BMC Public Health
(Accessed 31 January 2015)
http://www.biomedcentral.com/bmcpublichealth/content

Research article
Acceptability of financial incentives and penalties for encouraging uptake of healthy behaviours: focus groups
Emma L Giles, Falko F Sniehotta, Elaine McColl, Jean Adams BMC Public Health 2015, 15:58 (31 January 2015)

Bulletin of the World Health Organization
Volume 93, Number 2, February 2015, 65-132
http://www.who.int/bulletin/volumes/93/2/en/

SYSTEMATIC REVIEWS
The effectiveness of interventions to reduce the household economic burden of illness and injury: a systematic review
Beverley M Essue, Merel Kimman, Nina Svenstrup, Katharina Lindevig Kjoege, Tracey Lea Laba, Maree L Hackett & Stephen Jan
doi: 10.2471/BLT.14.139287
Abstract [HTML]
Objective
To determine the nature, scope and effectiveness of interventions to reduce the household economic burden of illness or injury.
Methods
We systematically reviewed reports published on or before 31 January 2014 that we found in the CENTRAL, CINAHL, Econlit, Embase, MEDLINE, PreMEDLINE and PsycINFO databases. We extracted data from prospective controlled trials and assessed the risk of bias. We narratively synthesized evidence.
Findings
Nine of the 4330 studies checked met our inclusion criteria – seven had evaluated changes to existing health-insurance programmes and two had evaluated different modes of delivering information. The only interventions found to reduce out-of-pocket expenditure significantly were those that eliminated or substantially reduced co-payments for a given patient population. However, the reductions only represented marginal changes in the total expenditures of patients. We found no studies that had been effective in addressing broader household economic impacts – such as catastrophic health expenditure – in the disease populations investigated.
Conclusion
In general, interventions designed to reduce the complex household economic burden of illness and injury appear to have had little impact on household economies. We only found a few relevant studies using rigorous study designs that were conducted in defined patient populations. The studies were limited in the range of interventions tested and they evaluated only a narrow range of household economic outcomes. There is a need for method development to advance the measurement of the household economic consequences of illness and injury and facilitate the development of innovative interventions to supplement the strategies based on health insurance.

Policy & Practice
Thresholds for the cost–effectiveness of interventions: alternative approaches
Elliot Marseille, Bruce Larson, Dhruv S Kazi, James G Kahn & Sydney Rosen
Many countries use the cost–effectiveness thresholds recommended by the World Health Organization’s Choosing Interventions that are Cost–Effective project (WHO-CHOICE) when evaluating health interventions. This project sets the threshold for cost–effectiveness as the cost of the intervention per disability-adjusted life-year (DALY) averted less than three times the country’s annual gross domestic product (GDP) per capita. Highly cost–effective interventions are defined as meeting a threshold per DALY averted of once the annual GDP per capita. We argue that reliance on these thresholds reduces the value of cost–effectiveness analyses and makes such analyses too blunt to be useful for most decision-making in the field of public health. Use of these thresholds has little theoretical justification, skirts the difficult but necessary ranking of the relative values of locally-applicable interventions and omits any consideration of what is truly affordable. The WHO-CHOICE thresholds set such a low bar for cost–effectiveness that very few interventions with evidence of efficacy can be ruled out. The thresholds have little value in assessing the trade-offs that decision-makers must confront. We present alternative approaches for applying cost–effectiveness criteria to choices in the allocation of health-care resources.

Perspectives
Rabies control in India: a need to close the gap between research and policy
Syed Shahid Abbas a & Manish Kakkar b
a. Institute of Development Studies, University of Sussex, Brighton, England.
b. Public Health Foundation of India, ISID Campus, 4 Vasant Kunj Institutional Area, New Delhi, 110070, India.
doi: http://dx.doi.org/10.2471/BLT.14.140723

Disability and Rehabilitation: Assistive Technology
Volume 10, Number 2 (March 2015)
http://informahealthcare.com/toc/idt/current

Case Report
Facilitating mathematics learning for students with upper extremity disabilities using touch-input system
March 2015, Vol. 10, No. 2 , Pages 170-180 (doi:10.3109/17483107.2013.873490)
Kup-Sze Choi, and Tak-Yin Chan
1Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University,
Hong Kong, China and 2Hong Kong Red Cross Princess Alexandra School, Kowloon, Hong Kong, China
Abstract
Purpose: To investigate the feasibility of using tablet device as user interface for students with upper extremity disabilities to input mathematics efficiently into computer. Methods: A touch-input system using tablet device as user interface was proposed to assist these students to write mathematics. User-switchable and context-specific keyboard layouts were designed to streamline the input process. The system could be integrated with conventional computer systems only with minor software setup. A two-week pre–post test study involving five participants was conducted to evaluate the performance of the system and collect user feedback. Results: The mathematics input efficiency of the participants was found to improve during the experiment sessions. In particular, their performance in entering trigonometric expressions by using the touch-input system was significantly better than that by using conventional mathematics editing software with keyboard and mouse. The participants rated the touch-input system positively and were confident that they could operate at ease with more practice. Conclusions: The proposed touch-input system provides a convenient way for the students with hand impairment to write mathematics and has the potential to facilitate their mathematics

Global Public Health
Volume 10, Issue 2, 2015
http://www.tandfonline.com/toc/rgph20/10/2#.VM2Niy5nBhU
Special Issue: Sexual and Reproductive Health and Rights for the next decades: What’s been achieved? What lies ahead?

Advancing sexual and reproductive health and rights in low- and middle-income countries: Implications for the post-2015 global development agenda
Adrienne Germain, Gita Sen, Claudia Garcia-Moreno & Mridula Shankar
pages 137-148
Open access
DOI:10.1080/17441692.2014.986177
Published online: 28 Jan 2015

THEME: INTEGRATED AND COMPREHENSIVE SRH SERVICES: A GLOBAL VIEW
Sexual and reproductive health: Progress and outstanding needs
Rachel C. Snow, Laura Laski & Massy Mutumba
pages 149-173
Open access
DOI:10.1080/17441692.2014.986178
Published online: 02 Jan 2015

Commentary: Actions to end violence against women: A multi-sector approach
Claudia García-Moreno & Marleen Temmerman
pages 186-188
Open access
DOI:10.1080/17441692.2014.986163
Published online: 28 Jan 2015

THEME: ADOLESCENTS’ HEALTH AND HUMAN RIGHTS
Sexual and reproductive health and rights in changing health systems
Gita Sen & Veloshnee Govender
pages 228-242
Open access
DOI:10.1080/17441692.2014.986161
Published online: 24 Dec 2014

THEME: SEXUAL HEALTH, HUMAN RIGHTS AND THE LAW
Advancing sexual health through human rights: The role of the law
Eszter Kismödi, Jane Cottingham, Sofia Gruskin & Alice M. Miller
pages 252-267
Open access
DOI:10.1080/17441692.2014.986175
Published online: 24 Dec 2014

Infectious Diseases of Poverty
[Accessed 31 January 2015]
http://www.idpjournal.com/content

Scoping Review
Ecohealth research in Southeast Asia: past, present and the way forward
Hung Nguyen-Viet, Siobhan Doria, Dinh Xuan Tung, Hein Mallee, Bruce A Wilcox and Delia Grace
Infectious Diseases of Poverty 2015, 4:5 doi:10.1186/2049-9957-4-5
Published: 29 January 2015
Abstract (provisional)
Ecohealth is a comprehensive approach to understanding health at its human, animal and environmental interface in a socio-ecological systems context. This approach was introduced widely in Southeast Asia (SEA) by the Canadian International Development Research Centre (IDRC) in the late 2000s. Aimed at addressing the problem of emerging infectious diseases (EIDs), numerous such projects and activities have been generated throughout the region. Ecohealth is increasingly converging with the One Health approach, as both movements emphasise a holistic understanding to health. We conducted a scoping review by considering all of the Ecohealth programmes, initiatives and projects that have been implemented in SEA since the introduction of the approach, and also gathered information from peer-reviewed literature. The objective of this paper is to review Ecohealth activities within SEA over the last 10 years to address the lessons learned, challenges faced and the way forward for Ecohealth in the region. Activities range from those focusing purely on capacity, projects focusing on research and projects covering both. Achievements to date include, for example, research contributing to the field of infectious diseases in relation to social ecological factors and associated urbanisation and agricultural intensification. Challenges remain at the project design and implementation level, in the available capacity and coordination to develop Ecohealth research teams in the countries, gauging teams’ assimilation of Ecohealth’s underlying tenets and their translation into sustainable disease prevention and control, as well as in the ability to scale up Ecohealth projects. We suggest that the way forward for Ecohealth should be from a regional perspective in terms of research, training and policy translation using Ecohealth in combination with the One Health approach.

International Health
Volume 109 Issue 2 February 2015
http://trstmh.oxfordjournals.org/content/109/2.toc
Special issue: Innovative community-based vector control interventions for improved dengue and Chagas disease prevention in Latin America

Innovative community-based vector control interventions for improved dengue and Chagas disease prevention in Latin America: introduction to the special issue
Johannes Sommerfelda,* and Axel Kroegera,b, Guest Editors

Dengue fever and Chagas disease are important public health problems in Latin America. Dengue is a re-emerging viral disease, mainly transmitted by Aedes aegyptii mosquitoes, leading to an increasing number of outbreaks notably in urban areas of the continent.1,2 Chagas disease, a parasitic disease transmitted by Triatomine bugs, is a major cause of morbidity and mortality among the continent’s rural poor and persisting in different social-ecological settings.3,4 In spite of their epidemiological difference, both are vector-borne neglected tropical diseases (NTDs) for which primary prevention can currently mainly be achieved through vector control.5

In the case of dengue, routine vector control usually consists of source reduction strategies, including larviciding and/or insecticide space-spraying.6 However, vertically organized and insecticide-based vector control efforts often lack effectiveness and sustainability, and the need for community-based vector control strategies that include environmental management has been highlighted.7–9 With Chagas disease, routine interventions are usually based on insecticide spraying to eliminate household infestation. With a focus on domestic transmission, the peri-domestic transmission context is often neglected.

Current strategies for integrated vector management call for the adaptation of vector control interventions to local vector ecology, epidemiology and resources.10 Therefore, further insights relevant to specific ecosystems, into transmission dynamics and the possibility of intersectoral ecosystem management programs for dengue and Chagas disease prevention and control are urgently needed. This will play a crucial function in defining locally relevant and appropriate interventions with the prospects for sustainable control of vector populations.

This special issue reports findings of a research and capacity building program on innovative community-based vector control interventions for improved dengue and Chagas disease prevention in Latin America. The overall objective of the research initiative was to improve dengue and Chagas disease prevention by better understanding, through multi-level/multi-scale and trans-disciplinary analysis, ecosystem-related, biological and social (‘eco-bio-social’) determinants, and to develop and evaluate community-based public health interventions targeting dengue and Chagas disease vector habitats and delivered through intersectoral actions. The research program was a collaborative effort between the Special Programme for Research and Training in Tropical Diseases (TDR) and the Ecosystems and Human Health Program of the International Development Research Centre (IDRC).

International Journal of Sustainable Development & World Ecology
Volume 22, Issue 1, 2015
http://www.tandfonline.com/toc/tsdw20/current#.VIORRslLDg2

Examining patterns of sustainability across Europe: a multivariate and spatial assessment of 25 composite indices
Richard R. Shaker & Sara L. Zubalsky
pages 1-13
DOI:10.1080/13504509.2014.923058
Published online: 10 Jun 2014
Abstract
Nearly all societies have now committed themselves to sustainable development by integrating some form of environmental quality, social equity, and economic welfare into their day-to-day activities. As such, there remains a strong political desire for the comprehensive assessment of conditions that evaluate the current status, measure progress, and help set future development goals. Indicators have been nominated as universal tools for progressing sustainable development across scales; however, there remains no consensus regarding the best approach to their design or use. While several studies have investigated the associations between indicators of sustainable development, few have directly addressed the question of how multiple measures can be used simultaneously to assess sustainability regionally. Building upon previous studies, this paper presents a quantitative and spatial assessment of 25 multi-metric indices across 36 European nations. The goals of this research were (1) to increase understanding of indicator complexity and (2) provide an applied example of their simultaneous use for regional assessment. Global Moran’s I-test and Pearson’s correlation coefficient (r) analysis were used to test spatial autocorrelation and multicollinearity, respectively. From the 25 composite indices, an overall rank was also provided for each country. Lastly, Ward’s cluster analysis was used to create country bundles of similarity. Our findings revealed that environmental performance index, global information networking institute coefficient, and happy planet index were numerically and spatially random. Cluster analysis revealed a four-bundle solution, while Norway, Switzerland, and Sweden ranked highest. This approach shows promise for systematically describing, visualizing, and monitoring sustainable development at the continental scale.

International Journal of Infectious Diseases
April 2015 Volume 33, p1
http://www.ijidonline.com/current

Prognosis of neonatal tetanus in the modern management era: an observational study in 107 Vietnamese infants
Phung Khanh Lam, Huynh T. Trieu, Inke Nadia D. Lubis, Huynh T. Loan, Tran Thi Diem Thuy, Bridget Wills, Christopher M. Parry, Nicholas P.J. Day, Phan T. Qui, Lam Minh Yen, C. Louise Thwaites
p7–11
Published online: December 11, 2014
Open Access

JAMA
January 27, 2015, Vol 313, No. 4
http://jama.jamanetwork.com/issue.aspx

Viewpoint | January 27, 2015
Sharing and Reporting the Results of Clinical Trials
Kathy L. Hudson, PhD1; Francis S. Collins, MD, PhD1
JAMA. 2015;313(4):355-356. doi:10.1001/jama.2014.10716.
This Viewpoint advocates initiating greater transparency in reporting results of clinical trials as a responsibility that will benefit the health of many.
The principle of data sharing dates to the dawn of scientific discovery—it is how researchers from different disciplines and countries form collaborations, learn from others, identify new scientific opportunities, and work to turn newly discovered information into shared knowledge and practical advances. When research involves human volunteers who agree to participate in clinical trials to test new drugs, devices, or other interventions, this principle of data sharing properly assumes the role of an ethical mandate. These participants are often informed that such research might not benefit them directly, but may affect the lives of others. If the clinical research community fails to share what is learned, allowing data to remain unpublished or unreported, researchers are reneging on the promise to clinical trial participants, are wasting time and resources, and are jeopardizing public trust.

Viewpoint | January 27, 2015
Maximizing Antiretroviral Therapy in Developing CountriesThe Dual Challenge of Efficiency and Quality
Christopher J. L. Murray, MD, DPhil1
JAMA. 2015;313(4):359-360. doi:10.1001/jama.2014.16376.
This Viewpoint discusses the need for improvement in both efficiency and quality of antiretroviral therapy programs in developing countries.
The rapid scale-up of antiretroviral therapy (ART) has been one of the great achievements of global health in the last decade. Declines in deaths from human immunodeficiency virus (HIV)/AIDS in high-income countries following the adoption of highly active ART starting in 1996 are well documented. In low-resource settings, demographic surveillance sites have recorded marked decreases in death rates with the scale-up of ART. In its modeling efforts, the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that global mortality declined by 35% from 2005 to 2013, with much of the decline related to ART scale-up.1 The Global Burden of Disease (GBD) collaboration recently estimated that 19 million extra years of life have been gained as a result of ART and prevention of mother-to-child transmission of HIV.2

Journal of Epidemiology & Community Health
February 2015, Volume 69, Issue 2
http://jech.bmj.com/content/current

Exposure to genocide and risk of suicide in Rwanda: a population-based case–control study
Wilson Rubanzana, Bethany L Hedt-Gauthier, Joseph Ntaganira, Michael D Freeman
J Epidemiol Community Health 2015;69:117-122 Published Online First: 8 December 2014 doi:10.1136/jech-2014-204307
Abstract
Background
In Rwanda, an estimated one million people were killed during the 1994 genocide, leaving the country shattered and social fabric destroyed. Large-scale traumatic events such as wars and genocides have been linked to endemic post-traumatic stress disorder, depression and suicidality. The study objective was to investigate whether the 1994 genocide exposure is associated with suicide in Rwanda.
Methods
We conducted a population-based case–control study. Suicide victims were matched to three living controls for sex, age and residential location. Exposure was defined as being a genocide survivor, having suffered physical/sexual abuse in the genocide, losing a first-degree relative in the genocide, having been convicted for genocide crimes or having a first-degree relative convicted for genocide. From May 2011 to May 2013, 162 cases and 486 controls were enrolled countrywide. Information was collected from the police, local village administrators and family members.
Results
After adjusting for potential confounders, having been convicted for genocide crimes was a significant predictor for suicide (OR=17.3, 95% CI 3.4 to 88.1). Being a survivor, having been physically or sexually abused during the genocide, and having lost a first-degree family member to genocide were not significantly associated with suicide.
Conclusions
These findings demonstrate that individuals convicted for genocide crimes are experiencing continued psychological disturbances that affect their social reintegration into the community even 20 years after the event. Given the large number of genocide perpetrators reintegrated after criminal courts and Gacaca traditional reconciling trials, suicide could become a serious public health burden if preventive remedial action is not identified.

The Lancet
Jan 31, 2015 Volume 385 Number 9966 p393-480
http://www.thelancet.com/journals/lancet/issue/current

Editorial
Women’s, children’s, and adolescents’ health: who will lead?
The Lancet
DOI: http://dx.doi.org/10.1016/S0140-6736(15)60135-0
Summary
Last week, Somalia became the 195th country to ratify the Convention on the Rights of the Child (CRC), making the USA the only UN member state yet to ratify the treaty. The CRC, adopted by the UN General Assembly in 1989, is a landmark international agreement delivering a comprehensive set of rights for the world’s youngest citizens; Somalia should be applauded for its move. The news comes in a year that is critical for children, and for women. In less than a month in Delhi, India (Feb 26–27), a consultation will take place on transitioning the Global Strategy for Women’s and Children’s Health (2010–15) into a post-2015 environment.

Articles
Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis
Li Liu, PhD, Shefali Oza, MSc, Daniel Hogan, PhD, Jamie Perin, PhD, Prof Igor Rudan, MD, Prof Joy E Lawn, MD, Prof Simon Cousens, MA, Colin Mathers, PhD, Prof Robert E Black, MD
Published Online: 30 September 2014
DOI: http://dx.doi.org/10.1016/S0140-6736(14)61698-6
Summary
Background
Trend data for causes of child death are crucial to inform priorities for improving child survival by and beyond 2015. We report child mortality by cause estimates in 2000–13, and cause-specific mortality scenarios to 2030 and 2035.
Methods
We estimated the distributions of causes of child mortality separately for neonates and children aged 1–59 months. To generate cause-specific mortality fractions, we included new vital registration and verbal autopsy data. We used vital registration data in countries with adequate registration systems. We applied vital registration-based multicause models for countries with low under-5 mortality but inadequate vital registration, and updated verbal autopsy-based multicause models for high mortality countries. We used updated numbers of child deaths to derive numbers of deaths by causes. We applied two scenarios to derive cause-specific mortality in 2030 and 2035.
Findings
Of the 6•3 million children who died before age 5 years in 2013, 51•8% (3•257 million) died of infectious causes and 44% (2•761 million) died in the neonatal period. The three leading causes are preterm birth complications (0•965 million [15•4%, uncertainty range (UR) 9•8−24•5]; UR 0•615–1•537 million), pneumonia (0•935 million [14•9%, 13•0–16•8]; 0•817–1•057 million), and intrapartum-related complications (0•662 million [10•5%, 6•7–16•8]; 0•421–1•054 million). Reductions in pneumonia, diarrhoea, and measles collectively were responsible for half of the 3•6 million fewer deaths recorded in 2013 versus 2000. Causes with the slowest progress were congenital, preterm, neonatal sepsis, injury, and other causes. If present trends continue, 4•4 million children younger than 5 years will still die in 2030. Furthermore, sub-Saharan Africa will have 33% of the births and 60% of the deaths in 2030, compared with 25% and 50% in 2013, respectively.
Interpretation
Our projection results provide concrete examples of how the distribution of child causes of deaths could look in 15–20 years to inform priority setting in the post-2015 era. More evidence is needed about shifts in timing, causes, and places of under-5 deaths to inform child survival agendas by and beyond 2015, to end preventable child deaths in a generation, and to count and account for every newborn and every child.
Funding
Bill & Melinda Gates Foundation.

Review
Countdown to 2015 and beyond: fulfilling the health agenda for women and children
Jennifer Harris Requejo, PhD, Prof Jennifer Bryce, EdD, Aluisio JD Barros, PhD, Prof Peter Berman, PhD, Prof Zulfiqar Bhutta, PhD, Mickey Chopra, MD, Bernadette Daelmans, MD, Andres de Francisco, PhD, Prof Joy Lawn, PhD, Blerta Maliqi, PhD, Elizabeth Mason, MD, Holly Newby, MS, Carole Presern, PhD, Ann Starrs, MPA, Prof Cesar G Victora, PhD
Published Online: 29 June 2014
DOI: http://dx.doi.org/10.1016/S0140-6736(14)60925-9
Summary
The end of 2015 will signal the end of the Millennium Development Goal era, when the world can take stock of what has been achieved. The Countdown to 2015 for Maternal, Newborn, and Child Survival (Countdown) has focused its 2014 report on how much has been achieved in intervention coverage in these groups, and on how best to sustain, focus, and intensify efforts to progress for this and future generations. Our 2014 results show unfinished business in achievement of high, sustained, and equitable coverage of essential interventions. Progress has accelerated in the past decade in most Countdown countries, suggesting that further gains are possible with intensified actions. Some of the greatest coverage gaps are in family planning, interventions addressing newborn mortality, and case management of childhood diseases. Although inequities are pervasive, country successes in reaching of the poorest populations provide lessons for other countries to follow. As we transition to the next set of global goals, we must remember the centrality of data to accountability, and the importance of support of country capacity to collect and use high-quality data on intervention coverage and inequities for decision making. To fulfill the health agenda for women and children both now and beyond 2015 requires continued monitoring of country and global progress; Countdown is committed to playing its part in this effort.

Nonprofit and Voluntary Sector Quarterly
February 2015; 44 (1)
http://nvs.sagepub.com/content/current

Design of Employee Training in Taiwanese Nonprofits
Nonprofit and Voluntary Sector Quarterly February 2015 44: 25-46, first published on September 10, 2013 doi:10.1177/0899764013502878
Wei-Wen Chang, Chun-Mam Huang, and Yung-Cheng Kuo

Female Overrepresentation in Public and Nonprofit Sector Jobs: Evidence From a French National Survey
Nonprofit and Voluntary Sector Quarterly February 2015 44: 47-74, first published on September 24, 2013 doi:10.1177/0899764013502579
Joseph Lanfranchi and Mathieu Narcy

Nonprofit Governance and Accountability: Broadening the Theoretical Perspective
Nonprofit and Voluntary Sector Quarterly February 2015 44: 75-97, first published on October 1, 2013 doi:10.1177/0899764013503906
Tracey M. Coule

PLOS Currents: Disasters
[Accessed 31 January 2015]
http://currents.plos.org/disasters/

Developing a Consensus-based Definition of “Kokoro-no Care” or Mental Health Services and Psychosocial Support: Drawing from Experiences of Mental Health Professionals Who Responded to the Great East Japan Earthquake
January 29, 2015 • Research article
Abstract
Objectives:
In this survey, we aimed to build consensus and gather opinions on ‘Kokoro-no care’ or mental health services and psychosocial support (MHSPSS) after a disaster, among mental health professionals who engaged in care after the Great East Japan Earthquake.
Methods:
We recruited mental health professionals who engaged in support activities after the Great East Japan Earthquake, which included local health professionals in the affected areas and members of mental health care teams dispatched from outside (n = 131). Adopting the Delphi process, we proposed a definition of ‘Kokoro-no care’, and asked the participants to rate the appropriateness on a 5-point Likert scale. We also solicited free comments based on the participants’ experiences during the disaster. After Round 1, we presented the summary statistics and comments, and asked the participants to re-rate the definition that had been modified based on their comments. This process was repeated twice, until the consensus criterion of ≥ 80% of the participants scoring ≥ 4 on the statement was fulfilled.
Results:
In Round 1, 68.7% of the respondents rated the proposed definition ≥ 4 for its appropriateness, and 88.4% did so in Round 2. The comments were grouped into categories (and subcategories) based on those related to the definition in general (Appropriate, Continuum of MHSPSS, Cautions in operation, Alternative categorisation of care components, Whether the care component should be categorised according to the professional involved, Ambiguous use of psychology, and Others), to mental health services (Appropriate, More specification within mental health services, More explicit remarks on mental health services, and Others), and to psychosocial support (Whether the care component should be categorised according to the professional involved, Raising concerns about the terms, and Others), and others.
Conclusion:
We achieved a consensus on the definition of ‘Kokoro-no care’, and systematically obtained suggestions on the concept, and practical advice on operation, based on the participants’ experiences from the Great East Japan Earthquake. This collective knowledge will serve as reference to prepare and respond to future disasters.

PLoS Currents: Outbreaks
http://currents.plos.org/outbreaks/
(Accessed 31 January 2015)

A Model of the 2014 Ebola Epidemic in West Africa with Contact Tracing
January 30, 2015 • Research
A differential equations model is developed for the 2014 Ebola epidemics in Sierra Leone and Liberia. The model describes the dynamic interactions of the susceptible and infected populations of these countries. The model incorporates the principle features of contact tracing, namely, the number of contacts per identified infectious case, the likelihood that a traced contact is infectious, and the efficiency of the contact tracing process. The model is first fitted to current cumulative reported case data in each country. The data fitted simulations are then projected forward in time, with varying parameter regimes corresponding to contact tracing efficiencies. These projections quantify the importance of the identification, isolation, and contact tracing processes for containment of the epidemics.

Projected Treatment Capacity Needs in Sierra Leone
January 30, 2015 • Research
Abstract
Background:
The ongoing outbreak of Ebola Virus Disease in West Africa requires immediate and sustained input from the international community in order to curb transmission. The CDC has produced a model that indicates that to end the outbreak by pushing the reproductive number below one, 25% of the patients must be placed in an Ebola Treatment Unit (ETC) and 45% must be isolated in community settings in which risk of disease transmission is reduced and safe burials are provided. In order to provide firmer targets for the international response in Sierra Leone, we estimated the national and international personnel and treatment capacity that may be required to reach these percentages.
Methods:
We developed a compartmental SEIR model that was fitted to WHO data and local data allowing the reproductive number to change every 8 weeks to forecast the progression of the EVD epidemic in Sierra Leone. We used the previously estimated 2.5x correction factor estimated by the CDC to correct for underreporting. Number of personnel required to provide treatment for the predicted number of cases was estimated using UNMEER and UN OCHA requests for resources required to meet the CDC target of 70% isolation.
Results:
As of today (2014-12-04), we estimate that there are 810 (95% CI=646 to 973) EVD active cases in treatment, with an additional 3751 (95% CI=2778 to 4723) EVD cases unreported and untreated. To reach the CDC targets today, we need 1140 (95% CI=894 to 1387) cases in ETCs and 2052 (95% CI=1608 to 2496) at home or in a community setting with a reduced risk for disease transmission. In 28 days (2015-01-01), we will need 1309 (95% CI=804 to 1814) EVD cases in ETCs and 2356 (95% CI=1447 to 3266) EVD cases at reduced risk of transmission. If the current transmission rate is not reduced, up to 3183 personnel in total will be required in 56 days (2015-01-29) to operate ETCs according to our model.
Conclusions:
The current outbreak will require massive input from the international community in order to curb the transmission through traditional containment mechanisms by breaking the chains of transmission in Sierra Leone. If sufficient treatment facilities, healthcare workers and support personnel are not rapidly deployed, the increasing number of cases will be overwhelming. In addition to supporting isolation and treatment mechanisms, other viable control options, such as the development of an effective vaccine, should be supported.

Global Climate Anomalies and Potential Infectious Disease Risks: 2014-2015
January 26, 2015 • Research
Abstract
Background:
The El Niño/Southern Oscillation (ENSO) is a global climate phenomenon that impacts human infectious disease risk worldwide through droughts, floods, and other climate extremes. Throughout summer and fall 2014 and winter 2015, El Niño Watch, issued by the US National Oceanic and Atmospheric Administration, assessed likely El Niño development during the Northern Hemisphere fall and winter, persisting into spring 2015.
Methods:
We identified geographic regions where environmental conditions may increase infectious disease transmission if the predicted El Niño occurs using El Niño indicators (Sea Surface Temperature [SST], Outgoing Longwave Radiation [OLR], and rainfall anomalies) and literature review of El Niño-infectious disease associations.
Results:
SSTs in the equatorial Pacific and western Indian Oceans were anomalously elevated during August-October 2014, consistent with a developing weak El Niño event. Teleconnections with local climate is evident in global precipitation patterns, with positive OLR anomalies (drier than average conditions) across Indonesia and coastal southeast Asia, and negative anomalies across northern China, the western Indian Ocean, central Asia, north-central and northeast Africa, Mexico/Central America, the southwestern United States, and the northeastern and southwestern tropical Pacific. Persistence of these conditions could produce environmental settings conducive to increased transmission of cholera, dengue, malaria, Rift Valley fever, and other infectious diseases in regional hotspots as during previous El Niño events.
Discussion and Conclusions:
The current development of weak El Niño conditions may have significant potential implications for global public health in winter 2014-spring 2015. Enhanced surveillance and other preparedness measures in predicted infectious disease hotspots could mitigate health impacts.

PLoS Medicine
(Accessed 31 January 2015)
http://www.plosmedicine.org/

Supporting Those Who Go to Fight Ebola
Michelle M. Mello, Maria W. Merritt, Scott D. Halpern
Editorial | published 26 Jan 2015 | PLOS Medicine 10.1371/journal.pmed.1001781
…Conclusion
Given the opportunities for HCPs to care for patients in desperate need and help avert global harm, the consistency of such service with HCPs’ professional ethics and AMCs’ missions, and institutions’ ability to manage risks attributable to HCPs’ temporary absence and return to work, health care institutions should routinely support willing and qualified HCPs’ service in West Africa. At a minimum, institutions should not impede employees from fulfilling their perceived professional duties to help the sick and, thereby, to do their part in responding to a global public health emergency. This means refraining from adverse action against those who choose to travel, arranging for others to provide the services the travelers normally render, and not imposing restrictions that exceed CDC recommendations for returning travelers.

Ideally, institutions would go further and actively promote HCPs’ service by enabling them to go as employees and preserving the full net of support and protection this status confers in the US, including travel insurance, worker’s compensation coverage, and pay. Such institutions would also assume liability for harms to third parties, although these situations would likely be rare.

Finally, institutions could fulfill their ethical responsibilities to contribute to the fight against Ebola in different ways. Some hospitals might step forward as primary centers of care for Ebola patients domestically while others focus on facilitating HCPs services’ abroad. However institutions choose to address these responsibilities, it is heartening that there are HCPs who wish to provide care in West Africa. This heroism is remarkable and reflects a deep humanitarian instinct. It calls for validation, not discouragement, by health care institutions.

Vaccine
Volume 33, Issue 8, Pages 943-1098 (18 February 2015)
http://www.sciencedirect.com/science/journal/0264410X/33/8

Human papillomavirus vaccination: Assessing knowledge, attitudes, and intentions of college female students in Lebanon, a developing country
Original Research Article
Pages 1001-1007
Mohammed Dany, Alissar Chidiac, Anwar H. Nassar
Abstract
Human papillomavirus (HPV) infection is a common cause for genital warts and cervical cancer. Developing countries in the Middle East such as Lebanon are traditionally considered to be conservative societies with low incidence of sexually transmitted infections. However, nowadays, there is an unexpected increase in the incidence of HPV infections among Middle Eastern females. Thus, the objective of this study is to assess the behavioral perceptions of HPV vaccination among female students attending an academic institution in Lebanon. This cross-sectional study invited 512 students to complete a self-administered questionnaire that assessed the knowledge, attitudes, and intentions towards HPV vaccination. Data analysis included the calculation of knowledge scores ranging from 0 to 100, attitude scores ranging from most positive (1) to most negative (5), and intention scores ranging from lowest intention (0) to highest intention (10). With a response rate of n = 215 (42%), 36.5% never heard of the vaccine before, and only 16.5% were already HPV vaccinated. The median knowledge score of 52.7% ± 1.71 reflects poor to moderate knowledge. Still, the median attitude score of 2.47 ± 0.05 shows a general positive attitude towards HPV vaccination where most of the participants agreed that female college students in Lebanon have a good chance of contracting HPV (62.1%) and that all gynecologists should recommend the vaccine (76.0%). Students in graduate programs, health related majors, and those who are vaccinated had significantly higher knowledge scores compared with students in undergraduate programs, non-health related majors, and HPV non-vaccinated students, respectively. Finally, the survey helped in increasing the intention to obtain HPV vaccine as the intention score increased significantly from 5.24 ± 0.27 before the students went through the survey to 6.98 ± 0.22 after the students completed the survey. Our study highlights the importance of offering guidance to female college students about HPV and its vaccination in developing countries where the incidence of sexually transmitted infections is on the rise.

.

Vaccine-criticism on the internet: New insights based on French-speaking websites
Original Research Article
Pages 1063-1070
Jeremy K. Ward, Patrick Peretti-Watel, Heidi J Larson, Jocelyn Raude, Pierre Verger
Abstract
The internet is playing an increasingly important part in fueling vaccine related controversies and in generating vaccine hesitant behaviors. English language Antivaccination websites have been thoroughly analyzed, however, little is known of the arguments presented in other languages on the internet. This study presents three types of results: (1) Authors apply a time tested content analysis methodology to describe the information diffused by French language vaccine critical websites in comparison with English speaking websites. The contents of French language vaccine critical websites are very similar to those of English language websites except for the relative absence of moral and religious arguments. (2) Authors evaluate the likelihood that internet users will find those websites through vaccine-related queries on a variety of French-language versions of google. Queries on controversial vaccines generated many more vaccine critical websites than queries on vaccination in general. (3) Authors propose a typology of vaccine critical websites. Authors distinguish between (a) websites that criticize all vaccines (“antivaccine” websites) and websites that criticize only some vaccines (“vaccine-selective” websites), and between (b) websites that focus on vaccines (“vaccine-focused” websites) and those for which vaccines were only a secondary topic of interest (“generalist” websites). The differences in stances by groups and websites affect the likelihood that they will be believed and by whom. This study therefore helps understand the different information landscapes that may contribute to the variety of forms of vaccine hesitancy. Public authorities should have better awareness and understanding of these stances to bring appropriate answers to the different controversies about vaccination.

.

Vaccine
Volume 33, Issue 7, Pages 833-942 (11 February 2015)
http://www.sciencedirect.com/science/journal/0264410X/33/7

Evaluation of invalid vaccine doses in 31 countries of the WHO African Region
Original Research Article
Pages 892-901
Manas K. Akmatov, Elizabeth Kimani-Murage, Frank Pessler, Carlos A. Guzman, Gérard Krause, Lothar Kreienbrock, Rafael T. Mikolajczyk
Abstract
We examined (a) the fraction of and extent to which vaccinations were administered earlier than recommended (age-invalid) or with too short intervals between vaccine doses (interval-invalid) in countries of the World Health Organisation (WHO) African Region and (b) individual- and community-level factors associated with invalid vaccinations using multilevel techniques. Data from the Demographic and Health Surveys conducted in the last 10 years in 31 countries were used. Information about childhood vaccinations was based on vaccination records (n = 134,442). Invalid vaccinations (diphtheria, tetanus, pertussis [DTP1, DTP3] and measles-containing vaccine (MCV)) were defined using the WHO criteria. The median percentages of invalid DTP1, DTP3 and MCV vaccinations across all countries were 12.1% (interquartile range, 9.4–15.2%), 5.7% (5.0–7.6%), and 15.5% (10.0–18.1%), respectively. Of the invalid DTP1 vaccinations, 7.4% and 5.5% were administered at child’s age of less than one and two weeks, respectively. In 12 countries, the proportion of invalid DTP3 vaccinations administered with an interval of less than two weeks before the preceding dose varied between 30% and 50%. In 13 countries, the proportion of MCV doses administered at child’s age of less than six months varied between 20% and 45%. Community-level variables explained part of the variation in invalid vaccinations. Invalid vaccinations are common in African countries. Timing of childhood vaccinations should be improved to ensure an optimal protection against vaccine-preventable infections and to avoid unnecessary wastage in these economically deprived countries.

Reducing the loss of vaccines from accidental freezing in the cold chain: The experience of continuous temperature monitoring in Tunisia
Original Research Article
Pages 902-907
John Lloyd, Patrick Lydon, Ramzi Ouhichi, Michel Zaffran

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 31 January 2015)

The Onchocerciasis Vaccine for Africa—TOVA—Initiative
Peter J. Hotez, Maria Elena Bottazzi, Bin Zhan, Benjamin L. Makepeace, Thomas R. Klei, David Abraham, David W. Taylor, Sara Lustigman
Editorial | published 29 Jan 2015 | PLOS Neglected Tropical Diseases 10.1371/journal.pntd.0003422
New supportive health intervention technologies, including a vaccine, may be required in order to achieve onchocerciasis (river blindness) elimination targets. A new transatlantic partnership has been established to develop and test an onchocerciasis vaccine for Africa…

…OVA Initiative is now establishing a roadmap for developing a vaccine to meet one of the two described TPPs, with plans to take at least one candidate forward to phase two trials (proof-of-concept trial for efficacy) by 2020. Among the key activities envisioned for TOVA Initiative is a program of confirmatory preclinical testing, optimization, and down-selection in the O. ochengi–cow model under conditions of natural exposure, together with scale-up process development, pilot manufacture, toxicology testing, regulatory filing, and phase one clinical testing. Indeed, TOVA Initiative is poised to lead on the development of this important new tool to aid in the elimination of onchocerciasis.

An onchocerciasis vaccine for Africa would build on past investments in OCP and APOC and support future investments planned under PENDA to help achieve elimination of onchocerciasis [19]. TOVA has begun to explore innovative financing mechanisms from major foundations, governments in North America, Europe, and elsewhere, as well as some of the major development banks committed to poverty reduction in sub-Saharan Africa. We strongly encourage the global public health community to embrace the prospect of an onchocerciasis vaccine and to incorporate plans for a vaccine’s development into future public policy and strategic plan considerations.

UN Chronicle
Vol. LI No. 3 2014 December 2014
http://unchronicle.un.org/

Issue Theme: Conference Diplomacy
This issue commemorates the bicentennial of the Congress of Vienna (1814-15) by looking at the development and effectiveness of multilateral conference diplomacy within the context of the United Nations.

Ebola/EVD: Additional Coverage [to 31 January 2015]

UNMEER [UN Mission for Ebola Emergency Response] @UNMEER #EbolaResponse

Editor’s Note: UNMEER’s website is aggregating and presenting content from various sources including its own External Situation Reports, press releases, statements and other formats.
We present a composite below from the week ending 31 January 2015. We also note that 1) a regular information category in these reports – human rights – has apparently eliminated as it no longer appears in any of the continuing updates, and 2) the content level of these reports continues, in our view, to trend less informative and less coherent. We will review continuing coverage of this material over the next few weeks.

UNMEER External Situation Reports
UNMEER External Situation Reports are issued daily (excepting Saturday) with content organized under these headings:
– Highlights
– Key Political and Economic Developments
– Human Rights
– Response Efforts and Health
– Logistics
– Outreach and Education
– Resource Mobilisation
– Essential Services
– Upcoming Events

The “Week in Review” will present highly-selected elements of interest from these reports. The full daily report is available as a pdf using the link provided by the report date.

:: 30 Jan 2015 UNMEER External Situation Report
Key Political and Economic Developments
1. Addressing the Stakeholder Meeting on Ebola, convened by the Chairperson of the AU Commission in Addis Ababa on 29 January, SRSG Ould Cheikh Ahmed called on all leaders to maintain commitment until the goal of zero cases is reached. The SRSG underscored that situation is still perilous as Ebola is still present in more than 25 of the 66 districts, counties and prefectures in the region.
Response Efforts and Health
3. On 29 January in Sierra Leone, UNMEER joined the government and UNDP to launch a month-long exercise to revise the hazard payment policy for Ebola Response Workers (ERWs). The reclassification exercise will now ensure that response work is based on real risks, save cost and at the same time ensure that hazard pay is sustainable. A local ICT firm is assisting in computerizing a database workers, which may among others provide details that reflects the trends in the Ebola fight. The hazard incentive programme is funded by the World Bank, the African Development Bank and DFID, with technical guidance, implementation and coordination support provided by UNDP and UNMEER.
Logistics
8. WFP is coordinating with WHO, UNICEF and other key partners to harmonise the supply chain of essential items for the three affected countries, in line with the shift in focus of the Ebola response to a district-by-district approach and early recovery activities. WFP has augmented its storage capacity at the Main Logistics Hub at Roberts International Airport, Monrovia, from four to six Mobile Storage Units (MSUs), in response to an increasingly high volume of supplies coming into Liberia via air transport.
Resource Mobilisation
11. The OCHA Ebola Virus Outbreak Overview of Needs and Requirements, now totaling USD 2.27 billion, has been funded for USD 1.22 billion, which is around 54% of the total ask.
12. The Ebola Response Multi-Partner Trust Fund currently has USD 135.8 million in commitments. In total USD 140 million has been pledged.
Essential Services
15. Preparation of school infection prevention and control (IPC) kits to facilitate the safe reopening of more than 4,000 schools in Liberia began in UNICEF’s Monrovia warehouse. Each kit is designed to support essential hygiene and sanitation measures and health screening for 150 students. Additionally, UNMEER attended a 2-day WHO supported Training of Trainers (ToT) workshop organized by the County Health Team (CHT) of Rivercess for 16 Ministry of Education (MoEd) personnel including County Education Officer, District Education Officers, Education Consultants and professionals to enhance awareness on EVD in preparation for the opening of schools next week. The trained group will later train 538 teachers and support staff in the entire county. The training was jointly developed by the government and partners.

:: 29 Jan 2015 UNMEER External Situation Report
Key Political and Economic Developments
1. The International Finance Corporation (IFC) announced plans to invest USD 30 million, to support Small and Medium Enterprises (SMEs) and the creation of jobs in Guinea.
Response Efforts and Health
5. In Sierra Leone, WFP and UNICEF jointly distributed food and WASH kits to over 500 quarantined households in the Western Area, including Waterloo. WFP also provided over 90mt of assorted food commodities to five quarantined communities in Port Loko District, Thigbono, Musaia, Bailor Wharf 1, Bailor Warf 2 and Petifu Walla. WFP with its cooperating partner CIDO has so far distributed assorted food commodities to approximately 39,000 households in Waterloo, with distributions ongoing to reach over 47,000 households targeted by general food distributions in this area.
8. WHO reports that for the first time since the week ending 29 June 2014, there have been fewer than 100 new confirmed cases reported in a week in the 3 most-affected countries. A combined total of 99 confirmed cases were reported from the 3 countries in the week to 25 January: 30 in Guinea, 4 in Liberia, and 65 in Sierra Leone.
Logistics
11. The WFP-led Logistics Cluster continues to facilitate the transportation and storage of essential relief items on behalf of the humanitarian community. Since September 2014, over 35,000m3 of cargo has been transported and over 52,000m3 stored, across Guinea, Liberia and Sierra Leone.
Outreach and Education
16. WHO reports that a total of 27 sub-prefectures in Guinea reported at least one security incident or other forms of refusal to cooperate in the week to 21 January. A total of 2 districts in Liberia and 4 districts in Sierra Leone reported at least one similar incident during the same reporting period.
17. Awareness of EVD transmission remains a challenge in pockets in Guinea. A group of youth threw stones at a Guinean Red Cross (GRC) vehicle, on a mission to disinfect a house in Koulé, N’Zérékoré, despite prior arrangement with local authorities.
Essential Services
18. In Guinea, UNMEER observes that the process of a full return to normal school activities continues at varying rates. Reports range from increasing numbers/attendance rates in the main high school in Kankan to delays in commencing university classes and in some cases boycotting of schools by students due to rumours that thermoflash thermometer are transmitting EDV.

:: 28 Jan 2015 UNMEER External Situation Report
Upcoming Events
14. On 29 January, UNDP will organize in New York a high-level event on Ebola recovery. From the UN Secretary-General’s initiative, a partnership has developed between the UN, the EU, the World Bank and the African Development Bank to support the national EVD recovery strategies of the affected countries to facilitate governments’ recovery priorities and reach agreement on areas of integrated support. This high-level event is an opportunity to update Members States on progress in this regard and share information on preliminary findings.

:: 27 Jan 2015 UNMEER External Situation Report
Key Political and Economic Developments
1. On 26 January, Senegal reopened its land borders with Guinea. Senegal had reopened air and sea borders on 14 November 2014, after closing all borders on 21 August 2014.
Outreach and Education
11. UNDP is training hundreds of community police officers to help keep EVD case numbers down and prevent future outbreaks. 450 newly trained officers have begun sharing information with communities in Matoto, in Guinea’s capital Conakry, enhance public awareness to help stop EVD spread and to build more trust between the public and the security services.
Essential Services
15. In Guinea, UNICEF in collaboration with other partners undertook a vaccination catch-up programme in 19 high risk health districts during its Child Health Days. While in Liberia, the second phase of the Periodic Intensification of Routine Immunization drive is set to begin to reach children aged under five with the measles vaccine. UNICEF is also financing the cold chain and vaccination teams in addition to leading social mobilisation efforts.
16. Under the leadership of the Liberian Ministry of Health, UNICEF is a key partner in the upcoming assessment and development of a budgeted health plan to building resilient health systems in Liberia. Discussions are underway on the scope and level of preparedness for this assessment. Eight thematic groups were formed, namely: (1) context and policies, (2) health governance, (3) health workforce, (4) healthcare financing, (5) health information and surveillance, (6) technology, medicines, supply chain management systems, (7) health service delivery, and (8) health infrastructure and logistics.

:: 26 Jan 2015 UNMEER External Situation Report
Key Political and Economic Developments
1. In an address to the nation on 22 January, President Koroma of Sierra Leone, declared the nation’s goal to move towards the target of zero cases by 31 March. The President announced the easing of restriction of movement; he highlighted measures for the safe re-opening of schools to be in the third and fourth week in March are underway. The President emphasized that the nation needs to continue to focus on surveillance and contact tracing; enhance social mobilisation and community engagement efforts; refrain from washing and touching corpses; and not to relent until Sierra Leone gets to zero cases for 42 days and until Liberia and Guinea have had zero cases for 42 days. He also underscored the importance of building the national surveillance capacity and resilient healthcare system to interrupt transmission and prevent future outbreaks.
Logistics
6. The WFP-led Emergency Telecommunication (ET) cluster is constructing towers (17x24m in height) across the three affected countries, in order to widen the coverage of internet in hard to reach locations. More Wi-Fi hotspots will now be available to the humanitarian community, as the ET cluster is in the process of constructing towers in six locations in Guinea; in three locations in Liberia; and in six locations in Sierra Leone.
Outreach and Education
13. In Guinea, UNICEF in partnership with CARITAS has set up 20 social Mediation Councils comprised of religious leaders of all faiths to act on resistance across the country; the social mediation councils have been deployed to communities reporting resistance. UNICEF, Research for Common Ground and the Ministry of Youth continue to use the platform provided by African Cup to scale social mobilization featuring football legends, Guinea national team and Miss Guinea.
14. On 24 January, WHO Guinea with support from CDC, IOM, UNMEER Guinea, Liberia and Sierra Leone organised a cross-border community-based consultative meeting in Nongowa, Guéckédou Prefecture, reuniting state, security and health officials from the tri-border area districts, prefectures and chiefdoms. 24 local community leaders from Liberia and Sierra Leone attended the meeting with support from UNMEER field teams. WHO representatives across the tri-border area districts – Guéckédou (Guinea), Kailahum (Sierra Leone) and Lofa (Liberia) led the discussions which were chaired by the prefect of Guéckédou. These were followed by a series of focus groups sessions. The objectives of the meeting was to share updates on the epidemiological reports; experiences and lessons learned as well as explore ways to strengthen cross border community engagement, surveillance and notification mechanisms, among all stakeholders.