Scaling-up climate services with users in Latin America

Latin America farmers are highly vulnerable to climate variability, with crop losses observed throughout the region on a virtually annual basis. For instance, as indicated by the United Nations’ Food and Agriculture Organization (FAO) and World Food Program (WFP), the 2014–2017 drought conditions in Central America affected over 3.5 million people in Guatemala, Honduras and El Salvador. At the same time, local stakeholders and farmers generally have limited access to existing climate and forecast information, do not have sufficient capacities to understand the climate information and/or mechanisms to relate this information to the impact that climate variations can generate at a local level. This precludes the translation of information into actionable knowledge, and therefore into action. In this study, we describe a process through which scientists and strategic partners have co-developed, tested and scaled out an approach to assess, co-produce, translate and transfer climate information to enable agricultural decision making –the Local Technical Agroclimatic Committees (LTAC). LTACs allow open and clear dialogues about climate variations at multiple timescales, how these can affect crops, and the design of measures to reduce crop loss, particularly providing agronomic recommendations to farmers. We systematically describe the process of evidence generation, creation, partner engagement, scaling up, and monitoring of the approach throughout Latin America. Currently, 35 LTACs exist in 9 Latin American countries, engaging more than 250 public and private institutions, increasing the resilience and food security of an estimated 330,000 farmers, and potentially transforming how Latin American farmers manage climate risk. The study illustrates changes in institutional and farmers' capacities to co-produce, translate and use climate information and explores how better climate and crop prediction models can effectively underpin this process. We show how strategic alliances with farmer organizations, national public, and private and regional climate outlook forums help deliver improved and accurate climate information to users. Finally, we document how LTACs and their integration with other local-scale processes have led to changes in farmers’ management practices to take better advantage of good climatic conditions or avoid losses

Cosecha de Alcances: Valoración de las transformaciones producidas por las Mesas Técnicas Agroclimáticas (MTA) en Latinoamérica

Durante el 2019 se realizó un proceso de análisis de las transformaciones que han generado las Mesas Técnicas Agroclimáticas (MTA), en los territorios en que han sido establecidas durante los últimos 6 años. El estudio se enfoca en los cambios observables de comunidades, organizaciones o instituciones que han modificado sus acciones, relaciones, políticas y prácticas en cuatro países de Latinoamérica. Cinco áreas de transformación han sido identificadas i) mayor confianza en la calidad de información climática y agroclimática en el nivel local; ii) información agroclimática más conocida, comprensible y conectada; iii) democratización de conocimiento climático; iv) transformaciones en las prácticas agrícolas, y v) incidencia política y transformación institucional. Se verifican más de 140 alcances o cambios sobre dichas áreas. Se evidencia que las MTA analizadas han promovido un mayor acercamiento de las Instituciones Meteorológicas Nacionales a las necesidades de los territorios, lo que, a su vez, ha propiciado la creación de comunidades de práctica locales sobre la aplicación de conocimientos de clima en la toma de decisiones. En efecto, se tiene evidencia que los agricultores adaptan sus prácticas productivas tomando decisiones basadas en información de variabilidad climática local, reduciendo pérdidas y aumentando rentabilidad. Se demuestra, además, que el desarrollo de alianzas inter-institucionales derivadas de las MTA en los países, ayudan a la construcción y fortalecimiento de políticas públicas locales y nacionales para la adaptación al cambio y la variabilidad climática en la agricultura. Finalmente, se identifican diversas oportunidades y desafíos relacionados con liderazgo y la sostenibilidad del proceso de establecimiento de las MTA en Latinoamérica.During 2019 a process of analysis of the effects or transformations that the Local Agro climatic Technical Committees (MTA) have been carried out, in the territories in which they have been established during the last 5 years. The study focuses on the observable changes of individuals, communities, organizations or institutions that have modified their actions, relationships, policies and practices in five Latin American countries. Five areas of transformation have been identified as outcomes of the MTAs, among which are analyzed: i) greater confidence in the quality of climate and agro climatic information at the local level; ii) best-known, understandable and connected agro climatic information; iii) democratization of climate knowledge; iv) transformations in agricultural practices, and v) political influence and institutional transformation. More than 140 scopes or changes over these areas are verified. There is evidence that the MTAs have promoted a closer approach of the national meteorological institutions to the need of the territories farmers, which in turn has led to the creation of local communities of practice on the application of climate knowledge in decision making agricultural. Indeed, evidence shows that farmers adapt their productive practices by making decisions based on information on local climate variability, reducing losses and increasing profitability. It is also demonstrated that the development of inter-institutional alliances derived from MTAs in the countries, helps to build and strengthen local and national public policies for adaptation to climate change and variability in agriculture. Finally, various opportunities and challenges related to leadership and the sustainability of the MTA establishment process in Latin America are identified

Etiology of chronic urticaria: the Ecuadorian experience

Background: The purpose of this study was to identify chronic urticaria (CU) etiologies and treatment modalities in Ecuador. We propose that the sample distribution fits the expected one, and that there is an association between the etiology and its treatment. Methods: We performed a retrospective study involving 112 patients diagnosed with CU using a Checklist for a complete chronic urticaria medical history. Demographic and clinical variables were collected. The etiology of CU was classified using the EAACI/GA2LEN/EDF/WAO guideline. Descriptive analyses were performed for demographical and clinical variables. Chi square tests were applied to analyze the fit of distribution and the independence of variables. P values less than 0.05 were considered significant. Results: Among all the patients, 76.8% were diagnosed with chronic spontaneous urticaria (CSU), of which 22.3% had a known etiology or possible exacerbating condition. Food allergy was identified as the most common accompanying condition in patients with CSU (10.7%) (p < 0.01).. On the other hand, 23.2% inducible urticarias (CIndU) were indentified; dermographism was the most common (10.7%) (p < 0.01). Regarding treatment regimens, sg-H1-antihistamines alone represented the highest proportion (44.6%). The combination of any H1-antihistamine plus other drug was a close second (42.0%) (p < 0.01). Almost 48% of CSUs of unknown etiology were treated with any antihistamine plus another drug. In patients with known etiology, sg-antihistamines alone (44.0%) was the most common management. In addition, 53.8% of CIndUs were treated with sg-antihistamines alone. Though, these associations were not statistically significant. Conclusion: CSU is the most frequent subtype of CU. Modern non-sedating antihistamines in licensed doses are the drug of choice. Nevertheless, a great proportion of patients require the addition of another type of medication

Strengthening the climate services chain in Central America

Central American farmers are highly vulnerable to climate variability, with crop losses observed throughout the region on a virtually annual basis. At the same time, local stakeholders and farmers generally have limited access to existing climate and forecast information, do not have sufficient capacities to understand the climate information and/or mechanisms to relate this information to the impact that climate variations can generate at the local level. This precludes the translation of information into actionable knowledge, and therefore into action. Here we describe a process through which scientists and strategic partners have co-developed, tested, and scaled out approaches to assess, co-produce, translate and transfer climate information to enable agricultural decision making (e.g. Next Generation of climate forecasts -NextGen, the Local Technical Agroclimatic Committees - LTAC, the Participatory Integrated Climate Services for Agriculture -PICSA). Through these approaches’ farmers and stakeholders access information about climate variations at multiple timescales, understand how these can affect crops, and design measures to reduce crop loss, particularly providing agronomic recommendations to farmers. We systematically describe the process of evidence generation, creation, partner engagement, scaling up, and monitoring of these approaches throughout Central America at a national level and at the local level especially in application sites known as the Climate-Smart Villages

Quality Assessment of Clinical Practice Guidelines on the Treatment of Psoriasis Using the AGREE II Tool

BACKGROUND: Clinical practice guidelines (CPGs) are designed to help health professionals provide patients with excellent medical care. The last critical appraisal of CPGs on the treatment of psoriasis evaluated publications up to 2009, but several new guidelines have been published since and their methodological quality remains unclear. OBJECTIVE: The aim of this study was to systematically evaluate the quality of CPGs on the treatment of psoriasis published between 2010 and 2020 using the Appraisal Guidelines Research and Evaluation II (AGREE II) tool. MATERIAL AND METHODS: We searched for relevant CPGs in MEDLINE, Embase, and LILACS (Latin American and Caribean Health Sciences Literature) as well as in the gray literature. Two reviewers working independently selected the guidelines for analysis and extracted the relevant data. Each guideline was then assessed using the AGREE II instrument by 5 reviewers, also working independently. RESULTS: Nineteen CPGs met the inclusion criteria and most of them had been produced in high-income countries. The mean (SD) domain scores were 84.9% (14.7%) for scope and purpose, 65.5% (19.3%) for stakeholder involvement, 66.7% (15.6%) for rigor of development, 72.8% (16.8%) for clarity of presentation, 46.6% (21.7%) for applicability, and 57.0% (30.4%) for editorial independence. CONCLUSIONS: Although about three-quarters of the CPGs assessed were judged to be of high quality and over half were recommended for use in clinical practice, standards of guideline development need to be raised to improve CPG quality, particularly in terms of applicability and editorial independence, which had the lowest scores in our evaluation

CGIAR modeling approaches for resource-constrained scenarios: I. Accelerating crop breeding for a changing climate.

Crop improvement efforts aiming at increasing crop production (quantity, quality) and adapting to climate change have been subject of active research over the past years. But, the question remains 'to what extent can breeding gains be achieved under a changing climate, at a pace sufficient to usefully contribute to climate adaptation, mitigation and food security?'. Here, we address this question by critically reviewing how model-based approaches can be used to assist breeding activities, with particular focus on all CGIAR (formerly the Consultative Group on International Agricultural Research but now known simply as CGIAR) breeding programs. Crop modeling can underpin breeding efforts in many different ways, including assessing genotypic adaptability and stability, characterizing and identifying target breeding environments, identifying tradeoffs among traits for such environments, and making predictions of the likely breeding value of the genotypes. Crop modeling science within the CGIAR has contributed to all of these. However, much progress remains to be done if modeling is to effectively contribute to more targeted and impactful breeding programs under changing climates. In a period in which CGIAR breeding programs are undergoing a major modernization process, crop modelers will need to be part of crop improvement teams, with a common understanding of breeding pipelines and model capabilities and limitations, and common data standards and protocols, to ensure they follow and deliver according to clearly defined breeding products. This will, in turn, enable more rapid and better-targeted crop modeling activities, thus directly contributing to accelerated and more impactful breeding efforts.Online Version of Record before inclusion in an issue