El proceso de adaptacion, que comprendio 15 pasos y fue guiado por un metodologo experimentado, Incluyo la seleccion de preguntas clinicas pertinentes y su priorizacion en funcion de las necesidades regionales. El grupo evaluo las ultimas directrices de la OMS e integro datos locales adicionales. Ajustaron la orientacion y la fuerza de varias recomendaciones para adaptarlas mejor al contexto caribeno, teniendo en cuenta los valores y preferencias locales, los recursos, la accesibilidad, la viabilidad y el impacto en la equidad sanitaria. Finalmente, cambiamos la orientacion de dos recomendaciones y la fuerza de cinco para adaptarlas a las realidades regionales. Esta iniciativa destaca la importancia de adaptar las directrices mundiales a los contextos locales, lo que mejora su aplicabilidad y eficacia. El proceso de adaptacion tambien constituye una valiosa oportunidad para la transferencia de conocimientos y el desarrollo de capacidades en la elaboracion de directrices. Es necesario seguir investigando para evaluar el impacto de estas adaptaciones en los resultados de la atencion sanitaria en el Caribe., Introduction Although the coronavirus disease 2019 (COVID-19) pandemic was a global catastrophe, its impact was not felt equally around the world. Despite being home to only 8% of the world's [...]

Abstract Introduction: The popularity of endolaparoscopic extraperitoneal repairs has been on the rise due to advantages such as sublay mesh placement and early return to daily activities. However, the procedure requires overcoming a learning curve, and with increased adoption, new complications have emerged. One significant complication is the rupture of the posterior rectus sheath (PRS). In this article, we present our modifications of the technique to reduce tension during PRS closure. Patients and Methods: The study included 105 patients who underwent endolaparoscopic extraperitoneal repairs for ventral hernias using two different techniques. Group A (n = 68) underwent the original technique, whereas Group B (n = 37) underwent the modified technique. The modifications in Group B included preserving the peritoneal bridge between the two PRS and the hernia sac, conducting a complete dissection of the space of Bogros and adopting a transverse or oblique closure of PRS along the lines of least tension. To assess the efficacy of these modifications in preventing PRS rupture, we compared the results of both groups. Results: Our findings indicate that following all the technical steps of the modified technique resulted in a reduced need for transversus abdominis release for PRS closure and a lower incidence of PRS rupture in the postoperative period. However, to further validate the effectiveness of these modifications, a larger follow-up period and a bigger sample size are required. Conclusions: The adoption of the modified technique can help achieve a tension-free PRS closure. Keywords: Abdominal closure technique, abdominal wall, laparoscopy, Author(s): Sarfaraz Jalil Baig [1]; Jignesh A. Gandhi [2]; Aarsh P. Gajjar (corresponding author) [3]; Pallawi Priya [1]; Devashree Sane [3] INTRODUCTION Endolaparoscopic sublay repairs have become popular for the [...]