David and Lucile Packard Foundation [to 16 January 2016]
http://www.packard.org/news/
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Packard Foundation Names Dr. Stephen H. Lockhart to its Board of Trustees
January 11, 2016
The David and Lucile Packard Foundation is pleased to announce that Dr. Stephen H. Lockhart, M.D., PhD., has joined its Board of Trustees. Dr. Lockhart is Chief Medical Officer for Sutter Health, a not for profit system of hospitals, physician organizations and research institutions in Northern California…
Pew Charitable Trusts [to 16 January 2016]
http://www.pewtrusts.org/en/about/news-room/press-releases
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Press Release
Pew Analysis Shows Access to Workplace Retirement Plans Varies Widely Across States
January 13, 2016
WASHINGTON—Wide differences in access to and participation in employer-based retirement plans exist across states, with variations by employer size and industry type as well as by workers’ income, age, education, race and ethnicity, according to a report released today by The Pew Charitable Trusts…
Report link: Who’s In, Who’s Out: A Look at Access to Employer-Based Retirement Plans and Participation in the States
Rockefeller Foundation [to 16 January 2016]
http://www.rockefellerfoundation.org/newsroom
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Encourage Capital Releases Report on Investment Strategies for Sustainable Fisheries in Brazil, Chile and The Philippines
Supported by Bloomberg Philanthropies and The Rockefeller Foundation
January 14, 2016 NEW YORK – Each year, more than $50 billion of economic value is lost due to poor fisheries management, depleting the oceans and affecting global seafood production. Today, Encourage Capital released the second installment of its comprehensive investment report, analyzing how investors can deploy capital in efforts to protect and restore global fisheries.
The report, “Investing for Sustainable Global Fisheries,” delivers a series of six blueprints about investments in fisheries in Brazil, Chile and the Philippines, which account for 7% of the global fish supply. The strategies are based on real-life examples and are available free of charge at investinvibrantoceans.org.
“More than 1 billion people globally rely on seafood as their primary source of protein, but 40% of fisheries are considered to be overexploited or collapsed,” said Jason Scott, Co-Managing Partner at Encourage Capital. “Encourage Capital’s Investment Blueprints demonstrate that there are ways to earn real profits through sustainable seafood investing strategies that improve seafood yield, enhance supply chain efficiency, and reduce supply volatility.”..
Report [42 pages]: http://encouragecapital.com/wp-content/uploads/2016/01/Executive_Summary_FINAL_1-11-16.pdf
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Millennial Trains Project Offers Platform for Millennial Innovators to Explore New Frontiers with Support from The Rockefeller Foundation
January 11, 2016 NEW YORK—Today, the Millennial Trains Project announced that The Rockefeller Foundation is coming on board as a major supporter of its August 2016 trans-continental train journeys for young innovators, which will support the development of next-generation, entrepreneurial leaders who share the Foundation’s desire to improve resilience and inclusivity in communities across America….
Robert Wood Johnson Foundation [to 16 January 2016]
http://www.rwjf.org/en/about-rwjf/newsroom/news-releases.html
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Warning Labels on Sweetened Drinks Deter Consumption
Thu Jan 14 2016
Health warning labels may increase parents’ understanding that sugar-sweetened beverages increase their child’s risk of weight gain, heart disease, and diabetes—and motivate them to buy fewer sugary drinks.
Wellcome Trust [to 16 January 2016]
http://www.wellcome.ac.uk/News/2016/index.htm
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Tribute to award-winning scientist Professor Glyn Humphreys
The news of the sudden death yesterday of Professor Glyn Humphreys, Watts Chair of Experimental Psychology at the University of Oxford, has saddened many friends and colleagues at the Wellcome Trust.
15 January 2016.
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Alternatives to antibiotics not a short-term solution to drug-resistant infections
A handful of alternatives to antibiotics – such as treatments and preventative measures based on live microorganisms or ‘probiotics’ – have the potential to combat bacterial infections in the next decade, but they are unlikely to replace traditional antibiotics.
13 January 2016
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£3bn a year needed to prepare the world for future pandemics
An investment of less than 50p per year for every person on the planet (£3bn/$4.5bn total) would make the world significantly more resilient to the threat of infectious disease, according to a group of international experts convened in the wake of the Ebola crisis.
13 January 2016
BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 16 January 2016)
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Research article
Perspectives and experiences of new migrants on health screening in Sweden
In Sweden, migrants from countries considered to have a high burden of certain infectious diseases are offered health screening to prevent the spread of these diseases, but also identify their health needs.
Faustine Kyungu Nkulu Kalengayi, Anna-Karin Hurtig, Annika Nordstrand, Clas Ahlm and Beth Maina Ahlberg
BMC Health Services Research 2016 16:14
Published on: 15 January 2016
BMC Medical Ethics
http://www.biomedcentral.com/bmcmedethics/content
(Accessed 16 January 2016)
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Research article
“Decision-making capacity for research participation among addicted people: a cross-sectional study”
Informed consent is a key element of ethical clinical research. Addicted population may be at risk for impaired consent capacity. However, very little research has focused on their comprehension of consent for…
Inés Morán-Sánchez, Aurelio Luna, Maria Sánchez-Muñoz, Beatriz Aguilera-Alcaraz and Maria D. Pérez-Cárceles
BMC Medical Ethics 2016 17:3
Published on: 13 January 2016
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Debate
Developing a new justification for assent
Amanda Sibley, Andrew J. Pollard, Raymond Fitzpatrick and Mark Sheehan
BMC Medical Ethics 2016 17:2
Published on: 12 January 2016
Abstract
Background
Current guidelines do not clearly outline when assent should be attained from paediatric research participants, nor do they detail the necessary elements of the assent process. This stems from the fact that the fundamental justification behind the concept of assent is misunderstood. In this paper, we critically assess three widespread ethical arguments used for assent: children’s rights, the best interests of the child, and respect for a child’s developing autonomy. We then outline a newly-developed two-fold justification for the assent process: respect for the parent’s pedagogical role in teaching their child to become an autonomous being and respect for the child’s moral worth.
Discussion
We argue that the ethical grounding for the involvement of young children in medical decision-making does not stem from children’s rights, the principle of best interests, or respect for developing autonomy. An alternative strategy is to examine the original motivation to engage with the child. In paediatric settings there are two obligations on the researcher: an obligation to the parents who are responsible for determining when and under what circumstances the child develops his capacity for autonomy and reasoning, and an obligation to the child himself. There is an important distinction between respecting a decision and encouraging a decision. This paper illustrates that the process of assent is an important way in which respect for the child as an individual can be demonstrated, however, the value lies not in the child’s response but the fact that his views were solicited in the first place.
Summary
This paper demonstrates that the common justifications for the process of assent are incomplete. Assent should be understood as playing a pedagogical role for the child, helping to teach him how specific decisions are made and therefore helping him to become a better decision-maker. How the researcher engages with the child supports his obligation to the child’s parents, yet why the researcher engages with the child stems from the child’s moral worth. Treating a child as having moral worth need not mean doing what they say but it may mean listening, considering, engaging or involving them in the decision.
BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 16 January 2016)
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Research article
Sociocultural determinants of anticipated oral cholera vaccine acceptance in three African settings: a meta-analytic approach
Neisha Sundaram, Christian Schaetti, Sonja Merten, Christian Schindler, Said M. Ali, Erick O. Nyambedha, Bruno Lapika, Claire-Lise Chaignat, Raymond Hutubessy and Mitchell G. Weiss
BMC Public Health 2016 16:36
Published on: 14 January 2016
Abstract
Background
Controlling cholera remains a significant challenge in Sub-Saharan Africa. In areas where access to safe water and sanitation are limited, oral cholera vaccine (OCV) can save lives. Establishment of a global stockpile for OCV reflects increasing priority for use of cholera vaccines in endemic settings. Community acceptance of vaccines, however, is critical and sociocultural features of acceptance require attention for effective implementation. This study identifies and compares sociocultural determinants of anticipated OCV acceptance across populations in Southeastern Democratic Republic of Congo, Western Kenya and Zanzibar.
Methods
Cross-sectional studies were conducted using similar but locally-adapted semistructured interviews among 1095 respondents in three African settings. Logistic regression models identified sociocultural determinants of OCV acceptance from these studies in endemic areas of Southeastern Democratic Republic of Congo (SE-DRC), Western Kenya (W-Kenya) and Zanzibar. Meta-analytic techniques highlighted common and distinctive determinants in the three settings.
Results
Anticipated OCV acceptance was high in all settings. More than 93 % of community respondents overall indicated interest in a no-cost vaccine. Higher anticipated acceptance was observed in areas with less access to public health facilities. In all settings awareness of cholera prevention methods (safe food consumption and garbage disposal) and relating ingestion to cholera causation were associated with greater acceptance. Higher age, larger households, lack of education, social vulnerability and knowledge of oral rehydration solution for self-treatment were negatively associated with anticipated OCV acceptance. Setting-specific determinants of acceptance included reporting a reliable income (W-Kenya and Zanzibar, not SE-DRC). In SE-DRC, intention to purchase an OCV appeared unrelated to ability to pay. Rural residents were less likely than urban counterparts to accept an OCV in W-Kenya, but more likely in Zanzibar. Prayer as a form of self-treatment was associated with vaccine acceptance in SE-DRC and W-Kenya, but not in Zanzibar.
Conclusions
These cholera-endemic African communities are especially interested in no-cost OCVs. Health education and attention to local social and cultural features of cholera and vaccines would likely increase vaccine coverage. High demand and absence of insurmountable sociocultural barriers to vaccination with OCVs indicate potential for mass vaccination in planning for comprehensive control or elimination.
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Research article
Factors associated with incomplete childhood immunization in Arbegona district, southern Ethiopia: a case – control study
The prevention of child mortality through immunization is one of the most cost-effective and widely applied public health interventions. In Ethiopia, the Expanded Program on Immunization (EPI) schedule is rare…
Abel Negussie, Wondewosen Kassahun, Sahilu Assegid and Ada K. Hagan
BMC Public Health 2016 16:27
Published on: 12 January 2016
BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 16 January 2016)
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Research article
Low-tech, high impact: care for premature neonates in a district hospital in Burundi. A way forward to decrease neonatal mortality
Brigitte Ndelema, Rafael Van den Bergh, Marcel Manzi, Wilma van den Boogaard, Rose J. Kosgei, Isabel Zuniga, Manirampa Juvenal and Anthony Reid
BMC Research Notes 2016 9:28
Published on: 16 January 2016
Abstract
Background
Death among premature neonates contributes significantly to neonatal mortality which in turn represents approximately 40 % of paediatric mortality. Care for premature neonates is usually provided at the tertiary care level, and premature infants in rural areas often remain bereft of care. Here, we describe the characteristics and outcomes of premature neonates admitted to neonatal services in a district hospital in rural Burundi that also provided comprehensive emergency obstetric care. These services included a Neonatal Intensive Care Unit (NICU) and Kangaroo Mother Care (KMC) ward, and did not rely on high-tech interventions or specialist medical staff.
Methods
A retrospective descriptive study, using routine programme data of neonates (born at <32 weeks and 32–36 weeks of gestation), admitted to the NICU and/or KMC at Kabezi District Hospital.
Results
437 premature babies were admitted to the neonatal services; of these, 134 (31 %) were born at <32 weeks, and 236 (54 %) at 32–36 weeks. There were 67 (15 %) with an unknown gestational age but with a clinical diagnosis of prematurity. Survival rates at hospital discharge were 62 % for the <32 weeks and 87 % for the 32–36 weeks groups; compared to respectively 30 and 50 % in the literature on neonates in low- and middle-income countries. Cause of death was categorised, non-specifically, as “Conditions associated with prematurity/low birth weight” for 90 % of the <32 weeks and 40 % of the 32–36 weeks of gestation groups.
Conclusions
Our study shows for the first time that providing neonatal care for premature babies is feasible at a district level in a resource-limited setting in Africa. High survival rates were observed, even in the absence of high-tech equipment or specialist neonatal physician staff. We suggest that these results were achieved through staff training, standardised protocols, simple but essential equipment, provision of complementary NICU and KMC units, and integration of the neonatal services with emergency obstetric care. This approach has the potential to considerably reduce overall neonatal mortality.
Current Opinion in Infectious Diseases
February 2016 – Volume 29 – Issue 1 pp: v-vi,1-98
http://journals.lww.com/co-infectiousdiseases/pages/currenttoc.aspx
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SEXUALLY TRANSMITTED DISEASES
Sexually transmitted infections in children as a marker of child sexual abuse and direction of future research
Rogstad, Karen E.; Wilkinson, Dawn; Robinson, Angela
Abstract
Purpose of review: This review considers recent evidence on sexually transmitted infections (STIs) as a marker of child sexual abuse (CSA), when diagnosed after the neonatal period. It also aims to identify if there are specific areas where additional research is required.
Recent findings: An evidence-based systematic review using strict inclusion criteria shows that CSA is a major cause of STIs in children. In children 12 years and below, 36–83% of Neisseria gonorrhoeae and 75–94% of Chlamydia trachomatis infections are due to CSA; for children 14 years and younger, 31–58% of anogenital warts are due to CSA. In child genital sampling, genital human papillomavirus (HPV) types were more common in those considered abused (13.7%) than nonabused (1.3%). HPV typing of genital warts in children were all of genital type 6. Subsequent research, into N. gonorrhoeae, C. trachomatis, Trichomonas vaginalis and syphilis in children including ophthalmic infection, found that 13 of 15 cases were confirmed/likely due to CSA. Recent data indicate that bacterial vaginosis and Mycoplasma genitalium are related to sexual activity in adults but did not assess children.
Summary: STIs in children under 13–14 years may indicate CSA. Genital HPV types are associated with CSA. Research is required of sufficient standard to contribute to the evidence base.
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Surveillance systems for sexually transmitted infections: a global review
Mohammed, Hamish; Hughes, Gwenda; Fenton, Kevin A.
Abstract
Purpose of review: Sexually transmitted infections (STIs) continue to exert a substantial public health burden globally but surveillance remains a challenge, especially in the developing world. We reviewed STI surveillance systems in various regions globally and used available data to provide an overview of recent trends in STI epidemiology.
Recent findings: STI surveillance systems in the developing world are often limited and restricted to ad hoc cross-sectional surveys; however, available data suggest that these areas are disproportionately affected by STIs, with a higher burden in marginalized groups such as sex workers. Developed countries typically have established surveillance systems. Recent reports suggest many of these countries are experiencing rising diagnoses of STIs in men who have sex with men (MSM) and an increasing contribution of HIV-positive MSM to STI epidemics.
Summary: There is considerable variability in the surveillance for STIs globally, ranging from active or passive, to sentinel, laboratory or clinic-based systems. Given different levels of resources and patterns of healthcare provision, it is difficult to compare surveillance data across regions; however, available data suggest that considerable inequality in STI burden exists. In resource-limited settings, syndromic surveillance with periodic laboratory assessments is recommended to monitor trends in STIs.
Eurosurveillance
Volume 21, Issue 2, 14 January 2016
http://www.eurosurveillance.org/Public/Articles/Archives.aspx?PublicationId=11678
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Rapid Communications
Zika virus infection in a traveller returning from the Maldives, June 2015
by E Korhonen, E Huhtamo, T Smura, H Kallio-Kokko, M Raassina, O Vapalahti
Multidrug-resistant bacteria in unaccompanied refugee minors arriving in Frankfurt am Main, Germany, October to November 2015
by U Heudorf, B Krackhardt, M Karathana, N Kleinkauf, C Zinn
Multidrug-resistant organisms detected in refugee patients admitted to a University Hospital, Germany June-December 2015
by C Reinheimer, V Kempf, S Göttig, M Hogardt, T Wichelhaus, F O’Rourke, C Brandt
Respiratory diphtheria in an asylum seeker from Afghanistan arriving to Finland via Sweden, December 2015
by J Sane, T Sorvari, M Wideström, H Kauma, U Kaukoniemi, E Tarkka, T Puumalainen, M Kuusi, M Salminen, O Lyytikäinen
Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 16 January 2016]
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Research
The development of ORACLe: a measure of an organisation’s capacity to engage in evidence-informed health policy
Steve R Makkar, Tari Turner, Anna Williamson, Jordan Louviere, Sally Redman, Abby Haynes, Sally Green, Sue Brennan Health Research Policy and Systems 2016, 14:4 (14 January 2016)
Abstract
Background
Evidence-informed policymaking is more likely if organisations have cultures that promote research use and invest in resources that facilitate staff engagement with research. Measures of organisations’ research use culture and capacity are needed to assess current capacity, identify opportunities for improvement, and examine the impact of capacity-building interventions. The aim of the current study was to develop a comprehensive system to measure and score organisations’ capacity to engage with and use research in policymaking, which we entitled ORACLe (Organisational Research Access, Culture, and Leadership).
Method
We used a multifaceted approach to develop ORACLe. Firstly, we reviewed the available literature to identify key domains of organisational tools and systems that may facilitate research use by staff. We interviewed senior health policymakers to verify the relevance and applicability of these domains. This information was used to generate an interview schedule that focused on seven key domains of organisational capacity. The interview was pilot-tested within four Australian policy agencies. A discrete choice experiment (DCE) was then undertaken using an expert sample to establish the relative importance of these domains. This data was used to produce a scoring system for ORACLe.
Results
The ORACLe interview was developed, comprised of 23 questions addressing seven domains of organisational capacity and tools that support research use, including (1) documented processes for policymaking; (2) leadership training; (3) staff training; (4) research resources (e.g. database access); and systems to (5) generate new research, (6) undertake evaluations, and (7) strengthen relationships with researchers. From the DCE data, a conditional logit model was estimated to calculate total scores that took into account the relative importance of the seven domains. The model indicated that our expert sample placed the greatest importance on domains (2), (3) and (4).
Conclusion
We utilised qualitative and quantitative methods to develop a system to assess and score organisations’ capacity to engage with and apply research to policy. Our measure assesses a broad range of capacity domains and identifies the relative importance of these capacities. ORACLe data can be used by organisations keen to increase their use of evidence to identify areas for further development.
International Journal of Infectious Diseases
January 2016 Volume 42, p1-74
http://www.ijidonline.com/issue/S1201-9712%2815%29X0012-9
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Editorial
Why is Pakistan a threat to “The Polio Eradication and Endgame Strategic Plan 2013–2018”? A look into the past decade
Tariq Khan, Bilal Haider Abbasi, Mubarak Ali Khan, Akhtar Nadhman
p4–6
Published online: November 16 2015
Abstract
The fight against endemic polio transmission is restricted to three countries: Pakistan, Afghanistan, and Nigeria. In 2012, when the world saw the lowest numbers of cases from polio-reporting countries, the World Health Organization (WHO) initiated a comprehensive strategy, “The Polio Eradication and Endgame Strategic Plan 2013–2018”.1 The plan (as it will be called from this point onwards) aims at: (1) wild polio virus (WPV) interruption by the end of 2014, (2) a strengthened immunization system and cessation of oral polio vaccine (OPV), (3) containment and certification, and (4) the quest for maintenance of a polio-free world by 2018.
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Perspective
Impacts of neglected tropical disease on incidence and progression of HIV/AIDS, tuberculosis, and malaria: scientific links
G.G. Simon
Management Sciences for Health, Arlington VA, USA
DOI: http://dx.doi.org/10.1016/j.ijid.2015.11.006
Highlights
:: The neglected tropical diseases (NTDs) share a high degree of geographic overlap with malaria and HIV.
:: Research suggests that NTDs can impact HIV, tuberculosis, and malaria disease progression.
:: Immunological, epidemiological, and social cofactors contribute to disease impact.
Summary
The neglected tropical diseases (NTDs) are the most common infections of humans in Sub-Saharan Africa. Virtually all of the population living below the World Bank poverty figure is affected by one or more NTDs. New evidence indicates a high degree of geographic overlap between the highest-prevalence NTDs (soil-transmitted helminths, schistosomiasis, onchocerciasis, lymphatic filariasis, and trachoma) and malaria and HIV, exhibiting a high degree of co-infection. Recent research suggests that NTDs can affect HIV and AIDS, tuberculosis (TB), and malaria disease progression. A combination of immunological, epidemiological, and clinical factors can contribute to these interactions and add to a worsening prognosis for people affected by HIV/AIDS, TB, and malaria. Together these results point to the impacts of the highest-prevalence NTDs on the health outcomes of malaria, HIV/AIDS, and TB and present new opportunities to design innovative public health interventions and strategies for these ‘big three’ diseases. This analysis describes the current findings of research and what research is still needed to strengthen the knowledge base of the impacts NTDs have on the big three.
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Reviews
Bridging the gap between evidence and policy for infectious diseases: How models can aid public health decision-making
Gwenan M. Knight, Nila J. Dharan, Gregory J. Fox, Natalie Stennis, Alice Zwerling, Renuka Khurana, David W. Dowdy
p17–23
Published online: November 3 2015
Highlights
:: Mathematical models are under-utilized in public health.
:: We discuss the current use of infectious disease modelling with a case study.
:: We lay out the methods and limitations of modelling infectious diseases.
:: We present a framework for improved interaction between public health and modellers.
:: This could lead to more transparent and evidence-driven policy decisions.
Summary
The dominant approach to decision-making in public health policy for infectious diseases relies heavily on expert opinion, which often applies empirical evidence to policy questions in a manner that is neither systematic nor transparent. Although systematic reviews are frequently commissioned to inform specific components of policy (such as efficacy), the same process is rarely applied to the full decision-making process. Mathematical models provide a mechanism through which empirical evidence can be methodically and transparently integrated to address such questions. However, such models are often considered difficult to interpret. In addition, models provide estimates that need to be iteratively re-evaluated as new data or considerations arise. Using the case study of a novel diagnostic for tuberculosis, a framework for improved collaboration between public health decision-makers and mathematical modellers that could lead to more transparent and evidence-driven policy decisions for infectious diseases in the future is proposed. The framework proposes that policymakers should establish long-term collaborations with modellers to address key questions, and that modellers should strive to provide clear explanations of the uncertainty of model structure and outputs. Doing so will improve the applicability of models and clarify their limitations when used to inform real-world public health policy decisions.
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Original Reports
Age and Ebola viral load correlate with mortality and survival time in 288 Ebola virus disease patients
Jin Li, Hui-Juan Duan, Hao-Yang Chen, Ying-Jie Ji, Xin Zhang, Yi-Hui Rong, Zhe Xu, Li-Jian Sun, Ji-Yuan Zhang, Li-Ming Liu, Bo Jin, Jian Zhang, Ning Du, Hai-Bin Su, Guang-Ju Teng, Yue Yuan, En-Qiang Qin, Hong-Jun Jia, Shu Wang, Tong-Sheng Guo, Ye Wang, Jin-Song Mu, Tao Yan, Zhi-Wei Li, Zheng Dong, Wei-Min Nie, Tian-Jun Jiang, Chen Li, Xu-Dong Gao, Dong Ji, Ying-Jie Zhuang, Lei Li, Li-Fu Wang, Wen-Gang Li, Xue-Zhang Duan, Yin-Ying Lu, Zhi-Qiang Sun, Alex B.J. Kanu, Sheku M. Koroma, Min Zhao, Jun-Sheng Ji, Fu-Sheng Wang
p34–39
Published online: October 30 2015
Journal of Medical Ethics
January 2016, Volume 42, Issue 1
http://jme.bmj.com/content/current
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Viewpoint
To research (or not) that is the question: ethical issues in research when medical care is disrupted by political action: a case study from Eldoret, Kenya
Darlene R House1,2, Irene Marete2,3, Eric M Meslin2,3,4
Author Affiliations
1Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
2Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
3Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya
4Center for Bioethics, Indiana University, Indianapolis, Indiana, USA
Correspondence to Dr Darlene R House, Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA; dhouse@iupui.edu
Abstract
While considerable attention has been focused on understanding the myriad of ethical analysis in international research in low and middle income countries, new issues always arise that have not been anticipated in guidelines or studied extensively. The disruption of medical care arising as a direct result of political actions, including strikes, postelection violence and related activities, is one such issue that leaves physician-researchers struggling to manage often conflicting professional responsibilities. This paper discusses the ethical conflicts that arise for physician-researchers, particularly when disruption threatens the completion of a study or completion is possible but at the expense of not addressing unmet medical needs of patients. We review three pragmatic strategies and the ethical issues arising from each: not starting research, stopping research that has already started, and continuing research already initiated. We argue that during episodes of medical care disruption, research that has been started can be continued only if the ethical standards imposed at the beginning of the study can continue to be met; however, studies that have been approved but not yet started should not begin until the disruption has ended and ethical standards can again be assured.
The Lancet
Jan 16, 2016 Volume 387 Number 10015 p199-310
http://www.thelancet.com/journals/lancet/issue/current
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Articles
Under-5 mortality in 2851 Chinese counties, 1996–2012: a subnational assessment of achieving MDG 4 goals in China
Yanping Wang, Xiaohong Li, Maigeng Zhou, Shusheng Luo, Juan Liang, Chelsea A Liddell, Matthew M Coates, Yanqiu Gao, Linhong Wang, Chunhua He, Chuyun Kang, Shiwei Liu, Li Dai, Austin E Schumacher, Maya S Fraser, Timothy M Wolock, Amanda Pain, Carly E Levitz, Lavanya Singh, Megan Coggeshall, Margaret Lind, Yichong Li, Qi Li, Kui Deng, Yi Mu, Changfei Deng, Ling Yi, Zheng Liu, Xia Ma, Hongtian Li, Dezhi Mu, Jun Zhu, Christopher J L Murray, Haidong Wang
Summary
Background
In the past two decades, the under-5 mortality rate in China has fallen substantially, but progress with regards to the Millennium Development Goal (MDG) 4 at the subnational level has not been quantified. We aimed to estimate under-5 mortality rates in mainland China for the years 1970 to 2012.
Methods
We estimated the under-5 mortality rate for 31 provinces in mainland China between 1970 and 2013 with data from censuses, surveys, surveillance sites, and disease surveillance points. We estimated under-5 mortality rates for 2851 counties in China from 1996 to 2012 with the reported child mortality numbers from the Annual Report System on Maternal and Child Health. We used a small area mortality estimation model, spatiotemporal smoothing, and Gaussian process regression to synthesise data and generate consistent provincial and county-level estimates. We compared progress at the county level with what was expected on the basis of income and educational attainment using an econometric model. We computed Gini coefficients to study the inequality of under-5 mortality rates across counties.
Findings
In 2012, the lowest provincial level under-5 mortality rate in China was about five per 1000 livebirths, lower than in Canada, New Zealand, and the USA. The highest provincial level under-5 mortality rate in China was higher than that of Bangladesh. 29 provinces achieved a decrease in under-5 mortality rates twice as fast as the MDG 4 target rate; only two provinces will not achieve MDG 4 by 2015. Although some counties in China have under-5 mortality rates similar to those in the most developed nations in 2012, some have similar rates to those recorded in Burkina Faso and Cameroon. Despite wide differences, the inter-county Gini coefficient has been decreasing. Improvement in maternal education and the economic boom have contributed to the fall in child mortality; more than 60% of the counties in China had rates of decline in under-5 mortality rates significantly faster than expected. Fast reduction in under-5 mortality rates have been recorded not only in the Han population, the dominant ethnic majority in China, but also in the minority populations. All top ten minority groups in terms of population sizes have experienced annual reductions in under-5 mortality rates faster than the MDG 4 target at 4·4%.
Interpretation
The reduction of under-5 mortality rates in China at the country, provincial, and county level is an extraordinary success story. Reductions of under-5 mortality rates faster than 8·8% (twice MDG 4 pace) are possible. Extremely rapid declines seem to be related to public policy in addition to socioeconomic progress. Lessons from successful counties should prove valuable for China to intensify efforts for those with unacceptably high under-5 mortality rates.
Funding
National “Twelfth Five-Year” Plan for Science and Technology Support, National Health and Family Planning Commission of The People’s Republic of China, Program for Changjiang Scholars and Innovative Research Team in University, the National Institute on Aging, and the Bill & Melinda Gates Foundation.
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Series
Antimicrobials: access and sustainable effectiveness
Exploring the evidence base for national and regional policy interventions to combat resistance
Osman A Dar, Rumina Hasan, Jørgen Schlundt, Stephan Harbarth, Grazia Caleo, Fazal K Dar, Jasper Littmann, Mark Rweyemamu, Emmeline J Buckley, Mohammed Shahid, Richard Kock, Henry Lishi Li, Haydar Giha, Mishal Khan, Anthony D So, Khalid M Bindayna, Anthony Kessel, Hanne Bak Pedersen, Govin Permanand, Alimuddin Zumla, John-Arne Røttingen, David L Heymann
Antimicrobials: access and sustainable effectiveness
International cooperation to improve access to and sustain effectiveness of antimicrobials
Christine Årdal, Kevin Outterson, Steven J Hoffman, Abdul Ghafur, Mike Sharland, Nisha Ranganathan, Richard Smith, Anna Zorzet, Jennifer Cohn, Didier Pittet, Nils Daulaire, Chantal Morel, Zain Rizvi, Manica Balasegaram, Osman A Dar, David L Heymann, Alison H Holmes, Luke S P Moore, Ramanan Laxminarayan, Marc Mendelson, John-Arne Røttingen
PLoS One
http://www.plosone.org/
[Accessed 16 January 2016]
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Spatiotemporal Evolution of Ebola Virus Disease at Sub-National Level during the 2014 West Africa Epidemic: Model Scrutiny and Data Meagreness
Eva Santermans, Emmanuel Robesyn, Tapiwa Ganyani, Bertrand Sudre, Christel Faes, Chantal Quinten, Wim Van Bortel, Tom Haber, Thomas Kovac, Frank Van Reeth, Marco Testa, Niel Hens, Diamantis Plachouras
Research Article | published 15 Jan 2016 | PLOS ONE
10.1371/journal.pone.0147172
This weekly digest is intended to aggregate and distill key content from a broad spectrum of practice domains and organization types including key agencies/IGOs, NGOs, governments, academic and research institutions, consortia and collaborations, foundations, and commercial organizations. We also monitor a spectrum of peer-reviewed journals and general media channels. The Sentinel’s geographic scope is global/regional but selected country-level content is included. We recognize that this spectrum/scope yields an indicative and not an exhaustive product. Comments and suggestions should be directed to:
David R. Curry
Editor &
Founding Managing Director
GE2P2 – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net
Press encounter with UN High Commissioner Filippo Grandi [Video: 20:24]
UNHCR: 7 Jan 2016 – Press encounter in Geneva with new UN High Commissioner Filippo Grandi.
[Editor’s Note: Informal and very useful reflections by the new UNHCR head just four days into his new role]
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Filippo Grandi takes helm as new UN High Commissioner for Refugees, speaks of focus on solutions
Press Releases, 4 January 2016
Filippo Grandi, a UN official who has worked in refugee and political affairs in the Middle East, Africa, and Asia, began his 5-year term as UN High Commissioner for Refugees on 1 January, succeeding António Guterres whose more than 10 years in office ended last week.
High Commissioner Grandi, who arrived at UNHCR’s headquarters office in Geneva earlier today, takes up the position at a time of unprecedented displacement challenges. Record numbers of people globally are forced to flee war and persecution, including more than one million refugees and migrants who crossed the Mediterranean to Europe during the past year. Other challenges include critical shortfalls in humanitarian funding, fewer voluntary returns than at any time in more than three decades, people staying in exile for longer periods of time and increased politicization of refugee issues in many countries.
“UNHCR is navigating extraordinarily difficult waters,” Grandi said. “The combination of multiple conflicts and resulting mass displacement, fresh challenges to asylum, the funding gap between humanitarian needs and resources, and growing xenophobia is very dangerous. The road ahead is a challenging one, but I hope that – working with governments, civil society, and other partners – we will make progress in ensuring international protection and improved living conditions for millions of refugees, internally displaced and stateless people. I also hope that solutions to crises of displacement will be pursued with renewed determination by addressing their root causes and investing adequate political and material resources. UNHCR, whose mandate includes the search for solutions, stands ready to work with all those pursuing this goal.”
Mr. Grandi (58), who is from Italy, has worked in international affairs for over 30 years, 27 of them with the United Nations. Formerly head of the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), he worked prior to that for the UN Assistance Mission in Afghanistan (UNAMA) as Deputy Special Representative, following a long career with UNHCR in Africa, Asia, the Middle East and at the organization’s Geneva headquarters.
UNHCR works worldwide to protect, assist and find solutions for refugees, internally displaced people and stateless populations. It has some 9,700 staff across 126 countries, many of them working in humanitarian emergencies and in close proximity to regions of conflict. In June 2015 it reported that worldwide forced displacement had reached a new post-World War II high of 59.5 million people. Displacement levels have continued to rise since, most visibly with the situation of more than one million refugees and migrants who have crossed the Mediterranean to Europe during 2015.
Briefing on the Humanitarian Consequences of El Niño and the Need for Urgent Action [Video: 1:47]
Under-Secretary-General and Emergency Relief Coordinator Stephen O’Brien
New York, 7 January 2016
Briefing Transcript: https://docs.unocha.org/sites/dms/Documents/USG%20OBrien%20Briefing%20to%20MS%207%20January%202016.pdf
Excerpt
I’m very grateful to you for being here today for the briefing on the humanitarian consequences of the El Nino phenomenon. As you know, El Nino is already having a devastating effect on many parts of the world.
We are here today to re-sound the alarm.
And we are here to spur a collective response to the humanitarian suffering caused by changes in weather patterns linked to El Niño, and to take action now to mitigate its effects.
If we act now, we will save lives and livelihoods, and prevent an even more serious humanitarian emergency from taking hold.
In some regions, millions of people are already facing food insecurity caused by drought related to El Niño. In other parts of the world, we have a short window of opportunity now to prepare for what we know will happen within months. In both cases, we must act together and we must act quickly.
As we will soon hear from our colleague from the World Meteorological Organization, the strength of the current El Niño has put our world into uncharted territory. El Niño itself is not caused by climate change, but the fact that it is taking place in a changed climate means that its impacts are less predictable, and could be more severe.
El Niño is likely to decline in strength in January 2016, but this does not mean that the danger has passed. El Niño and a possible subsequent La Niña event will continue to affect different parts of the world at different times with a mix of above- or below average rainfall. The impacts, especially on food insecurity, may last as long as two years.
I am particularly concerned about a number of countries spread across Central and South America, the Pacific region, and East and South Africa…
…By the nature of its scale, its slow onset and the early warning afforded to us by reliable scientific analysis, El Niño poses a critical test to our global humanitarian system in two fundamental areas.
Firstly, El Niño tests our commitment to early action, which was re-affirmed after the devastating Horn of Africa drought of 2011. The warning signs are there. Are we prepared to act on them? Do we collectively make the resources available now on the basis of these firm clues—known on scientific evidence and experience to be lead indicators—or do we wait for the proof of these facts of a crisis, of course then rapidly a humanitarian and massive crisis, and donors’ money coming to the rescue in the end? Are the politicians in donor countries prepared to risk their taxpayers cash before that proof? Can we make the investments in preparedness and early response that we know to be far less costly in human and economic terms than waiting until the full scale of disaster is upon us?
Secondly, El Niño challenges our commitment to joint action between humanitarian and development actors, and between the international community and national and local governments. Are we able to forge the partnerships necessary to focus development efforts on the most vulnerable? Can we work together to build the resilience of people and communities and prevent them from falling into humanitarian need? If we are to save lives and reduce suffering, of course we must answer ’yes’ to all of these questions…
AN UNCERTAIN PATH – Justice for Crimes and Human Rights Violations against Migrants and Refugees in Mexico
Research Report – NOVEMBER 2015 :: 60 pages
Washington Office on Latin America [WOLA} and several migrant rights organizations [listed at bottom]
Authors: José Knippen, Clay Boggs, and Maureen Meyer |
Pdf: http://www.wola.org/sites/default/files/Uncertain%20Path.pdf
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KEY FINDINGS
:: THE SOUTHERN BORDER PROGRAM HAS SIGNIFICANTLY INCREASED
MIGRATION ENFORCEMENT OPERATIONS, AS WELL AS MIGRANT DETENTIONS
AND DEPORTATIONS.
From July 2014 to June 2015, detentions of migrants rose 73 percent compared to the same period the year before; between July 2013 and June 2014, 97,245 migrants were detained, while 168,280 were detained between July 2014 and June 2015. Furthermore, government data indicates there has been an increase in migration enforcement operations; however, more reliable data is needed.
:: THIS INCREASED ENFORCEMENT HAS PROMPTED AN UPTICK IN HUMAN RIGHTS VIOLATIONS AGAINST MIGRANTS.
Abuses have been documented in these migration operations, which are increasingly conducted in conjunction with security forces. Migrant shelters have documented kidnappings, extortions, robberies, and abuses throughout the country.
• GIVEN THIS CONTEXT, THE MEXICAN GOVERNMENT’S EFFORTS TO STRENGTHEN ITS CAPACITY TO PROTECT MIGRANTS HAVE FALLEN SHORT OF WHAT IS NEEDED.
For example, the Mexican Commission for Refugee Assistance (Comisión Mexicana de Ayuda a Refugiados, COMAR) only has 15 protection officers in the entire country to ensure access to international protection for the more than 100,000 migrants detained during the course of a year. Moreover, COMAR’s budget did not increase in real terms from 2014 to 2015.
:: THERE IS NO EVIDENCE THAT VICTIMS OF CRIMES AND HUMAN RIGHTS VIOLATIONS HAVE EFFECTIVE ACCESS TO JUSTICE, DESPITE THE CREATION OF NEW SPECIALIZED PROSECUTORS’ OFFICES.
There is a lack of conclusive data regarding justice for migrants in Mexico. The most detailed data are from the specialized prosecutor’s office in Oaxaca, which reports that, of the 383 complaints received over four years, only 96 resulted in a preliminary investigation being opened and only four resulted in sentences for the perpetrators. Additionally, of the 1,617 complaints of human rights violations against migrants that the National Human Rights Commission (Comisión Nacional de los Derechos Humanos, CNDH) received from December 1, 2012 to June 15, 2015, only four resulted in a formal recommendation issued to the institution implicated in the complaint.
:: THE SOUTHERN BORDER PROGRAM HAS FOCUSED ON ENFORCEMENT ACTIVITIES AND THIS FOCUS IS REFLECTED IN THE BUDGET OF THE NATIONAL MIGRATION INSTITUTE (INSTITUTO NACIONAL DE MIGRACIÓN, INM). INDEED, IN 2014 THE INM SPENT THE LARGEST BUDGET IN ITS HISTORY.
For its part, the United States government has offered the Mexican government political and financial support for migration enforcement, especially following the drastic increase in the number of unaccompanied minors and migrant families—primarily from Central America—arriving at the United States’ southwest border.
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Sponsoring Organizations:
CASA DEL MIGRANTE DE SALTILLO “FRONTERA CON JUSTICIA”, AC, in Saltillo, Coahuila, provides comprehensive humanitarian assistance as well as case documentation and legal services.
FUNDAR, CENTRO DE ANÁLISIS E INVESTIGACIÓN, AC is a civil society organization based in Mexico City, Mexico that works toward a substantive democracy.
ALBERGUE DE MIGRANTES “HERMANOS EL CAMINO,” in Ixtepec, Oaxaca, provides comprehensive humanitarian assistance to migrants in transit in Mexico.
LA 72, HOGAR—REFUGIO PARA PERSONAS MIGRANTES, is a Franciscan project dedicated to providing comprehensive assistance to migrants and refugees traveling through Tenosique, Tabasco in Mexico.
WOLA (WASHINGTON OFFICE ON LATIN AMERICA) is a leading research and advocacy organization that promotes human rights in the Americas.
LA RED SONORA is a network of three organizations based in Sonora, Mexico dedicated to defending and providing humanitarian assistance to migrants in Mexico.
Centro Comunitario de Atención al Migrante y Necesitado, in Altar, is a migrant shelter run by the local Nuestra Señora de Guadelupe Church.
Centro de Recursos para Migrantes, in Agua Prieta, works to provide humanitarian assistance
to migrants and document abuses.
Kino Border Initiative is an organization based in Nogales, Sonora and Nogales, Arizona that works in support of migrants and refugees in the United States and Mexico.
UN MUNDO, UNA NACIÓN, AC is an organization dedicated to providing humanitarian assistance and promoting the human rights of migrants in Apizaco, Tlaxcala.
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Publication
Migrant Detentions, and Rights Abuses, Increase in Mexico
MacArthur Foundation
January 6, 2016
A report from the Washington Office on Latin America and several migrant rights organizations shows that about 168,000 migrants were detained in Mexico from July 2014 to June 2015 – a 73 percent increase from the previous year that has brought with it rising crimes and abuses against migrants. The MacArthur-supported report attributes the increase to the Southern Border Protection program, which increased security at the country’s southern border and caused migrants to take less-traveled, more dangerous routes that expose them to assault, rape, extortion, and other crimes.
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