Disaster Medicine and Public Health Preparedness
Volume 10 – Issue 5 – October 2016
https://www.cambridge.org/core/journals/disaster-medicine-and-public-health-preparedness/latest-issue

.
Commentary
Yemen’s Unprecedented Humanitarian Crisis: Implications for International Humanitarian Law, the Geneva Convention, and the Future of Global Health Security
Published online: 11 August 2016, pp. 701-703
Alba Ripoll Gallardo, Frederick M. Burkle, Luca Ragazzoni, Francesco Della Corte
DOI: http://dx.doi.org/10.1017/dmp.2016.50
Abstract
The current humanitarian crisis in Yemen is unprecedented in many ways. The Yemeni War tragedy is symptomatic of gross failures to recognize, by combatants, existing humanitarian law and the Geneva Convention that have become the new norm in unconventional armed conflicts and are increasingly replicated in Africa, Afghanistan, and other areas of the Middle East with dire consequences on aid workers and the noncombatant population. The health and humanitarian professions must take collective responsibility in calling for all belligerent parties to cease the massacre and commit to guaranteed medical assistance, humanitarian aid, and the free flow of information and respect for the humanitarian principles that protect the neutrality and impartiality of the humanitarian workforce. (Disaster Med Public Health Preparedness. 2016; page 1 of 3)

.

Policy Analysis
Zika Virus: A Basic Overview of an Emerging Arboviral Infection in the Western Hemisphere
Published online: 29 March 2016, pp. 707-712
Kelly G. Vest
DOI: http://dx.doi.org/10.1017/dmp.2016.43

.

Systematic Review
Tools and Checklists Used for the Evaluation of Hospital Disaster Preparedness: A Systematic Review
Published online: 27 May 2016, pp. 781-788
Mahmood Nekoie-Moghadam, Lisa Kurland, Mahmood Moosazadeh, Pier Luigi Ingrassia, Francesco Della Corte, Ahmadreza Djalali
DOI: http://dx.doi.org/10.1017/dmp.2016.30

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 29 October 2016]

.
Research
Civil society participation in the health system: the case of Brazil’s Health Councils
Martha Gabriela Martinez and Jillian Clare Kohler
Globalization and Health 2016 12:64
Published on: 26 October 2016
Abstract
Background
Brazil created Health Councils to bring together civil society groups, heath professionals, and government officials in the discussion of health policies and health system resource allocation. However, several studies have concluded that Health Councils are not very influential on healthcare policy. This study probes this issue further by providing a descriptive account of some of the challenges civil society face within Brazil’s Health Councils.
Methods
Forty semi-structured interviews with Health Council Members at the municipal, state and national levels were conducted in June and July of 2013 and May of 2014. The geographical location of the interviewees covered all five regions of Brazil (North, Northeast, Midwest, Southeast, South) for a total of 5 different municipal Health Councils, 8 different state Health Councils, and the national Health Council in Brasilia. Interview data was analyzed using a thematic approach.
Results
Health Councils are limited by a lack of legal authority, which limits their ability to hold the government accountable for its health service performance, and thus hinders their ability to fulfill their mandate. Equally important, their membership guidelines create a limited level of inclusivity that seems to benefit only well-organized civil society groups. There is a reported lack of support and recognition from the relevant government that negatively affects the degree to which Health Council deliberations are implemented. Other deficiencies include an insufficient amount of resources for Health Council operations, and a lack of training for Health Council members. Lastly, strong individual interests among Health Council members tend to influence how members participate in Health Council discussions.
Conclusions
Brazil’s Health Councils fall short in providing an effective forum through which civil society can actively participate in health policy and resource allocation decision-making processes. Restrictive membership guidelines, a lack of autonomy from the government, vulnerability to government manipulation, a lack of support and recognition from the government and insufficient training and operational budgets have made Health Council largely a forum for consultation. Our conclusions highlight, that among other issues, Health Councils need to have the legal authority to act independently to promote government accountability, membership guidelines need to be revised in order include members of marginalized groups, and better training of civil society representatives is required to help them make more informed decisions.

JAMA
October 25, 2016, Vol 316, No. 16, Pages 1615-1726
http://jama.jamanetwork.com/issue.aspx

.
Viewpoint
Systems Strategies for Health Throughout the Life Course
J. Michael McGinnis, MD, MA, MPP; Angela Diaz, MD, MPH; Neal Halfon, MD, MPH
JAMA. 2016;316(16):1639-1640. doi:10.1001/jama.2016.14896
This Viewpoint from the National Academy of Medicine’s 2016 Vital Directions initiative discusses strategies to improve the health of populations at each stage of life through incentivizing and measuring health system performance to improve health, creating an interoperable digital health platform, and fostering a culture and practice of continuous health improvement.

.
Viewpoint
Addressing Social Determinants of Health and Health Inequalities
Nancy E. Adler, PhD; M. Maria Glymour, ScD, MS; Jonathan Fielding, MD, MPH
JAMA. 2016;316(16):1641-1642. doi:10.1001/jama.2016.14058
This Viewpoint from the National Academy of Medicine’s 2016 Vital Directions initiative emphasizes the importance of refocusing some health policies toward addressing social and behavioral determinants of health and the potential effects of reducing health inequalities and improving the health and longevity of all people in the United States.

.
Viewpoint
Preparing for Better Health and Health Care for an Aging Population
John W. Rowe, MD; Terry Fulmer, PhD, RN; Linda Fried, MD
JAMA. 2016;316(16):1643-1644. doi:10.1001/jama.2016.12335
This Viewpoint from the National Academy of Medicine’s 2016 Vital Directions initiative recommends ways to improve the health and health care of older persons, including development of new care delivery models for people with chronic conditions and strengthening of the elder care workforce.

JBI Database of Systematic Review and Implementation Reports
September 2016 – Volume 14 – Issue 9 pp: 1-380
http://journals.lww.com/jbisrir/Pages/currenttoc.aspx

.
Editorial
Riding a wave in developing countries: challenges and priorities for evidence based practice
Enuameh, Yeetey Akpe Kwesi
[Initial text]
Over the past decade, developing countries have become increasingly engaged with the processes and activities of evidence-based practice (EBP).1,2 Some facilitators of this process include the Joanna Briggs Institute (JBI) and Cochrane, among others. Organizations from a number of developing countries are currently members of these two bodies1,2 — a testament to their increasing participation in evidence synthesis. Systematic reviews and other EBP processes and resources are also being accessed and utilized by the developing world.
The Joanna Briggs Institute, Cochrane and the Collaboration for Evidence-Based Healthcare in Africa (CEBHA) have in recent times established evidence synthesis and translation groups in sub-Saharan and Asian countries.3,4 Researchers, educationists, healthcare providers, health program implementers and policy makers are keen to understand the concept of EBP across the developing world. Institutions of higher learning and research in developing countries are encouraging graduate students to conduct and publish systematic reviews as a component of their programs of study. Some organizations have further provided end-users with platforms to access systematic reviews and relevant derivatives to guide practice and policy.5…

.

Systematic Review Protocols
Community health workers’ experiences of mobile device-enabled clinical decision support systems for maternal, newborn and child health in developing countries: a qualitative…
Dzabeng, Francis; Enuameh, Yeetey; Adjei, George; More
Abstract
Review question/objective: The objective of this review is to synthesize evidence on the experiences of community health workers (CHWs) of mobile device-enabled clinical decision support systems (CDSSs) interventions designed to support maternal newborn and child health (MNCH) in low-and middle-income countries.
Specific objectives:
* To identify the perceived benefits and barriers of using mobile device-enabled CDSSs.
* To identify the deficiencies in mobile device-enabled CDSSs as perceived by CHWs.
* To understand how these systems affect CHWs work patterns based on behavioral change theories.

Journal of Cultural Heritage Management and Sustainable Development
2016: Volume 6 Issue 3
http://www.emeraldinsight.com/toc/jchmsd/6/2

.
Research paper
Challenges to urban cultural heritage conservation and management in the historic centre of Sulaimaniyah, Kurdistan – Iraq
Hanaw M. Taqi M. Amin , Emmanuel Akwasi Adu-Ampong
Abstract
Purpose
The purpose of this research paper is to examine the challenges to urban cultural heritage management conservation in the historical city of Sulaimaniyah, Kurdistan-Iraq. The paper focuses on the roles and interactions of stakeholders and the issues that confront the decision making processes that underpin the management of historic city towns.
Design/methodology/approach
A case study methodology is utilised for this research. It involves documentary analysis and interviews with stakeholders who are part of the management of the historic city centre of Sulaimaniyah, Kurdistan-Iraq. The findings from this case study are analysed in a systematic way before being discussed in the context of the literature on urban cultural heritage management.
Findings
The research shows that although there is a shared vision of the need to preserve and conserve urban cultural heritage, the management process is a contentious one. Stakeholders have different ideas as to how to achieve conservation goals which leads to increasing conflicts among stakeholders. This situation is compounded by the limited financial resources available to local government agencies, political interference in the work of implementation agencies and the lack of capacity in local government to enforce rules and carry out conservation projects. There are also significant power differentials among stakeholders in the decision making process which often means that local residents are excluded from the process of conserving their built urban heritage.
Practical implications
This research can help practitioners who are in charge of urban cultural heritage management in dealing with stakeholder conflicts. The paper offers insight into a number of sources of stakeholder conflicts and on ways to overcome these in the planning process.
Originality/value
The originality of research lies in the novelty of the case study area. This research highlights the issues of built heritage conservation management and planning practices in an area – Sulaimaniyah, Kurdistan-Iraq – that is geographically less represented in the extant literature. The research also identifies some of the key sources of conflict in urban heritage conservation projects and provides an insight into the roles of stakeholders in the management of smaller locally-dependent historic city centres.
Purpose
The purpose of this research paper is to examine the challenges to urban cultural heritage management conservation in the historical city of Sulaimaniyah, Kurdistan-Iraq. The paper focuses on the roles and interactions of stakeholders and the issues that confront the decision making processes that underpin the management of historic city towns.
Design/methodology/approach
A case study methodology is utilised for this research. It involves documentary analysis and interviews with stakeholders who are part of the management of the historic city centre of Sulaimaniyah, Kurdistan-Iraq. The findings from this case study are analysed in a systematic way before being discussed in the context of the literature on urban cultural heritage management.
Findings
The research shows that although there is a shared vision of the need to preserve and conserve urban cultural heritage, the management process is a contentious one. Stakeholders have different ideas as to how to achieve conservation goals which leads to increasing conflicts among stakeholders. This situation is compounded by the limited financial resources available to local government agencies, political interference in the work of implementation agencies and the lack of capacity in local government to enforce rules and carry out conservation projects. There are also significant power differentials among stakeholders in the decision making process which often means that local residents are excluded from the process of conserving their built urban heritage.
Practical implications
This research can help practitioners who are in charge of urban cultural heritage management in dealing with stakeholder conflicts. The paper offers insight into a number of sources of stakeholder conflicts and on ways to overcome these in the planning process.
Originality/value
The originality of research lies in the novelty of the case study area. This research highlights the issues of built heritage conservation management and planning practices in an area – Sulaimaniyah, Kurdistan-Iraq – that is geographically less represented in the extant literature. The research also identifies some of the key sources of conflict in urban heritage conservation projects and provides an insight into the roles of stakeholders in the management of smaller locally-dependent historic city centres.

Journal of Immigrant and Minority Health
Volume 18, Issue 5, October 2016
http://link.springer.com/journal/10903/18/5/page/1

.
Original Paper
Prevalence of Chronic Disease and Their Risk Factors Among Iranian, Ukrainian, Vietnamese Refugees in California, 2002–2011
Michelle-Linh Thuy Nguyen, David H. Rehkopf

.
Original Paper
Diabetes Among United States-Bound Adult Refugees, 2009–2014
Stephen R. Benoit, Edward W. Gregg…

The Lancet
Oct 29, 2016 Volume 388 Number 10056 p2057-2208
http://www.thelancet.com/journals/lancet/issue/current

.
Special Report
WHO’s Director-General candidates: visions and priorities
Richard Horton, Udani Samarasekera
A new Director-General of WHO will be selected in May, 2017. Richard Horton and Udani Samarasekera asked the six candidates competing for the position about their candidacy.
The forthcoming election of the next Director-General of WHO comes at a critical moment not only for the world’s only multilateral health agency but also for the precarious trajectory of global health itself. WHO is often criticised for failing to live up to the expectations of the health community. Sometimes, as in the case of how the agency managed the early stages of the Ebola virus outbreak, that criticism is justified. But WHO plays a vital and successful, and frequently neglected, part in setting norms and standards for health in countries. It has a powerful convening role. And, should a Director-General choose to do so, the agency has unprecedented authority to offer leadership in health.

As the world enters a new era—that of the Sustainable Development Goals—the Director-General has an essential voice in shaping the meaning of health in an era of human dislocation, pervasive inequality, mass migration, ecological degradation, climate change, war, and humanitarian crisis. Six excellent candidates for Director-General are standing. All have wide experience in health, as one would expect, but each offers a very different platform. Some candidates have formidable international experience in global health. Others have forged their reputations nationally. Some have strong technical credentials. Others offer political skills. Some come from countries that should be WHO’s greatest concern. Others are from nations that are traditionally seen as donors. Some have expertise in what might be considered the traditional agenda of global health (infectious diseases and women’s and children’s health). Others bring experience of newer concerns. This great diversity of candidates is a strength. It allows the Executive Board of WHO in January, 2017, and then the World Health Assembly in May, to select a candidate based on a clear diagnosis of the global predicament for health and the solutions needed. To help clarify their experience, visions, and ideas, we invited each candidate to offer a brief manifesto and to answer a series of ten questions to illuminate their positions on what we see as some priorities for the organisation…

.

Series
Maternal Health
Diversity and divergence: the dynamic burden of poor maternal health
Wendy Graham, Susannah Woodd, Peter Byass, Veronique Filippi, Giorgia Gon, Sandra Virgo, Doris Chou, Sennen Hounton, Rafael Lozano, Robert Pattinson, Susheela Singh
2164
PDF

Maternal Health
Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide
Suellen Miller, Edgardo Abalos, Monica Chamillard, Agustin Ciapponi, Daniela Colaci, Daniel Comandé, Virginia Diaz, Stacie Geller, Claudia Hanson, Ana Langer, Victoria Manuelli, Kathryn Millar, Imran Morhason-Bello, Cynthia Pileggi Castro, Vicky Nogueira Pileggi, Nuriya Robinson, Michelle Skaer, João Paulo Souza, Joshua P Vogel, Fernando Althabe

Maternal Health
The scale, scope, coverage, and capability of childbirth care
Oona M R Campbell, Clara Calvert, Adrienne Testa, Matthew Strehlow, Lenka Benova, Emily Keyes, France Donnay, David Macleod, Sabine Gabrysch, Luo Rong, Carine Ronsmans, Salim Sadruddin, Marge Koblinsky, Patricia Bailey

Nature
Volume 538 Number 7626 pp427-548 27 October 2016
http://www.nature.com/nature/current_issue.html

.
Letter
Changing cultural attitudes towards female genital cutting
Sonja Vogt, Nadia Ahmed Mohmmed Zaid, Hilal El Fadil Ahmed, Ernst Fehr & Charles Efferson
Entertaining movies addressing both individual values and marriageability can provide a way to change cultural attitudes towards female genital cutting within certain cultures.
[Initial text]
As globalization brings people with incompatible attitudes into contact, cultural conflicts inevitably arise. Little is known about how to mitigate conflict and about how the conflicts that occur can shape the cultural evolution of the groups involved. Female genital cutting is a prominent example1, 2, 3. Governments and international agencies have promoted the abandonment of cutting for decades, but the practice remains widespread with associated health risks for millions of girls and women4, 5. In their efforts to end cutting, international agents have often adopted the view that cutting is locally pervasive and entrenched1. This implies the need to introduce values and expectations from outside the local culture. Members of the target society may view such interventions as unwelcome intrusions1, 2, 3, 6, 7, 8, 9, and campaigns promoting abandonment have sometimes led to backlash1, 7, 8, 10, 11 as they struggle to reconcile cultural tolerance with the conviction that cutting violates universal human rights1, 9. Cutting, however, is not necessarily locally pervasive and entrenched1, 3, 12. We designed experiments on cultural change that exploited the existence of conflicting attitudes within cutting societies. We produced four entertaining movies that served as experimental treatments in two experiments in Sudan, and we developed an implicit association test to unobtrusively measure attitudes about cutting. The movies depart from the view that cutting is locally pervasive by dramatizing members of an extended family as they confront each other with divergent views about whether the family should continue cutting. The movies significantly improved attitudes towards girls who remain uncut, with one in particular having a relatively persistent effect. These results show that using entertainment to dramatize locally discordant views can provide a basis for applied cultural evolution without accentuating intercultural divisions…

PLOS Currents: Disasters
http://currents.plos.org/disasters/
[Accessed 29 October 2016]

.
Quality of Life of Persons Injured on 9/11: Qualitative Analysis from the World Trade Center Health Registry
October 27, 2016 · Research Article
Introduction: A number of studies published by the World Trade Center Health Registry (Registry) document the prevalence of injuries sustained by victims of the World Trade Center Disaster (WTCD) on 9/11. Injury occurrence during or in the immediate aftermath of this event has been shown to be a risk factor for long-term adverse physical and mental health status. More recent reports of ongoing health and mental health problems and overall poor quality of life among survivors led us to undertake this qualitative study to explore the long-term impact of having both disaster-related injuries and peri-event traumatic exposure on quality of life in disaster survivors.
Methods: Semi-structured, in-depth individual telephone interviews were conducted with 33 Registry enrollees who reported being injured on 9/11/01. Topics included: extent and circumstance of the injury(ies), description of medical treatment for injury, current health and functional status, and lifestyle changes resulting from the WTCD. The interviews were recorded, transcribed, and inductively open-coded for thematic analysis.
Results: Six themes emerged with respect to long term recovery and quality of life: concurrent experience of injury with exposure to peri-event traumatic exposure (e.g., witnessing death or destruction, perceived life threat, etc.); sub-optimal quality and timeliness of short- and long-term medical care for the injury reported and mental health care; poor ongoing health status, functional limitations, and disabilities; adverse impact on lifestyle; lack of social support; and adverse economic impact. Many study participants, especially those reporting more serious injuries, also reported self-imposed social isolation, an inability to participate in or take enjoyment from previously enjoyable leisure and social activities and greatly diminished overall quality of life.
Discussion: This study provided unique insight into the long-term impact of disasters on survivors. Long after physical injuries have healed, some injured disaster survivors report having serious health and mental health problems, economic problems due to loss of livelihood, limited sources of social support, and profound social isolation. Strategies for addressing the long-term health problems of disaster survivors are needed in order to support recovery.

.

Developing the Philippines as a Global Hub for Disaster Risk Reduction – A Health Research Initiative as Presented at the 10th Philippine National Health Research System Week Celebration
October 25, 2016 · Discussion
The recent Philippine National Health Research System (PNHRS) Week Celebration highlighted the growing commitment to Disaster Risk Reduction (DRR) in the Philippines. The event was lead by the Philippine Council for Health Research and Development of the Department of Science and Technology and the Department of Health, and saw the participation of national and international experts in DRR, and numerous research consortia from all over the Philippines. With a central focus on the Sendai Framework for Disaster Risk Reduction, the DRR related events recognised the significant disaster risks faced in the Philippines. They also illustrated the Philippine strengths and experience in DRR. Key innovations in science and technology showcased at the conference include the web-base hazard mapping applications ‘Project NOAH’ and ‘FaultFinder’. Other notable innovations include ‘Surveillance in Post Extreme Emergencies and Disasters’ (SPEED) which monitors potential outbreaks through a syndromic reporting system. Three areas noted for further development in DRR science and technology included: integrated national hazard assessment, strengthened collaboration, and improved documentation. Finally, the event saw the proposal to develop the Philippines into a global hub for DRR. The combination of the risk profile of the Philippines, established national structures and experience in DRR, as well as scientific and technological innovation in this field are potential factors that could position the Philippines as a future global leader in DRR. The purpose of this article is to formally document the key messages of the DRR-related events of the PNHRS Week Celebration.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 29 October 2016)
.
Research Article
Impacts on Breastfeeding Practices of At-Scale Strategies That Combine Intensive Interpersonal Counseling, Mass Media, and Community Mobilization: Results of Cluster-Randomized Program Evaluations in Bangladesh and Viet Nam
Purnima Menon, Phuong Hong Nguyen, Kuntal Kumar Saha, Adiba Khaled, Andrew Kennedy, Lan Mai Tran, Tina Sanghvi, Nemat Hajeebhoy, Jean Baker, Silvia Alayon, Kaosar Afsana, Raisul Haque, Edward A. Frongillo, Marie T. Ruel, Rahul Rawat
| published 25 Oct 2016 PLOS Medicine
http://dx.doi.org/10.1371/journal.pmed.1002159
.

Towards Equity in Service Provision for Gay Men and Other Men Who Have Sex with Men in Repressive Contexts
Chris Beyrer, Keletso Makofane, Ifeanyi Orazulike, Daouda Diouf, Stefan D. Baral
Editorial | published 25 Oct 2016 PLOS Medicine
http://dx.doi.org/10.1371/journal.pmed.1002154

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 29 October 2016)
.
Research Article
The Global Burden of Latent Tuberculosis Infection: A Re-estimation Using Mathematical Modelling
Rein M. G. J. Houben, Peter J. Dodd
| published 25 Oct 2016 PLOS Medicine
http://dx.doi.org/10.1371/journal.pmed.1002152
Abstract
Background
The existing estimate of the global burden of latent TB infection (LTBI) as “one-third” of the world population is nearly 20 y old. Given the importance of controlling LTBI as part of the End TB Strategy for eliminating TB by 2050, changes in demography and scientific understanding, and progress in TB control, it is important to re-assess the global burden of LTBI.
Methods and Findings
We constructed trends in annual risk in infection (ARI) for countries between 1934 and 2014 using a combination of direct estimates of ARI from LTBI surveys (131 surveys from 1950 to 2011) and indirect estimates of ARI calculated from World Health Organisation (WHO) estimates of smear positive TB prevalence from 1990 to 2014. Gaussian process regression was used to generate ARIs for country-years without data and to represent uncertainty. Estimated ARI time-series were applied to the demography in each country to calculate the number and proportions of individuals infected, recently infected (infected within 2 y), and recently infected with isoniazid (INH)-resistant strains. Resulting estimates were aggregated by WHO region. We estimated the contribution of existing infections to TB incidence in 2035 and 2050.
In 2014, the global burden of LTBI was 23.0% (95% uncertainty interval [UI]: 20.4%–26.4%), amounting to approximately 1.7 billion people. WHO South-East Asia, Western-Pacific, and Africa regions had the highest prevalence and accounted for around 80% of those with LTBI. Prevalence of recent infection was 0.8% (95% UI: 0.7%–0.9%) of the global population, amounting to 55.5 (95% UI: 48.2–63.8) million individuals currently at high risk of TB disease, of which 10.9% (95% UI:10.2%–11.8%) was isoniazid-resistant. Current LTBI alone, assuming no additional infections from 2015 onwards, would be expected to generate TB incidences in the region of 16.5 per 100,000 per year in 2035 and 8.3 per 100,000 per year in 2050.
Limitations included the quantity and methodological heterogeneity of direct ARI data, and limited evidence to inform on potential clearance of LTBI.
Conclusions
We estimate that approximately 1.7 billion individuals were latently infected with Mycobacterium tuberculosis (M.tb) globally in 2014, just under a quarter of the global population. Investment in new tools to improve diagnosis and treatment of those with LTBI at risk of progressing to disease is urgently needed to address this latent reservoir if the 2050 target of eliminating TB is to be reached.
.

The Tuberculosis Cascade of Care in India’s Public Sector: A Systematic Review and Meta-analysis
Ramnath Subbaraman, Ruvandhi R. Nathavitharana, Srinath Satyanarayana, Madhukar Pai, Beena E. Thomas, Vineet K. Chadha, Kiran Rade, Soumya Swaminathan, Kenneth H. Mayer
Research Article | published 25 Oct 2016 PLOS Medicine
http://dx.doi.org/10.1371/journal.pmed.1002149

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
[Accessed 29 October 2016]

.
Review
Diagnostics in Ebola Virus Disease in Resource-Rich and Resource-Limited Settings
Robert J Shorten, Colin S Brown, Michael Jacobs, Simon Rattenbury, Andrew J. Simpson, Stephen Mepham
| published 27 Oct 2016 PLOS Neglected Tropical Diseases
http://dx.doi.org/10.1371/journal.pntd.0004948

.

Editorial
Blue Marble Health and the Global Burden of Disease Study 2013
Peter J Hotez, Ashish Damania, Mohsen Naghavi
| published 27 Oct 2016 PLOS Neglected Tropical Diseases
http://dx.doi.org/10.1371/journal.pntd.0004744

.

Research Article
Integrated Healthcare Delivery: A Qualitative Research Approach to Identifying and Harmonizing Perspectives of Integrated Neglected Tropical Disease Programs
Arianna Rubin Means, Julie Jacobson, Aryc W. Mosher, Judd L. Walson
| published 24 Oct 2016 PLOS Neglected Tropical Diseases

PLoS One
http://www.plosone.org/
[Accessed 29 October 2016]

.
Research Article
Preparation and Response to the 2014 Ebola Virus Disease Epidemic in Nigeria—The Experience of a Tertiary Hospital in Nigeria
Dimie Ogoina, Abisoye Sunday Oyeyemi, Okubusa Ayah, Austin Onabor A, Adugo Midia, Wisdom Tudou Olomo, Onyaye E. Kunle-Olowu
| published 27 Oct 2016 PLOS ONE
http://dx.doi.org/10.1371/journal.pone.0165271

.

Research Article
Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold Standard
Tomas Maria Perez-Porcuna, Hélio Doyle Pereira-da-Silva, Carlos Ascaso, Adriana Malheiro, Samira Bührer, Flor Martinez-Espinosa, Rosa Abellana
| published 26 Oct 2016 PLOS ONE
http://dx.doi.org/10.1371/journal.pone.0164181

.

Research Article
The Impact of Internal Migration on under-Five Mortality in 27 Sub-Saharan African Countries
Abukari I. Issaka, Kingsley E. Agho, Andre M. N. Renzaho
| published 26 Oct 2016 PLOS ONE
http://dx.doi.org/10.1371/journal.pone.0163179
Abstract
Objective
The literature on the impact of internal migration on under-five mortality in sub-Saharan Africa has been limited. This study examined the impact of internal migration on under-five mortality rate in 27 sub-Saharan African countries.
Design
The analysis used cross-sectional data from the most recent Demographic and Health Surveys of 27 sub-Saharan African countries. Information on the number of live births and the number of under-five deaths in the five years preceding the surveys in these countries was examined. Using variables from which migration data were generated, four migration statuses were computed, and the impact of each migration status on under-five mortality was analysed by using multivariate Cox proportional hazards regression models.
Results
Of the 96333 live births, 7036 deaths were reported. Adjusting for internal migration status revealed a 20% increase in under-five mortality rate among urban-rural migrant mothers [HR = 1.20; 95% confidence interval (CI): (1.06–1.35)], a 40% increase in under-five mortality rates among rural non-migrant mothers, [HR = 1.40; 95% CI: (1.29–1.53)] and a 43% increase in under-five deaths among rural-urban migrant mothers [HR = 1.43; 95% CI: (1.30–1.58)]. Whilst under-five mortality rate did not change considerably when we adjusted for country and demographic variables, there were significant decreases among rural non-migrant and rural-urban migrant mothers when health care service utilization factors were adjusted for [HR = 1.20; 95% CI: (1.07–1.33) and [HR = 1.29; 95% CI: (1.14–1.45)]. The decreased risk of under-five deaths was not significant among rural non-migrant and rural-urban migrant mothers when socio-economic factors were adjusted for. Other factors for which there were significant risks of under-five deaths included household poverty, lack of health care services
Conclusion
Although under-five child mortality rate declined by 52% between 1990 and 2015 (from 179 to 86 per1000 live births) in sub-Saharan Africa, the continent still has the highest rate in the world. This finding highlights the need to consider providing education and health care services in rural areas, when implementing interventions meant to reduce under-five mortality rates among internal migrant mothers.

PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/

.
Sackler Colloquium on Coupled Human and Environmental Systems – Biological Sciences – Sustainability Science:
Quantifying and sustaining biodiversity in tropical agricultural landscapes
Chase D. Mendenhall, Analisa Shields-Estrada, Arjun J. Krishnaswami, and Gretchen C. Daily
PNAS 2016 ; published ahead of print October 24, 2016, doi:10.1073/pnas.1604981113
Abstract
Decision-makers increasingly seek scientific guidance on investing in nature, but biodiversity remains difficult to estimate across diverse landscapes. Here, we develop empirically based models for quantifying biodiversity across space. We focus on agricultural lands in the tropical forest biome, wherein lies the greatest potential to conserve or lose biodiversity. We explore two questions, drawing from empirical research oriented toward pioneering policies in Costa Rica. First, can remotely sensed tree cover serve as a reliable basis for improved estimation of biodiversity, from plots to regions? Second, how does tropical biodiversity change across the land-use gradient from native forest to deforested cropland and pasture? We report on understory plants, nonflying mammals, bats, birds, reptiles, and amphibians. Using data from 67,737 observations of 908 species, we test how tree cover influences biodiversity across space. First, we find that fine-scale mapping of tree cover predicts biodiversity within a taxon-specific radius (of 30–70 m) about a point in the landscape. Second, nearly 50% of the tree cover in our study region is embedded in countryside forest elements, small (typically 0.05–100 ha) clusters or strips of trees on private property. Third, most species use multiple habitat types, including crop fields and pastures (to which 15% of species are restricted), although some taxa depend on forest (57% of species are restricted to forest elements). Our findings are supported by comparisons of 90 studies across Latin America. They provide a basis for a planning tool that guides investments in tropical forest biodiversity similar to those for securing ecosystem services.

Science
28 October 2016 Vol 354, Issue 6311
http://www.sciencemag.org/current.dtl
.
EDITORIAL
Dealing with details in Marrakesh
Patricia Espinosa
Summary
Over the next few weeks, two major events will take place—the 2015 Paris Agreement on climate change will enter into force on 4 November, and 3 days later, nearly 200 countries will convene in Marrakesh, Morocco, at the 22nd United Nations (UN) Conference of the Parties (COP22) to decide on how to rapidly implement the agreement. Indeed, the agreement’s governing body will hold its first meeting during COP22. This swift action to commit and come up with climate action plans is a welcome departure for the international community, and it sends a clear message that success in tackling climate challenges requires more than just a historic political agreement.

.

Policy Forum
Making climate science more relevant
By Charles F. Kennel, Stephen Briggs, David G. Victor
Science28 Oct 2016 : 421-422 Full Access
Better indicators for risk management are needed after Paris
Summary
For nearly three decades, the central goal in international climate policy had been to set the political agenda—to engage all countries on the need for action. So long as that was the goal, it was sufficient for policy-makers to focus on simple indicators of climate change, such as global average surface temperature With the 2015 Paris Agreement, governments launched a process that can move beyond setting agendas to coordinating national policies to manage the climate. Next month in Marrakesh, diplomats will convene to flesh out the Agreement. They need to focus on the infrastructure of data and analysis that will be needed as the Agreement becomes operational. The scientific community can help by identifying better lagging indicators to describe what has changed as policy efforts progress, and leading indicators to focus policy on the right risks as the planet warms.

.

Climate change: The 2015 Paris Agreement thresholds and Mediterranean basin ecosystems
By Joel Guiot, Wolfgang Cramer
Science 28 Oct 2016 : 465-468 Restricted Access
Global warming above 1.5°C will likely change Mediterranean ecosystems in ways unprecedented in the Holocene record.
Editor’s Summary
A warming limit for the Mediterranean basin
Pollen cores from sediments provide rich detail on the history of vegetation and climate in the Mediterranean during the Holocene (the most recent ~10,000 years). Guiot and Cramer used this information as a baseline against which to compare predictions of future climate and vegetation under different climate-change scenarios. Vegetation and land-use systems observed in the Holocene records may persist under a 1.5°C warming above preindustrial temperature levels. A 2°C warming, however, is likely over the next century to produce ecosystems in the Mediterranean basin that have no analog in the past 10,000 years.
Abstract
The United Nations Framework Convention on Climate Change Paris Agreement of December 2015 aims to maintain the global average warming well below 2°C above the preindustrial level. In the Mediterranean basin, recent pollen-based reconstructions of climate and ecosystem variability over the past 10,000 years provide insights regarding the implications of warming thresholds for biodiversity and land-use potential. We compare scenarios of climate-driven future change in land ecosystems with reconstructed ecosystem dynamics during the past 10,000 years. Only a 1.5°C warming scenario permits ecosystems to remain within the Holocene variability. At or above 2°C of warming, climatic change will generate Mediterranean land ecosystem changes that are unmatched in the Holocene, a period characterized by recurring precipitation deficits rather than temperature anomalies.

Social Science & Medicine
Volume 169, Pages 1-202 (November 2016)
http://www.sciencedirect.com/science/journal/02779536/169
.
Original Research Article
Financing the HIV response in sub-Saharan Africa from domestic sources: Moving beyond a normative approach
Pages 66-76
Michelle Remme, Mariana Siapka, Olivier Sterck, Mthuli Ncube, Charlotte Watts, Anna Vassall
Abstract
Despite optimism about the end of AIDS, the HIV response requires sustained financing into the future. Given flat-lining international aid, countries’ willingness and ability to shoulder this responsibility will be central to access to HIV care. This paper examines the potential to expand public HIV financing, and the extent to which governments have been utilising these options.
We develop and compare a normative and empirical approach. First, with data from the 14 most HIV-affected countries in sub-Saharan Africa, we estimate the potential increase in public HIV financing from economic growth, increased general revenue generation, greater health and HIV prioritisation, as well as from more unconventional and innovative sources, including borrowing, health-earmarked resources, efficiency gains, and complementary non-HIV investments. We then adopt a novel empirical approach to explore which options are most likely to translate into tangible public financing, based on cross-sectional econometric analyses of 92 low and middle-income country governments’ most recent HIV expenditure between 2008 and 2012.
If all fiscal sources were simultaneously leveraged in the next five years, public HIV spending in these 14 countries could increase from US$3.04 to US$10.84 billion per year. This could cover resource requirements in South Africa, Botswana, Namibia, Kenya, Nigeria, Ethiopia, and Swaziland, but not even half the requirements in the remaining countries. Our empirical results suggest that, in reality, even less fiscal space could be created (a reduction by over half) and only from more conventional sources. International financing may also crowd in public financing.
Most HIV-affected lower-income countries in sub-Saharan Africa will not be able to generate sufficient public resources for HIV in the medium-term, even if they take very bold measures. Considerable international financing will be required for years to come. HIV funders will need to engage with broader health and development financing to improve government revenue-raising and efficiencies.

Social Science & Medicine
Volume 169, Pages 1-202 (November 2016)
http://www.sciencedirect.com/science/journal/02779536/169
.
Review Article
Disrespectful intrapartum care during facility-based delivery in sub-Saharan Africa: A qualitative systematic review and thematic synthesis of women’s perceptions and experiences
Pages 157-170
Susan Bradley, Christine McCourt, Juliet Rayment, Divya Parmar
Abstract
The psycho-social elements of labour and delivery are central to any woman’s birth experience, but international efforts to reduce maternal mortality in low-income contexts have neglected these aspects and focused on technological birth. In many contexts, maternity care is seen as dehumanised and disrespectful, which can have a negative impact on utilisation of services. We undertook a systematic review and meta-synthesis of the growing literature on women’s experiences of facility-based delivery in sub-Saharan Africa to examine the drivers of disrespectful intrapartum care. Using PRISMA guidelines, databases were searched from 1990 to 06 May 2015, and 25 original studies were included for thematic synthesis. Analytical themes, that were theoretically informed and cognisant of the cultural and social context in which the dynamics of disrespectful care occur, enabled a fresh interpretation of the factors driving midwives’ behaviour. A conceptual framework was developed to show how macro-, meso- and micro-level drivers of disrespectful care interact. The synthesis revealed a prevailing model of maternity care that is institution-centred, rather than woman-centred. Women’s experiences illuminate midwives’ efforts to maintain power and control by situating birth as a medical event and to secure status by focusing on the technical elements of care, including controlling bodies and knowledge.
Midwives and women are caught between medical and social models of birth. Global policies encouraging facility-based delivery are forcing women to swap the psycho-emotional care they would receive from traditional midwives for the technical care that professional midwives are currently offering. Any action to change the current performance and dynamic of birth relies on the participation of midwives, but their voices are largely missing from the discourse. Future research should explore their perceptions of the value and practice of interpersonal aspects of maternity care and the impact of disrespectful care on their sense of professionalism and personal ethics

Social Science & Medicine
Volume 169, Pages 1-202 (November 2016)
http://www.sciencedirect.com/science/journal/02779536/169

.
Associations between quantitative measures of women’s empowerment and access to care and health status for mothers and their children: A systematic review of evidence from the developing world
Review Article
Pages 119-131
Pierre Pratley
Abstract
Research on the association between women’s empowerment and maternal and child health has rapidly expanded. However, questions concerning the measurement and aggregation of quantitative indicators of women’s empowerment and their associations with measures of maternal and child health status and healthcare utilization remain unanswered. Major challenges include complexity in measuring progress in several dimensions and the situational, context dependent nature of the empowerment process as it relates to improvements in maternal and child health status and maternal care seeking behaviors. This systematic literature review summarizes recent evidence from the developing world regarding the role women’s empowerment plays as a social determinant of maternal and child health outcomes. A search of quantitative evidence previously reported in the economic, socio-demographic and public health literature finds 67 eligible studies that report on direct indicators of women’s empowerment and their association with indicators capturing maternal and child health outcomes. Statistically significant associations were found between women’s empowerment and maternal and child health outcomes such as antenatal care, skilled attendance at birth, contraceptive use, child mortality, full vaccination, nutritional status and exposure to violence. Although associations differ in magnitude and direction, the studies reviewed generally support the hypothesis that women’s empowerment is significantly and positively associated with maternal and child health outcomes. While major challenges remain regarding comparability between studies and lack of direct indicators in key dimensions of empowerment, these results suggest that policy makers and practitioners must consider women’s empowerment as a viable strategy to improve maternal and child health, but also as a merit in itself. Recommendations include collection of indicators on psychological, legal and political dimensions of women’s empowerment and development of a comprehensive conceptual framework that can guide research and policy making.

Sustainability
Volume 8, Issue 10 (October 2016)
http://www.mdpi.com/2071-1050/8/10

.
Adopters and Non-Adopters of Low-Cost Household Latrines: A Study of Corbelled Pit Latrines in 15 Districts of Malawi
by Rochelle Holm, Mavuto Tembo, Dalo Njera, Victor Kasulo, Mphatso Malota, Willy Chipeta, Wales Singini and Joshua Mchenga
Published: 27 September 2016
Abstract
The Sustainable Development Goals will challenge low- and middle-income settings to look at new approaches for rural sanitation. In 2013, Mzuzu University, in partnership with United Nations Children’s Fund (UNICEF) Malawi, started a low-cost latrine program in rural areas using the corbelled latrine design supported by locally owned sustainable businesses. The objective of this work was to trace customers (early household adopters) and non-customers through field observations and interviews in 15 districts of Malawi. The research team spent 193 personnel work days in data collection and found 21 households as adopters in 7 districts. Most respondents had a preference with regard to the design of the sanitation facility they would like to use. Although sharing of sanitation facilities was common, the corbelled latrine is promoted as a single household pit latrine design. Unfortunately, 8% (23/304) of non-adopters responded they practiced open defecation. Households were satisfied with the corbelled latrine design, and no latrine was found to have collapsed during field visits. To promote the corbelled latrine in Malawi, the following are recommended: (1) education of frontline government extension workers towards non-subsidized household latrines; (2) identification of rural low-income households as the best target for potential adopters; and (3) linkage of low-cost sanitation technologies to community mobilization campaigns led by the government, such as Community Led Total Sanitation.

.

How Frugal Innovation Promotes Social Sustainability
by Rakhshanda Khan
Sustainability 2016, 8(10), 1034; doi:10.3390/su8101034
Received: 27 June 2016 / Revised: 5 October 2016 / Accepted: 11 October 2016 / Published: 15 October 2016
Abstract
There is a need to develop an understanding of how frugal innovation promotes social sustainability. The objective of this paper is to find the connections between the two concepts of social sustainability and frugal innovation, by reviewing the existing literature concerning both fields. This paper presents a framework that identifies essential themes of social sustainability and explores them through frugal innovation. The framework builds on the important themes of social sustainability and shows their relevance in practice through frugal innovation. The notion of frugal innovation can be viewed as an approach towards realizing social sustainability and fulfilling the United Nations’ Sustainable Development Goals.

.

Critical Review of the Millennium Project in Nepal
by Ashma Vaidya and Audrey L. Mayer
Sustainability 2016, 8(10), 1043; doi:10.3390/su8101043
Published: 18 October 2016
Abstract
“Our Common Future” harmonized development policies around a new sustainable development (SD) paradigm, and experts also emphasize the importance of a democratic and equitable approach to define and achieve sustainable development. However, SD targets and indicators are often defined by a suite of experts or a few stakeholder groups, far removed from on-the-ground conditions. The most common expert-led development framework, the United Nations’ Millennium Development Goals (MDGs), promoted one set of targets and indicators for all developing countries. While progress towards these targets was routinely reported at the national scale, these targets may not reflect context-specific sustainable development. We evaluated the relevance and comprehensiveness of MDG 7 (environmental sustainability) for Nepal. Although Nepal has met most of the MDG 7 (e.g., forest cover, protected areas coverage, water and sanitation), on closer inspection these indicators do not provide adequate context for ensuring that these targets provide the intended levels of development. Simple forest cover and protected area indicators belie the dearth of ecological conservation on the ground, and water and sanitation indicators do not reflect the inequality of access based on poverty and regions. While the Millennium Development Goals align with broad sustainability concerns in Nepal, these indicators do not reveal its true development conditions.

.

The Impact of Conditional Cash Transfer on Toilet Use in eThekwini, South Africa
by Elizabeth Tilley and Isabel Günther
Sustainability 2016, 8(10), 1070; doi:10.3390/su8101070
Published: 22 October 2016
Abstract
In the developing world, having access to a toilet does not necessarily imply use: infrequent or non-use limits the desired health outcomes of improved sanitation. We examine the sanitation situation in a rural part of South Africa where recipients of novel, waterless “urine-diverting dry toilets” are not regularly using them. In order to determine if small, conditional cash transfers (CCT) could motivate families to use their toilets more, we paid for urine via different incentive-based interventions: two were based on volumetric pricing and the third was a flat-rate payment (irrespective of volume). A flat-rate payment (approx. €1) resulted in the highest rates of regular (weekly) participation at 59%. The low volumetric payment (approx. €0.05/L) led to regular participation rates of only 12% and no increase in toilet use. The high volumetric payment (approx. €0.1/L) resulted in lower rates of regular participation (35%), but increased the average urine production per household per day by 74%. As a first example of conditional cash transfers being used in the sanitation sector, we show that they are an accepted and effective tool for increasing toilet use, while putting small cash payments in the hands of poor, largely unemployed populations in rural South Africa.

TORTURE Journal
Volume 26, Nr. 2, 2016
http://www.irct.org/Default.aspx?ID=5768
.
Scientific Articles
Creating community life among immigrant survivors of torture and their allies
Nancy Bothne, Christopher B. Keys

Measuring change and changing measures: The development of a torture survivor specific measure of change
Rebecca Horn, Andy Keefe

Prevalence of torture and other war-related traumatic events in forced migrants: A systematic review
Erika Sigvardsdotter, Marjan Vaez, Ann-Marie Rydholm Hedman, Fredrik Saboonchi

Torture survivors’ symptom load compared to chronic pain and psychiatric in-patients
Uwe Harlacher, Linda Nordin, Peter Polatin
.

Statement
Statement on Anal Examinations in Cases of Alleged Homosexuality
Independent Forensic Expert Group