How COVID-19 affects the use of evidence informed policymaking among iranian health policymakers and managers

Background The COVID-19 pandemic increased the need for new valid scientific evidence to support urgent clinical and policy decision making; as well as improved processes for the rapid synthesis, uptake and application of that evidence. Evidence informed policymaking (EIPM) can be considered as a way to access and use the results of evidence in practice. This study aimed to determine what effects COVID-19 had on the way Iranian health managers and policymakers use evidence in their decisions. Methods This study was conducted in 2021 applying a qualitative research design. Data was collected through semi-structured interviews. Thirty health care managers, policy makers and medical university faculty members were recruited as the study participants, initially via a purposive sample, followed by snowballing. A conventional content analysis presented by Hsieh and Shannon (2005) was applied for data analysis. Results Ten main themes emerged from the data including: 1) roles and duties of knowledge brokers (KBs); 2-5) the roles, benefits, barriers and necessities of applying Knowledge Translation Exchange (KTE) tools; 6-8) the facilitators, benefits and barriers to the application of evidence during COVID-19; 9) challenges of rapid evidence production evidence during COVID-19 and 10) consequences of not applying evidence during COVID-19. According to the present conceptual framework, KBs act as an intermediator between the large amounts of knowledge produced and decision makers. KTE tools should be applied to enhance EIPM during COVID-19. Attention should be paid to the facilitators, barriers, benefits and necessities of evidence application during COVID-19 to avoid negative consequences for the health system. Conclusions Results of this study show that developing KTE tools and activating KBs can be among the main strategies to produce applied actionable messages for policymakers to move toward EIPM; and that this applies even when rapid decision making is required, such as during the COVID-19 pandemic. It is strongly recommended to reinforce the local capacities through supporting scientific networks and relationships between research centers and local and national policymakers. At the same time, attention to local barriers to and facilitators of the application of evidence while facing a pandemic can pave the way to better identification of health system`s problems and rapid responses.

Egg production and life history of Alona guttata Sars, 1862 (Cladocera, Chydoridae): implications for colonization of temporary ponds

Cladocerans are a diverse group of species that show rapid responses to changes in environmental conditions. This adaptive capacity has important implications for egg production and life cycle, especially in transitory environments such as temporary waterbodies. The present study investigated the life history and egg production of Alona gutatta Sars, 1862 (Crustacea, Cladocera), an abundant and frequent species from a high-altitude temporary pond (Lagoa Seca, Minas Gerais, Brazil). Newly hatched neonates were monitored in relation to time of maturation, number of eggs produced per female and time of survival. Neonates required a mean of 8 days to mature. A. guttata survived for a mean of 30.9 ± 8.1 days and produced 2 eggs per brood, generating a mean of 10.95 ± 6.41 neonates during the entire life cycle. The rapid development, short time to produce eggs and long life cycle are important adaptations to the adverse environmental conditions of temporary aquatic environments, which can contribute to the rapid colonization of Alona guttata in transitory ecosystems.

Onset and Decline Rates of Marine Heatwaves: Global Trends, Seasonal Forecasts and Marine Management

Changing ocean conditions due to anthropogenic climate change, particularly the increasing severity and frequency of extreme events, are a growing concern for a range of marine sectors. Here we explore the global trends in marine heatwaves (MHWs), specifically onset and decline rates, two metrics which describe how quickly a MHW will emerge or disappear from a location. These rates determine the reaction window—the start of a MHW event to peak MHW temperatures—and the coping window—time from peak temperatures to the end of an event—two important time periods relevant to a marine decision-maker. We show that MHW onset and decline rates are fastest in dynamic ocean regions and that overall, the global trend in onset rate is greater than the global trend in decline rate. We map ocean regions where these rates are changing together with forecast skill from a seasonal dynamical model (ACCESS-S). This analysis highlights areas where the length of the preparation window for impending MHWs is increased by using forecasts, and areas where marine decision-makers should be prepared for rapid responses based on realtime observations as MHWs evolve. In regions such as south Africa and Kerguelen, northwest Atlantic, northwest Pacific, southwest South Atlantic and off Australian east coast where rapid median onset and decline rates are observed, there is also a positive trend in onset and decline rates i.e., MHWs are developing and declining more rapidly. This will be a concern for many decision-makers operating in these regions.

Climate Adaptation for Tropical Island Land Stewardship: Adapting a Workshop Planning Process to Hawai‘i

Tropical island ecosystems are highly vulnerable to the multiple threats of climate change (Nurse et al. 2014; Bonan 2008). In response, agencies and organizations are tasked with developing land-management strategies to help ecosystems adapt to changing environmental conditions (Swanston et al. 2016). Research has shown that proactive planning can reduce climate change impacts by facilitating more efficient and rapid responses (Bierbaum et al. 2013). Complex socio-ecological conditions, environmental change related stressors (e.g., wildfire, pests, disease, and drought), a lack of resources, and shifting public policy and agency mandates (Nagel et al. 2017) can all hinder response effectiveness (Crausbay et al. 2020). Despite these challenges, considerable progress has been made in assessing climate vulnerabilities of forest ecosystems and in developing adaptation options for land managers (Swanston and Janowiak 2012; Janowiak et al. 2014; Swanston et al. 2016; Halofsky et al. 2018; Schmitt et al. 2021). Adaptation planning in response to significant anticipated changes is becoming increasingly sophisticated, especially with respect to anticipated changes in forest wildfire regimes, species invasion, species composition, ecosystem health, and hydrological functioning due to climate change. Here we describe our conversion of a highly successful adaptation workshop process (Schmitt et al. 2021) to a virtual environment in response to COVID-19. We effectively delivered content to managers and created an experiential learning environment in which they developed adaptation tactics for their management projects, integrating Indigenous science and knowledge into the workshop format and content. This workshop was additionally novel because it used an adaptation process (Janowiak et al. 2014, Ontl et al. 2018) that has been applied many times in the continental U.S. within primarily temperate and sub-boreal systems (https://forestadaptation.org/), and applied it for the first time to a tropical island system.

Paradoxical relationship between speed and accuracy in olfactory figure-background segregation

In natural settings, many stimuli impinge on our sensory organs simultaneously. Parsing these sensory stimuli into perceptual objects is a fundamental task faced by all sensory systems. Similar to other sensory modalities, increased odor backgrounds decrease the detectability of target odors by the olfactory system. The mechanisms by which background odors interfere with the detection and identification of target odors are unknown. Here we utilized the framework of the Drift Diffusion Model (DDM) to consider possible interference mechanisms in an odor detection task. We first considered pure effects of background odors on either signal or noise in the decision-making dynamics and showed that these produce different predictions about decision accuracy and speed. To test these predictions, we trained mice to detect target odors that are embedded in random background mixtures in a two-alternative choice task. In this task, the inter-trial interval was independent of behavioral reaction times to avoid motivating rapid responses. We found that increased backgrounds reduce mouse performance but paradoxically also decrease reaction times, suggesting that noise in the decision making process is increased by backgrounds. We further assessed the contributions of background effects on both noise and signal by fitting the DDM to the behavioral data. The models showed that background odors affect both the signal and the noise, but that the paradoxical relationship between trial difficulty and reaction time is caused by the added noise.

Early Dynamics and Depth of Response in Multiple Myeloma Patients Treated With BCMA CAR-T Cells

Chimeric antigen receptor T-cell (CAR-T) therapy targeted against B-cell maturation antigen (BCMA) in multiple myeloma (MM) has produced rapid responses but many eventually relapse. In light of this new treatment, novel predictors of progression-free survival (PFS) are needed. We performed a single institution analysis of 54 BCMA-CAR-T patients. We analyzed patient’s overall response rate (ORR) by the IMWG criteria, involved serum-free light chains (iFLC), and minimal residual disease testing by next-generation sequencing (MRD-NGS). Between patients who achieved a ≤SD and those who achieved a ≥PR, PFS differed significantly (p < 0.0001); though there was no difference between patients who achieved a ≥CR vs. VGPR/PR (p = 0.2). In contrast, patients who achieved a nonelevated iFLC at 15 days (p < 0.0001, HR = 6.8; 95% CI, 2.7–17.3) or 30 days (p < 0.001, HR = 16.7; 95% CI, 3.9–71.7) had a prolonged PFS compared with those with an elevated iFLC. Patients achieving MRD-NGS less than the detectable limit at a sensitivity of 10−6 had a better PFS than those with detectable disease at 1 month (p = 0.02) and 3 months (p = 0.02). In conclusion, achieving a nonelevated iFLC and an undetectable MRD-NGS quickly were factors that were strongly associated with improved PFS. Further studies are needed to confirm the role of these markers in MM patients receiving CAR-T therapies.

PP293 Tiered Rapid Response Products In The Evidence Directorate Of Healthcare Improvement Scotland

IntroductionThe Evidence Directorate produced eighteen rapid responses during the early stages of the COVID-19 pandemic. To address this need while retaining methodological integrity a three-tiered system for rapid responses was developed.MethodsAll rapid responses answer specific research questions rather than broad health system issues. The appropriate level varies depending on the time and resource available, and the requester's need: •Level 1 – Reference List (turnaround 4–8hrs, delivered by an information scientist): a quick search for best available evidence, and results presented as a reference list.•Level 2 – Summary of evidence (turnaround 1–2 days, delivered by an information scientist): a quick search and brief summary of the best available evidence.•Level 3 – Synthesis of evidence (turnaround 3–7 days, delivered by a Health Services Researcher or Health Economist): a quick search and then a narrative summary and synthesis of the best available evidence, with a brief appraisal of validity, reliability and generalizability.ResultsSince the launch of the three-tiered model in September 2020 there have been five rapid responses. Two were Level 2 products and three were Level 3 products.ConclusionsThe Evidence Directorate of Healthcare Improvement Scotland now has an agile rapid response product which can be applied to a variety of settings and needs. This was borne out of a need for a rapid turnaround and evidence synthesis during the COVID-19 pandemic.

Refugees’ Integration in the Built Environment: The Sweden Case

The resettlement and integration of a displaced population into a new society faces a plethora of challenges. These range from lack of national legal frameworks to plan and implement planned relocation, to the absence of a long-term vision, inadequate funds, and poor institutional structures. The 3-year EU Erasmus+ funded REGARD Project (REbuildinG AfteR Displacement) set out to address some of these challenges and develop guidance with a focus on the roles and responsibilities of the host and the resettled community in order to understand the needs of both. This paper focuses on the Swedish experience (one of four case studies in the project) in the aftermath of the mass influx of Syrian refugees in 2015. A needs assessment conceptual framework of both host and displaced communities guided the multi-method approach applied in the Sweden case where data was drawn from a scoped literature review on issues related to integration and social cohesion complimented and validated by in-depth interviews with a number of municipalities and non-governmental organizations all working with asylum seekers resettlement. The results of the research indicate that while the Swedish case was a relative success by comparison to others in Europe, there was still systemic shortcomings that needed attention. First, cooperation and coordination between government and non-governmental actors and at different levels up and down the chain of services provided for resettled refugees is still lacking where the reality on the ground is not fully grasped by centrally driven policy and decision-making. Second, what determines the effectiveness of resettlement and integration efforts is focusing on the individuality of each displacee’s needs and circumstances where one-size does not fit all, and recognizing that integration is a two-way process that has to involve both host and guest community and not simply the absorption of one into the other. Finally, the paper concludes that the pressured and often highly politicized situations both host and guest community are put into usually force rapid responses, while long-term visions and sustainable solutions when adequate time is taken to establish trust and build viable networks between the two communities can lead to far better results.