Evidence-based practices to increase hand hygiene compliance in health care facilities: An integrated review

American Journal of Infection Control
June 2016 Volume 44, Issue 6, p619-738, e81-e102

State of the Science Review
Evidence-based practices to increase hand hygiene compliance in health care facilities: An integrated review
Jun Rong Jeffrey Neo, Rana Sagha-Zadeh, Ole Vielemeyer, Ella Franklin
Published in issue: June 01 2016
:: Five key categories of hand hygiene intervention (HHI) emerged: (1) improving awareness with education (knowledge transfer, evaluation, mentoring and feedback), (2) facility design and planning, (3) unit-level protocols and procedures, (4) institution-wide programs, and (5) multimodal interventions.
:: Although some evidence-based HHI has been developed, sustaining hand hygiene compliance remains challenging.
:: Components like environmental psychology, behavioral economics, and financial rewards should be used to better understand and catalyze improved behavioral change in various contexts and environments to improve hand hygiene.
Hand hygiene (HH) in health care facilities is a key component to reduce pathogen transmission and nosocomial infections. However, most HH interventions (HHI) have not been sustainable.
This review aims to provide a comprehensive summary of recently published evidence-based HHI designed to improve HH compliance (HHC) that will enable health care providers to make informed choices when allocating limited resources to improve HHC and patient safety.
The Medline electronic database (using PubMed) was used to identify relevant studies. English language articles that included hand hygiene interventions and related terms combined with health care environments or related terms were included.
Seventy-three studies that met the inclusion criteria were summarized. Interventions were categorized as improving awareness with education, facility design, and planning, unit-level protocols and procedures, hospital-wide programs, and multimodal interventions. Past successful HHIs may not be as effective when applied to other health care environments. HH education should be interactive and engaging. Electronic monitoring and reminders should be implemented in phases to ensure cost-effectiveness. To create hospitalwide programs that engage end users, policy makers should draw expertise from interdisciplinary fields. Before implementing the various components of multimodal interventions, health care practitioners should identify and examine HH difficulties unique to their organizations.
Future research should seek to achieve the following: replicate successful HHI in other health care environments, develop reliable HHC monitoring tools, understand caregiver-patient-family interactions, examine ways (eg, hospital leadership, financial support, and strategies from public health and infection prevention initiatives) to sustain HHC, and use simulated lab environments to refine study designs.

American Journal of Public Health – Volume 106, Issue 6 (June 2016)

American Journal of Public Health
Volume 106, Issue 6 (June 2016)

Lack of Evidence Supporting the Effectiveness of Disaster Supply Kits
Tara N. Heagele
American Journal of Public Health: June 2016, Vol. 106, No. 6: 979–982.

Human Trafficking and Health: A Survey of Male and Female Survivors in England
American Journal of Public Health: June 2016, Vol. 106, No. 6: 1073–1078.
Siân Oram, Melanie Abas, Debra Bick, Adrian Boyle, Rebecca French, Sharon Jakobowitz, Mizanur Khondoker, Nicky Stanley, Kylee Trevillion, Louise Howard, Cathy Zimmerman
Objectives. To investigate physical and mental health and experiences of violence among male and female trafficking survivors in a high-income country.
Methods. Our data were derived from a cross-sectional survey of 150 men and women in England who were in contact with posttrafficking support services. Interviews took place over 18 months, from June 2013 to December 2014.
Results. Participants had been trafficked for sexual exploitation (29%), domestic servitude (29.3%), and labor exploitation (40.4%). Sixty-six percent of women reported forced sex during trafficking, including 95% of those trafficked for sexual exploitation and 54% of those trafficked for domestic servitude. Twenty-one percent of men and 24% of women reported ongoing injuries, and 8% of men and 23% of women reported diagnosed sexually transmitted infections. Finally, 78% of women and 40% of men reported high levels of depression, anxiety, or posttraumatic stress disorder symptoms.
Conclusions. Psychological interventions to support the recovery of this highly vulnerable population are urgently needed.

Sexual Violence
Social Support, Sexual Violence, and Transactional Sex Among Female Transnational Migrants to South Africa
American Journal of Public Health: June 2016, Vol. 106, No. 6: 1123–1129.
Margaret Giorgio, Loraine Townsend, Yanga Zembe, Sally Guttmacher, Farzana Kapadia, Mireille Cheyip, Catherine Mathews
Objectives. To examine the relationship between sexual violence and transactional sex and assess the impact of social support on this relationship among female transnational migrants in Cape Town, South Africa.
Methods. In 2012 we administered a behavioral risk factor survey using respondent-driven sampling to transnational migrant women aged between 16 and 39 years, born outside South Africa, living in Cape Town, and speaking English, Shona, Swahili, Lingala, Kirundi, Kinyarwanda, French, or Somali.
Results. Controlling for study covariates, travel-phase sexual violence was positively associated with engagement in transactional sex (adjusted prevalence ratio [APR] = 1.38; 95% confidence interval [CI] = 1.07, 1.77), and social support was shown to be a protective factor (APR = 0.84; 95% CI = 0.75, 0.95). The interaction of experienced sexual violence during migration and social support score was APR = 0.85 (95% CI = 0.66, 1.10). In the stratified analysis, we found an increased risk of transactional sex among the low social support group (APR = 1.56; 95% CI = 1.22, 2.00). This relationship was not statistically significant among the moderate or high social support group (APR = 1.04; 95% CI = 0.58, 1.87).
Conclusions. Programs designed to strengthen social support may reduce transactional sex among migrant women after they have settled in their receiving communities.

Perspectives of frontline health workers on Ghana’s National Health Insurance Scheme before and after community engagement interventions

BMC Health Services Research
(Accessed 28 May 2016)

Research article
Perspectives of frontline health workers on Ghana’s National Health Insurance Scheme before and after community engagement interventions
Barely a decade after introduction of Ghana’s National Health Insurance Scheme (NHIS), significant successes have been recorded in universal access to basic healthcare services.
Robert Kaba Alhassan, Edward Nketiah-Amponsah, Nicole Spieker, Daniel Kojo Arhinful and Tobias F. Rinke de Wit
BMC Health Services Research 2016 16:192
Published on: 28 May 2016

BMC Infectious Diseases (Accessed 28 May 2016)

BMC Infectious Diseases

(Accessed 28 May 2016)

Research article
Implementation of coordinated global serotype 2 oral poliovirus vaccine cessation: risks of potential non-synchronous cessation
The endgame for polio eradication involves coordinated global cessation of oral poliovirus vaccine (OPV) with cessation of serotype 2 OPV (OPV2 cessation) implemented in late April and early May 2016…
Radboud J. Duintjer Tebbens, Lee M. Hampton and Kimberly M. Thompson
BMC Infectious Diseases 2016 16:231
Published on: 26 May 2016

Research article
Gaining and sustaining schistosomiasis control: study protocol and baseline data prior to different treatment strategies in five African countries
The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) was established in 2008 to answer strategic questions about schistosomiasis control. For programme managers, a high-priority quest…
Amara E. Ezeamama, Chun-La He, Ye Shen, Xiao-Ping Yin, Sue C. Binder, Carl H. Campbell, Stephen Rathbun, Christopher C. Whalen, Eliézer K. N’Goran, Jürg Utzinger, Annette Olsen, Pascal Magnussen, Safari Kinung’hi, Alan Fenwick, Anna Phillips, Josefo Ferro…
BMC Infectious Diseases 2016 16:229
Published on: 26 May 2016

Research article
Human papillomavirus infection in Rwanda at the moment of implementation of a national HPV vaccination programme
Cervical cancer is the most common female cancer in Rwanda that, in 2011, became the first African country to implement a national vaccination programme against human papillomavirus (HPV).
Fidele Ngabo, Silvia Franceschi, Iacopo Baussano, M. Chantal Umulisa, Peter J. F. Snijders, Anne M. Uyterlinde, Fulvio Lazzarato, Vanessa Tenet, Maurice Gatera, Agnes Binagwaho and Gary M. Clifford
BMC Infectious Diseases 2016 16:225
Published on: 24 May 2016

Research impact: a narrative review

BMC Medicine
(Accessed 28 May 2016)

Research impact: a narrative review
Trisha Greenhalgh, James Raftery, Steve Hanney and Matthew Glover
BMC Medicine201614:78
DOI: 10.1186/s12916-016-0620-8
Impact occurs when research generates benefits (health, economic, cultural) in addition to building the academic knowledge base. Its mechanisms are complex and reflect the multiple ways in which knowledge is generated and utilised. Much progress has been made in measuring both the outcomes of research and the processes and activities through which these are achieved, though the measurement of impact is not without its critics. We review the strengths and limitations of six established approaches (Payback, Research Impact Framework, Canadian Academy of Health Sciences, monetisation, societal impact assessment, UK Research Excellence Framework) plus recently developed and largely untested ones (including metrics and electronic databases). We conclude that (1) different approaches to impact assessment are appropriate in different circumstances; (2) the most robust and sophisticated approaches are labour-intensive and not always feasible or affordable; (3) whilst most metrics tend to capture direct and proximate impacts, more indirect and diffuse elements of the research-impact link can and should be measured; and (4) research on research impact is a rapidly developing field with new methodologies on the horizon.

Improving the provision of pregnancy care for Aboriginal and Torres Strait Islander women: a continuous quality improvement initiative

BMC Pregnancy and Childbirth
(Accessed 28 May 2016)

Research article
Improving the provision of pregnancy care for Aboriginal and Torres Strait Islander women: a continuous quality improvement initiative
Australian Aboriginal and Torres Strait Islander (Indigenous) women are at greater risk of adverse pregnancy outcomes than non-Indigenous women.
Melanie E. Gibson-Helm, Alice R. Rumbold, Helena J. Teede, Sanjeeva Ranasinha, Ross S. Bailie and Jacqueline A. Boyle
BMC Pregnancy and Childbirth 2016 16:118
Published on: 24 May 2016

Global Public Health – Volume 11, Issue 5-6, 2016

Global Public Health
Volume 11, Issue 5-6, 2016
Special Issue: Participatory Visual Methodologies in Global Public Health

Participatory visual methodologies in global public health
pages 521-527
Claudia M. Mitchell & Marni Sommer
This Introduction serves to map out a range of participatory visual approaches, as well as critical issues related to the use of participatory visual methodologies in global health. In so doing, it offers both an overview of these innovative practices in global health and a consideration of some of the key questions that researchers might ask themselves in design and implementation.

Research as intervention? Exploring the health and well-being of children and youth facing global adversity through participatory visual methods
pages 528-545
Miranda D’Amico, Myriam Denov, Fatima Khan, Warren Linds & Bree Akesson
Global health research typically relies on the translation of knowledge (from health professionals to the community) and the dissemination of knowledge (from research results to the wider public). However, Greenhalgh and Wieringa [2011. Is it time to drop the ‘knowledge translation’ metaphor? A critical literature review. Journal of the Royal Society of Medicine, 104(12), 501–509. doi:10.1258/jrsm.2011.110285] suggest ‘that while “translation” is a widely used metaphor in medicine, it constrains how we conceptualize and study the link between knowledge and practice’ (p. 501). Often the knowledge garnered from such research projects comes from health professionals rather than reflecting the lived experiences of people and communities. Likewise, there has been a gap in ‘translating’ and ‘disseminating’ the results of participatory action research projects to policymakers and medical practitioners. This paper will look at how using participatory visual methodologies in global health research with children and youth facing global adversity incorporates the multiple functions of their lived realities so that research becomes a means of intervention. Drawing from a literature review of participatory visual methods as media, content and processes of global health research, this paper raises practical, theoretical, and ethical questions that arise from research as intervention. The paper concludes by exploring what lessons emerge when participatory visual methodologies are integrated into global health research with children and youth facing global adversity.

From informed consent to dissemination: Using participatory visual methods with young people with long-term conditions at different stages of research
pages 636-650
Cecilia Vindrola-Padros, Ana Martins, Imelda Coyne, Gemma Bryan & Faith Gibson
Research with young people suffering from a long-term illness has more recently incorporated the use of visual methods to foster engagement of research participants from a wide age range, capture the longitudinal and complex factors involved in young people’s experiences of care, and allow young people to express their views in multiple ways. Despite its contributions, these methods are not always easy to implement and there is a possibility that they might not generate the results or engagement initially anticipated by researchers. We hope to expand on the emerging discussion on the use of participatory visual methods by presenting the practical issues we have faced while using this methodology during different stages of research: informed assent/consent, data collection, and the dissemination of findings. We propose a combination of techniques to make sure that the research design is flexible enough to allow research participants to shape the research process according to their needs and interests.


Beyond engagement in working with children in eight Nairobi slums to address safety, security, and housing: Digital tools for policy and community dialogue
pages 651-665
Claudia Mitchell, Fatuma Chege, Lucy Maina & Margot Rothman
This article studies the ways in which researchers working in the area of health and social research and using participatory visual methods might extend the reach of participant-generated creations such as photos and drawings to engage community leaders and policy-makers. Framed as going ‘beyond engagement’, the article explores the idea of the production of researcher-led digital dialogue tools, focusing on one example, based on a series of visual arts-based workshops with children from eight slums in Nairobi addressing issues of safety, security, and well-being in relation to housing. The authors conclude that there is a need for researchers to embark upon the use of visual tools to expand the life and use of visual productions, and in particular to ensure meaningful participation of communities in social change.

Outwitting dengue threat and epidemics resurgence in Asia-Pacific countries: strengthening integrated dengue surveillance, monitoring and response systems

Infectious Diseases of Poverty
[Accessed 28 May 2016]

Outwitting dengue threat and epidemics resurgence in Asia-Pacific countries: strengthening integrated dengue surveillance, monitoring and response systems
Dengue is still a substantial vector-borne viral disease threat and burden of public health importance worldwide. This situation is complicated by dengue virus unprecedented resurgence and persistence …
Ernest Tambo, Jun-Hu Chen, Xiao-Nong Zhou and Emad I. M. Khater
Infectious Diseases of Poverty 2016 5:56
Published on: 27 May 2016

The Lancet – May 28, 2016

The Lancet
May 28, 2016 Volume 387 Number 10034 p2163-2262 e28

Eliminating FGM: what can health professionals do?
The Lancet
Female genital mutilation (FGM)—defined by WHO as “procedures that involve the partial or total removal of external genitalia or other injury to the female genital organs for non-medical reasons”—is internationally recognised as a violation of the human rights of girls and women. Worldwide, more than 200 million girls and women suffer the physical and psychological consequences of FGM. FGM is a harmful practice and can cause several immediate and long-term health consequences such as haemorrhage, post-traumatic stress disorder, painful urination, and complications in childbirth.


Yellow fever: the resurgence of a forgotten disease
Margaret Chan
Published Online: 23 May 2016
The possibility that a mosquito bite during pregnancy could cause severe brain damage in newborn babies has alarmed the public and astonished scientists. The Zika outbreak in the Americas shows how a disease that slumbered for six decades in Africa and Asia, never causing an outbreak, can become a global health emergency. The Ebola and Zika outbreaks have revealed gaping holes in our lines of defence: weak health infrastructures and capacities in west Africa and the demise of programmes for mosquito control in the Americas.

Genetically Modified (GM) Mosquito Use to Reduce Mosquito-Transmitted Disease in the US: A Community Opinion Survey

PLoS Currents: Outbreaks
(Accessed 28 May 2016)

Research Article
Genetically Modified (GM) Mosquito Use to Reduce Mosquito-Transmitted Disease in the US: A Community Opinion Survey
May 25, 2016 ·
Introduction: Mosquito-borne infectious diseases such as dengue, chikungunya, and now Zika, pose a public health threat to the US, particularly Florida, the Gulf Coast states, and Hawaii. Recent autochthonous transmission of dengue and chikungunya in Florida, the recent dengue outbreak in Hawaii, and the potential for future local spread of Zika in the US, has led to the consideration of novel approaches to mosquito management. One such novel approach, the release of sterile genetically modified mosquitoes, has been proposed as a possible intervention, and a trial release of GM mosquitoes is being considered in one Florida community. However, this proposal has been controversial. The objective of this research was to increase understanding of community knowledge, attitudes, and beliefs regarding mosquito control and GM mosquitoes.
Methods: An 18-question self-administered survey was mailed to all households in the identified Key West, Florida neighborhood where a GM mosquito trial has been proposed. This survey was fielded between July 20, 2015 and November 1, 2015. The main outcome variable was opposition to the use of GM mosquitoes. Measures included demographic information and opinions on mosquitoes, mosquito control, and vector-borne diseases.
Results: A majority of survey respondents did not support use of GM mosquitoes as a mosquito control method.
Discussion: Reasons for opposition included general fears about possible harmful impacts of this intervention, specific worries about human and animal health impacts from the GM mosquitoes, and environmental concerns about potential negative effects on the ecosystem. Residents were more likely to oppose GM mosquito use if they had a low perception of the potential risks posed by diseases like dengue and chikungunya, if they were female, and if they were less concerned about the need to control mosquitoes in general. These findings suggest a need for new approaches to risk communication, including educational efforts surrounding mosquito control and reciprocal dialogue between residents and public health officials.

Health Research and the World Humanitarian Summit—Not a Thousand Miles Apart

PLoS Medicine
(Accessed 28 May 2016)

Health Research and the World Humanitarian Summit—Not a Thousand Miles Apart
The PLOS Medicine Editors
| published 23 May 2016 | PLOS Medicine

May 23–24, 2016, marks the first World Humanitarian Summit (WHS), convened in Istanbul by United Nations Secretary-General Ban Ki-Moon following three years of preparatory consultations [1]. In an effort to resolve current humanitarian crises and avert future ones, the event aims to bring together heads of state, leaders of crisis-affected communities, representatives from industry, multilateral and nongovernment organizations, and other groups involved in humanitarian crises. Remarkably, the same dates bring a key meeting for another UN agency: the 69th World Health Assembly, through which member states govern the World Health Organization (WHO), meets May 23–28 in Geneva, more than 1,000 miles away.

Health crises are both cause and consequence of humanitarian crises. As part of the WHS consultation process, WHO has emphasized that “[t]he health and well-being of affected populations is the ultimate goal of humanitarian action” [2]. The Secretary-General’s report for the WHS, which includes the five-section Agenda for Humanity, describes the present situation in cataclysmic terms that include global threats to health:
Brutal and seemingly intractable conflicts have devastated the lives of millions of people…. More countries are slipping into fragility, marked by extreme poverty…. Violent extremism, terrorism and transnational crime are creating persistent instability. Growing economic inequality within countries and the widening gap between the rich and the poor are further marginalizing the most vulnerable people in society. Climate change continues to cause increased humanitarian stress as it exacerbates food insecurity, water scarcity, conflict, migration and other trends. Disasters are becoming more frequent and intense. Pandemics, epidemics and other global health threats continue to emerge frequently, and at worrying levels… [3]

In the context of this clear common ground, it seems ironic that a scheduling conflict effectively precludes health ministers and WHO leadership from attending both WHA and WHS. As journal editors, we are prompted to ask in turn how the core concerns of our work—medicine and health research—align with the priorities of the Agenda for Humanity.
Medical interventions appear in the Secretary-General’s report as part of Core Responsibility 2 (“uphold the norms that safeguard humanity”), in which the human rights of civilians are noted to include access to humanitarian medical services, care for the sick and wounded, and protection against attacks on hospitals and medical workers. We support this identification of medical services as crucially important. Having joined the call in 2014 for an end to deliberate attacks on medical services in conflict settings [4], we can scarcely conceive language sufficient to condemn the repeated bombing of hospitals in air-strikes that have since become widespread [5–7]. Core Responsibility 3 (“leave no one behind”) includes recognition that women and girls in crisis settings, as well as displaced people with disabilities and older people, are particularly at risk of poor access to health programs. Even in a document clearly intended to emphasize critical needs for political leadership and financing, these few mentions of health are notable for their brevity.

Limited mention of health and medicine may reflect the prominence of UN Sustainable Development Goal 3, devoted specifically to health and well-being; to expect each initiative to cover every important topic would invite loss of focus. Even so, moving from medical services to medical research, one finds the word “research” only once in the report’s 62 pages of text; the words “science” and “scientific” do not appear at all. Rather, the report emphasizes the need to collect, share, and analyze data for the purpose of assessing need, anticipating crises, and monitoring responses: “All actors should commit to consolidating available data in open and widely accessible databases, with adequate security and privacy protection…to inform joint analysis and a common picture of the most pressing risks. This common picture should be used to set ambitious targets towards implementing and financing preparedness and risk management strategies” [3].

In many crisis situations, a surveillance and monitoring approach may be more appropriate than the classic scientific approach of designing studies to test hypotheses and generate new, generalizable knowledge. At other times, the two approaches may overlap, testing the limits of the scientific method, as we cannot expect data obtained in a crisis situation to attain the methodological rigor of prospectively designed studies in controlled settings. In addition to publishing scientific studies, a journal may raise awareness of issues and thoughtful approaches to solutions. (Recent examples in this journal include essays on the role of physicians in refugee detention centers in Australia [8] and statistical approaches to making the most of limited mortality data on forced migrants, such as those in Southern Sudan and Iraq [9].) Nonetheless, we believe that a scientific approach has more to offer than may be apparent from the wording of the Secretary-General’s report. While opportunities to obtain sound data in crises may be fleeting and perilous, and opportunities to replicate conclusions uncertain, the results can still be illuminating and useful.

One of PLOS Medicine’s more frequently viewed and cited articles attributed one-third of deaths following the United States invasion of Iraq not to direct violence but to indirect causes such as failures of health, sanitation, and other systems [10]. We believe that this research, based on household survey reports, analyzed against a historical comparison group, and unlikely to be replicated directly, has substantially advanced understanding of the scope of humanitarian crises that follow war. While the results are necessarily estimates, had the investigation not been conducted using established scientific methodology, the reliability of the conclusions would be impossible to assess.

The widespread occurrence of current atrocities and the threat of future devastation demand action. We applaud the potential of WHS to align the necessary agencies and resources. Yet, the very need for such a summit suggests that, despite advances in human rights over recent decades, governments and agencies with the capacity to act still lack evidence for prioritizing and pursuing effective action. In humanitarian crises, collecting and monitoring data will be necessary but not sufficient; a sustainable impact on effects requires an understanding of causes, and responsible action requires investigation of how best to implement what is understood [11].

While science cannot by itself resolve disasters of such profound political and ethical dimensions, research can bring objectivity and innovation to understanding the causes of humanitarian crises and evaluating approaches to their prevention and resolution. We hope that discussions sparked by the Istanbul Summit will more closely integrate health objectives and clarify the role that original research should play in the global response to humanitarian crises.

Epidemiology and Reporting Characteristics of Systematic Reviews of Biomedical Research: A Cross-Sectional Study

PLoS Medicine
(Accessed 28 May 2016)

Research Article
Epidemiology and Reporting Characteristics of Systematic Reviews of Biomedical Research: A Cross-Sectional Study
Matthew J. Page, Larissa Shamseer, Douglas G. Altman, Jennifer Tetzlaff, Margaret Sampson, Andrea C. Tricco, Ferrán Catalá-López, Lun Li, Emma K. Reid, Rafael Sarkis-Onofre, David Moher
| published 24 May 2016 | PLOS Medicine
Systematic reviews (SRs) can help decision makers interpret the deluge of published biomedical literature. However, a SR may be of limited use if the methods used to conduct the SR are flawed, and reporting of the SR is incomplete. To our knowledge, since 2004 there has been no cross-sectional study of the prevalence, focus, and completeness of reporting of SRs across different specialties. Therefore, the aim of our study was to investigate the epidemiological and reporting characteristics of a more recent cross-section of SRs.
Methods and Findings
We searched MEDLINE to identify potentially eligible SRs indexed during the month of February 2014. Citations were screened using prespecified eligibility criteria. Epidemiological and reporting characteristics of a random sample of 300 SRs were extracted by one reviewer, with a 10% sample extracted in duplicate. We compared characteristics of Cochrane versus non-Cochrane reviews, and the 2014 sample of SRs versus a 2004 sample of SRs. We identified 682 SRs, suggesting that more than 8,000 SRs are being indexed in MEDLINE annually, corresponding to a 3-fold increase over the last decade. The majority of SRs addressed a therapeutic question and were conducted by authors based in China, the UK, or the US; they included a median of 15 studies involving 2,072 participants. Meta-analysis was performed in 63% of SRs, mostly using standard pairwise methods. Study risk of bias/quality assessment was performed in 70% of SRs but was rarely incorporated into the analysis (16%). Few SRs (7%) searched sources of unpublished data, and the risk of publication bias was considered in less than half of SRs. Reporting quality was highly variable; at least a third of SRs did not report use of a SR protocol, eligibility criteria relating to publication status, years of coverage of the search, a full Boolean search logic for at least one database, methods for data extraction, methods for study risk of bias assessment, a primary outcome, an abstract conclusion that incorporated study limitations, or the funding source of the SR. Cochrane SRs, which accounted for 15% of the sample, had more complete reporting than all other types of SRs. Reporting has generally improved since 2004, but remains suboptimal for many characteristics.
An increasing number of SRs are being published, and many are poorly conducted and reported. Strategies are needed to help reduce this avoidable waste in research.

PLoS Neglected Tropical Diseases (Accessed 28 May 2016)

PLoS Neglected Tropical Diseases
(Accessed 28 May 2016)

Research Article
Projected Impact of Dengue Vaccination in Yucatán, Mexico
Thomas J. Hladish, Carl A. B. Pearson, Dennis L. Chao, Diana Patricia Rojas, Gabriel L. Recchia, Héctor Gómez-Dantés, M. Elizabeth Halloran, Juliet R. C. Pulliam, Ira M. Longini
Research Article | published 26 May 2016 | PLOS Neglected Tropical Diseases

Old World Cutaneous Leishmaniasis and Refugee Crises in the Middle East and North Africa
Rebecca Du, Peter J. Hotez, Waleed S. Al-Salem, Alvaro Acosta-Serrano
Editorial | published 26 May 2016 | PLOS Neglected Tropical Diseases

Research Capacity Strengthening in Low and Middle Income Countries – An Evaluation of the WHO/TDR Career Development Fellowship Programme
Michael Käser, Christine Maure, Beatrice M. M. Halpaap, Mahnaz Vahedi, Sara Yamaka, Pascal Launois, Núria Casamitjana
Research Article | published 25 May 2016 | PLOS Neglected Tropical Diseases

Mobile phone data highlights the role of mass gatherings in the spreading of cholera outbreaks

PNAS – Proceedings of the National Academy of Sciences of the United States of America
(Accessed 28 May 2016)

Physical Sciences – Environmental Sciences:
Mobile phone data highlights the role of mass gatherings in the spreading of cholera outbreaks
Flavio Finger, Tina Genolet, Lorenzo Mari, Guillaume Constantin de Magny, Noël Magloire Manga, Andrea Rinaldo, and Enrico Bertuzzo
PNAS 2016 ; published ahead of print May 23, 2016, doi:10.1073/pnas.1522305113
Big data and, in particular, mobile phone data are expected to revolutionize epidemiology, yet their full potential is still untapped. Here, we take a significant step forward by developing an epidemiological model that accounts for the spatiotemporal patterns of human mobility derived by directly tracking properly anonymized mobile phone users. Such data allow us to investigate, with an unprecedented level of detail, the effect that mass gatherings can have on the spreading of waterborne diseases like cholera. Identifying and understanding transmission hotspots opens the way to the implementation of novel disease control strategies.

The spatiotemporal evolution of human mobility and the related fluctuations of population density are known to be key drivers of the dynamics of infectious disease outbreaks. These factors are particularly relevant in the case of mass gatherings, which may act as hotspots of disease transmission and spread. Understanding these dynamics, however, is usually limited by the lack of accurate data, especially in developing countries. Mobile phone call data provide a new, first-order source of information that allows the tracking of the evolution of mobility fluxes with high resolution in space and time. Here, we analyze a dataset of mobile phone records of ∼150,000 users in Senegal to extract human mobility fluxes and directly incorporate them into a spatially explicit, dynamic epidemiological framework. Our model, which also takes into account other drivers of disease transmission such as rainfall, is applied to the 2005 cholera outbreak in Senegal, which totaled more than 30,000 reported cases. Our findings highlight the major influence that a mass gathering, which took place during the initial phase of the outbreak, had on the course of the epidemic. Such an effect could not be explained by classic, static approaches describing human mobility. Model results also show how concentrated efforts toward disease control in a transmission hotspot could have an important effect on the large-scale progression of an outbreak.

Research and Evaluations of the Health Aspects of Disasters…

Prehospital & Disaster Medicine
Volume 31 – Issue 03 – June 2016

Special Reports
Research and Evaluations of the Health Aspects of Disasters, Part VIII: Risk, Risk Reduction, Risk Management, and Capacity Building
Marvin L. Birnbaum, Alessandro Loretti, Elaine K. Daily and Ann P. O’Rourke
June 2016, pp 300 – 308
DOI: http://dx.doi.org/10.1017/S1049023X16000285
Published online: 30 March 2016
There is a cascade of risks associated with a hazard evolving into a disaster that consists of the risk that: (1) a hazard will produce an event; (2) an event will cause structural damage; (3) structural damage will create functional damages and needs; (4) needs will create an emergency (require use of the local response capacity); and (5) the needs will overwhelm the local response capacity and result in a disaster (ie, the need for outside assistance). Each step along the continuum/cascade can be characterized by its probability of occurrence and the probability of possible consequences of its occurrence, and each risk is dependent upon the preceding occurrence in the progression from a hazard to a disaster. Risk-reduction measures are interventions (actions) that can be implemented to: (1) decrease the risk that a hazard will manifest as an event; (2) decrease the amounts of structural and functional damages that will result from the event; and/or (3) increase the ability to cope with the damage and respond to the needs that result from an event. Capacity building increases the level of resilience by augmenting the absorbing and/or buffering and/or response capacities of a community-at-risk. Risks for some hazards vary by the context in which they exist and by the Societal System(s) involved.

Special Reports
Research and Evaluations of the Health Aspects of Disasters, Part IX: Risk-Reduction Framework
Marvin L. Birnbaum, Elaine K. Daily, Ann P. O’Rourke and Alessandro Loretti
DOI: http://dx.doi.org/10.1017/S1049023X16000352
Published online: 01 April 2016
A disaster is a failure of resilience to an event. Mitigating the risks that a hazard will progress into a destructive event, or increasing the resilience of a society-at-risk, requires careful analysis, planning, and execution. The Disaster Logic Model (DLM) is used to define the value (effects, costs, and outcome(s)), impacts, and benefits of interventions directed at risk reduction. A Risk-Reduction Framework, based on the DLM, details the processes involved in hazard mitigation and/or capacity-building interventions to augment the resilience of a community or to decrease the risk that a secondary event will develop. This Framework provides the structure to systematically undertake and evaluate risk-reduction interventions. It applies to all interventions aimed at hazard mitigation and/or increasing the absorbing, buffering, or response capacities of a community-at-risk for a primary or secondary event that could result in a disaster. The Framework utilizes the structure provided by the DLM and consists of 14 steps: (1) hazards and risks identification; (2) historical perspectives and predictions; (3) selection of hazard(s) to address; (4) selection of appropriate indicators; (5) identification of current resilience standards and benchmarks; (6) assessment of the current resilience status; (7) identification of resilience needs; (8) strategic planning; (9) selection of an appropriate intervention; (10) operational planning; (11) implementation; (12) assessments of outputs; (13) synthesis; and (14) feedback. Each of these steps is a transformation process that is described in detail. Emphasis is placed on the role of Coordination and Control during planning, implementation of risk-reduction/capacity building interventions, and evaluation

Refugee Survey Quarterly – Volume 35 Issue 2 June 2016

Refugee Survey Quarterly
Volume 35 Issue 2 June 2016
Special Issue: Humanitarianism and the Migration Crisis
Guest Editor: Tom Scott-Smith
Humanitarian Dilemmas in a Mobile World
Tom Scott-Smith
Refugee Survey Quarterly (2016) 35 (2): 1-21 doi:10.1093/rsq/hdw001

Search and Rescue in the Mediterranean Sea: Negotiating Political Differences
Hernan del Valle
Refugee Survey Quarterly (2016) 35 (2): 22-40 doi:10.1093/rsq/hdw002

Detention of Migrants and Asylum-Seekers: The Challenge for Humanitarian Actors
Ioanna Kotsioni
Refugee Survey Quarterly (2016) 35 (2): 41-55 doi:10.1093/rsq/hdw004

Be Near a Road: Humanitarian Practice and Displaced Persons in North Kivu
Sean Healy and Sandrine Tiller
Refugee Survey Quarterly (2016) 35 (2): 56-78 doi:10.1093/rsq/hdw003

Aid and the Perpetuation of Refugee Camps: The Case of Dadaab in Kenya 1991–2011
Hakim Chkam
Refugee Survey Quarterly (2016) 35 (2): 79-97 doi:10.1093/rsq/hdw005

Continuity of Care for Migrant Populations in Southern Africa
Aurélie Ponthieu and Andrea Incerti
Refugee Survey Quarterly (2016) 35 (2): 98-115 doi:10.1093/rsq/hdw006

The Journey to Dreamland Never Ends: A Refugee’s Journey from Somalia to Sweden
Ali Hassan and Linn Biörklund

Brazilian crisis threatens science and environment

27 May 2016 Vol 352, Issue 6289

In Depth
Brazilian crisis threatens science and environment
By Lizzie Wade
Science27 May 2016 : 1044
In the midst of Brazil’s political turmoil, scientists and environmentalists are wondering whether they have an enemy in Interim President Michel Temer, who came to power after Dilma Rousseff was removed on 12 May. Days after Temer assumed office, the government merged the science ministry with the communications ministry, leaving researchers fearing for what’s left of their already diminished budgets. Meanwhile, pro-development forces are moving ahead on a constitutional amendment that could speed approval for dams, highways, mines, and other megaprojects. The measure has alarmed scientists, environmentalists, and indigenous rights advocates, who fear it would gut the country’s environmental licensing process.

Social Science & Medicine – Volume 156, Pages 1-212 (May 2016)

Social Science & Medicine
Volume 156, Pages 1-212 (May 2016)

Review articles
Where the lay and the technical meet: Using an anthropology of interfaces to explain persistent reproductive health disparities in West Africa
Review Article
Pages 175-183
Yannick Jaffré, Siri Suh
Despite impressive global investment in reproductive health programs in West Africa, maternal mortality remains unacceptably high and obstetric care is often inadequate. Fertility is among the highest in the world, while contraceptive prevalence remains among the lowest. This paper explores the social and technical dimensions of this situation. We argue that effective reproductive health programs require analyzing the interfaces between technical programs and the social logics and behaviors of health professionals and client populations. Significant gaps between health programs’ goals and the behaviors of patients and health care professionals have been observed. While public health projects aim to manage reproduction, sexuality, fertility, and professional practices are regulated socially. Such projects may target technical practices, but access to care is greatly influenced by social norms and ethics. This paper shows how an empirical anthropology that investigates the social and technical interfaces of reproduction can contribute to improved global health.


Exploring the views of people with mental health problems’ on the concept of coercion: Towards a broader socio-ethical perspective
Original Research Article
Pages 204-211
Reidun Norvoll, Reidar Pedersen
In mental health care, coercion is a controversial issue that has led to much debate and research on its nature and use. Yet, few previous studies have explicitly explored the views on the concept of coercion among people with first-hand experiences of being coerced. This study includes semi-structured focus-groups and individual interviews with 24 participants who had various mental health problems and experiences with coercion. Data were collected in 2012–2013 in three regions of Norway and analysed by a thematic content analysis. Findings show that participants had wide-ranging accounts of coercion, including formal and informal coercion across health- and welfare services. They emphasised that using coercion reflects the mental health system’s tendency to rely on coercion and the lack of voluntary services and treatment methods that are more helpful. Other core characteristics of coercion were deprivation of freedom, power relations, in terms of powerlessness and ‘counter-power,’ and coercion as existential and social life events. Participants’ views are consistent with prevailing theories of coercion and research on perceived coercion. However, this study demonstrates a need for broader existential and socio-ethical perspectives on coercion that are intertwined with treatment and care systems in research and practice. Implications for mental health policy and services are discussed.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
Week ending 21 May 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

pdf version: The Sentinel_ week ending 21 May 2016

Migration / Refugees /Asylum

Migration / Refugees /Asylum

Mediterranean Migrant Arrivals in 2016: 190,973; Deaths 1,359
05/20/16 – IOM
Italy – IOM reports an estimated 190,973 migrants and refugees have entered Europe by sea in 2016 through 18 May, arriving in Italy, Greece, Cyprus and Spain.


Greece: “Europe’s lack of political will creating serious suffering for thousands of migrants in Greece” – UN rights expert
ATHENS / GENEVA (17 May 2016) – “The suffering of migrants in Greece is the result of a complete absence of long-term vision and the clear lack of political will of the European Union,” United Nations human rights expert François Crépeau said at the end of a follow-up mission* to Greece.

“This is not only a humanitarian crisis,” the UN Special Rapporteur on the human rights of migrants warned. “This is more importantly a political crisis in which the EU and the overwhelming majority of EU member states have abandoned Greece – a country that is fighting to implement austerity measures – leaving it to deal with an issue that requires efforts from all.”

Mr. Crépeau stressed that the closure of the borders surrounding Greece, coupled with the new EU-Turkey agreement, have exponentially increased the number of irregular migrants in the country. “Unlike before, Greece is no longer a transit country and is struggling to ‘catch up’ and develop a mechanism to deal with immediate needs, in the absence of a clear commitment from the EU to support the country,” he said.

The independent expert expressed particular concern with conditions in the Reception and Identification Centres (RIC or ‘hotspots’), which have become closed centres as a result of the EU-Turkey deal, and “are creating an unacceptable level of confusion, frustration, violence and fear.”

He noted, among other worrying issues, the length of process to identify vulnerable migrants, the blatant over-crowding that is amplifying inter-communal friction, the mix of families and young single males, the absence of many Government services during the weekend, the contradictory information received regarding procedures and timelines, as well as insufficient procedural safeguards in detention facilities for migrants…


EU-Turkey deal: Greek decision highlights fundamental flaws
Press Release – Amnesty International
20 May 2016, 19:11 UTC
A Syrian national who arrived on the Greek island of Lesvos has won an appeal against a decision that would have led to his forcible return to Turkey, underscoring the fundamental flaws in the migration deal agreed in March between the European Union and Turkey, Amnesty International said.

In the first such decision Amnesty International has seen since the deal, an appeals committee in Athens overturned an initial decision considering Turkey a safe third country on the grounds that Turkey does not afford refugees the full protection required under the Refugee Convention. The committee also ruled that Turkey does not guarantee the principle of non-refoulement, which forbids returning someone to a country where he or she is at risk of serious human rights violations.

“This decision goes to the heart of why the EU-Turkey deal was so deeply flawed to begin with,” said Gauri van Gulik, Deputy Europe Director at Amnesty International.

“Turkey is not safe for refugees, it does not offer them full protection, and assurances on paper are simply not good enough. We’ve seen the reality on the ground: until Turkey ends all violations against refugees and guarantees them full protection, nobody else should be sent back under this deal. Instead Europe should focus on its part of the deal by accepting refugees for resettlement from Turkey. It should also urgently improve conditions for refugees in Greece.”…