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Soil salinity is emerging as a major threat to the sustainability of modern agricultural production systems and, historically, land and water degradation due to salinity has defeated civilisations whenever the cost of remediation exceeded the benefits. This work discusses the complexity inherent in working with salinity, and the opportunities where salt damaged land and water is viewed as a resource. It takes a wider look at land and waterscapes, seeing them as systems that link damage and repair across time and space to bridge the divide between the main beneficiaries of ecosystem services and the main actors, farmers, and land managers. We first discuss the mechanistic basis of crop reduction by salinity and evolution of ideas about how to shape the plant-soil-water nexus. We then discuss the needs of farmers and other land users required for adequate planning and land management within the constraints of existing policy. Lastly, an approach that provides a new technical and economic tool for the remediation of land in several land use categories is presented. We conclude that a more concerted effort is required to turn payments for ecosystem services into a true market, accepted as such by the land managers, whose agency is essential so the ‘knowledge of what can be done can be transformed into benefits’. Achieving this will require a transformation in the paradigm of how natural resources are managed.

We report the case of a seven year old girl with 22q11 deletion mosaicism who presented with a sudden onset rapidly enlarging left parotid mass and ipsilateral facial nerve paresis. MRI and cytology were inconclusive. She underwent partial superficial parotidectomy to obtain definitive histopathology, which was reported as suggestive of acute Epstein Barr infection. A subsequent quantitative Epstein–Barr Virus (EBV) PCR clinched the diagnosis four weeks after her initial presentation. She was stared on oral Valgancyclovir and her facial nerve showed recovery. We discuss the challenges faced in managing this case with delayed conclusive diagnosis of acute Epstein Barr virus infection.

Centers for Disease Control guidelines for schistosomiasis and strongyloidiasis in Sudanese and Somali refugees are not widely implemented. Given limited prevalence data, we conducted a seroprevalence study of schistosomiasis, strongyloidiasis, and loiasis in Sudanese refugees across diverse ages. Sudanese refugees, ages 4-78, were recruited via community organizations. Half of the patients (86/172), were seropositive for schistosomiasis (46/171; 26.9%), strongyloidiasis (56/172; 33%), or both (16/171; 9.4%). No Loa loa infections were detected. Infection rates were similar in adults and children except that no schistosomiasis was detected in children4 years of age at the time of immigration to the United States. The high prevalence of schistosomiasis and strongyloidiasis in a community-based sample of Sudanese confirms the urgency for compliance with CDC refugee health guidelines. We detected no co-infection with Loa loa using the most sensitive serologic techniques, allowing use of ivermectin, the most effective treatment of strongyloidiasis.