International Journal of Strategic Property Management
Volume 20, Issue 3, 2016
Social and technological aspects of disaster resilience
DOI: 10.3846/1648715X.2016.1185477
Luisa Giuliania*, Alexandra Revezb, Jorgen Sparfc, Suranga Jayasenad & Michael Havbro Fabera
pages 277-290
ABSTRACT
Large scale projects tasked with designing infrastructures and urban networks resilient to disasters face a common challenge, i.e. the need to address concomitant technological issues and social problems. What is more, conflicting technologies and the diverse philosophical underpinnings of distinct academic disciplines pose difficulties in the collaboration among experts of different fields. These difficulties and possible ways to tackle them have been highlighted by a questionnaire developed in the framework of an EU project named ANDRDD (Academic Network for Disaster Resilience to optimize Educational development). More specifically, the project investigated the level of interdisciplinary work in current research and educational projects within the field of disaster resilience. findings illustrate the number and types of disciplines involved in disaster resilience projects and suggest that a higher degree of integration between different disciplines in tertiary education could promote a transdisciplinary approach to disaster resilience, resulting in design efficiency and innovation.

Current Opinion in Psychiatry
Post Author Corrections: July 18, 2016
doi: 10.1097/YCO.0000000000000266
REVIEW
Psychosocial and behavioral aspects of populations affected by humanitarian emergencies: recent developments.
Murthy, Rangaswamy Srinivasa
Abstract
Purpose of review: Understand recent developments in psychosocial and behavioral aspects of populations affected by humanitarian emergencies. The review covers the prevalence, longitudinal course, risk factors, posttraumatic growth, biological basis and interventions to address the needs.
Recent findings: Populations living in humanitarian emergencies, over 50 million worldwide, have higher risk of developing a range of mental disorders. There is evidence of persistence of these disturbances over long periods of time. There is growing body of knowledge to indicate the biological pathways to the occurrence of mental disorders. A proportion of population report posttraumatic growth. There is new focus on identifying the characteristics of risk factors, resilience at the individual, family, community and societal levels. Range of interventions to address the mental health needs is in use from strengthening the coping of individuals, parenting, school-based interventions and use of cognitive behavior therapy. Biological basis is becoming clear.
Summary: The most important message of the review is the high mental health needs of individuals living in emergency situations and the urgent need to work toward adequate preparedness for natural disasters, integrate psychosocial interventions as part of relief, rehabilitation and reconstruction and work toward preventing situations of conflict, war, migration and refugee situations.

Journal of Operations Management
Available online 15 July 2016
In Press, Corrected Proof — Note to users
Demand forecasting and order planning for humanitarian logistics: An empirical assessment
Erwin van der Laana, Jan van Dalena, Michael Rohrmosera, Rob Simpsonb
Abstract
Humanitarian aid organizations are most known for their short-term emergency relief. While getting aid items to those in need can be challenging, long-term projects provide an opportunity for demand planning supported by forecasting methods. Based on standardized consumption data of the Operational Center Amsterdam of Médecins Sans Frontières (MSF-OCA) regarding nineteen longer-term aid projects and over 2000 medical items consumed in 2013, we describe and analyze the forecasting and order planning process. We find that several internal and external factors influence forecast and order planning performance, be it indirectly through demand volatility and safety markup. Moreover, we identify opportunities for further improvement for MSF-OCA, and for humanitarian logistics organizations in general.

Journal of Environmental Management
Available online 18 July 2016
In Press, Corrected Proof — Note to users
Review
Understanding illegality and corruption in forest governance
A Sundström
Highlights
:: This article reviews the research on illegality and corruption in forest management.
:: The review provides theoretical reasoning why corruption increases illegal logging.
:: It examines previous empirical findings, cross-national as well as in-depth studies.
:: The review discusses the implications for conservation, including REDD+ programs.
:: It discusses how to improve monitoring of the forest sector in corrupt contexts.
Abstract
This review synthesizes the literature studying illegality and government corruption in forest management. After discussing the theoretical connections between different types of corruption and illegal forest-related activities it describes the major trends in previous studies, examining cross-national patterns as well as local in-depth studies. Both theory and available empirical findings provide a straightforward suggestion: Bribery is indeed a “door opener” for illegal activities to take place in forest management. It then discusses the implications for conservation, focusing first on international protection schemes such as the REDD+ and second on efforts to reduce illegality and bribery in forest management. Key aspects to consider in the discussion on how to design monitoring institutions of forest regulations is how to involve actors without the incentive to engage in bribery and how to make use of new technologies that may publicize illegal behavior in distant localities. The review concludes by discussing avenues for future research.

JBI Database of Systematic Reviews and Implementation Reports
June 2016 – Volume 14 – Issue 6

.
Advance directives in the provision of care for incarcerated adults: a scoping review protocol
Hand, Mikel W.; Mitchell, Sheryl; DeGregory, Cristy
pp: 1-361
Scoping review question/objective: The objective of this review is to map the available evidence around advance directives in the care of incarcerated adults in terms of what has been undertaken, what outcomes have been reported, and what research gaps exist.

The specific areas of investigation will include:
:: Practices, policies or interventions used with incarcerated adults concerning advanced directives.
:: Prisoners’ experiences with advanced directives when receiving care.
:: Barriers to establishing and implementing advanced directives.
:: Healthcare providers’ experiences with implementing advanced directives while providing care.

The specific questions for this scoping review are:
:: What types of research related to advanced directives in the provision of care for incarcerated adults have been conducted and reported?
:: What research gaps exist in this area?

Center conducting the review: The Indiana Centre for Evidence-Based Nursing Practice: a Collaborating Centre of the Joanna Briggs Institute

Trauma, Violence, & Abuse
July 2016; 17 (3)
http://tva.sagepub.com/content/17/3.toc

.
Articles
Responding to Delayed Disclosure of Sexual Assault in Health Settings A Systematic Review
Published online before print July 19, 2016, doi: 10.1177/1524838016659484
Stephanie Lanthier1,2, Janice Du Mont1,2, Robin Mason1,2
1Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
2Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
Abstract
Few adolescent and adult women seek out formal support services in the acute period (7 days or less) following a sexual assault. Instead, many women choose to disclose weeks, months, or even years later. This delayed disclosure may be challenging to support workers, including those in health-care settings, who lack the knowledge and skills to respond effectively. We conducted a systematic literature review of health-care providers’ responses to delayed disclosure by adolescent and adult female sexual assault survivors. Our primary objective was to determine how health-care providers can respond appropriately when presented with a delayed sexual assault disclosure in their practice. Arising out of this analysis, a secondary objective was to document recommendations from the articles for health-care providers on how to create an environment conducive to disclosing and support disclosure in their practice. These recommendations for providing an appropriate response and supporting disclosure are summarized.

Current Psychiatry Reports
September 2016, 18:79
http://link.springer.com/journal/11920
Child and Family Disaster Psychiatry

.
First Online: 16 July 2016
Children’s Mental Health in the Context of Terrorist Attacks, Ongoing Threats, and Possibilities of Future Terrorism
DOI: 10.1007/s11920-016-0722-1
Jonathan S. Comer, Laura J. Bry, Bridget Poznanski, Alejandra M. Golik
Abstract
Over the past two decades, the field has witnessed tremendous advances in our understanding of terrorism and its impacts on affected youth. It is now well established that a significant proportion of exposed youth show elevated PTSD symptoms in the months following a terrorist attack. In more recent years, research has expanded beyond confirming our understanding of the association between direct terrorism exposure and child PTSD symptoms by elucidating (a) links between terrorism exposure and non-PTSD clinical outcomes (e.g., externalizing problems, substance use), (b) individual differences associated with divergent patterns of risk and resilience, (c) the clinical correlates of media-based contact with terrorism, (d) clinical outcomes associated with exposure to recurrent terrorist attacks, and (e) exposure to extended contexts of uncertainty and the possibilities of future terrorism. Researchers studying the effects of terrorism and political violence on youth have increasingly examined a much broader range of regions in the world, affording needed opportunities to consider the generalizability of prior findings to youth living in different political contexts, in less developed regions of the world, and/or in regions with different rates of recurrent terrorism. In order to understand and, in turn, best meet the clinical needs of the majority of terrorism-affected youth across the globe, more targeted research on exposed youth is needed in developing regions of the world and regions enduring more recurrent terrorist attacks.

Journal of Human Rights and Social Work
First Online: 13 July 2016
DOI: 10.1007/s41134-016-0013-0
Article
Between a Rock and a Hard place: a Trauma-Informed Approach to Documenting the Traumatic Experiences of Tamil Refugees
Hilary N Weaver
Abstract
Refugees and asylum seekers typically experience dislocation, persecution, and significant cultural adjustments, making them highly vulnerable populations that deserve more attention from helping professionals. As a profession grounded in human rights and committed to serving disenfranchised populations, social work is well situated to attend to the needs of refugees, asylum seekers, and other displaced populations. These populations often experience multiple forms of trauma from their own governments as well as from rebel forces. This project models a trauma-informed approach to research using an assessment tool tailored to the South Asian Tamil population. Data are presented on the traumatic experiences and related sequelae for 30 Tamils living in the USA and Canada. The majority experienced multiple traumatic events including lack of food or clean water, being displaced, lack of shelter, ill health without access to medical care, murder of a family member or someone known, being detained, and beatings. Most respondents reported dwelling on their traumatic experiences, feeling as though they were happening again, feeling hopeless, recurrent bad dreams, and having less interest in daily activities. The data presented here can inform helping professionals about the lived experiences of this population. Considerations for helping professionals working with this population are included.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 16 July 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 Global Foundation – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

pdf version: The Sentinel_ week ending 16 July 2016

Contents
:: Week in Review
:: Key Agency/IGO/Governments Watch – Selected Updates from 30+ entities
:: INGO/Consortia/Joint Initiatives Watch – Media Releases, Major Initiatives, Research
:: Foundation/Major Donor Watch -Selected Updates
:: Journal Watch – Key articles and abstracts from 100+ peer-reviewed journals

:: Journal Watch
The Sentinel will track key peer-reviewed journals which address a broad range of interests in human rights, humanitarian response, health and development. It is not intended to be exhaustive. We will add to those monitored below as we encounter relevant content and upon recommendation from readers. We selectively provide full text of abstracts and other content but note that successful access to some of the articles and other content may require subscription or other access arrangement unique to the publisher. Please suggest additional journals you feel warrant coverage.

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 16 July 2016)

.
Research article
Do informal caregivers for elderly in the community use support measures? A qualitative study in five European countries
Informal caregivers are essential figures for maintaining frail elderly at home. Providing informal care can affect the informal caregivers’ physical and psychological health and labour market participation ca…
Evi Willemse, Sibyl Anthierens, Maria Isabel Farfan-Portet, Olivier Schmitz, Jean Macq, Hilde Bastiaens, Tinne Dilles and Roy Remmen
BMC Health Services Research 2016 16:270
Published on: 16 July 2016

.

Research article
Effective health care for older people living and dying in care homes: a realist review
Care home residents in England have variable access to health care services. There is currently no coherent policy or consensus about the best arrangements to meet these needs. The purpose of this review was t…
Claire Goodman, Tom Dening, Adam L. Gordon, Susan L. Davies, Julienne Meyer, Finbarr C. Martin, John R. F. Gladman, Clive Bowman, Christina Victor, Melanie Handley, Heather Gage, Steve Iliffe and Maria Zubair
BMC Health Services Research 2016 16:269
Published on: 16 July 2016

.

Research article
Can Sierra Leone maintain the equitable delivery of their Free Health Care Initiative? The case for more contextualised interventions: results of a cross-sectional survey
In 2010, the Ministry of Health and Sanitation in Sierra Leone launched their Free Health Care Initiative (FHCI) for pregnant and lactating mothers and children under-5. Despite an increase in the update of se…
Frédérique Vallières, Emma Louise Cassidy, Eilish McAuliffe, Brynne Gilmore, Allieu S. Bangura and Joseph Musa
BMC Health Services Research 2016 16:258
Published on: 13 July 2016

BMC Medical Ethics
http://www.biomedcentral.com/bmcmedethics/content
(Accessed 16 July 2016)

.
Research article
HIV/AIDS clients, privacy and confidentiality; the case of two health centres in the Ashanti Region of Ghana
While most studies on HIV/AIDS often identify stigmatization and patients’ unwillingness to access health care as critical problems in the control of the pandemic, very few studies have focused on the possible…
Jonathan Mensah Dapaah and Kodjo A. Senah
BMC Medical Ethics 2016 17:41
Published on: 16 July 2016

.

Research article
Cluster randomized trial assessing the effects of rapid ethical assessment on informed consent comprehension in a low-resource setting
Adamu Addissie, Serebe Abay, Yeweyenhareg Feleke, Melanie Newport, Bobbie Farsides and Gail Davey
BMC Medical Ethics 2016 17:40
Published on: 12 July 2016
Abstract
Background
Maximizing comprehension is a major challenge for informed consent processes in low-literacy and resource-limited settings. Application of rapid qualitative assessments to improve the informed consent process is increasingly considered useful. This study assessed the effects of Rapid Ethical Assessment (REA) on comprehension, retention and quality of the informed consent process.
Methods
A cluster randomized trial was conducted among participants of HPV sero-prevalence study in two districts of Northern Ethiopia, in 2013. A total of 300 study participants, 150 in the intervention and 150 in the control group, were included in the study. For the intervention group, the informed consent process was designed with further revisions based on REA findings. Informed consent comprehension levels and quality of the consent process were measured using the Modular Informed Consent Comprehension Assessment (MICCA) and Quality of Informed Consent (QuIC) process assessment tools, respectively.
Result
Study recruitment rates were 88.7 % and 80.7 % (p = 0.05), while study retention rates were 85.7 % and 70.3 % (p  < 0.005) for the intervention and control groups respectively. Overall, the mean informed consent comprehension scores for the intervention and control groups were 73.1 % and 45.2 %, respectively, with a mean difference in comprehension score of 27.9 % (95 % CI 24.0 % - 33.4 %; p <  0.001,). Mean scores for quality of informed consent for the intervention and control groups were 89.1 % and 78.5 %, respectively, with a mean difference of 10.5 % (95 % CI 6.8 -14.2 %; p < 0.001).
Conclusion
Levels of informed consent comprehension, quality of the consent process, study recruitment and retention rates were significantly improved in the intervention group. We recommend REA as a potential modality to improve informed consent comprehension and quality of informed consent process in low resource settings.

BMC Pregnancy and Childbirth
http://www.biomedcentral.com/bmcpregnancychildbirth/content
(Accessed 16 July 2016)

.
Research article
Birth preparedness and place of birth in Tandahimba district, Tanzania: what women prepare for birth, where they go to deliver, and why
As making preparations for birth and health facility delivery are behaviours linked to positive maternal and newborn health outcomes, we aimed to describe what birth preparations were made, where women deliver…
Tara Tancred, Tanya Marchant, Claudia Hanson, Joanna Schellenberg and Fatuma Manzi
BMC Pregnancy and Childbirth 2016 16:165
Published on: 16 July 2016

.

Research article
Implementation of repeat HIV testing during pregnancy in Kenya: a qualitative study
Repeat HIV testing in late pregnancy has the potential to decrease rates of mother-to-child transmission of HIV by identifying mothers who seroconvert after having tested negative for HIV in early pregnancy.
Anna Joy Rogers, Elly Weke, Zachary Kwena, Elizabeth A. Bukusi, Patrick Oyaro, Craig R. Cohen and Janet M. Turan
BMC Pregnancy and Childbirth 2016 16:151
Published on: 11 July 2016

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 16 July 2016)

.
Research article
The risk of falling into poverty after developing heart disease: a survival analysis
Those with a low income are known to have a higher risk of developing heart disease. However, the inverse relationship – falling into income poverty after developing heart disease has not been explored with lo…
Emily J. Callander and Deborah J. Schofield
BMC Public Health 2016 16:570
Published on: 15 July 2016

.

Research article
A systematic review of randomized controlled trials of mHealth interventions against non-communicable diseases in developing countries
The reasons of deaths in developing countries are shifting from communicable diseases towards non-communicable diseases (NCDs). At the same time the number of health care interventions using mobile phones (mHe…
Victor Stephani, Daniel Opoku and Wilm Quentin
BMC Public Health 2016 16:572
Published on: 15 July 2016

Eurosurveillance
Volume 21, Issue 28, 14 July 2016
http://www.eurosurveillance.org/Public/Articles/Archives.aspx?PublicationId=11678

.
Surveillance report
Réunion Island prepared for possible Zika virus emergence, 2016
by S Larrieu, L Filleul, O Reilhes, M Jaffar-Bandjee, C Dumont, T Abossolo, H Thebault, E Brottet, F Pagès, P Vilain, I Leparc-Goffart, E Antok, D Vandroux, P Poubeau, M Moiton, P Von Theobald, F Chieze, A Gallay, H De Valk, F Bourdillon

Zika emergence in the French Territories of America and description of first confirmed cases of Zika virus infection on Martinique, November 2015 to February 2016
by E Daudens-Vaysse, M Ledrans, N Gay, V Ardillon, S Cassadou, F Najioullah, I Leparc-Goffart, D Rousset, C Herrmann, R Cesaire, M Maquart, O Flusin, S Matheus, P Huc-Anaïs, J Jaubert, A Criquet-Hayot, B Hoen, F Djossou, C Locatelli-Jouans, A Blateau, A McKenzie, M Melin, P Saint-Martin, F Dorléans, C Suivant, L Carvalho, M Petit-Sinturel, A Andrieu, H Noël, A Septfons, A Gallay, M Paty, L Filleul, A Cabié, the Zika Surveillance Working Group

.

Research Articles
The epidemiology and transmissibility of Zika virus in Girardot and San Andres island, Colombia, September 2015 to January 2016
by DP Rojas, NE Dean, Y Yang, E Kenah, J Quintero, S Tomasi, EL Ramirez, Y Kelly, C Castro, G Carrasquilla, ME Halloran, IM Longini

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 16 July 2016]

.
Commentary
Civil society: the catalyst for ensuring health in the age of sustainable development
Julia Smith, Kent Buse and Case Gordon
Published on: 16 July 2016
Abstract
Sustainable Development Goal Three is rightly ambitious, but achieving it will require doing global health differently. Among other things, progressive civil society organisations will need to be recognised and supported as vital partners in achieving the necessary transformations. We argue, using illustrative examples, that a robust civil society can fulfill eight essential global health functions. These include producing compelling moral arguments for action, building coalitions beyond the health sector, introducing novel policy alternatives, enhancing the legitimacy of global health initiatives and institutions, strengthening systems for health, enhancing accountability systems, mitigating the commercial determinants of health and ensuring rights-based approaches. Given that civil society activism has catalyzed tremendous progress in global health, there is a need to invest in and support it as a global public good to ensure that the 2030 Agenda for Sustainable Development can be realised.

.

Research
Breast cancer policy in Latin America: account of achievements and challenges in five countries
The recent increase of breast cancer mortality has put on alert to most countries in the region. However it has taken some time before breast cancer could be considered as a relevant problem.
Gustavo Nigenda, Maria Cecilia Gonzalez-Robledo, Luz Maria Gonzalez-Robledo and Rosa Maria Bejarano-Arias
Published on: 12 July 2016

Infectious Diseases of Poverty
http://www.idpjournal.com/content
[Accessed 16 July 2016]

.
Research Article
Optimal control analysis of Ebola disease with control strategies of quarantine and vaccination
Muhammad Dure Ahmad, Muhammad Usman, Adnan Khan and Mudassar Imran
Published on: 13 July 2016
Abstract
Background
The 2014 Ebola epidemic is the largest in history, affecting multiple countries in West Africa. Some isolated cases were also observed in other regions of the world.
Method
In this paper, we introduce a deterministic SEIR type model with additional hospitalization, quarantine and vaccination components in order to understand the disease dynamics. Optimal control strategies, both in the case of hospitalization (with and without quarantine) and vaccination are used to predict the possible future outcome in terms of resource utilization for disease control and the effectiveness of vaccination on sick populations. Further, with the help of uncertainty and sensitivity analysis we also have identified the most sensitive parameters which effectively contribute to change the disease dynamics. We have performed mathematical analysis with numerical simulations and optimal control strategies on Ebola virus models.
Results
We used dynamical system tools with numerical simulations and optimal control strategies on our Ebola virus models. The original model, which allowed transmission of Ebola virus via human contact, was extended to include imperfect vaccination and quarantine. After the qualitative analysis of all three forms of Ebola model, numerical techniques, using MATLAB as a platform, were formulated and analyzed in detail. Our simulation results support the claims made in the qualitative section.
Conclusion
Our model incorporates an important component of individuals with high risk level with exposure to disease, such as front line health care workers, family members of EVD patients and Individuals involved in burial of deceased EVD patients, rather than the general population in the affected areas. Our analysis suggests that in order for R 0 (i.e., the basic reproduction number) to be less than one, which is the basic requirement for the disease elimination, the transmission rate of isolated individuals should be less than one-fourth of that for non-isolated ones. Our analysis also predicts, we need high levels of medication and hospitalization at the beginning of an epidemic. Further, optimal control analysis of the model suggests the control strategies that may be adopted by public health authorities in order to reduce the impact of epidemics like Ebola.

JAMA
July 12, 2016, Vol 316, No. 2
http://jama.jamanetwork.com/issue.aspx

.
Viewpoint | July 12, 2016
An HIV Vaccine -Mapping Uncharted Territory FREE
Anthony S. Fauci, MD1
JAMA. 2016;316(2):143-144. doi:10.1001/jama.2016.7538.
Scaling up access to antiretroviral therapy and proven approaches to HIV prevention potentially could control the HIV/AIDS pandemic and reduce it to a low level of endemicity. However, a safe and effective HIV vaccine would help reach this goal more quickly and in a more sustained way.

The scientific quest for an HIV vaccine spans nearly 3 decades and has taken multiple pathways, including attempts to induce antibody responses, T-cell responses, or combinations of both. These efforts have included human efficacy trials of monomeric HIV envelope glycoproteins, vectors containing inserts of HIV genes expressing envelope and other viral proteins, and prime-boost regimens that combine both approaches.1

So far, the only HIV vaccine efficacy trial to show promise was the RV144 trial conducted in Thailand. For immunogens, this study used a canarypox vector expressing HIV genes as a prime, followed by 2 booster injections of a recombinant HIV envelope glycoprotein.2 The trial resulted in a very modest vaccine efficacy of 31%. Neither broadly neutralizing antibodies nor cytolytic CD8+ T-cell responses were associated with protection against infection. Rather, IgG antibodies against the V1V2 region of the HIV envelope protein were associated with reduced infection.3 Efforts are now under way to improve on the results of RV144 in a southern African population by using multiple boosts, modified vectors, and adjuvants.

In addition to the follow-up of RV144, major HIV vaccine efforts have been launched in another direction: inducing broadly neutralizing antibodies (bNAbs) that can neutralize a wide range of HIV variants and hence afford protection against the rapidly mutating virus.1

Neutralizing antibodies have long been considered the “gold standard” of protection for vaccines against viruses because of the consistent observation that essentially all viral infections induce neutralizing antibodies, typically within days of infection. If the patient survives the infection, neutralizing antibodies usually clear the virus and provide lifelong protection against subsequent exposure to the same virus. Thus, the proof of concept for the development of a vaccine for most viruses is already provided by natural infection, and vaccines that optimally mimic natural infection have been the norm.

Not so for an HIV vaccine. The antigens presented by HIV to the immune system in natural infection do not elicit an adequate immune response to clear a virus that integrates,4 as evidenced by the lack of documented immune-mediated clearance of the virus by any known HIV-infected individual. HIV elicits high levels of broadly neutralizing antibodies in only a fraction of patients, usually only after a period of 2 or more years.1 With HIV, proving it is even possible for a vaccine to induce such antibodies is being explored by vaccinologists who are working in previously uncharted territory.

In their pursuit of bNAbs against HIV, scientists have used technologies that never before had been required (or even considered) in developing vaccines for other pathogens.1 These include x-ray crystallography and more recently cryoelectron microscopy to determine the native conformation of HIV envelope; novel cellular cloning technologies to isolate the rare B cells that recognize HIV envelope epitopes; high-throughput deep sequencing of B-cell genes and the unprecedented interrogation of the B-cell lineage to identify unmutated, germline B cells that might bind to known HIV envelope epitopes; and approaches to “steering” the B-cell lineage to make bNAbs.

The leading candidate for an HIV vaccine immunogen that elicits bNAbs is the viral envelope glycoprotein in forms that present native envelope epitopes. The HIV envelope is inherently unstable; in natural infection it preferentially presents to the immune system epitopes that elicit antibodies that are not broadly neutralizing, and that would be inadequate in the context of a vaccine. Investigators have determined that non-neutralizing antibodies bind to structures displayed on the unstable envelope, whereas several bNAbs bind readily to structural elements expressed on an experimentally stabilized envelope trimer.

A reasonable assumption, then, would be that the stable HIV envelope trimer may serve as a component of an immunogen to engage the relevant HIV-specific B-cell repertoire and induce it to produce bNAbs. Using the structural biological tools of x-ray crystallography and most recently the elegant technique of cryoelectron microscopy, investigators have successfully identified the near-native structure of the envelope trimer and stabilized it by insertion of various mutations.5 However, that was only the first step. The next step is to engage (if possible) the unmutated, naive B cells that give rise to bNAbs. These B cells are rare, occurring as infrequently as 1 in 2.5 million cells.

A major challenge encountered by scientists is that certain HIV envelope epitopes to which naturally occurring bNAbs bind do not bind to any identifiable germline B cell. Another potential obstacle was observed in an animal model: vaccination with a stable envelope trimer induced autologous neutralizing antibodies but not bNAbs.6 Thus, the process of generating bNAbs did not achieve its intended goal.
Subsequent efforts have been intensively directed at overcoming the inability to get past autologous neutralizing antibodies and proceed to production of bNAbs, notably with a new strategy that has been called “B-cell lineage design.” This concept was exemplified by a fortuitous experiment of nature. In an acute HIV infection study with extremely close follow-up of study participants, a patient who became infected was studied from the very earliest point after acute HIV infection.7 Scientists closely monitored the evolution of the antibody response and how the virus mutated to escape that evolving immune response. What unfolded was a back-and-forth of mutating virus escaping the immune response and the immune response evolving to keep up with the mutating virus. At the end of more than 2 years, the virus had coaxed along the immune response to produce antibodies that were broadly neutralizing for a wide variety of archived HIV isolates. However, the patient still had virus that was not neutralized by the resulting bNAb.7 Nonetheless, this observation fortified the concept of “B-cell lineage design” and the pursuit of sequential stimulation of the B-cell lineage with slightly different immunogens that mimic the evolving and mutating virus. Clearly, this strategy is quite different from the classic approach in vaccinology of priming and boosting with essentially the same antigen. The technically complex and intense interrogation and engagement of the B-cell limb of the immune response has provided some of the most elegant scientific studies performed in the context of vaccine development. However, it is unclear whether the application of this approach will be feasible in the context of a vaccine for millions of people.

Indeed, the field of HIV vaccinology is in uncharted territory. If efforts in developing an HIV vaccine based on the induction of bNAbs are successful, this achievement will represent the most elegant and complex scientific approach toward any vaccine in history. In contrast, if unsuccessful, this experience will be recorded as the most highly sophisticated and scientifically elegant proof that the development of such a vaccine is impossible. Hopefully, the former and not the latter will be true.

.
Viewpoint
Marking Time in the Global HIV/AIDS Pandemic FREE
Gerald Friedland, MD
[Excerpt]
…The IAS conference returns to Durban in July 2016, and presents a unique opportunity to review the 15 years since the landmark 2000 meeting. It will document the current status of the global pandemic and consider and plan the future goals and strategies for the global struggle against HIV/AIDS.

Remarkably, a historic turn of events has been achieved during the past 15 years, representing perhaps one of the greatest scientific, medical, and public health realignment of resources between rich and poor. Resources and expertise have been shifted toward those poorer communities and populations in the world where the epidemic has reached full force. Research support has increased and has demonstrated the importance of new treatment and prevention tools and strategies of global benefit. Local governments and international agencies such as the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization; the Global Fund on AIDS, Tuberculosis, and Malaria; the US President’s Emergency Plan for AIDS Relief; other nations’ programs; nongovernmental organizations; academic institutions; private philanthropy; and other efforts have been assembled to meaningfully counteract the global pandemic, providing evidence-based prevention and treatment and attempting to reduce many of the issues of equity and health disparities at the pandemic’s core.

New HIV infections have declined by 35% since 2000 and the number of people accessing ART globally has doubled every 3 to 4 years, increasing exponentially from an estimated 690 000 in 2000 (the vast majority in the developed world) to 3 million in 2007 and to 17 million people at the end of 2015.3 Of these, 10.3 million (61%) were in sub-Saharan Africa. Global coverage of ART increased from less than 5% in 2000 to 46% at the end of 2015.4 South Africa has the largest HIV epidemic in the world, with an estimated 6.3 million people living with HIV in 2013, but now has initiated ART for nearly 3.4 million people living with HIV/AIDS, more than any other country in the world.4 Studies have demonstrated a restoration of life expectancy on a population level, similar to what had been seen in the United States after the introduction of ART5 and population-based declines in HIV transmission were shown as ART was rolled out.

The past 15 years also have seen a large increase in effective HIV prevention tools, including condoms, harm reduction, male circumcision, and vaginal microbicides as well as structural (ie, policies, laws, institutional, and administrative approaches) and community-based approaches. The availability and use of ART remains the most potent tool, both as treatment and prevention of new infections in maternal to child transmission, HIV discordant partners,6 and, most recently, as preexposure prophylaxis.7 All of these strategies, including those that address fundamental human rights, must be used in combination to provide the greatest benefit. With these effective tools and strategies, is the world now on the cusp of another epochal change in the pandemic?

The power of combining treatment and prevention has resulted in the formulation by UNAIDS of the 90-90-90 strategy to be accomplished by 2020.8 This is defined as 90% of all people living with HIV will know their HIV status, 90% of these will receive sustained ART, and 90% of these will have viral suppression. Further extending this to 2030 with a strategy of 95-95-95 is estimated to avert an additional 17.6 million HIV infections and 10.8 million AIDS-related deaths between 2016 and 2030,8 and carries the expectation that the pandemic will be eliminated (ie, the global prevalence of HIV will be reduced to a negligible amount and no longer represent a global public health threat).

However, enormous challenges remain in reaching these goals. They include the difficulties of engaging key populations with the treatment and prevention benefits, the fragility and weakness of the health care systems needed for their delivery, the fact that neither a vaccine nor cure is expected within this time frame and ART remains a lifelong therapy with challenges of linkage to care, medication adherence, and loss to follow-up all impinging on sustained viral suppression. Continued stigma and intractable human rights challenges, comorbidities, such as tuberculosis (the leading cause of mortality in people living with HIV/AIDS), and increasingly drug-resistant tuberculosis, all pose major hurdles.

In addition, it is unclear whether the costs to local and international communities will be bearable, estimated as increasing from the current $19 billion per year to $36 billion per year, and whether political will can be sustained over time.9 A central question at the 2016 IAS conference will be if, with the now-available powerful prevention and treatment tools, these goals and strategies are realistic and attainable or, at best, only aspirational.

The accomplishments of the past 15 years were similarly deemed unrealistic and aspirational, and perhaps such a triumph of global success will be repeated and the HIV/AIDS pandemic not only can be reversed, but contained. The 2016 IAS meeting in Durban will again provide a view of the present and a glimpse into the future of the still disastrous and volatile HIV/AIDS pandemic.

.
Editorials
Condomless Sex With Virologically Suppressed HIV-Infected Individuals: How Safe Is It? FREE
Eric S. Daar, MD; Katya Corado, MD

Antiretrovirals for HIV Treatment and Prevention: The Challenges of Success FREE
Kenneth H. Mayer, MD; Douglas S. Krakower, MD

Visions for an AIDS-Free Generation: Red Ribbons of Hope FREE
Preeti N. Malani, MD, MSJ

.

Original Investigations
Effect of Patient Navigation With or Without Financial Incentives on Viral Suppression Among Hospitalized Patients With HIV Infection and Substance Use: A Randomized Clinical Trial FREE
Lisa R. Metsch, PhD; Daniel J. Feaster, PhD; Lauren Gooden, PhD; Tim Matheson, PhD; Maxine Stitzer, PhD; Moupali Das, MD; Mamta K. Jain, MD; Allan E. Rodriguez, MD; Wendy S. Armstrong, MD; Gregory M. Lucas, MD, PhD; Ank E. Nijhawan, MD; Mari-Lynn Drainoni, PhD; Patricia Herrera, MD; Pamela Vergara-Rodriguez, MD; Jeffrey M. Jacobson, MD; Michael J. Mugavero, MD; Meg Sullivan, MD; Eric S. Daar, MD; Deborah K. McMahon, MD; David C. Ferris, MD; Robert Lindblad, MD; Paul VanVeldhuisen, PhD; Neal Oden, PhD; Pedro C. Castellón, MPH; Susan Tross, PhD; Louise F. Haynes, MSW; Antoine Douaihy, MD; James L. Sorensen, PhD; David S. Metzger, PhD; Raul N. Mandler, MD; Grant N. Colfax, MD; Carlos del Rio, MD
Includes: Supplemental Content

.
Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy FREE
Alison J. Rodger, MD; Valentina Cambiano, PhD; Tina Bruun, RN; Pietro Vernazza, MD; Simon Collins; Jan van Lunzen, PhD; Giulio Maria Corbelli; Vicente Estrada, MD; Anna Maria Geretti, MD; Apostolos Beloukas, PhD; David Asboe, FRCP; Pompeyo Viciana, MD; Félix Gutiérrez, MD; Bonaventura Clotet, PhD; Christian Pradier, MD; Jan Gerstoft, MD; Rainer Weber, MD; Katarina Westling, MD; Gilles Wandeler, MD; Jan M. Prins, PhD; Armin Rieger, MD; Marcel Stoeckle, MD; Tim Kümmerle, PhD; Teresa Bini, MD; Adriana Ammassari, MD; Richard Gilson, MD; Ivanka Krznaric, PhD; Matti Ristola, PhD; Robert Zangerle, MD; Pia Handberg, RN; Antonio Antela, PhD; Sris Allan, FRCP; Andrew N. Phillips, PhD; Jens Lundgren, MD; for the PARTNER Study Group
Includes: CME, Supplemental Content
Editorial: Condomless Sex With Virologically Suppressed HIV-Infected Individuals;
Eric S. Daar, MD; Katya Corado, MD

.
Association of Medical Male Circumcision and Antiretroviral Therapy Scale-up With Community HIV Incidence in Rakai, Uganda FREE
Xiangrong Kong, PhD; Godfrey Kigozi, MB, ChB, PhD; Joseph Ssekasanvu, MS; Fred Nalugoda, PhD; Gertrude Nakigozi, MD, MPH; Anthony Ndyanabo, MSc; Tom Lutalo, MS; Steven J. Reynolds, MD, MPH; Robert Ssekubugu, MHS; Joseph Kagaayi, MB, ChB, PhD; Eva Bugos, BS; Larry W. Chang, MD, MPH; Pilgrim Nanlesta, PhD; Grabowski Mary, PhD; Amanda Berman, MSPH, MPhil; Thomas C. Quinn, MD; David Serwadda, MB, ChB, MMed, MPH; Maria J. Wawer, MD, MSH; Ronald H. Gray, MD, MSc
Includes: CME, Supplemental Content

.

Special Communication
Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults: 2016 Recommendations of the International Antiviral Society–USA Panel FREE
Huldrych F. Günthard, MD; Michael S. Saag, MD; Constance A. Benson, MD; Carlos del Rio, MD; Joseph J. Eron, MD; Joel E. Gallant, MD, MPH; Jennifer F. Hoy, MBBS, FRACP; Michael J. Mugavero, MD, MHSc; Paul E. Sax, MD; Melanie A. Thompson, MD; Rajesh T. Gandhi, MD; Raphael J. Landovitz, MD; Davey M. Smith, MD; Donna M. Jacobsen, BS; Paul A. Volberding, MD
Includes: CME, Supplemental Content
Editorial: Antiretrovirals for HIV Treatment and Prevention; Kenneth H. Mayer, MD; Douglas S. Krakower, MD

.

From the JAMA Network
Reaching High-Risk Patients for HIV Preexposure Prophylaxis FREE
James Riddell IV, MD; Jonathan A. Cohn, MD, MS

Journal of Community Health
Volume 41, Issue 4, August 2016
http://link.springer.com/journal/10900/41/3/page/1

.
Original Paper
The Role of Food Banks in Addressing Food Insecurity: A Systematic Review
August 2016, Volume 41, Issue 4, pp 732-740
Chantelle Bazerghi, Fiona H. McKay, Matthew Dunn
Abstract
Food banks play a major role in the food aid sector by distributing donated and purchased groceries directly to food insecure families. The public health implications of food insecurity are significant, particularly as food insecurity has a higher prevalence among certain population groups. This review consolidates current knowledge about the function and efficacy of food banks to address food insecurity. A systematic review was conducted. Thirty-five publications were reviewed, of which 14 examined food security status, 13 analysed nutritional quality of food provided, and 24 considered clients’ needs in relation to food bank use. This review found that while food banks have an important role to play in providing immediate solutions to severe food deprivation, they are limited in their capacity to improve overall food security outcomes due to the limited provision of nutrient-dense foods in insufficient amounts, especially from dairy, vegetables and fruits. Food banks have the potential to improve food security outcomes when operational resources are adequate, provisions of perishable food groups are available, and client needs are identified and addressed.

The Lancet
Jul 16, 2016 Volume 388 Number 10041 p211-306
http://www.thelancet.com/journals/lancet/issue/current

.
Articles
Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends
Gilda Sedgh, Jonathan Bearak, Susheela Singh, Akinrinola Bankole, Anna Popinchalk, Bela Ganatra, Clémentine Rossier, Caitlin Gerdts, Özge Tunçalp, Brooke Ronald Johnson Jr, Heidi Bart Johnston, Leontine Alkema
258
Summary
Background
Information about the incidence of induced abortion is needed to motivate and inform efforts to help women avoid unintended pregnancies and to monitor progress toward that end. We estimate subregional, regional, and global levels and trends in abortion incidence for 1990 to 2014, and abortion rates in subgroups of women. We use the results to estimate the proportion of pregnancies that end in abortion and examine whether abortion rates vary in countries grouped by the legal status of abortion.
Methods
We requested abortion data from government agencies and compiled data from international sources and nationally representative studies. With data for 1069 country-years, we estimated incidence using a Bayesian hierarchical time series model whereby the overall abortion rate is a function of the modelled rates in subgroups of women of reproductive age defined by their marital status and contraceptive need and use, and the sizes of these subgroups.
Findings
We estimated that 35 abortions (90% uncertainty interval [UI] 33 to 44) occurred annually per 1000 women aged 15–44 years worldwide in 2010–14, which was 5 points less than 40 (39–48) in 1990–94 (90% UI for decline −11 to 0). Because of population growth, the annual number of abortions worldwide increased by 5·9 million (90% UI −1·3 to 15·4), from 50·4 million in 1990–94 (48·6 to 59·9) to 56·3 million (52·4 to 70·0) in 2010–14. In the developed world, the abortion rate declined 19 points (−26 to −14), from 46 (41 to 59) to 27 (24 to 37). In the developing world, we found a non-significant 2 point decline (90% UI −9 to 4) in the rate from 39 (37 to 47) to 37 (34 to 46). Some 25% (90% UI 23 to 29) of pregnancies ended in abortion in 2010–14. Globally, 73% (90% UI 59 to 82) of abortions were obtained by married women in 2010–14 compared with 27% (18 to 41) obtained by unmarried women. We did not observe an association between the abortion rates for 2010–14 and the grounds under which abortion is legally allowed.
Interpretation
Abortion rates have declined significantly since 1990 in the developed world but not in the developing world. Ensuring access to sexual and reproductive health care could help millions of women avoid unintended pregnancies and ensure access to safe abortion.
Funding
UK Government, Dutch Ministry of Foreign Affairs, Norwegian Agency for Development Cooperation, The David and Lucile Packard Foundation, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction.