Greetings ,

This is the last issue of The BeTER LeTTER for 2021, making it a good opportunity to take a brief look at our progress this year. Of course, the goal is not to gloat over past achievements but rather to use those achievements - as well as our shortcomings - to plot a productive course for 2022. I hope you will help give us advice, feedback, and maybe even join us for the journey.

Among the BTER Foundation's achievements for 2021 - which include 3 published scientific papers, dozens of trainings, connecting patients with therapists, and the granting of several patient treatment subsidies - was the acceptance and publication of the Foundation's position statement on assessing and achieving competency as a maggot therapist. More about the impact of this paper in a moment, but first I would like to acknowledge the authors of this project, most of whom spent up to 6 years developing these recommendations with us, and working to reach consensus. In alphabetical order, they are: David G. Armstrong, DPM, MD, PhD (Professor of Surgery and Co-Director, USC Limb Preservation Program; Director, Southwestern Academic Limb Salvage Alliance; Keck School of Medicine of University of Southern California); Lisa Bernard, RN, BSN, CWOCN (Victoria Ostomy Care Center, Victoria, BC, Canada); Jose Contreras-Ruiz, MD (Medical Director, Mexican Institute of Advanced Wound Care; Director, Interdisciplinary Clinic for Wound and Stoma Care, Division of Dermatology, Hospital General 'Manuel Gea González', Mexico City, Mexico); Rachel Chon, BS (Research & Communications Intern with the BTER Foundation); Alicia Fonseca-Muñoz, PhD (Escuela de Sistemas Biológicos e Innovación Tecnológica, Universidad Autónoma 'Benito Juárez' de Oaxaca, Unidad Oaxaca, Mexico); Sharon Mendez, RN, CWS (Spokane, WA); Kosta Y. Mumcuoglu, PhD (Department of Microbiology and Molecular Genetics, The Hebrew University of Jerusalem, Hadassah Medical School, The Kuvin Center for the Study of Infectious and Tropical Diseases, Jerusalem, Israel); Jeffrey A. Niezgoda, MD, FACHM, MAPWCA, CHWS (President and Chief Medical Officer, AZH Wound & Vascular Centers, President, American Professional Wound Care Association, Milwaukee, WI); Lee C. Rogers, DPM (CMO, Amputation Prevention Experts Health Network, Simi Valley, CA); Charles E. Shapiro, MD, FACS (Department of Urology, Kaiser Permanente, Los Angeles, CA; Associate Professor, Kaiser Permanente Bernard J. Tyson School of Medicine); Tarek I Tantawi, PhD (Professor of Medical and Forensic Entomology, Department of Zoology, Faculty of Science, Alexandria University, Moharrem Bey, Alexandria, Egypt); Aletha Tippett, MD, BSChE (Cincinnati, OH); Carlos Vincent, MD (Director, Pie Diabético Biomedicina, Professor, Internal Medicine and Endocrinology, Universidad de Guayaquil, Guayaqui, Ecuador).

The reason that the Position Statement on Assessing Competency of Clinicians Performing Maggot Therapy is an important achievement for biotherapy is that it brings biotherapy more fully into mainstream medical care by demonstrating, with concrete examples, how maggot therapy can and should easily fit into the training, assessment and certification structure that already exists among health care professionals. The position statement is essentially a roadmap that shows clinicians the route to optimal training, shows regulators how to create assessment and certification programs, and ultimately will assist patients to identify the most competent therapists. By recognizing and rewarding quality care, the field will achieve greater respect, greater demand for training, and consequently higher quality patient care.

How do we follow that? Well, unlike maggot therapy and very few other exceptions, most animal-assisted treatments do not have commercially available products cleared by regulators, and many do not even yet have a body of clinical studies that are irrefutably "sufficiently supportive." Therefore, the BTER Foundation plans to advance clinical research in 2022. To that end, we will also optimize the sharing of research resources so that groups around the world can work synergistically rather than redundantly.

We will describe specific programs in more detail in the coming months. For now, be assured that we will not forsake our successful core programs in education and patient support, despite the planned expansion of our research efforts. Our BioTherapy Live! monthly webinar will also continue. Information about next month's program can be found below.

I hope you will share your thoughts and your priorities with us. We will do BeTER with your help. If you are a clinician, willing to participate in clinical research . . . please contact us. If you are skilled in statistics, database management, library science . . . please join us. If you would like to share your latest research with our audience . . . let us know. If you are not a clinician, you can help us by sharing this information with your therapists, friends, and family. And of course, anyone can help to advance healthcare with us, by contributing financially, in kind, or in services.

Best wishes to you all. May 2022 be even BeTER than 2021 !!!

Advancing healthcare through education and research in biotherapy,