PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/
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Biological Sciences – Population Biology:
Vaccination strategies against respiratory syncytial virus
Dan Yamin, Forrest K. Jones, John P. DeVincenzo, Shai Gertler, Oren Kobiler, Jeffrey P. ownsend, and Alison P. Galvani
PNAS 2016 ; published ahead of print October 31, 2016, doi:10.1073/pnas.1522597113
Significance
The WHO estimates that respiratory syncytial virus (RSV) vaccination will be available in the next 5–10 y. To evaluate the population effectiveness of an RSV vaccination program in the United States, we developed a transmission model that integrates data on daily infectious viral load and behavior changes while symptomatic. Our model simulations demonstrate that vaccinating children younger than 5 y of age will be the most efficient and effective way to prevent RSV infection in both children and older adults, a result that is robust across the US states considered. Accordingly, the population burden of RSV would be most effectively reduced if current vaccine candidates were to focus on children.
Abstract
Respiratory syncytial virus (RSV) is the most common cause of US infant hospitalization. Additionally, RSV is responsible for 10,000 deaths annually among the elderly across the United States, and accounts for nearly as many hospitalizations as influenza. Currently, several RSV vaccine candidates are under development to target different age groups. To evaluate the potential effectiveness of age-specific vaccination strategies in averting RSV incidence, we developed a transmission model that integrates data on daily infectious viral load and changes of behavior associated with RSV symptoms. Calibrating to RSV weekly incidence rates in Texas, California, Colorado, and Pennsylvania, we show that in all states considered, an infected child under 5 y of age is more than twice as likely as a person over 50 y of age to transmit the virus. Geographic variability in the effectiveness of a vaccination program across states arises from interplay between seasonality patterns, population demography, vaccination uptake, and vaccine mechanism of action. Regardless of these variabilities, our analysis showed that allocating vaccine to children under 5 y of age would be the most efficient strategy per dose to avert RSV in both children and adults. Furthermore, due to substantial indirect protection, the targeting of children is even predicted to reduce RSV in the elderly more than directly vaccinating the elderly themselves. Our results can help inform ongoing clinical trials and future recommendations on RSV vaccination.

Qualitative Health Research
December 2016; 26 (14)
http://qhr.sagepub.com/content/current
Special Issue: General

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General Articles
Reframing Narratives of Aboriginal Health Inequity: Exploring Cree Elder Resilience and Well-Being in Contexts of Historical Trauma
Andrew R. Hatala, Michel Desjardins, and Amy Bombay
Qual Health Res December 2016 26: 1911-1927, first published on October 21, 2015 doi:10.1177/1049732315609569
Abstract
A large body of literature explores historical trauma or intergenerational trauma among Aboriginal communities around the globe. This literature connects contemporary forms of social suffering and health inequity to broader historical processes of colonization and the residential school systems in Canada. There are tendencies within this literature, however, to focus on individual pathology and victimization while minimizing notions of resilience or well-being. Through a social constructionist lens, this research examined how interpersonal responses to historical traumas can be intertwined with moments of and strategies for resilience. Detailed narrative interviews occurred with four Aboriginal Cree elders living in central Saskatchewan, Canada, who all experienced historical trauma to some extent. From this analysis, we argue that health research among Aboriginal populations must be sensitive to the complex individual and social realities that necessarily involve both processes of historical and contemporary traumas as well as resilience, strength, and well-being.

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General Articles
Toward an Understanding of the Poor Health Status of Indigenous Australian Men
David Mellor, Marita McCabe, Lina Ricciardelli, Alex Mussap, and Matthew Tyler
Qual Health Res December 2016 26: 1949-1960, first published on October 18, 2015 doi:10.1177/1049732315609898

Science
04 November 2016 Vol 354, Issue 6312
http://www.sciencemag.org/current.dtl

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In Depth
Controversial HIV vaccine strategy gets a second chance
By Jon Cohen
Science04 Nov 2016 : 535 Restricted Access
Modest success in Thailand inspires South Africa trial
Summary
A two-pronged HIV vaccine strategy that delivered lackluster results in a trial in Thailand 7 years ago will get another chance in South Africa. Last week, researchers injected the first of what they hope will be 5400 participants in the $130 million study, which should show once and for all whether the combination actually works. But some researchers say the trial amounts to a waste of money. In the Thai study, the vaccine combination reduced the risk of HIV infection by only 31.2%, and the study failed to show a mechanism that explained this modest benefit, critics say. Backers of the new trial counter that there’s enough evidence to give it another try and argue that even a modestly efficacious vaccine would help South Africa, which has more than 6 million HIV-infected people.

Tropical Medicine & International Health
November 2016 Volume 21, Issue 11 Pages 1347–1488, E1–E1
http://onlinelibrary.wiley.com/doi/10.1111/tmi.2016.21.issue-11/issuetoc

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Reviews
Pregnancy and childbirth after repair of obstetric fistula in sub-Saharan Africa: Scoping Review (pages 1348–1365)
Alexandre Delamou, Bettina Utz, Therese Delvaux, Abdoul Habib Beavogui, Asm Shahabuddin, Akoi Koivogui, Alain Levêque, Wei-Hong Zhang and Vincent De Brouwere
Version of Record online: 6 SEP 2016 | DOI: 10.1111/tmi.12771
Abstract
Objective
To synthesise the evidence on pregnancy and childbirth after repair of obstetric fistula in sub-Saharan Africa and to identify the existing knowledge gaps.
Methods
A scoping review of studies reporting on pregnancy and childbirth in women who underwent repair for obstetric fistula in sub-Saharan Africa was conducted. We searched relevant articles published between 1 January 1970 and 31 March 2016, without methodological or language restrictions, in electronic databases, general Internet sources and grey literature.
Results
A total of 16 studies were included in the narrative synthesis. The findings indicate that many women in sub-Saharan Africa still desire to become pregnant after the repair of their obstetric fistula. The overall proportion of pregnancies after repair estimated in 11 studies was 17.4% (ranging from 2.5% to 40%). Among the 459 deliveries for which the mode of delivery was reported, 208 women (45.3%) delivered by elective caesarean section (CS), 176 women (38.4%) by emergency CS and 75 women (16.3%) by vaginal delivery. Recurrence of fistula was a common maternal complication in included studies while abortions/miscarriage, stillbirths and neonatal deaths were frequent foetal consequences. Vaginal delivery and emergency C-section were associated with increased risk of stillbirth, recurrence of the fistula or even maternal death.
Conclusion
Women who get pregnant after repair of obstetric fistula carry a high risk for pregnancy complications. However, the current evidence does not provide precise estimates of the incidence of pregnancy and pregnancy outcomes post-repair. Therefore, studies clearly assessing these outcomes with the appropriate study designs are needed.

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Scoping review: strategies of providing care for children with chronic health conditions in low- and middle-income countries (pages 1366–1388)
Hamish Graham, Mariam Tokhi and Trevor Duke
Version of Record online: 16 SEP 2016 | DOI: 10.1111/tmi.12774

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Measuring domestic water use: a systematic review of methodologies that measure unmetered water use in low-income settings (pages 1389–1402)
Charlotte C. Tamason, Sophia Bessias, Adriana Villada, Suhella M. Tulsiani, Jeroen H. J. Ensink, Emily S. Gurley and Peter Kjær Mackie Jensen
Version of Record online: 30 AUG 2016 | DOI: 10.1111/tmi.12769

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Systematic review of evidence on the effectiveness of safe child faeces disposal interventions (pages 1403–1419)
Tomohiko Morita, Samuel Godfrey and Christine Marie George
Version of Record online: 16 SEP 2016 | DOI: 10.1111/tmi.12773

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Assessing the impact of defining a global priority research agenda to address HIV-associated tuberculosis (pages 1420–1427)
Anna Odone, Alberto Matteelli, Valentina Chiesa, Paola Cella, Antonio Ferrari, Federica Pezzetti, Carlo Signorelli and Haileyesus Getahun
Version of Record online: 31 AUG 2016 | DOI: 10.1111/tmi.12768

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Occupational hazards of traditional healers: repeated unprotected blood exposures risk infectious disease transmission (pages 1476–1480)
Carolyn M. Audet, José Salato, Meridith Blevins, Wilson Silva, Lázaro González-Calvo, Sten H. Vermund and Felisbela Gaspar
Version of Record online: 16 SEP 2016 | DOI: 10.1111/tmi.12775

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Original Research Papers
Rotavirus vaccines contribute towards universal health coverage in a mixed public–private healthcare system (pages 1458–1467)
Tharani Loganathan, Mark Jit, Raymond Hutubessy, Chiu-Wan Ng, Way-Seah Lee and Stéphane Verguet
Version of Record online: 24 AUG 2016 | DOI: 10.1111/tmi.12766
Abstract
Objectives
To evaluate rotavirus vaccination in Malaysia from the household’s perspective. The extended cost-effectiveness analysis (ECEA) framework quantifies the broader value of universal vaccination starting with non-health benefits such as financial risk protection and equity. These dimensions better enable decision-makers to evaluate policy on the public finance of health programmes.
Methods
The incidence, health service utilisation and household expenditure related to rotavirus gastroenteritis according to national income quintiles were obtained from local data sources. Multiple birth cohorts were distributed into income quintiles and followed from birth over the first five years of life in a multicohort, static model.
Results
We found that the rich pay more out of pocket (OOP) than the poor, as the rich use more expensive private care. OOP payments among the poorest although small are high as a proportion of household income. Rotavirus vaccination results in substantial reduction in rotavirus episodes and expenditure and provides financial risk protection to all income groups. Poverty reduction benefits are concentrated amongst the poorest two income quintiles.
Conclusion
We propose that universal vaccination complements health financing reforms in strengthening Universal Health Coverage (UHC). ECEA provides an important tool to understand the implications of vaccination for UHC, beyond traditional considerations of economic efficiency.

Travel Medicine and Infectious Diseases
September-October, 2016 Volume 14, Issue 5
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Editorials
Hajj 2016: Required vaccinations, crowd control, novel wearable tech and the Zika threat
Qanta A. Ahmed, Ziad A. Memish
Vol. 14, Issue 5, p429–432
Published online: September 20, 2016
Article Outline [initial text]
Today 1,323,520 Muslims arrived in Saudi Arabia joining millions more Muslims from around the world to perform Hajj. As physician experts in Hajj medicine who have also performed the Hajj pilgrimage and attended pilgrim-patients both during Hajj at the Hajj sites we welcome the arrival of novel wearable technology introduced by Saudi Arabia to safeguard the Hajj pilgrim during what is one of the world’s largest mass gatherings [1].

Like all mass gatherings, physical hazards are a risk and among them one of the most dangerous is stampede that unfortunately impacted Hajj 2015 on a causeway on route to the Three Pillars in the Mina area of the Holy Sites [2]. Looking at the modern history of the Hajj, stampedes have indeed occurred sporadically though the 2015 events marked the end of years free of mass stampedes following significant reengineering of crowd management. Certainly this calamity is at the forefront of Hajj planners’ priorities with some interesting solutions already being piloted, but as every year basic precautions -cough etiquette, facemask use, hand hygiene and careful food hygiene remain paramount [[3], [4]].

Routine vaccination is not only recommended but is required- Hajj visa applications being accepted contingent upon on full sets of immunizations as is standard. Like every year, the three key vaccine requirements for visa issuing include yellow fever vaccination for all travellers arriving from countries or areas at risk of yellow fever given at least 10 days prior to arrival, quadrivalent (ACYW135) meningococcal vaccine; both polysaccharide and conjugated vaccines are valid with attention to differing duration of protection [5] issued no more than 3 years and no less than 10 days before arrival in Saudi Arabia and proof of receipt of a dose of oral polio vaccine (OPV) or inactivated poliovirus vaccine (IPV), within the previous 12 months and at least 6 weeks prior to departure for travellers arriving from polio-endemic countries which have never interrupted indigenous virus transmission. In addition, the Ministry of Health of Saudi Arabia continues to recommend that international pilgrims be vaccinated against seasonal influenza with most recently available vaccines particularly those at increased risk of severe influenza diseases including pregnant women, children aged over 5 years, the elderly, and individuals with pre-existing health conditions such as asthma, chronic heart or lung diseases and HIV/AIDS infection [[5], [6], [7]]…

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 5 November 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-5-november-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.

American Journal of Preventive Medicine
November 2016 Volume 51, Issue 5, p637-864, e119-e154
http://www.ajpmonline.org/current
Theme: Digital Health: Leveraging New Technologies to Develop, Deploy, and Evaluate Behavior Change Interventions
Guest Editors: Lucy Yardley, Tanzeem Choudhury, Kevin Patrick

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Research Articles
Concomitant Adolescent Vaccination in the U.S., 2007–2012
Jennifer L. Moss, Paul L. Reiter, Noel T. Brewer
p693–705
Published online: June 30, 2016
Abstract
Introduction
Concomitant (same-day) delivery of two or more vaccines to adolescents is effective, safe, and efficient. Increasing concomitant vaccination could improve coverage for recommended adolescent vaccines, but little is known about who receives vaccines concomitantly.
Methods
Data came from healthcare provider–verified records on 70,144 adolescents (aged 13–17 years) in the 2008–2012 versions of the National Immunization Survey–Teen who had received at least one dose of tetanus, diphtheria, and acellular pertussis (Tdap) booster; meningococcal conjugate vaccine (MenACWY); or human papillomavirus (HPV) vaccine. Separately for each vaccine, multivariable logistic regression identified adolescent and household correlates of concomitant versus single vaccination, stratified by adolescent sex. Vaccination took place in 2007–2012, data collection in 2008–2012, and data analysis in 2015.
Results
Among vaccinated adolescents, 51%–65% of girls and 25%–53% of boys received two vaccines concomitantly. Concomitant uptake of each vaccine increased over survey years (e.g., 2012 vs 2008: girls’ Tdap booster, OR=1.88, 95% CI=1.56, 2.26; boys’ Tdap booster, OR=2.62, 95% CI=2.16, 3.16), with the exception of HPV vaccination among boys. Additionally, concomitant vaccination was less common as adolescents got older and in the Northeast (all p<0.05). For MenACWY and HPV vaccine, concomitant uptake was less common for girls whose mothers had higher versus lower education and for boys who lived in metropolitan versus non-metropolitan areas (all p<0.05).
Conclusions
Missed opportunities for concomitant adolescent vaccination persist, particularly for HPV vaccine. Future interventions targeting groups with low rates of concomitant vaccination could improve population-level coverage with recommended vaccines.

American Journal of Public Health
Volume 106, Issue 11 (November 2016)
http://ajph.aphapublications.org/toc/ajph/current

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AJPH SPECIAL SECTION: WORLD HEALTH ORGANIZATION
Whither WHO? Our Global Health Leadership
Elizabeth Fee
American Journal of Public Health: November 2016, Vol. 106, No. 11: 1903–1904.

World Health Organization Reform—A Normative or an Operational Organization?
Derek Yach
American Journal of Public Health: November 2016, Vol. 106, No. 11: 1904–1906.

Finance and Governance: Critical Challenges for the Next WHO Director-General
Julio Frenk
American Journal of Public Health: November 2016, Vol. 106, No. 11: 1906–1907.

A New Leader for a New World Health
Ariel Pablos-Mendez, Susanna Baker
American Journal of Public Health: November 2016, Vol. 106, No. 11: 1907–1908.

The Election of the Next World Health Organization Director-General Explained to a Visitor From Mars
Gilles Dussault
American Journal of Public Health: November 2016, Vol. 106, No. 11: 1908–1909.

World Health Organization: Overhaul or Dismantle?
Suwit Wibulpolprasert, Mushtaque Chowdhury
American Journal of Public Health: November 2016, Vol. 106, No. 11: 1910–1911.

At the Roots of The World Health Organization’s Challenges: Politics and Regionalization
Elizabeth Fee, Marcu Cueto, Theodore M. Brown
American Journal of Public Health: November 2016, Vol. 106, No. 11: 1912–1917.

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AJPH PERSPECTIVES FROM THE SOCIAL SCIENCES – ISLAM
Islamophobia and Public Health in the United States
Goleen Samari
American Journal of Public Health: November 2016, Vol. 106, No. 11: 1920–1925.

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 29 October 2016)

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Research article
The impact of active surveillance and health education on an Ebola virus disease cluster — Kono District, Sierra Leone, 2014–2015
During December 2014–February 2015, an Ebola outbreak in a village in Kono district, Sierra Leone, began following unsafe funeral practices after the death of a person later confirmed to be infected with Ebola…
Tasha Stehling-Ariza, Alexander Rosewell, Sahr A. Moiba, Brima Berthalomew Yorpie, Kai David Ndomaina, Kai Samuel Jimissa, Eva Leidman, Dingeman J. Rijken, Colin Basler, James Wood and Dumbuya Manso
BMC Infectious Diseases 2016 16:611
Published on: 27 October 2016

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 29 October 2016)
Editorial
Medicine and the future of health: reflecting on the past to forge ahead
Dale Fisher, Paul Wicks and Zaheer-Ud-Din Babar
BMC Medicine 2016 14:169
Published on: 25 October 2016
Abstract
The development of new therapies has a rich history, evolves quickly with societal trends, and will have an exciting future. The last century has seen an exponential increase in complex interactions between medical practitioners, pharmaceutical companies, governments and patients. We believe technology and societal expectations will open up the opportunity for more individuals to participate as information becomes more freely available and inequality less acceptable. Corporations must recognize that usual market forces do not function ideally in a setting where health is regarded as a human right, and as modern consumers, patients will increasingly take control of their own data, wellbeing, and even the means of production for developing their own treatments. Ethics and legislation will increasingly impact the processes that facilitate drug development, distribution and administration. This article collection is a cross-journal collaboration, between the Journal of Pharmaceutical Policy and Practice (JoPPP) and BMC Medicine that seeks to cover recent advances in drug development, medicines use, policy and access with high clinical and public health relevance in the future.

BMC Pregnancy and Childbirth
http://www.biomedcentral.com/bmcpregnancychildbirth/content
(Accessed 29 October 2016)

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Research article
Obstetric outcomes for women with female genital mutilation at an Australian hospital, 2006–2012: a descriptive study
Women, who have been subjected to female genital mutilation (FGM), can suffer serious and irreversible physical, psychological and psychosexual complications. They have more adverse obstetric outcomes as compa...
Nesrin Varol, Angela Dawson, Sabera Turkmani, John J. Hall, Susie Nanayakkara, Greg Jenkins, Caroline S. E. Homer and Kevin McGeechan
BMC Pregnancy and Childbirth 2016 16:328
Published on: 28 October 2016

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Research article
Women’s status and experiences of mistreatment during childbirth in Uttar Pradesh: a mixed methods study using cultural health capital theory
Mistreatment of women in healthcare settings during childbirth has been gaining attention globally. Mistreatment during childbirth directly and indirectly affects health outcomes, patient satisfaction, and the…
May Sudhinaraset, Emily Treleaven, Jason Melo, Kanksha Singh and Nadia Diamond-Smith
BMC Pregnancy and Childbirth 2016 16:332
Published on: 28 October 2016

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 29 October 2016)

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Research article
Life expectancy and healthy life expectancy of Japan: the fastest graying society in the world
We appraised time trends of Japanese life expectancy (LE) and healthy life expectancy (HALE) by gender, LE-HALE and (LE-HALE)/LE figures, along with the women–men’s differences. LE and HALE consistently linearly elongated for both sexes over the study period. Not only LE-HALE but also (LE-HALE)/LE values were still growing for both sexes. Public health measures, nursing-care/services as well as social security schemes are called for to further elevate longevities, HALE in particular, and enhance quality of life and well-being.
Shinkan Tokudome, Shuji Hashimoto and Akihiro Igata
Published on: 28 October 2016

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

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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)

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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

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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]

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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

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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.

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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.

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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

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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…

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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

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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

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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

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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

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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…

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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
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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