BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 19 December 2015)

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Research article
MERS-CoV geography and ecology in the Middle East: analyses of reported camel exposures and a preliminary risk map
Middle Eastern respiratory syndrome coronavirus (MERS-CoV) has spread rapidly across much of the Middle East, but no quantitative mapping of transmission risk has been developed to date.
Tarian Reeves, Abdallah M. Samy and A. Townsend Peterson
BMC Research Notes 2015 8:801
Published on: 18 December 2015

British Medical Journal
19 December 2015 (vol 351, issue 8038)
http://www.bmj.com/content/351/8038

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Editorials Christmas 2015
Responding to the needs of refugees
BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h6731 (Published 16 December 2015) Cite this as: BMJ 2015;351:h6731
Frank Arnold, convenor, anti-torture initiative1, Cornelius Katona, lead23, Juliet Cohen, head of doctors4, Lucy Jones, UK programme manager5, David McCoy, director16
Author affiliations
Knowledge of and skills in human rights medicine will be needed
At the time of writing it is unclear how many people will eventually receive refuge in Britain from encampments in countries surrounding Syria through the UN vulnerable persons relocation scheme. The government’s current commitment to receive a maximum of 20 000 over five years, if delivered at a constant rate, would result in 4000 arrivals a year.1 It is also unclear when they will arrive and what financial and other arrangements are being made for local councils to support them. But even if the UK maintains its decision to opt out of the EU refugee sharing scheme, the number of asylum seekers reaching the UK by other routes may increase, given that more than half a million people seeking protection arrived in Europe by sea in 2015.

Whatever the numbers, many will have high levels of complex physical, psychological, social, and legal needs arising from their experiences in their countries of origin or during their often prolonged and dangerous journeys. This is particularly the case for people admitted under the UN relocation scheme, which emphasises vulnerability and damage as primary selection criteria.2

These health needs will interact with each other and with wider social needs (housing, schooling, linguistic, and cultural support) to produce challenges that exceed the experience of most UK clinicians. The issues that the responsible practices and hospitals will need to address are many and complex but largely predictable (box). The current crisis must be met by a plan to train and support clinicians to assist this vulnerable group. Such a plan would also benefit the many traumatised, tortured, and ill refugees, asylum seekers, and undocumented migrants who are already in the country.

Common interacting medical needs of refugees
Psychological
:: Post-traumatic stress disorder and other mental health problems resulting from trauma
Physical
:: Consequences of torture such as damage to feet from repeated blunt trauma or brachial plexus damage after suspension by hyper-extended arms
:: Screening for sexually transmitted diseases (if rape revealed)
:: Traumatic war injuries
Social and legal
:: Adequate interpreting
:: Access to primary and secondary care and difficulties of negotiating exemption from overseas visitors charging regulations
:: Protection from subsequent unsafe repatriation or redress may require careful documentation of medical evidence of human rights abuses, including photographs or clinical notes of physical or psychological damage on arrival

So what needs to happen? Government departments should make use of standard handheld records of medical information gleaned during selection for relocation and ensure that the data follow the patients to their new practitioners. The European Union is developing such a record.3 For people who require secondary care the Home Office should provide immigration status documents and circulate them with advice to relevant officers to prevent inappropriate attempts to charge user fees. The entitlements of migrants to care are complex, but survivors of torture and other human rights abuses do not have to pay under the current regulations.4 And unless a general practice has a policy requiring all new registrants to supply documents, to do so for migrants only would constitute impermissible discrimination.5

As health professionals, we are occupationally and morally required to offer the highest standard of healthcare to all patients, including survivors of human rights abuses who arrive on these shores.6 But clinicians need to be trained and supported to help this vulnerable group. The knowledge and skills in human rights medicine and psychology developed by a relatively small number of specialist health professionals within the NHS and third sector organisations needs to be harnessed and used wisely to enable this to happen. These organisations include Freedom from Torture (www.freedomfromtorture.org), the Helen Bamber Foundation (www.helenbamber.org), and Doctors of the World (www.doctorsoftheworld.org.uk/pages/UK-Programme). The Royal Society of Medicine is hosting training sessions organised by Medact on clinical aspects of torture and trauma. Public Health England, which has a helpful Migrant Health Guide,7 the royal colleges, the BMA, and other health professional bodies can also facilitate relevant educational initiatives. Close collaboration between the statutory and charity sectors will be crucial.

The voice and mandate of health professionals also needs to be used to prevent xenophobia and tackle the root causes of the refugee crisis. We should make good use of the expressions of goodwill and solidarity from much of the UK population towards those who need help and highlight the past and potential long term economic and social contributions that such refugees have and can make in the UK. We should also seek to educate and engage the UK health community about the need to promote peace and human security, particularly in north Africa and the Middle East. The refugee crisis will not be resolved otherwise.

Conflict and Health
http://www.conflictandhealth.com/
[Accessed 19 December 2015]

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Research
Providing surgery in a war-torn context: the Médecins Sans Frontières experience in Syria
Trelles M, Dominguez L, Tayler-Smith K, Kisswani K, Zerboni A, Vandenborre T, Dallatomasina S, Rahmoun A et al. Conflict and Health 2015, 9:36 (15 December 2015)
Abstract
Background
Since 2011, civil war has crippled Syria leaving much of the population without access to healthcare. Various field hospitals have been clandestinely set up to provide basic healthcare but few have been able to provide quality surgical care. In 2012, Medecins Sans Frontieres (MSF) began providing surgical care in the Jabal al-Akrad region of north-western Syria. Based on the MSF experience, we describe, for the period 5th September 2012 to 1st January 2014: a) the volume and profile of surgical cases, b) the volume and type of anaesthetic and surgical procedures performed, and c) the intraoperative mortality rate.
Methods
A descriptive study using routinely collected MSF programme data. Quality surgical care was assured through strict adherence to the following minimum standards: adequate infrastructure, adequate water and sanitation provisions, availability of all essential disposables, drugs and equipment, strict adherence to hygiene requirements and universal precautions, mandatory use of sterile equipment for surgical and anaesthesia procedures, capability for blood transfusion and adequate human resources.
Results
During the study period, MSF operated on 578 new patients, of whom 57 % were male and median age was 25 years (Interquartile range: 21–32 years). Violent trauma was the most common surgical indication (n-254, 44 %), followed by obstetric emergencies (n-191, 33 %) and accidental trauma (n-59, 10 %). In total, 712 anaesthetic procedures were performed. General anaesthesia without intubation was the most common type of anaesthesia (47 % of all anaesthetics) followed by spinal anaesthesia (25 %). A total of 831 surgical procedures were performed, just over half being minor/wound care procedures and nearly one fifth, caesarean sections. There were four intra-operative deaths, giving an intra-operative mortality rate of 0.7 %.
Conclusions
Surgical needs in a conflict-afflicted setting like Syria are high and include both combat and non-combat indications, particularly obstetric emergencies. Provision of quality surgical care in a complex and volatile setting like this is possible providing appropriate measures, supported by highly experienced staff, can be implemented that allow a specific set of minimum standards of care to be adhered to. This is particularly important when patient outcomes – as a reflection of quality of care – are difficult to assess.

Eurosurveillance
Volume 20, Issue 50, 17 December 2015
http://www.eurosurveillance.org/Public/Article/Archives.aspx?PublicationId=11678

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Research Articles
Assessment of the MSF triage system, separating patients into different wards pending Ebola virus laboratory confirmation, Kailahun, Sierra Leone, July to September 2014
by F Vogt, G Fitzpatrick, G Patten, R van den Bergh, K Stinson, L Pandolfi, J Squire, T Decroo, H Declerck, M Van Herp

Global Health: Science and Practice (GHSP)
December 2015 | Volume 3 | Issue 4
http://www.ghspjournal.org/content/current

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Editorial
Behavior Change Fast and Slow: Changing Multiple Key Behaviors a Long-Term Proposition?
An intensive radio campaign in rural areas of Burkina Faso addressed multiple key behaviors to reduce child mortality, using a randomized cluster design. After 20 months, despite innovative approaches and high reported listenership, only modest reported change in behavior was found, mainly related to care seeking rather than habitual behavior such as hand washing. Various methodologic difficulties may have obscured a true greater impact. Analysis of the intervention after its full 35-month duration may reveal more impact, including on actual child mortality. Improving a number of key behaviors is essential to child survival efforts, and much of it may require strong and sustained efforts.
Glob Health Sci Pract 2015;3(4):521-524. First published online November 3, 2015. http://dx.doi.org/10.9745/GHSP-D-15-00331

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Original Articles
The Saturation+ Approach to Behavior Change: Case Study of a Child Survival Radio Campaign in Burkina Faso
This randomized radio campaign focused on the 3 principles of the Saturation+ approach to behavior change: (1) saturation (high exposure to messages), (2) science (basing design on data and modeling), and (3) creative storytelling. Locally developed short spots and longer dramas targeted multiple child survival-related behaviors and were delivered entirely by local radio stations. Innovative partnerships with radio stations provided free airtime in return for training, equipment, and investment in solar power.
Joanna Murray, Pieter Remes, Rita Ilboudo, Mireille Belem, Souleymane Salouka, Will Snell,
Cathryn Wood, Matthew Lavoie, Laurent Deboise, Roy Head
Glob Health Sci Pract 2015;3(4):544-556. First published online November 3, 2015. http://dx.doi.org/10.9745/GHSP-D-15-00049

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Monitoring and Evaluating the Transition of Large-Scale Programs in Global Health
Monitoring and evaluating large-scale global health program transitions can strengthen accountability, facilitate stakeholder engagement, and promote learning about the transition process and how best to manage it. We propose a conceptual framework with 4 main domains relevant to transitions—leadership, financing, programming, and service delivery—along with guiding questions and illustrative indicators to guide users through key aspects of monitoring and evaluating transition. We argue that monitoring and evaluating transitions can bring conceptual clarity to the transition process, provide a mechanism for accountability, facilitate engagement with local stakeholders, and inform the management of transition through learning.
James Bao, Daniela C Rodriguez, Ligia Paina, Sachiko Ozawa, Sara Bennett
Glob Health Sci Pract 2015;3(4):591-605. http://dx.doi.org/10.9745/GHSP-D-15-00221

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FIELD ACTION REPORTS
Introduction of Mobile Health Tools to Support Ebola Surveillance and Contact Tracing in Guinea
An informatics system consisting of a mobile health application and business intelligence software was used for collecting and analyzing Ebola contact tracing data. This system offered potential to improve data access and quality to support evidence-based decision making for the Ebola response in Guinea. Implementation challenges included software limitations, technical literacy of users, coordination among partners, government capacity for data utilization, and data privacy concerns.
Jilian A Sacks, Elizabeth Zehe, Cindil Redick, Alhoussaine Bah, Kai Cowger, Mamady Camara,
Aboubacar Diallo, Abdel Nasser Iro Gigo, Ranu S Dhillon, Anne Liu
Glob Health Sci Pract 2015;3(4):646-659. First published online November 12, 2015. http://dx.doi.org/10.9745/GHSP-D-15-00207

Global Public Health
Volume 11, Issue 1-2, 2016
http://www.tandfonline.com/toc/rgph20/current
Special Issue: Conceptualising the agency of highly marginalised women: Intimate partner violence in extreme settings

Guest Editors’ Introduction
Conceptualising the agency of highly marginalised women: Intimate partner violence in extreme settings
Catherine Campbella* & Jenevieve Mannellb
pages 1-16
DOI: 10.1080/17441692.2015.1109694

Abstract
How is the agency of women best conceptualised in highly coercive settings? We explore this in the context of international efforts to reduce intimate partner violence (IPV) against women in heterosexual relationships. Articles critique the tendency to think of women’s agency and programme endpoints in terms of individual actions, such as reporting violent men or leaving violent relationships, whilst neglecting the interlocking social, economic and cultural contexts that make such actions unlikely or impossible. Three themes cut across the articles. (1) Unhelpful understandings of gender and power implicit in commonly used ‘men-women’ and ‘victim-agent’ binaries obscure multi-faceted and hidden forms of women’s agency, and the complexity of agency-violence intersections. (2) This neglect of complexity results in a poor fit between policy and interventions to reduce IPV, and women’s lives. (3) Such neglect also obscures the multiplicities of women’s agency, including the competing challenges they juggle alongside IPV, differing levels of response, and the temporality of agency. We outline a notion of ‘distributed agency’ as a multi-level, incremental and non-linear process distributed across time, space and social networks, and across a continuum of action ranging from survival to resistance. This understanding of agency implies a different approach to those currently underpinning policies and interventions.

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 19 December 2015]

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Review
Short term global health experiences and local partnership models: a framework
Contemporary interest in in short-term experiences in global health (STEGH) has led to important questions of ethics, responsibility, and potential harms to receiving communities.
Lawrence C. Loh, William Cherniak, Bradley A. Dreifuss, Matthew M. Dacso, Henry C. Lin and Jessica Evert
Globalization and Health 2015 11:50
Published on: 18 December 2015

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Research
Towards a simple typology of international health partnerships
International health partnerships are one approach to capacity building in health systems. The evidence base for institutional partnerships for health service development remains weak…
Suzanne Edwards, Dan Ritman, Emily Burn, Natascha Dekkers and Paula Baraitser
Globalization and Health 2015 11:49
Published on: 15 December 2015

International Journal of Sustainable Development & World Ecology
Volume 23, Issue 1, 2016
http://www.tandfonline.com/toc/tsdw20/current#.VSj2SpMw1hX

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Original Articles
Revisiting the national corporate social responsibility index
DOI:10.1080/13504509.2015.1099121
Antonis Skouloudisa*, David Isaacb & Kostis Evaggelinosc
pages 61-70
Abstract
This paper relies on Gjølberg’s national corporate social responsibility (CSR) index while its purpose is twofold. First, it seeks to extend the methodological instrument for assessing national CSR and, second, it applies the new approach to a much larger pool of countries (n = 86) in an attempt to provide a global CSR outlook. The emergent picture from the study is one of deficient CSR penetration and wide variation among countries where most of the assessed countries are still lagging in the endorsement of international CSR initiatives and schemes. Findings offer fertile ground to theorists and researchers for a deeper investigation of the national specificity of CSR and to further identify institutional determinants that shape the social responsiveness and self-regulation of business entities. The study has also implications for managers and top executives to consider as it infers that the national background can be influential in the development of a CSR agenda and can condition the level of CSR penetration.

International Migration Review
Winter 2015 Volume 49, Issue 4 Pages 843–1070, e33–e48
http://onlinelibrary.wiley.com/doi/10.1111/imre.2015.49.issue-3/issuetoc

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MIGRATION AND HEALTH
How Migrant Status Affects Health Beyond Socioeconomic Status: Evidence from Austria (pages 843–877)
Sascha Sardadvar
Article first published online: 2 SEP 2014 | DOI: 10.1111/imre.12108

Explaining the Mexican-American Health Paradox Using Selectivity Effects (pages 878–906)
Jose N. Martinez, Ernesto Aguayo-Tellez and Erick Rangel-Gonzalez
Article first published online: 11 NOV 2014 | DOI: 10.1111/imre.12112

The Decade of Immigrant Dispersion and Growth: A Cohort Analysis of Children of Immigrants’ Educational Experiences 1990–2002 (pages 1001–1041)
Stephanie Potochnick and Margarita Mooney
Article first published online: 2 SEP 2014 | DOI: 10.1111/imre.12111

Journal of Humanitarian Logistics and Supply Chain Management
Volume 5 Issue 3 2015
http://www.emeraldinsight.com/toc/jhlscm/5/3

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Borrowing theories in humanitarian supply chain management
Tunca Tabaklar , Árni Halldórsson , Gyöngyi Kovács , Karen Spens (pp. 281 – 299)

Measuring humanitarian supply chain performance in a multi-goal context
Ira Haavisto , Jarrod Goentzel (pp. 300 – 324)

Hybrid simulation modeling for humanitarian relief chain coordination
Caroline C Krejci (pp. 325 – 347)

How standards and modularity can improve humanitarian supply chain responsiveness: The case of emergency response units
Marianne Jahre , Nathalie Fabbe-Costes (pp. 348 – 386)

Centralized vehicle leasing in humanitarian fleet management: the UNHCR case
Nathan Kunz , Luk N. Van Wassenhove , Rob McConnell , Ketil Hov (pp. 387 – 404)

The Lancet
Dec 19, 2015 Volume 386 Number 10012 p2445-2540 e61
http://www.thelancet.com/journals/lancet/issue/current

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Editorial
Health security: the defining challenge of 2016
The Lancet
Summary
This end-of-year double issue of The Lancet is a moment to pause, reflect on the passing year, and consider how the journey through 2015, with its planned milestones and unforeseen global events, might shape the path ahead in 2016. This Year in Medicine crystallises the key moments of 2015: a year that continued to be dominated by the Ebola outbreak; adoption by nations of 17 Sustainable Development Goals, setting the health agenda for the next 15 years; and appalling acts of war and terrorism, which have seen murderous violence in, for example, Syria, Paris, and California.

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Editorial
Time to eliminate rabies
The Lancet
Summary
On Dec 10, WHO and the World Organisation for Animal Health, in collaboration with the UN Food and Agriculture Organization and the Global Alliance for the Control of Rabies, launched a global framework to eliminate rabies by 2030. This initiative marks the first time that the human and animal health sectors have come together to adopt a common strategy to tackle this devastating, but massively neglected, disease.

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This Year in Medicine
2015: review of the year
Farhat Yaqub
The year, progress was made for Ebola virus disease, genetic disorders, and the health of the planet and its population, with two new global agendas agreed. Farhat Yaqub reports

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Viewpoint
The medical response to multisite terrorist attacks in Paris
Martin Hirsch, Pierre Carli, Rémy Nizard, Bruno Riou, Barouyr Baroudjian, Thierry Baubet, Vibol Chhor, Charlotte Chollet-Xemard, Nicolas Dantchev, Nadia Fleury, Jean-Paul Fontaine, Youri Yordanov, Maurice Raphael, Catherine Paugam Burtz, Antoine Lafont, health professionals of Assistance Publique-Hôpitaux de Paris (APHP)

Medical Decision Making (MDM)
January 2016; 36 (1)
http://mdm.sagepub.com/content/current

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Mind the Gap! A Multilevel Analysis of Factors Related to Variation in Published Cost-Effectiveness Estimates within and between Countries
Christian E. H. Boehler, PhD, Joanne Lord, PhD
Institute for Prospective Technological Studies, Joint Research Centre–European Commission, Seville, Spain (CEHB)
Health Economics Research Group, Brunel University, Uxbridge, UK (JL)
Abstract
Background. Published cost-effectiveness estimates can vary considerably, both within and between countries. Despite extensive discussion, little is known empirically about factors relating to these variations.
Objectives. To use multilevel statistical modeling to integrate cost-effectiveness estimates from published economic evaluations to investigate potential causes of variation.
Methods. Cost-effectiveness studies of statins for cardiovascular disease prevention were identified by systematic review. Estimates of incremental costs and effects were extracted from reported base case, sensitivity, and subgroup analyses, with estimates grouped in studies and in countries. Three bivariate models were developed: a cross-classified model to accommodate data from multinational studies, a hierarchical model with multinational data allocated to a single category at country level, and a hierarchical model excluding multinational data. Covariates at different levels were drawn from a long list of factors suggested in the literature.
Results. We found 67 studies reporting 2094 cost-effectiveness estimates relating to 23 countries (6 studies reporting for more than 1 country). Data and study-level covariates included patient characteristics, intervention and comparator cost, and some study methods (e.g., discount rates and time horizon). After adjusting for these factors, the proportion of variation attributable to countries was negligible in the cross-classified model but moderate in the hierarchical models (14%−19% of total variance). Country-level variables that improved the fit of the hierarchical models included measures of income and health care finance, health care resources, and population risks.
Conclusions. Our analysis suggested that variability in published cost-effectiveness estimates is related more to differences in study methods than to differences in national context. Multinational studies were associated with much lower country-level variation than single-country studies. These findings are for a single clinical question and may be atypical.

Nature
Volume 528 Number 7582 pp307-430 17 December 2015
http://www.nature.com/nature/current_issue.html

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Review
Rarity in mass extinctions and the future of ecosystems
Pincelli M. Hull, Simon A. F. Darroch & Douglas H. Erwin
The fossil record provides a nuanced view of ecosystem collapse over intervals of mass extinction, with abundant, biomineralizing and widespread species preferentially preserved; here the authors collate evidence for ‘mass rarity’ during these intervals, and suggest that the increasing rarity of modern species, rather than their outright extinction, may be a better metric for comparing the current biodiversity crisis to the ‘Big Five’ mass extinctions in the Earth’s history.

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 19 December 2015)

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Review
Earth Observation, Spatial Data Quality, and Neglected Tropical Diseases
Nicholas A. S. Hamm, Ricardo J. Soares Magalhães, Archie C. A. Clements
Published: December 17, 2015
DOI: 10.1371/journal.pntd.0004164
Abstract
Earth observation (EO) is the use of remote sensing and in situ observations to gather data on the environment. It finds increasing application in the study of environmentally modulated neglected tropical diseases (NTDs). Obtaining and assuring the quality of the relevant spatially and temporally indexed EO data remain challenges. Our objective was to review the Earth observation products currently used in studies of NTD epidemiology and to discuss fundamental issues relating to spatial data quality (SDQ), which limit the utilization of EO and pose challenges for its more effective use. We searched Web of Science and PubMed for studies related to EO and echinococossis, leptospirosis, schistosomiasis, and soil-transmitted helminth infections. Relevant literature was also identified from the bibliographies of those papers. We found that extensive use is made of EO products in the study of NTD epidemiology; however, the quality of these products is usually given little explicit attention. We review key issues in SDQ concerning spatial and temporal scale, uncertainty, and the documentation and use of quality information. We give examples of how these issues may interact with uncertainty in NTD data to affect the output of an epidemiological analysis. We conclude that researchers should give careful attention to SDQ when designing NTD spatial-epidemiological studies. This should be used to inform uncertainty analysis in the epidemiological study. SDQ should be documented and made available to other researchers.

PLoS One
http://www.plosone.org/
[Accessed 19 December 2015]

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Research Article
Global Update and Trends of Hidden Hunger, 1995-2011: The Hidden Hunger Index
Julie C. Ruel-Bergeron, Gretchen A. Stevens, Jonathan D. Sugimoto, Franz F. Roos, Majid Ezzati,
Robert E. Black, Klaus Kraemer
Published: December 16, 2015
DOI: 10.1371/journal.pone.0143497
Abstract
Background
Deficiencies in essential vitamins and minerals–also termed hidden hunger–are pervasive and hold negative consequences for the cognitive and physical development of children.
Methods
This analysis evaluates the change in hidden hunger over time in the form of one composite indicator–the Hidden Hunger Index (HHI)–using an unweighted average of prevalence estimates from the Nutrition Impact Model Study for anemia due to iron deficiency, vitamin A deficiency, and stunting (used as a proxy indicator for zinc deficiency). Net changes from 1995–2011 and population weighted regional means for various time periods are measured.
Findings
Globally, hidden hunger improved (-6.7 net change in HHI) from 1995–2011. Africa was the only region to see a deterioration in hidden hunger (+1.9) over the studied time period; East Asia and the Pacific performed exceptionally well (-13.0), while other regions improved only slightly. Improvements in HHI were mostly due to reductions in zinc and vitamin A deficiencies, while anemia due to iron deficiency persisted and even increased.
Interpretation
This analysis is critical for informing and tracking the impact of policy and programmatic efforts to reduce micronutrient deficiencies, to advance the global nutrition agenda, and to achieve the Millennium Development Goals (MDGs). However, there remains an unmet need to invest in gathering frequent, nationally representative, high-quality micronutrient data as we renew our efforts to scale up nutrition, and as we enter the post-2015 development agenda.
Funding
Preparation of this manuscript was funded by Sight and Life. There was no funding involved in the study design, data collection, analysis, or decision to publish.

PNAS – Proceedings of the National Academy of Sciences of the United States
of America
http://www.pnas.org/content/early/
(Accessed 19 December 2015)

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Changing recruitment capacity in global fish stocks
Gregory L. Brittena,b,1, Michael Dowdc, and Boris Worma
Author Affiliations
Significance
Marine fish stocks play an important role in marine ecosystems and provide a source of protein for billions of people worldwide. Recent environmental changes have affected the distribution of many stocks, but it is yet unclear whether their productivity is affected as well. We show that recruitment capacity (the ability of stocks to produce surviving offspring) has been significantly altered by both environmental changes and biological changes brought about by overfishing. In total, these effects have reduced recruitment capacity by 3% of the historical maximum per decade, on average. This paper helps us to understand and track previously unrecognized changes in fish stock productivity during the early stages of their life cycle.
Abstract
Marine fish and invertebrates are shifting their regional and global distributions in response to climate change, but it is unclear whether their productivity is being affected as well. Here we tested for time-varying trends in biological productivity parameters across 262 fish stocks of 127 species in 39 large marine ecosystems and high-seas areas (hereafter LMEs). This global meta-analysis revealed widespread changes in the relationship between spawning stock size and the production of juvenile offspring (recruitment), suggesting fundamental biological change in fish stock productivity at early life stages. Across regions, we estimate that average recruitment capacity has declined at a rate approximately equal to 3% of the historical maximum per decade. However, we observed large variability among stocks and regions; for example, highly negative trends in the North Atlantic contrast with more neutral patterns in the North Pacific. The extent of biological change in each LME was significantly related to observed changes in phytoplankton chlorophyll concentration and the intensity of historical overfishing in that ecosystem. We conclude that both environmental changes and chronic overfishing have already affected the productive capacity of many stocks at the recruitment stage of the life cycle. These results provide a baseline for ecosystem-based fisheries management and may help adjust expectations for future food production from the oceans.

Science
18 December 2015 vol 350, issue 6267, pages 1437-1580
http://www.sciencemag.org/current.dtl

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Policy Forum
Science Governance
A more systematic approach to biological risk
Megan J. Palmer1, Francis Fukuyama2,3, David A. Relman1,3,4,*
Author Affiliations
1Center for International Security and Cooperation, Stanford University, Stanford, CA, USA.
2Center on Democracy, Development, and the Rule of Law, and Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA.
3Department of Microbiology and Immunology, Stanford University, Stanford, CA, USA.
4Department of Medicine, Stanford University, Stanford, CA, USA.

Management of emerging risks in life science and technology requires new leadership and a sober assessment of the legacy of Asilomar

Social Science & Medicine
Volume 146, Pages 1-348 (December 2015)
http://www.sciencedirect.com/science/journal/02779536/146
Special issue section Violence, Health and South-North Collaboration: Furthering an Interdisciplinary Agenda

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Children’s exposure to community and war violence and mental health in four African countries
Original Research Article
Pages 292-299
Holly Foster, Jeanne Brooks-Gunn
Abstract
In this article we review the mental health consequences of children’s exposure to community and war violence (ETV) in four African countries: South Africa, Sierra Leone, Gambia and Rwanda. A focus on Africa is particularly pressing because of children’s high levels of community and war ETV in countries therein. Regions of Africa present important macro-contexts for understanding children’s various types of violence exposure amidst war and economic disadvantage. Findings of the review across 20 quantitative studies from 2004 to 2015 indicate consistent associations between exposure to war and community violence and children’s symptoms of Post-traumatic Stress disorder (PTSD), depression, and aggression. School climate and family support mitigate these ETV influences upon children: however, more research is needed on the buffering effects of such resources. The effects of war violence are mediated by perceived discrimination in communities post-conflict. We integrate findings across studies to synthesize knowledge on children’s ETV in Africa around a model of its correlates, mediators, and moderators in relation to mental health. Emerging research points to avenues for prevention and future inquiry.

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Stock-outs, uncertainty and improvisation in access to healthcare in war-torn Northern Uganda
Original Research Article
Pages 316-323
Herbert Muyinda, James Mugisha
Abstract
Stock-outs, also known as shortages or complete absence of a particular inventory, in public health facilities have become a hallmark in Uganda’s health system making the notions of persistent doubt in access to healthcare – uncertainty, and doing more with less – ‘improvisation’, very pronounced. The situation becomes more critical in post-conflict areas with an over whelming burden of preexisting and conflict-related ailments amidst weak health systems. Particularly in the war-torn Northern Uganda, the intersection between the effects of violent conflict and shortage of medications is striking. There are problems getting the right type of medications to the right people at the right time, causing persistent shortages and uncertainty in access to healthcare. With reference to patients on Antiretroviral Therapy (ART), we present temporal trends in access to healthcare in the context of medication shortages in conflict-affected areas. We examine uncertainties in access to care, and how patients, medical practitioners, and the state – the key actors in the domain of supplying and utilizing medicines, respond. Our observation is that, while improvisation is a feature of biomedicine and facilitates problem solving in daily life, it is largely contextual. Given the rapidly evolving contexts and social and professional sensitivities that characterize war affected areas, there is a need for deliberate healthcare programs tailored to the unique needs of people and to the shaping of appropriate policies in post-conflict settings, which call for more North-South collaboration on equal terms.

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Preventing gender-based violence engendered by conflict: The case of Côte d’Ivoire
Original Research Article
Pages 341-347
Morkeh Blay-Tofey, Bandy X. Lee
Abstract
Despite a growing awareness of the increased prevalence of intimate partner violence and sexual violence in conflict and post-conflict settings, much less is known about the dynamics, as well as the interventions that would be effective at individual, relational, and structural levels. In addition to the human capital lost by conflict violence, gender-based violence (GBV) poses a grave threat to the post-conflict rehabilitation process. With regard to violence that occurs during and post conflict, research must take into consideration the different types of violence that share similar causes as the larger conflict as well as become widespread as a result of the conflict and use existing frameworks to build future interventions. Researchers are trying to understand the interplay of personal, situational, and socio-cultural factors in conflict settings that combine to cause GBV and lead to guidelines for program planning to address the health and social needs of survivors as well as to prevent further GBV. These actions result from a growing recognition that violence represents a serious public health problem, is an important cause of many physical and psychological illnesses, and can cause social disruptions that impede reconstruction efforts for generations. This review studies the manifestations of GBV during and following the Ivoirian Civil War, juxtaposes them against narratives, as well as lists relevant interventions at the individual, relational, community, and institutional levels. Part of a growing literature that aims to better understand the nature of violence during and after conflict and to plan effective responses to it, this study hopes to suggest solutions for the situation of Côte d’Ivoire and elsewhere.

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‘He always thinks he is nothing’: The psychosocial impact of discrimination on adolescent refugees in urban Uganda
Original Research Article
Pages 173-181
Lindsay Stark, Willyanne DeCormier Plosky, Rebecca Horn, Mark Canavera
Abstract
Armed conflict causes massive displacement, erodes the social fabric of communities, and threatens the healthy development of a nation’s future – its youth. Although more than half of the world’s registered refugees under the age of eighteen currently reside in urban areas, research on the unique needs of and realities experienced by this population remain limited. In Uganda, as in many refugee-receiving countries, most regulated refugee protections and entitlements fail to extend beyond the confines of official settlements or camps. This dearth of support, in combination with few material resources, uncertain local connections, and little knowledge of the language, leaves refugee families vulnerable to the added burden of an unwelcome reception in cities. Drawing on qualitative data from a study conducted in March and April 2013 with Congolese and Somali adolescents, caregivers, and service providers in refugee settlements in Kampala, this manuscript explores the pervasive nature of discrimination against urban refugees and its effects upon adolescent well-being. Findings suggest that discrimination not only negatively impacts acculturation as youth pursue social recognition in the classroom and among neighborhood peers, but it also impedes help-seeking behavior by caregivers and restricts their ability to ameliorate protection concerns, thereby lowering adolescents’ psychosocial well-being. Youth reported low self-worth, withdrawal from school, and an adverse turn toward street connections. Targeted and innovative strategies along with reformed policies that address the unique challenges facing urban refugees are paramount to ensuring that young people in this population experience greater protection, well-being, and future success.

Tropical Medicine and Health
Vol. 43(2015) No. 4
https://www.jstage.jst.go.jp/browse/tmh/43/0/_contents

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Original Papers
Occupational Stress among Textile Workers in the Democratic Republic of Congo
Panda Lukongo Kitronza, Philippe Mairiaux
Released: December 12, 2015
[Advance Publication] Released: August 20, 2015

Field Reports
“Ten Minimum Requirement”: A Management Tool to Improve Quality of Healthcare Services in Lao People Democratic Republic (Lao PDR)
Koji Wada, Sommana Rattana, Chanphomma Vongsamphanh
Released: December 12, 2015
[Advance Publication] Released: October 03, 2015]

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
__________________________________________________
Week ending 12 December 2015

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Editor &
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pdf version: The Sentinel_ week ending 12 December 2015

blog edition: comprised of the 35+ entries  posted below on 15 December 2015