The Lancet
Mar 05, 2016 Volume 387 Number 10022 p917-1026 e22
http://www.thelancet.com/journals/lancet/issue/current

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Editorial
Health—an explicit human right
The Lancet
Summary
“The past year severely tested the international system’s capacity to respond to crises and mass forced displacements of people, and found it woefully inadequate.” So begins Amnesty International’s annual report for 2015, The state of the world’s human rights, published last week. Set against the backdrop of unprecedented and worldwide migration, recurring themes include access to health services, the effects of conflict on health, women and children’s health, sexual rights, and the denial of health care in prisons.

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Comment
Zika virus and microcephaly in Brazil: a scientific agenda
Mauricio L Barreto, Manoel Barral-Netto, Rodrigo Stabeli, Naomar Almeida-Filho, Pedro F C Vasconcelos, Mauro Teixeira, Paulo Buss, Paulo E Gadelha
Summary
Since 1981, the Brazilian population has had dengue fever epidemics and all control efforts have been unsuccessful.1 In 2014, chikungunya fever was reported for the first time in the country.2 In 2015, the occurrence of Zika virus was also reported,3 along with an increase of microcephaly and brain damage in newborn babies.4,5 The mosquito Aedes aegypti is the most conventional vector of these three viral infections and is widely disseminated in a great part of urban Brazil. Brazilian public health authorities declared a National Public Health Emergency on Nov 11, 2015, and intensified the vector control campaign to tackle the epidemic.

Lancet Global Health
Mar 2016 Volume 4 Number 3 e137-e214
http://www.thelancet.com/journals/langlo/issue/current

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Articles
Effect of Haemophilus influenzae type b vaccination without a booster dose on invasive H influenzae type b disease, nasopharyngeal carriage, and population immunity in Kilifi, Kenya: a 15-year regional surveillance study
Laura L Hammitt, Rosie J Crane, Angela Karani, Alex Mutuku, Susan C Morpeth, Polly Burbidge, David Goldblatt, Tatu Kamau, Shahnaaz Sharif, Neema Mturi, J Anthony G Scott
Summary
Background
Haemophilus influenzae type b (Hib) conjugate vaccine, delivered as a three-dose series without a booster, was introduced into the childhood vaccination programme in Kenya in 2001. The duration of protection and need for a booster dose are unknown. We aimed to assess vaccine effectiveness, the impact of the vaccine on nasopharyngeal carriage, and population immunity after introduction of conjugate Hib vaccine in infancy without a booster dose in Kenya.
Methods
This study took place in the Kilifi Health and Demographic Surveillance System (KHDSS), an area of Kenya that has been monitored for vital events and migration every 4 months since 2000. We analysed sterile site cultures for H influenzae type b from children (aged ≤12 years) admitted to the Kilifi County Hospital (KCH) from Jan 1, 2000, through to Dec 31, 2014. We determined the prevalence of nasopharyngeal carriage by undertaking cross-sectional surveys in random samples of KHDSS residents (of all ages) once every year from 2009 to 2012, and measured Hib antibody concentrations in five cross-sectional samples of children (aged ≤12 years) within the KHDSS (in 1998, 2000, 2004–05, 2007, and 2009). We calculated incidence rate ratios between the prevaccine era (2000–01) and the routine-use era (2004–14) and defined vaccine effectiveness as 1 minus the incidence rate ratio, expressed as a percentage.
Findings
40 482 children younger than 13 years resident in KHDSS were admitted to KCH between 2000 and 2014, 38 206 (94%) of whom had their blood cultured. The incidence of invasive H influenzae type b disease in children younger than 5 years declined from 62·6 (95% CI 46·0–83·3) per 100 000 in 2000–01 to 4·5 (2·5–7·5) per 100 000 in 2004–14, giving a vaccine effectiveness of 93% (95% CI 87–96). In the final 5 years of observation (2010–14), only one case of invasive H influenzae type b disease was detected in a child younger than 5 years. Nasopharyngeal H influenzae type b carriage was detected in one (0·2%) of 623 children younger than 5 years between 2009 and 2012. In the 2009 serosurvey, 92 (79%; 95% CI 70–86) of 117 children aged 4–35 months had long-term protective antibody concentrations.
Interpretation
In this region of Kenya, use of a three-dose primary series of Hib vaccine without a booster dose has resulted in a significant and sustained reduction in invasive H influenzae type b disease. The prevalence of nasopharyngeal carriage is low and the profile of Hib antibodies suggests that protection wanes only after the age at greatest risk of disease. Although continued surveillance is important to determine whether effective control persists, these findings suggest that a booster dose is not currently required in Kenya.
Funding
Gavi, the Vaccine Alliance, Wellcome Trust, European Society for Paediatric Infectious Diseases, and National Institute for Health Research.

PLoS Currents: Outbreaks
http://currents.plos.org/outbreaks/
(Accessed 5 March 2016)

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Research Article
Knowledge, Attitude and Perception of Ebola Virus Disease among Secondary School Students in Ondo State, Nigeria, October, 2014
March 4, 2016 ·
Introduction: The first case of Ebola Virus Disease (EVD) in Nigeria was imported on 20th July 2014, by an air traveller. On 8th August, 2014, WHO declared the Ebola outbreak in West Africa a Public Health Emergency of International Concern (PHEIC). This study aimed at assessing the knowledge, perception and attitude of secondary school students towards EVD and adopting disease preventive behaviour.
Methods: A descriptive cross sectional study of 440 students from a mixed secondary school in Owo, Ondo State was done. Data was collected in October 2014 when Nigeria was yet to be declared EVD free. Simple random sampling was used to select the school while Systematic random sampling was used in the selection of participants. A semi-structured, interviewer administered questionnaire was used to collect data. Data was analyzed with SPSS version 21. Descriptive statistics and Chi-square test were done, level of statistical significant was 5%.
Results: Mean age of respondents was 13.7±1.9 years. Females were 48.2%. Most of the respondents had heard of Ebola Virus Disease (95.4%). Female respondents (51.3%), those who were 15 years and above (51.1%) and in the senior class (54.1%), and had good general knowledge of EVD and across all domains. Being in the senior secondary class and seeking for health care in the hospital were positively associated with good general knowledge (p-value: 0.029, and <0.001 respectively). Three commonest modes of spread of EVD mentioned were contact between infected animals and men (74.8%), touching body fluids of a person who is sick of EVD (57.0%), and contact (55.2%). The top three signs of EVD mentioned were abnormal bleeding from any part of the body (56.10%), vomiting (47.0%) and fever (42.3%).
Conclusion: Our results revealed suboptimal EVD-related knowledge, attitude and practice among the students. Promotion of health messages and training of students on prevention of EVD to effectively control past and future outbreaks of EVD in Nigeria was immediately initiated in schools in Ondo State.

ttp://www.plosmedicine.org/
(Accessed 5 March 2016)
Transformative Innovations in Reproductive, Maternal, Newborn, and Child Health over the Next 20 Years
Cyril M. Engmann, Sadaf Khan, Cheryl A. Moyer, Patricia S. Coffey, Zulfiqar A. Bhutta
Collection Review | published 02 Mar 2016 | PLOS Medicine
10.1371/journal.pmed.1001969
Summary Points
:: Accelerating progress in reproductive, maternal, newborn, and child health (RMNCH) over the past 30 years has resulted in significant decreases in mortality, as well as shifts in causes of death. For example, deaths from diarrhea among children under age 5 have significantly declined. This increased survival means an increasing fraction of under-5 deaths occur in the first 4 weeks of life, the neonatal period.
:: Transformative changes, including advances such as the development of immunizations, wide uptake of contraception, and the availability of medications such as oxytocin, have contributed to an improved morbidity and mortality curve. Such advances are set against a broader backdrop of increasing national wealth, stronger health systems, aligned political agendas, and advocacy systems.
:: Global mechanisms and strategies such as the Global Strategy for Women’s, Children’s, and Adolescents’ Health, Global Alliance for the Vaccine Initiative (GAVI), the United Nations Commission on Life-Saving Commodities for Women and Children, Family Planning 2020, and the Every Newborn Action Plan, among others, are serving to drive the global agenda forward, although stubborn gaps remain.
:: In this paper, we discuss promising innovations that in our opinion have significant promise in moving the RMNCH agenda forward. While some of these are technologies, others are efforts aimed at improving commodities, increasing demand for services, and promoting equity in access.

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 5 March 2016)

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Zika Virus: Medical Countermeasure Development Challenges
Robert W. Malone, Jane Homan, Michael V. Callahan, Jill Glasspool-Malone, Lambodhar Damodaran, Adriano De Bernardi Schneider, Rebecca Zimler, James Talton, Ronald R. Cobb, Ivan Ruzic, Julie Smith-Gagen, Daniel Janies, James Wilson, Zika Response Working Group
Review | published 02 Mar 2016 | PLOS Neglected Tropical Diseases
10.1371/journal.pntd.0004530
Abstract
Introduction
Reports of high rates of primary microcephaly and Guillain–Barré syndrome associated with Zika virus infection in French Polynesia and Brazil have raised concerns that the virus circulating in these regions is a rapidly developing neuropathic, teratogenic, emerging infectious public health threat. There are no licensed medical countermeasures (vaccines, therapies or preventive drugs) available for Zika virus infection and disease. The Pan American Health Organization (PAHO) predicts that Zika virus will continue to spread and eventually reach all countries and territories in the Americas with endemic Aedes mosquitoes. This paper reviews the status of the Zika virus outbreak, including medical countermeasure options, with a focus on how the epidemiology, insect vectors, neuropathology, virology and immunology inform options and strategies available for medical countermeasure development and deployment.
Methods
Multiple information sources were employed to support the review. These included publically available literature, patents, official communications, English and Lusophone lay press. Online surveys were distributed to physicians in the US, Mexico and Argentina and responses analyzed. Computational epitope analysis as well as infectious disease outbreak modeling and forecasting were implemented. Field observations in Brazil were compiled and interviews conducted with public health officials.

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Eliminating the Neglected Tropical Diseases: Translational Science and New Technologies
Peter J. Hotez, Bernard Pecoul, Suman Rijal, Catharina Boehme, Serap Aksoy, Mwelecele Malecela, Roberto Tapia-Conyer, John C. Reeder
Review | published 02 Mar 2016 | PLOS Neglected Tropical Diseases
10.1371/journal.pntd.0003895
Abstract
Today, the World Health Organization recognizes 17 major parasitic and related infections as the neglected tropical diseases (NTDs). Despite recent gains in the understanding of the nature and prevalence of NTDs, as well as successes in recent scaled-up preventive chemotherapy strategies and other health interventions, the NTDs continue to rank among the world’s greatest global health problems. For virtually all of the NTDs (including those slated for elimination under the auspices of a 2012 London Declaration for NTDs and a 2013 World Health Assembly resolution [WHA 66.12]), additional control mechanisms and tools are needed, including new NTD drugs, vaccines, diagnostics, and vector control agents and strategies. Elimination will not be possible without these new tools. Here we summarize some of the key challenges in translational science to develop and introduce these new technologies in order to ensure success in global NTD elimination efforts.

PLoS One
http://www.plosone.org/
[Accessed 5 March 2016]

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The Success of a Universal Hepatitis B Immunization Program as Part of Thailand’s EPI after 22 Years’ Implementation
Nawarat Posuwan, Nasamon Wanlapakorn, Pattaratida Sa-nguanmoo, Rujipat Wasitthankasem, Preeyaporn Vichaiwattana, Sirapa Klinfueng, Viboonsak Vuthitanachot, Siriporn Sae-lao, Monthana Foonoi, Apinya Fakthongyoo, Jamorn Makaroon, Klaita Srisingh, Duangporn Asawarachun, Somchai Owatanapanich, Norra Wutthiratkowit, Kraisorn Tohtubtiang, Pornsak Yoocharoen, Sompong Vongpunsawad, Yong Poovorawan
Research Article | published 03 Mar 2016 | PLOS ONE
10.1371/journal.pone.0150499

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Immunization Coverage Surveys and Linked Biomarker Serosurveys in Three Regions in Ethiopia
Mark A. Travassos, Berhane Beyene, Zenaw Adam, James D. Campbell, Nigisti Mulholland, Seydou S. Diarra, Tassew Kassa, Lisa Oot, Jenny Sequeira, Mardi Reymann, William C. Blackwelder, Yukun Wu, Inna Ruslanova, Jaya Goswami, Samba O. Sow, Marcela F. Pasetti, Robert Steinglass, Amha Kebede, Myron M. Levine
Research Article | published 02 Mar 2016 | PLOS ONE
10.1371/journal.pone.0149970
Abstract
Objective
Demographic and health surveys, immunization coverage surveys and administrative data often divergently estimate vaccination coverage, which hinders pinpointing districts where immunization services require strengthening. We assayed vaccination coverage in three regions in Ethiopia by coverage surveys and linked serosurveys.
Methods
Households with children aged 12–23 (N = 300) or 6–8 months (N = 100) in each of three districts (woredas) were randomly selected for immunization coverage surveys (inspection of vaccination cards and immunization clinic records and maternal recall) and linked serosurveys. IgG-ELISA serologic biomarkers included tetanus antitoxin ≥ 0.15 IU/ml in toddlers (receipt of tetanus toxoid) and Haemophilus influenzae type b (Hib) anti-capsular titers ≥ 1.0 mcg/ml in infants (timely receipt of Hib vaccine).
Findings
Coverage surveys enrolled 1,181 children across three woredas; 1,023 (87%) also enrolled in linked serosurveys. Administrative data over-estimated coverage compared to surveys, while maternal recall was unreliable. Serologic biomarkers documented a hierarchy among the districts. Biomarker measurement in infants provided insight on timeliness of vaccination not deducible from toddler results.
Conclusion
Neither administrative projections, vaccination card or EPI register inspections, nor parental recall, substitute for objective serological biomarker measurement. Including infants in serosurveys informs on vaccination timeliness.

PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/
(Accessed 5 March 2016)

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Biological Sciences – Ecology:
Global change and terrestrial plant community dynamics
Janet Franklina,1, Josep M. Serra-Diaza,b, Alexandra D. Syphardc, and Helen M. Regand
Author Affiliations
Significance
Global terrestrial vegetation plays a critical role in biogeochemical cycles and provides important ecosystem services. Vegetation has been altered by anthropogenic global change drivers including land-use change, altered disturbance regimes, invasive species, and climate change, for decades to centuries, or in some cases millennia. Vegetation responses to land use and disturbance can be more immediate than to climate change and can be long lasting. The effect of global warming on water balance may have a stronger influence than the direct effects of temperature on vegetation. Models deployed at multiple ecological scales, populations, communities, and landscapes will be required to forecast vegetation responses and feedbacks to accelerated global change.

Abstract
Anthropogenic drivers of global change include rising atmospheric concentrations of carbon dioxide and other greenhouse gasses and resulting changes in the climate, as well as nitrogen deposition, biotic invasions, altered disturbance regimes, and land-use change. Predicting the effects of global change on terrestrial plant communities is crucial because of the ecosystem services vegetation provides, from climate regulation to forest products. In this paper, we present a framework for detecting vegetation changes and attributing them to global change drivers that incorporates multiple lines of evidence from spatially extensive monitoring networks, distributed experiments, remotely sensed data, and historical records. Based on a literature review, we summarize observed changes and then describe modeling tools that can forecast the impacts of multiple drivers on plant communities in an era of rapid change. Observed responses to changes in temperature, water, nutrients, land use, and disturbance show strong sensitivity of ecosystem productivity and plant population dynamics to water balance and long-lasting effects of disturbance on plant community dynamics. Persistent effects of land-use change and human-altered fire regimes on vegetation can overshadow or interact with climate change impacts. Models forecasting plant community responses to global change incorporate shifting ecological niches, population dynamics, species interactions, spatially explicit disturbance, ecosystem processes, and plant functional responses. Monitoring, experiments, and models evaluating multiple change drivers are needed to detect and predict vegetation changes in response to 21st century global change.

PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/
(Accessed 5 March 2016)

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Social Sciences – Sustainability Science:
Impacts of nonstate, market-driven governance on Chilean forests
Robert Heilmayra,1 and Eric F. Lambinb,c,d,1
Author Affiliations
Significance
Global trade in commodities has become an important driver of environmental degradation. In response, there has been a proliferation of nonstate, market-driven governance seeking to reduce environmental degradation through interventions in the supply chain. We provide some of the first quasiexperimental evidence to show that private, market-driven policies can slow deforestation. We compare the impacts of two certification schemes and a deforestation moratorium in Chile using a factorial quasiexperimental design. Our results indicate that governance regimes with greater collaboration between environmental and industry stakeholders achieved better environmental outcomes. In contrast to many public conservation policies, we find that private governance systems can effectively target high-deforestation properties.

Abstract
Global markets for agricultural products, timber, and minerals are critically important drivers of deforestation. The supply chains driving land use change may also provide opportunities to halt deforestation. Market campaigns, moratoria, and certification schemes have been promoted as powerful tools to achieve conservation goals. Despite their promise, there have been few opportunities to rigorously quantify the ability of these nonstate, market-driven (NSMD) governance regimes to deliver conservation outcomes. This study analyzes the impacts of three NSMD governance systems that sought to end the conversion of natural forests to plantations in Chile at the start of the 21st century. Using a multilevel, panel dataset of land use changes in Chile, we identify the impact of participation within each of the governance regimes by implementing a series of matched difference-in-differences analyses. Taking advantage of the mosaic of different NSMD regimes adopted in Chile, we explore the relative effectiveness of different policies. NSMD governance regimes reduced deforestation on participating properties by 2–23%. The NSMD governance regimes we studied included collaborative and confrontational strategies between environmental and industry stakeholders. We find that the more collaborative governance systems studied achieved better environmental performance than more confrontational approaches. Whereas many government conservation programs have targeted regions with little likelihood of conversion, we demonstrate that NSMD governance has the potential to alter behavior on high-deforestation properties.

Public Health Ethics
Volume 9 Issue 1 April 2016
http://phe.oxfordjournals.org/content/current

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Ethical Criteria for Human Challenge Studies in Infectious Diseases
Ben Bambery, Michael Selgelid, Charles Weijer, Julian Savulescu, and Andrew J. Pollard
Public Health Ethics (2016) 9 (1): 92-103 doi:10.1093/phe/phv026
Abstract
Purposeful infection of healthy volunteers with a microbial pathogen seems at odds with acceptable ethical standards, but is an important contemporary research avenue used to study infectious diseases and their treatments. Generally termed ‘controlled human infection studies’, this research is particularly useful for fast tracking the development of candidate vaccines and may provide unique insight into disease pathogenesis otherwise unavailable. However, scarce bioethical literature is currently available to assist researchers and research ethics committees in negotiating the distinct issues raised by research involving purposefully infecting healthy volunteers. In this article, we present two separate challenge studies and highlight the ethical issues of human challenge studies as seen through a well-constructed framework. Beyond the same stringent ethical standards seen in other areas of medical research, we conclude that human challenge studies should also include: (i) independent expert reviews, including systematic reviews; (ii) a publicly available rationale for the research; (iii) implementation of measures to protect the public from spread of infection beyond the research setting; and (iv) a new system for compensation for harm. We hope these additions may encourage safer and more ethical research practice and help to safeguard public confidence in this vital research alternative in years to come.

Qualitative Health Research
March 2016; 26 (4)
http://qhr.sagepub.com/content/current
Special Issue: Autoethnography

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Commentary
Autoethnography in Health Research: Growing Pains?
Heewon Chang
1Eastern University, St. Davids, Pennsylvania, USA
Abstract
Autoethnography is gaining acceptance as a legitimate research method in health science research. The growing volume of published autoethnographies is indicative of this trend. After discussing the methodological tenents of this qualitative research method and its compatibility with health-related research, the author illustrates this trend with examples of published autoethnogrpahic books, theses, and journal articles. While celebrating the potential of autoethnography as a suitable health research method, the author critiques dominatly descriptive and evocative illness self-narratives that may evoke emontionally compelling responses from readers but offer insufficient sociocultural insights about the illness phenomenon. To identify a “desirable” autoethnography that provides not only a “thick description” of personal experiences but also a sociocultural interpretation of such experiences, the author recommends both creators and consumers of autoethnography to ask five evaluative questions: (1) Does the autoethnography use authentic and trustworthy data?; (2) Does the autoethnography follow a reliable research process and show the process clearly?; (3) Does the autoethnography follow ethical steps to protect the rights of self and others presented and implicated in the autoethnography?; (4) Does the autoethnography analyze and interpret the sociocultural meaning of the author’s personal experiences?; and (5) Does the autoethnography attempt to make a scholarly contribution with its conclusion and engagement of the existing literature?

Science
04 March 2016 Vol 351, Issue 6277
http://www.sciencemag.org/current.dtl

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Policy Forum
Liberating field science samples and data
By Marcia McNutt, Kerstin Lehnert, Brooks Hanson, Brian A. Nosek, Aaron M. Ellison, John Leslie King
Science04 Mar 2016 : 1024-1026
Summary
Transparency and reproducibility enhance the integrity of research results for scientific and public uses and empower novel research applications. Access to data, samples, methods, and reagents used to conduct research and analysis, as well as to the code used to analyze and process data and samples, is a fundamental requirement for transparency and reproducibility. The field sciences (e.g., geology, ecology, and archaeology), where each study is temporally (and often spatially) unique, provide exemplars for the importance of preserving data and samples for further analysis. Yet field sciences, if they even address such access, commonly do so by simply noting “data and samples available upon request.” They lag behind some laboratory sciences in making data and samples available to the broader research community. It is time for this to change. We discuss cultural, financial, and technical barriers to change and ways in which funders, publishers, scientific societies, and others are responding.

Vaccine
Volume 34, Issue 12, Pages 1423-1488 (14 March 2016)
http://www.sciencedirect.com/science/journal/0264410X/34/12

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Supplemental measles vaccine antibody response among HIV-infected and -uninfected children in Malawi after 1- and 2-dose primary measles vaccination schedules
Original Research Article
Pages 1459-1464
Ashley L. Fowlkes, Desiree Witte, Judy Beeler, Susette A. Audet, Robin Broadhead, William J. Bellini, Felicity Cutts, Rita F. Helfand
Abstract
Background
The long-term antibody response to measles vaccine (MV) administered at age 6 months with or without subsequent doses is not well documented.
Methods
Measles serum antibody responses were evaluated after a supplemental dose of measles vaccine (sMV) administered at a median age of 20 months among Malawian children who had previously received 2 doses of measles vaccine (MV) at ages 6 and 9 months (HIV-infected and random sample of HIV-uninfected) or 1 dose at age 9 months (random sample of HIV-uninfected). We compared measles antibody seropositivity between groups by enzyme linked immunoassay and seroprotection by plaque reduction neutralization geometric mean concentrations.
Results
Of 1756 children enrolled, 887 (50.5%) received a sMV dose following MV at 9 months of age and had specimens available after sMV receipt, including 401 HIV-uninfected children who received one MV dose at 9 months, 464 HIV-uninfected and 22 HIV-infected children who received two doses of MV at ages 6 and 9 months. Among HIV-uninfected children, protective levels of antibody were found post sMV in 90–99% through ages 24–36 months and were not affected by MV schedule. Geometric mean concentration levels of measles antibody were significantly increased post-sMV among those HIV-uninfected children previously non-responsive to vaccination. Among HIV-infected children, the proportion seroprotected increased initially but by 9 months post-sMV was no higher than pre-sMV.
Conclusions
Our findings support early 2-dose MV to provide measles immunity for young infants without risk of interference with antibody responses to subsequent MV doses administered as part of SIAs.

Vulnerable Children and Youth Studies
An International Interdisciplinary Journal for Research, Policy and Care
Volume 11, Issue 1, 2016
http://www.tandfonline.com/toc/rvch20/current

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Original Articles
Challenges faced by caregivers of vulnerable children in Cross River State and Abuja Federal Capital Territory, Nigeria
pages 24-32
DOI:10.1080/17450128.2016.1151094
Published online: 03 Mar 2016
Catherine Gana, Edward Oladele, Mariya Saleh, Osagbemi Makanjuola, Diana Gimba, Doreen Magaji, Temitayo Odusote, Hadiza Khamofu & Kwasi Torpey
ABSTRACT
This study describes the characteristics of caregivers, examines the relationships between caregivers and their children and analyzes the experiences and challenges of caring for orphans and vulnerable children (OVC) faced by caregivers in the community. Using a combination of questionnaire, informant interviews and focus group discussions, data were collected from 150 female and male caregivers in Cross Rivers State and the Federal Capital Territory selected through convenient sampling. Careful analysis of the data revealed that majority of the caregivers were women, mostly widows caring for about 3–6 children. They were largely married with primary or no formal education. Most of them were engaged in petty trading and farming. Their incomes were generally low, less than 10,000 naira (approximately 52 dollars) per annum. Challenges of caring for children were listed to include; lack of access to education, nutrition, inadequate clothing and shelter and lack of psychosocial support in that order. Family supports to these caregivers have either dwindled considerably or non-existent. In the words of these caregivers, our relatives have their own problems in this era of economic crisis to bother about the problems of other people. A few of the organized supports came from non-governmental organizations and faith-based organizations in the form of handouts to meet needs of food and school supplies. These do not address the root cause of caregivers’ problems of lack of skills and income generation for sustainable care. The study recommends empowering caregivers as a sustainable approach to the problem of vulnerable children in the community.

Vulnerable Children and Youth Studies
An International Interdisciplinary Journal for Research, Policy and Care
Volume 11, Issue 1, 2016
http://www.tandfonline.com/toc/rvch20/current

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Original Articles
Borderline personality disorder typical symptoms among Brazilian adolescents in a foster care institution
pages 13-23
DOI:10.1080/17450128.2016.1151093
Published online: 03 Mar 2016
Julia L. Schäfer, Vinícius G. Dornelles & Rogério L. Horta
ABSTRACT
Borderline personality disorder (BPD) symptoms usually emerge during adolescence. Because it is a highly dysfunctional disorder, this study aimed to identify the presence of BPD typical symptoms in Brazilian adolescents in a foster care institution. This research was conducted with 44 adolescents ranging from 12 to 17 years old from a foster care institution in south of Brazil. The adolescents answered the instrument Borderline Symptoms List-23 to assess BPD symptomatology, and the psychologist of the institution answered a questionnaire about the adolescents regarding sex, age, education, the process of entering the institution and mental health history. The sample was divided in two groups: one composed of adolescents with problematic levels of symptoms, showing an intense presentation of BPD symptoms, and the other made of adolescents with non-problematic levels of symptoms, showing a slight presentation of BPD symptoms. Comparisons between sex and the instrument total scores showed that girls had significant higher means than boys (p < 0.05). Through regression analysis, the adolescents presenting problematic levels of symptoms were those who entered the foster care institution at 12 years old or older (p < 0.05), and were in high school (p < 0.05). The results of this study indicate the presence of different levels of BPD symptoms in Brazilian adolescents in the foster care institution suggesting the importance of the development of interventions aiming mental health promotion.

World Heritage Review
n°78 – February 2016
http://whc.unesco.org/en/review/78/

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World Heritage and gender equality
It is increasingly recognized that culture has an essential role to play as a driver of sustainable development, contributing to the eradication of poverty and enhancing social inclusion. Culture helps to define people’s identities and determines the way they shape their future. Gender equality, which is a UNESCO priority, refers to the roles and responsibilities of men and women and gender dynamics within families, societies and cultures.

Oxford Review of Economic Policy
Spring 2016
Reorienting health aid to meet post-2015 global health challenges: a case study of Sweden as a donor
Gavin Yamey, Jesper Sundewall, Helen Saxenian, Robert Hecht, Keely Jordan, Marco Schäferhoff, Christina Schrade, Cécile Deleye, Milan Thomas, Nathan Blanchet, Lawrence Summers, and Dean Jamison
Abstract
The international development community is transitioning from the era of the Millennium Development Goals (MDGs), ending in 2015, to the era of the Sustainable Development Goals (SDGs), which have a 2030 target. Global development assistance for health (DAH) increased substantially in the MDGs era, from US $10.8 billion in 2001 to $28.1 billion by 2012 (in 2010 US dollars), and it played a crucial role in tackling global challenges such as HIV/AIDS and malaria. In this paper, we describe the likely health challenges of the SDGs era and the types of international assistance that will be required to help tackle these challenges. We propose a new way of classifying DAH based on considering the functions that it will need to serve in order to address these post-2015 challenges. We apply this new classification to the current health aid spending of one donor, Sweden, as a case study. Based on our findings, we suggest ways in which Sweden’s DAH could be reoriented towards meeting the health challenges of the next two decades.

PLoS Biology
Published: March 2, 2016
DOI: 10.1371/journal.pbio.1002376
Honing the Priorities and Making the Investment Case for Global Health
Trevor Mundel
Abstract
In the aftermath of the Ebola crisis, the global health community has a unique opportunity to reflect on the lessons learned and apply them to prepare the world for the next crisis. Part of that preparation will entail knowing, with greater precision, what the scale and scope of our specific global health challenges are and what resources are needed to address them. However, how can we know the magnitude of the challenge, and what resources are needed without knowing the current status of the world through accurate primary data? Once we know the current status, how can we decide on an intervention today with a predicted impact decades out if we cannot project into that future? Making a case for more investments will require not just better data generation and sharing but a whole new level of sophistication in our analytical capability—a fundamental shift in our thinking to set expectations to match the reality. In this current status of a distributed world, being transparent with our assumptions and specific with the case for investing in global health is a powerful approach to finding solutions to the problems that have plagued us for centuries.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
__________________________________________________
Week ending 27 February 2016

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

pdf version: The Sentinel_ week ending 27 February 2016

blog edition: comprised of the 35+ entries  posted below on 29 February through 3 March 2016

Editor’s Note:
The cessation of hostilities agreement in Syria and announcements involving the refugee crisis the conflict has spawned lead our Week in Review section. We include the full text of the Security Council resolution below.

Syria
Syrian Arab Republic: Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Stephen O’Brien – Statement to the Security Council on Syria, New York, 24 February 2016
Initial text
Mr. President,
Next month, we will mark a grim anniversary: the brutal conflict will have torn Syria apart for five long years. It has been a relentless period of violence and destruction. The Syrian people have seen their country reduced to rubble, loved ones killed or injured, and millions of people displaced, either inside the country or in the region and beyond. They have suffered far too much and for far too long. The international community watched on as Syria became one of the largest and most destructive crises of our times, with the majority of the population – some 13.5 million people – in dire need of protection and humanitarian assistance.

The announcement by the chairs of the International Syria Support Group, the United States and the Russian Federation, of a nationwide cessation of hostilities scheduled to come into effect this weekend is a welcome development and a long-awaited signal of hope to the Syrian people. I echo the call of the Secretary-General for the parties to abide by the terms of the agreement to bring about an immediate reduction in violence as a first step towards a more durable ceasefire and to create the conditions necessary for an increase in humanitarian aid…

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Security Council Unanimously Endorses Syria Cessation of Hostilities Accord, Unanimously Adopting Resolution 2268 (2016)
26 February 2016
SC/12261
7634thy Meeting (PM)
An hour before it was due to go into effect, the Security Council today unanimously endorsed the cessation of hostilities agreement aimed at ending five years of bloodshed in Syria.

The 15-member Council approved resolution 2268 (2016), endorsing the deal announced in the Joint Statement by the United States and the Russian Federation, Co-chairs of the International Syria Support Group. The resolution demanded that all parties to the agreement live up to its terms, and urged all Member States to use their influence to ensure that parties to the conflict fulfil their commitments and create the conditions for a durable and lasting ceasefire.

Briefing the Council before the vote, Staffan de Mistura, the Secretary-General’s Special Envoy for Syria, said the cessation of hostilities was the result of lengthy and detailed discussions and the outcome of intense negotiations at the highest level. Speaking via videoconference from Geneva, he added that it was a “major achievement”.

Much work for the implementation of the agreement lay ahead, he continued, stressing that Saturday would be a critical day and warning that there would be no shortage of attempts to undermine the process under way. The international community must work fast to address any incidents that may arise, while all parties must demonstrate restraint. He announced that, provided the cessation of hostilities held and humanitarian access was kept open, he intended to reconvene formal Syria peace talks in Geneva on Monday, 7 March…

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[Editor’s text bolding]
Resolution
The full text of resolution 2268 (2016) reads as follows:
“The Security Council,
“Recalling its resolutions 2042 (2012), 2043 (2012), 2118 (2013), 2139 (2014), 2165 (2014), 2170 (2014), 2175 (2014), 2178 (2014), 2191 (2014), 2199 (2015), 2235 (2015), 2249 (2015), 2253 (2015), 2254 (2015) and 2258 (2015), and Presidential Statements of 3 August 2011 (S/PRST/2011/16), 21 March 2012 (S/PRST/2012/6), 5 April 2012 (S/PRST/2012/10), 2 October 2013 (S/PRST/2013/15), 24 April 2015 (S/PRST/2015/10) and 17 August 2015 (S/PRST/2015/15),

“Reaffirming its strong commitment to the sovereignty, independence, unity and territorial integrity of the Syrian Arab Republic, and to the purposes and principles of the Charter of the United Nations,

“Recognizing the efforts of the Secretary-General in implementing resolution 2254 (2015) and noting, through his good offices and by his Special Envoy for Syria, the launch of the formal negotiations on a political transition process, consistent with paragraph 2 of resolution 2254 (2015), on 29 January 2016,

“Commending the commitment of the International Syria Support Group (ISSG) to ensure a Syrian-led and Syrian-owned political transition based on the Geneva communiqué of 30 June 2012 in its entirety and to immediately facilitate the full implementation of resolution 2254 (2015), and emphasizing the urgency for all parties in Syria to work diligently and constructively towards this goal,

“Welcoming the ISSG statement of 11 February 2016, including the establishment of an ISSG humanitarian task force and an ISSG ceasefire task force,

“1. Endorses in full the Joint Statement of the United States and the Russian Federation, as Co-Chairs of the ISSG, on Cessation of Hostilities in Syria of 22 February 2016 and the Terms for the Cessation of Hostilities in Syria (hereafter referred to as ‘the Annex’) attached to the Statement, and demands the cessation of hostilities to begin at 00:00 (Damascus time) on 27 February 2016;

“2. Demands the full and immediate implementation of resolution 2254 (2015) to facilitate a Syrian-led and Syrian-owned political transition, in accordance with the Geneva communiqué as set forth in the ISSG Statements, in order to end the conflict in Syria, and stresses again that the Syrian people will decide the future of Syria;

“3. Demands that all parties to whom the cessation of hostilities applies as set forth in the Annex (hereafter referred to as the “parties to the cessation of hostilities”) fulfil their commitments laid out in the Annex, and urges all Member States, especially ISSG members, to use their influence with the parties to the cessation of hostilities to ensure fulfilment of those commitments and to support efforts to create conditions for a durable and lasting ceasefire; “

4. Recognizes the efforts of the Russian Federation and the United States to reach understanding on the Terms of the Cessation of Hostilities, and acknowledges and welcomes that the forces of the Syrian Government and those supporting it, as communicated to the Russian Federation, and the Syrian armed opposition groups, as communicated to the Russian Federation or the United States, have accepted and committed to abide by the Terms of the Cessation of Hostilities, and as such are now parties to it;

“5. Reiterates its call on the parties to immediately allow humanitarian agencies rapid, safe and unhindered access throughout Syria by most direct routes, allow immediate, humanitarian assistance to reach all people in need, in particular in all besieged and hard-to-reach areas, and immediately comply with their obligations under international law, including international humanitarian law and international human rights law as applicable;

“6. Expresses support for the ISSG initiative, coordinated through the ISSG humanitarian working group, to accelerate the urgent delivery of humanitarian aid, with the view towards the full, sustained, and unimpeded access throughout the country, including to Deir ez Zor, Foah, Kafraya, Az-Zabadani, Madaya/Bqin, Darayya, Madamiyet Elsham, Duma, East Harasta, Arbin, Zamalka, Kafr Batna, Ein Terma, Hammuria, Jisrein, Saqba, Zabadin, Yarmuk, eastern and western rural Aleppo, Azaz, Afrin, At Tall, Rastan, Talbiseh, Al Houle, Tier Malah/Al Gantho/Der Kabira, Al Waer, Yalda, Babila and Beit Saham;

“7. Reaffirms its support for a Syrian-led political process facilitated by the United Nations, requests the Secretary-General, through his good offices and the efforts of his Special Envoy for Syria, to resume the formal negotiations between the representatives of the Syrian government and the opposition, under the auspices of the United Nations, as soon as possible, and urges the representatives of the Syrian Government and the Syrian opposition to engage in good faith in these negotiations;

“8. Welcomes the cessation of hostilities as a step towards a lasting ceasefire and reaffirms the close linkage between a ceasefire and a parallel political process, pursuant to the 2012 Geneva communiqué, and that both initiatives should move ahead expeditiously as expressed in resolution 2254 (2015);

“9. Calls on all states to use their influence with the Government of Syria and the Syrian opposition to advance the peace process, confidence-building measures, including the early release of any arbitrarily detained persons, particularly women and children, and implementation of the cessation of hostilities;

“10. Requests the Secretary-General to report to the Council on the implementation of this resolution, including by drawing on information provided by the ISSG ceasefire taskforce, and on resolution 2254 (2015), within 15 days of the adoption of this resolution and every 30 days thereafter;

“11. Decides to remain actively seized of the matter.”

UNHCR, UNICEF launch Blue Dot hubs to boost protection for children and families on the move across Europe
Joint UNHCR, UNICEF Press Release
26 February 2016
As part of a joint endeavour to step up protection for the growing numbers of children and others with specific needs arriving in Europe, UNHCR, the UN Refugee Agency, and UNICEF are setting up special support centres for children and families along the most frequently used migration routes in Europe.

Twenty Child and Family Support Hubs, to be known as “Blue Dots,” will provide a safe space for children and their families, vital services, play, protection and counselling in a single location. The hubs aim to support vulnerable families on the move, especially the many unaccompanied or separated children at risk of sickness, trauma, violence, exploitation and trafficking.

While the situation continues to evolve, at present the first hubs are now operational or about to open in Greece, the former Yugoslav Republic of Macedonia, Serbia, Croatia and Slovenia. All 20 will be operational within the next three months.

The “Blue Dot” hubs come at a time when women and children account for two thirds of those crossing to Europe: In February, women and children made up nearly 60 per cent of sea arrivals compared to 27 per cent in September 2015. They will also aim to identify and protect children and adolescents travelling alone, and reunite them with family wherever possible, depending on their best interests.

“We are concerned about the welfare of unaccompanied boys and girls on the move and unprotected across Europe, many of whom have experienced war and hardship in making these journeys alone,” said UNHCR Assistant High Commissioner for Protection Volker Türk. “The hubs will play a key role in identifying these children and providing the protection they need in an unfamiliar environment, where they may be at risk,” he added…