BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 30 January 2016)

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Research article
Adult pertussis is unrecognized public health problem in Thailand
Nirada Siriyakorn, Pornvimol Leethong, Terapong Tantawichien, Saowalak Sripakdee, Anusak Kerdsin, Surang Dejsirilert and Leilani Paitoonpong
BMC Infectious Diseases 2016 16:25
Published on: 25 January 2016
Abstract
Background
Although pertussis has been considered a disease of childhood, it is also recognized as an important respiratory tract infection in adolescents and adults. However, in countries with routine vaccination against pertussis with high coverage, pertussis is not usually taken into consideration for the etiology of prolonged cough in adults. Previous studies in a variety of populations in developed countries have documented that pertussis is quite common, ranging from 2.9 to 32 % of adolescents and adults with prolonged cough. The anticipation and early recognition of this change in the epidemiology is important because the affected adolescents and adults act as reservoirs of the disease and source of infection to the vulnerable population of infants, for whom the disease can be life threatening. We conducted a prospective study to determine the prevalence of pertussis in Thai adults with prolonged cough.
Methods
Seventy-six adult patients with a cough lasting for more than 2 weeks (range, 14–180 days) were included in the present study. The data regarding medical history and physical examination were carefully analyzed. Nasopharyngeal swabs from all patients were obtained for the detection of deoxyribonucleic acid of Bordetella pertussis by the polymerase chain reaction (PCR) method. Paired serum samples were collected and tested for IgG antibody against pertussis toxin by using an ELISA method.
Results
Of 76 adult patients, 14 patients (18.4 %) with the mean age of 59 (range, 28–85) years and the mean duration of cough of 34 (range, 14–120) days had laboratory evidence of acute pertussis infection. One patient was diagnosed by the PCR method, while the rest had serological diagnosis. Whooping cough is a significantly associated symptom of patients with chronic cough who had laboratory evidence of pertussis. (p < .05, odds ratio 3.75, 95 % confidence interval: 1.00,14.06)
Conclusion
Pertussis is being increasingly recognized as a cause of prolonged, distressing cough among adults in Thailand. This result addresses the need of pertussis vaccination in Thai adults for preventing transmission to a high risk group such as newborn infants.

BMC Pregnancy and Childbirth
http://www.biomedcentral.com/bmcpregnancychildbirth/content
(Accessed 30 January 2016)

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Research article
The impact of a community driven mass media campaign on the utilisation of maternal health care services in rural Malawi
Collins O. F. Zamawe, Masford Banda and Albert N. Dube
Published on: 27 January 2016

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Research article
Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences
2.7 million babies were stillborn in 2015 worldwide; behind these statistics lie the experiences of bereaved parents.
Alison Ellis, Caroline Chebsey, Claire Storey, Stephanie Bradley, Sue Jackson, Vicki Flenady, Alexander Heazell and Dimitrios Siassakos
BMC Pregnancy and Childbirth 2016 16:16
Published on: 25 January 2016

Cost Effectiveness and Resource Allocation
http://www.resource-allocation.com/
(Accessed 30 January 2016)

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Review
Economic evaluations of interventions to reduce neonatal morbidity and mortality: a review of the evidence in LMICs and its implications for South Africa
Mandy Maredza, Lumbwe Chola and Karen Hofman
Abstract
Background
Newborn mortality, comprising a third of all under-5 deaths, has hardly changed in low and middle income countries (LMICs) including South Africa over the past decade. To attain the MDG 4 target, greater emphasis must be placed on wide-scale implementation of proven, cost-effective interventions. This paper reviews economic evidence on effective neonatal health interventions in LMICs from 2000–2013; documents lessons for South African policy on neonatal health; and identifies gaps and areas for future research.
Methods
A narrative review was performed in leading public health databases for full economic evaluations conducted between 2000 and 2013. Data extraction from the articles included in the review was guided by the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist, and the quality of the included economic evaluations was assessed using the Quality of Health Economics Studies Instrument (QHES).
Results
Twenty-seven economic evaluations were identified, from South East Asia and sub-Saharan Africa, with those from sub-Saharan Africa primarily focused on HIV/AIDS. Packages of care to prevent neonatal mortality were more cost-effective than vertical interventions. A wide variability in methodological approaches challenges the comparability of study results between countries. In South Africa, there is limited cost-effectiveness evidence for the interventions proposed by the National Perinatal Morbidity and Mortality Committee.
Conclusions
Neonatal strategies have a strong health system focus but this review suggests that strengthening community care could be an additional component for averting neonatal deaths. While some evidence exists, having a more complete understanding of how to most effectively deploy scarce resources for neonatal health in South Africa in the post-2015 era is essential.

Global Public Health
Volume 11, Issue 3, 2016
http://www.tandfonline.com/toc/rgph20/current

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Articles
Developing collaborative approaches to international research: Perspectives of new global health researchers
Paula Godoy-Ruiz, Donald C. Cole, Lindsey Lenters & Kwame McKenzie
pages 253-275
Open access
DOI:10.1080/17441692.2014.999814
Abstract
Within a global context of growing health inequities, the fostering of partnerships and collaborative research have been promoted as playing a critical role in tackling health inequities and health system problems worldwide. Since 2004, the Canadian Coalition for Global Health Research (CCGHR) has facilitated annual Summer Institutes for new global health researchers aimed at strengthening global health research competencies and partnerships among participants. We sought to explore CCGHR Summer Institute alumni perspectives on the Summer Institute experience, particularly on the individual research pairings of Canadian and low- and middle-income countries researchers that have characterised the program. The results reveal that the Summer Institute offered an enriching learning opportunity for participants and worked to further their collaborative projects through providing dedicated one-on-one time with their international research partner, feedback from colleagues from around the world and mentorship by more senior researchers. Positive individual relationships among researchers, as well as the existence of institutional collaborations, employer and funding support, and agendas of local and national politicians were factors that have influenced the ongoing collaboration of partners. There is a need to more fully examine the interplay between individual and institutional-level collaborations, as well as their social and political contexts.

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Articles
Alternative accounting in maternal and infant global health
Vincanne Adams, Sienna R. Craig & Arlene Samen
DOI:10.1080/17441692.2015.1021364
pages 276-294
Abstract
Efforts to augment accountability through the use of metrics, and especially randomised controlled trial or other statistical methods place an increased burden on small nongovernmental organisations (NGOs) doing global health. In this paper, we explore how one small NGO works to generate forms of accountability and evidence that may not conform to new metrics trends but nevertheless deserve attention and scrutiny for being effective, practical and reliable in the area of maternal and infant health. Through an analysis of one NGO and, in particular, its organisational and ethical principles for creating a network of safety for maternal and child health, we argue that alternative forms of (ac)counting like these might provide useful evidence of another kind of successful global health work

Journal of Health Care for the Poor and Underserved (JHCPU)
Volume 27, Number 1, February 2016
https://muse.jhu.edu/journals/journal_of_health_care_for_the_poor_and_underserved/toc/hpu.27.1.html

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Original Papers
Ideological vs. Instrumental Barriers to Accessing Formal Mental Health care in the Developing World: Focus on South-eastern Nigeria
pp. 157-175
Ugo Ikwuka, Niall Galbraith, Ken Manktelow, Josephine Chen-Wilson, Femi Oyebode, Rosemary C. Muomah, Anuli Igboaka

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Original Papers
Estimates of Mental Health Problems in a Vulnerable Population within a Primary Care Setting
pp. 308-326
Darrell L. Hudson, Kimberly A. Kaphingst, Merriah A. Croston, Melvin S. Blanchard, Melody S. Goodman

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

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Original paper
HPV Vaccine Awareness, Barriers, Intentions, and Uptake in Latina Women
Julia Lechuga, Lina Vera-Cala…
Abstract
Latina women are at heightened risk of cervical cancer incidence and mortality. The human papillomavirus (HPV) is the principal cause of the majority of cervical cancer cases. A vaccine that protects against HPV was licensed in 2006. Eight years post-licensure, mixed research findings exist regarding the factors that predict vaccine uptake in Latinas. We conducted a population-based phone survey with a random sample of 296 Latinas living in a Midwestern U.S. City. Intention to vaccinate was significantly associated with health care provider recommendations, worry about side effects, knowing other parents have vaccinated, perceived severity of HPV, and worry that daughter may become sexually active following vaccination. Worry that daughter may become sexually active was the only factor related to vaccine uptake. Findings suggest that training providers to discuss the low risk of severe side effects, consequences of persistent HPV, and sexuality related concerns with Latino women may encourage vaccination.

Journal of the Royal Society – Interface
01 January 2016; volume 13, issue 114
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Research Articles
Self-enforcing regional vaccination agreements
Petra Klepac, Itamar Megiddo, Bryan T. Grenfell, Ramanan Laxminarayan
J. R. Soc. Interface 2016 13 20150907; DOI: 10.1098/rsif.2015.0907. Published 20 January 2016
Abstract
In a highly interconnected world, immunizing infections are a transboundary problem, and their control and elimination require international cooperation and coordination. In the absence of a global or regional body that can impose a universal vaccination strategy, each individual country sets its own strategy. Mobility of populations across borders can promote free-riding, because a country can benefit from the vaccination efforts of its neighbours, which can result in vaccination coverage lower than the global optimum. Here we explore whether voluntary coalitions that reward countries that join by cooperatively increasing vaccination coverage can solve this problem. We use dynamic epidemiological models embedded in a game-theoretic framework in order to identify conditions in which coalitions are self-enforcing and therefore stable, and thus successful at promoting a cooperative vaccination strategy. We find that countries can achieve significantly greater vaccination coverage at a lower cost by forming coalitions than when acting independently, provided a coalition has the tools to deter free-riding. Furthermore, when economically or epidemiologically asymmetric countries form coalitions, realized coverage is regionally more consistent than in the absence of coalitions.

Knowledge Management for Development Journal
Vol 11, No 2 (2015)
http://journal.km4dev.org/journal/index.php/km4dj/index

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Papers
Data sharing and use of ICTs in agriculture: working with small farmer groups in Colombia
Fanny Cecile Howland, Luis Armando Muñoz, Simone Staiger, James Cock, Sophie Alvarez
Abstract
This article describes the experience of analyzing groups of Colombian fruit farmers’ capacity to collect information and their interest and ability to take advantage of the opportunities offered by information and communication technologies (ICTs). Three cycles were designed to understand the attitudes, skills, and current practices of fruit growers and to define the necessary conditions for effective information sharing. The three cycles involved individual farmers, farmer groups meeting face to face, and virtual meeting with farmer groups. The results contribute to the design of strategies for farmer engagement in the knowledge-sharing online platform of the AES-CE (Acronym in Spanish for Sharing Experiences for Site Specific Agriculture) project, designed to assist growers in improved decision making through sharing of multiple types of information from multiple sources. We find that farmers understand the usefulness of record keeping, but data collection is often imposed externally, and records are not generally used to better manage production. Farmers, overall, were positive towards information sharing and understand the benefits of using information from a wider environment, shared through an ICT platform, but shortage of skills in using these technologies is a serious limiting factor to expansion to a broader scale. We discuss future strategies that can be used to the design and implement ICT platforms which farmers can use to share information and improve their management.

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Papers
Mainstreaming as a knowledge process: new lessons from mainstreaming gender, disability and sexual diversity
Saskia C. van Veen, Petra Staal, Rob van Poelje
Abstract
Mainstreaming is a strategy to enhance citizen participation of marginalised groups. In development practice, various mainstreaming issues have caught the attention of development organisations that shows their commitment to initiate inclusive development practice. However, influencing societal change by inclusive practices is difficult and requires a knowledge process to co-create socially robust knowledge. This paper brings together the knowledge and experiences from existing literature and from three cases on mainstreaming, namely from gender, disability inclusions and sexual diversity. We show how capacity development and knowledge co-creation at non-governmental organisations (NGOs) can be a lever for the inclusion of marginalised groups in society. The lessons learned may help development practitioners to reinforce and strengthen their emancipating work.

The Lancet
Jan 30, 2016 Volume 387 Number 10017 p403-504
http://www.thelancet.com/journals/lancet/issue/current

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Editorial
Ebola’s legacy: UK deficits and their global lessons
The Lancet
Summary
A devastating report on the UK’s lessons from Ebola was published this week by the House of Commons Science and Technology Committee. Much of the blame for the world’s lacklustre response to Ebola has been laid at the door of WHO. But the committee also found surprising weaknesses in the UK’s application of science to global health emergencies. It makes important recommendations for corrective action. Although targeted towards the UK, the committee’s findings will also likely apply to other high-income countries involved in the response to Ebola.

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Articles
Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group
Leontine Alkema, Doris Chou, Daniel Hogan, Sanqian Zhang, Ann-Beth Moller, Alison Gemmill, Doris Ma Fat, Ties Boerma, Marleen Temmerman, Colin Mathers, Lale Say, United Nations Maternal Mortality Estimation Inter-Agency Group collaborators, technical advisory group
Summary
Background
Millennium Development Goal 5 calls for a 75% reduction in the maternal mortality ratio (MMR) between 1990 and 2015. We estimated levels and trends in maternal mortality for 183 countries to assess progress made. Based on MMR estimates for 2015, we constructed projections to show the requirements for the Sustainable Development Goal (SDG) of less than 70 maternal deaths per 100 000 livebirths globally by 2030.
Methods
We updated the UN Maternal Mortality Estimation Inter-Agency Group (MMEIG) database with more than 200 additional records (vital statistics from civil registration systems, surveys, studies, or reports). We generated estimates of maternal mortality and related indicators with 80% uncertainty intervals (UIs) using a Bayesian model. The model combines the rate of change implied by a multilevel regression model with a time-series model to capture data-driven changes in country-specific MMRs, and includes a data model to adjust for systematic and random errors associated with different data sources.
Results
We had data for 171 of 183 countries. The global MMR fell from 385 deaths per 100 000 livebirths (80% UI 359–427) in 1990, to 216 (207–249) in 2015, corresponding to a relative decline of 43·9% (34·0–48·7), with 303 000 (291 000–349 000) maternal deaths worldwide in 2015. Regional progress in reducing the MMR since 1990 ranged from an annual rate of reduction of 1·8% (0·0–3·1) in the Caribbean to 5·0% (4·0–6·0) in eastern Asia. Regional MMRs for 2015 ranged from 12 deaths per 100 000 livebirths (11–14) for high-income regions to 546 (511–652) for sub-Saharan Africa. Accelerated progress will be needed to achieve the SDG goal; countries will need to reduce their MMRs at an annual rate of reduction of at least 7·5%.
Interpretation
Despite global progress in reducing maternal mortality, immediate action is needed to meet the ambitious SDG 2030 target, and ultimately eliminate preventable maternal mortality. Although the rates of reduction that are needed to achieve country-specific SDG targets are ambitious for most high mortality countries, countries that made a concerted effort to reduce maternal mortality between 2000 and 2010 provide inspiration and guidance on how to accomplish the acceleration necessary to substantially reduce preventable maternal deaths.
Funding
National University of Singapore, National Institute of Child Health and Human Development, USAID, and the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction.

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Series
Breastfeeding
Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect
Cesar G Victora, Rajiv Bahl, Aluísio J D Barros, Giovanny V A França, Susan Horton, Julia Krasevec, Simon Murch, Mari Jeeva Sankar, Neff Walker, Nigel C Rollins, The Lancet Breastfeeding Series Group

Breastfeeding
Why invest, and what it will take to improve breastfeeding practices?
Nigel C Rollins, Nita Bhandari, Nemat Hajeebhoy, Susan Horton, Chessa K Lutter, Jose C Martines, Ellen G Piwoz, Linda M Richter, Cesar G Victora, The Lancet Breastfeeding Series Group

New England Journal of Medicine
January 28, 2016 Vol. 374 No. 4
http://www.nejm.org/toc/nejm/medical-journal

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Editorial
Sharing Clinical Trial Data — A Proposal from the International Committee of Medical Journal Editors
Darren B. Taichman, M.D., Ph.D., Joyce Backus, M.S.L.S., Christopher Baethge, M.D., Howard Bauchner, M.D., Peter W. de Leeuw, M.D., Jeffrey M. Drazen, M.D., John Fletcher, M.B., B.Chir., M.P.H., Frank A. Frizelle, M.B., Ch.B., F.R.A.C.S., Trish Groves, M.B., B.S., M.R.C.Psych., Abraham Haileamlak, M.D., Astrid James, M.B., B.S., Christine Laine, M.D., M.P.H., Larry Peiperl, M.D., Anja Pinborg, M.D., Peush Sahni, M.B., B.S., M.S., Ph.D., and Sinan Wu, M.D.
N Engl J Med 2016; 374:384-386
January 28, 2016
DOI: 10.1056/NEJMe1515172

The International Committee of Medical Journal Editors (ICMJE) believes that there is an ethical obligation to responsibly share data generated by interventional clinical trials because participants have put themselves at risk. In a growing consensus, many funders around the world — foundations, government agencies, and industry — now mandate data sharing. Here we outline the ICMJE’s proposed requirements to help meet this obligation. We encourage feedback on the proposed requirements. Anyone can provide feedback at http://www.icmje.org by 18 April 2016.

The ICMJE defines a clinical trial as any research project that prospectively assigns people or a group of people to an intervention, with or without concurrent comparison or control groups, to study the cause-and-effect relationship between a health-related intervention and a health outcome. Further details may be found in the Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals at http://www.icmje.org.

As a condition of consideration for publication of a clinical trial report in our member journals, the ICMJE proposes to require authors to share with others the deidentified individual-patient data (IPD) underlying the results presented in the article (including tables, figures, and appendices or supplementary material) no later than 6 months after publication. The data underlying the results are defined as the IPD required to reproduce the article’s findings, including necessary metadata. This requirement will go into effect for clinical trials that begin to enroll participants beginning 1 year after the ICMJE adopts its data-sharing requirements. (The ICMJE plans to adopt data-sharing requirements after considering feedback received to the proposals made here.)

Enabling responsible data sharing is a major endeavor that will affect the fabric of how clinical trials are planned and conducted and how their data are used. By changing the requirements of the manuscripts we will consider for publication in our journals, editors can help foster this endeavor. As editors, our direct influence is logically, and practically, limited to those data underpinning the results and analyses we publish in our journals.

The ICMJE also proposes to require that authors include a plan for data sharing as a component of clinical trial registration. This plan must include where the researchers will house the data and, if not in a public repository, the mechanism by which they will provide others access to the data, as well as other data-sharing plan elements outlined in the 2015 Institute of Medicine Report (e.g., whether data will be freely available to anyone upon request or only after application to and approval by a learned intermediary, whether a data use agreement will be required).1 ClinicalTrials.gov has added an element to its registration platform to collect data-sharing plans. We encourage other trial registries to similarly incorporate mechanisms for the registration of data-sharing plans. Trialists who want to publish in ICMJE member journals (or nonmember journals that choose to follow these recommendations) should choose a registry that includes a data-sharing plan element as a specified registry item or allows for its entry as a free-text statement in a miscellaneous registry field. As a condition of consideration for publication in our member journals, authors will be required to include a description of the data-sharing plan in the submitted manuscript. Authors may choose to share the deidentified IPD underlying the results presented in the article under less restrictive, but not more restrictive, conditions than were indicated in the registered data-sharing plan.

The ICMJE already requires the prospective registration of all clinical trials prior to enrollment of the first participant. This requirement aims, in part, to prevent selective publication and selective reporting of research outcomes, and to prevent unnecessary duplication of research effort. Including a commitment to a data-sharing plan is a logical addition to trial registration that will further each of these goals. Prospective trial registration currently includes documenting the planned primary and major secondary end points to be assessed, which enables identification of incomplete reporting as well as post hoc analyses. Declaring the plan for sharing data prior to their collection will further enhance transparency in the conduct and reporting of clinical trials by exposing when data availability following trial completion differs from prior commitments.

Sharing clinical trial data, including deidentified IPD, requires planning to ensure appropriate ethics committee or institutional review board approval and the informed consent of study participants. Accordingly, we will defer these requirements for 1 year to allow investigators, trial sponsors, and regulatory bodies time to plan for their implementation.

Just as the confidentiality of trial participants must be protected (through the deidentification of IPD), and the needs of those reasonably requesting data met (through the provision of useable data), the reasonable rights of investigators and trial sponsors must also be protected. The ICMJE proposes the following to safeguard these rights. First, ICMJE editors will not consider the deposition of data in a registry to constitute prior publication. Second, authors of secondary analyses using these shared data must attest that their use was in accordance with the terms (if any) agreed to upon their receipt. Third, they must reference the source of the data using a unique identifier of a clinical trial’s data set to provide appropriate credit to those who generated it and allow searching for the studies it has supported. Fourth, authors of secondary analyses must explain completely how theirs differ from previous analyses. In addition, those who generate and then share clinical trial data sets deserve substantial credit for their efforts. Those using data collected by others should seek collaboration with those who collected the data. However, because collaboration will not always be possible, practical, or desired, an alternative means of providing appropriate credit needs to be developed and recognized in the academic community. We welcome ideas about how to provide such credit.

Data sharing is a shared responsibility. Editors of individual journals can help foster data sharing by changing the requirements of the manuscripts they will consider for publication in their journals. Funders and sponsors of clinical trials are in a position to support and ensure adherence to IPD-sharing obligations. If journal editors become aware that IPD-sharing obligations are not being met, they may choose to request additional information; to publish an expression of concern; to notify the sponsors, funders, or institutions; or in certain cases, to retract the publication.

In the rare situation in which compliance with these requirements is impossible, editors may consider authors’ requests for exceptions. If an exception is made, the reason(s) must be explained in the publication.

Sharing data will increase confidence and trust in the conclusions drawn from clinical trials. It will enable the independent confirmation of results, an essential tenet of the scientific process. It will foster the development and testing of new hypotheses. Done well, sharing clinical trial data should also make progress more efficient by making the most of what may be learned from each trial and by avoiding unwarranted repetition. It will help to fulfill our moral obligation to study participants, and we believe it will benefit patients, investigators, sponsors, and society.

PLOS Currents: Disasters
http://currents.plos.org/disasters/
[Accessed 30 January 2016]

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Evacuation During Hurricane Sandy: Data from a Rapid Community Assessment
January 29, 2016 · Research Article
Introduction: In anticipation of Hurricane Sandy in 2012 New York City officials issued mandatory evacuation orders for evacuation Zone A. However, only a small proportion of residents complied. Failure to comply with evacuation warnings can result in severe consequences including injury and death. To better ascertain why individuals failed to heed pre¬-emptive evacuation warnings for Hurricane Sandy we assessed factors that may have affected evacuation among residents in neighborhoods severely affected by the storm.
Methods: Data from a mental health needs assessment survey conducted among adult residents in South Brooklyn, the Rockaways, and Staten Island from December 13-¬18, 2012 was assessed. Several disasters related questions were evaluated, and prevalence estimates of evacuation and evacuation timing by potential factors that may influence evacuation were estimated. Measures of association were assessed using chi-¬square and t-¬test.
Results: Our sample consisted of 420 residents of which, only 49% evacuated at any time for Sandy. Evacuation was higher among those who witnessed trauma to others related to the World Trade Center attacks (66% vs. 40%, p=0.024). Those who reported extensive household damage after Sandy, had a higher rate of evacuation than those with minimal damage (83% vs. 30%, p<0.001). Among those who evacuated, evacuation before the storm was lower among residents living on higher floors (56% vs. 22%, p=0.022).
Discussion: Given that warnings to evacuate were issued before Sandy made landfall, evacuation among residents in South Brooklyn, the Rockaways and Staten Island, while higher than the overall Zone A evacuation rate, was less than optimal. Continued research on evacuation behaviors is needed, particularly on how timing affects evacuation. A better understanding may help to reduce barriers, and improve evacuation compliance.

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Immediate Needs and Concerns among Pregnant Women During and after Typhoon Haiyan (Yolanda)
January 25, 2016 · Research Article
Introduction: Pregnant and postpartum women are especially vulnerable to natural disasters. These women suffer from increased risk of physical and mental issues including pregnant related problems. Typhoon Haiyan (Yolanda), which hit the Philippines affected a large number of people and caused devastating damages. During and after the typhoon, pregnant women were forced to live in particularly difficult circumstances. The purpose of this study was to determine concerns and problems regarding public health needs and coping mechanisms among pregnant women during and shortly after the typhoon.
Methods: This study employed a cross-sectional design utilizing focus group discussions (FGDs). Participants were 53 women (mean age: 26.6 years old; 42 had children) from four affected communities who were pregnant at the time of the typhoon. FGDs were conducted 4 months after the typhoon, from March 19 to 28, 2014, using semi-structured interviews. Data were analyzed using the qualitative content analysis.
Result: Three themes were identified regarding problems and concerns during and after the typhoon: 1) having no ideas what is going to happen during the evacuation, 2) lacking essentials to survive, and 3) being unsure of how to deal with health concerns. Two themes were identified as means of solving issues: 1) finding food for survival and 2) avoiding diseases to save my family. As the pregnant women already had several typhoon experiences without any major problems, they underestimated the catastrophic nature of this typhoon. During the typhoon, the women could not ensure their safety and did not have a strong sense of crisis management. They suffered from hunger, food shortage, and poor sanitation. Moreover, though the women had fear and anxiety regarding their pregnancy, they had no way to resolve these concerns. Pregnant women and their families also suffered from common health problems for which they would usually seek medical services. Under such conditions, the pregnant woman cooperated with others for survival and used their knowledge of disease prevention.
Discussion: Pregnant women experienced difficulties with evacuation, a lack of minimum survival needs, and attending to their own health issues. Pregnant women were also concerned about needs and health issues of their families, particular, when they had small children. Collecting accurate information regarding the disaster and conducting self-sustainable preparation prior to the disaster among pregnant women will help them to protect their pregnancy status, thereby improving their families’ chance of survival during and after disasters

PLoS Currents: Outbreaks
http://currents.plos.org/outbreaks/
(Accessed 30 January 2016)

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Historical Parallels, Ebola Virus Disease and Cholera: Understanding Community Distrust and Social Violence with Epidemics
January 26, 2016 · Discussion
In the three West African countries most affected by the recent Ebola virus disease (EVD) outbreak, resistance to public health measures contributed to the startling speed and persistence of this epidemic in the region. But how do we explain this resistance, and how have people in these communities understood their actions? By comparing these recent events to historical precedents during Cholera outbreaks in Europe in the 19th century we show that these events have not been new to history or unique to Africa. Community resistance must be analysed in context and go beyond simple single-variable determinants. Knowledge and respect of the cultures and beliefs of the afflicted is essential for dealing with threatening disease outbreaks and their potential social violence.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 30 January 2016)

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Editorial
Can Data Sharing Become the Path of Least Resistance?
The PLOS Medicine Editors
Published: January 26, 2016
DOI: 10.1371/journal.pmed.1001949
Initial text
The year 2016 could be the year when medical research converges on data sharing as a universal standard, if recent events, reflected in several PLOS Medicine articles this month, are a good indication. Attaining that standard, however, may take a little longer…

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Strategies to Prevent Cholera Introduction during International Personnel Deployments: A Computational Modeling Analysis Based on the 2010 Haiti Outbreak
Joseph A. Lewnard, Marina Antillón, Gregg Gonsalves, Alice M. Miller, Albert I. Ko, Virginia E. Pitzer
Research Article | published 26 Jan 2016 | PLOS Medicine
10.1371/journal.pmed.1001947
Abstract
Background
Introduction of Vibrio cholerae to Haiti during the deployment of United Nations (UN) peacekeepers in 2010 resulted in one of the largest cholera epidemics of the modern era. Following the outbreak, a UN-commissioned independent panel recommended three pre-deployment intervention strategies to minimize the risk of cholera introduction in future peacekeeping operations: screening for V. cholerae carriage, administering prophylactic antimicrobial chemotherapies, or immunizing with oral cholera vaccines. However, uncertainty regarding the effectiveness of these approaches has forestalled their implementation by the UN. We assessed how the interventions would have impacted the likelihood of the Haiti cholera epidemic.
Methods and Findings
We developed a stochastic model for cholera importation and transmission, fitted to reported cases during the first weeks of the 2010 outbreak in Haiti. Using this model, we estimated that diagnostic screening reduces the probability of cases occurring by 82% (95% credible interval: 75%, 85%); however, false-positive test outcomes may hamper this approach. Antimicrobial chemoprophylaxis at time of departure and oral cholera vaccination reduce the probability of cases by 50% (41%, 57%) and by up to 61% (58%, 63%), respectively. Chemoprophylaxis beginning 1 wk before departure confers a 91% (78%, 96%) reduction independently, and up to a 98% reduction (94%, 99%) if coupled with vaccination. These results are not sensitive to assumptions about the background cholera incidence rate in the endemic troop-sending country. Further research is needed to (1) validate the sensitivity and specificity of rapid test approaches for detecting asymptomatic carriage, (2) compare prophylactic efficacy across antimicrobial regimens, and (3) quantify the impact of oral cholera vaccine on transmission from asymptomatic carriers.
Conclusions
Screening, chemoprophylaxis, and vaccination are all effective strategies to prevent cholera introduction during large-scale personnel deployments such as that precipitating the 2010 Haiti outbreak. Antimicrobial chemoprophylaxis was estimated to provide the greatest protection at the lowest cost among the approaches recently evaluated by the UN.

PLoS One
http://www.plosone.org/
[Accessed 30 January 2016]

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Assessing Progress towards Public Health, Human Rights, and International Development Goals Using Frontier Analysis
Jeanne Luh, Ryan Cronk, Jamie Bartram
Research Article | published 26 Jan 2016 | PLOS ONE
10.1371/journal.pone.0147663
71/journal.pone.0145548
Abstract
Indicators to measure progress towards achieving public health, human rights, and international development targets, such as 100% access to improved drinking water or zero maternal mortality ratio, generally focus on status (i.e., level of attainment or coverage) or trends in status (i.e., rates of change). However, these indicators do not account for different levels of development that countries experience, thus making it difficult to compare progress between countries. We describe a recently developed new use of frontier analysis and apply this method to calculate country performance indices in three areas: maternal mortality ratio, poverty headcount ratio, and primary school completion rate. Frontier analysis is used to identify the maximum achievable rates of change, defined by the historically best-performing countries, as a function of coverage level. Performance indices are calculated by comparing a country’s rate of change against the maximum achievable rate at the same coverage level. A country’s performance can be positive or negative, corresponding to progression or regression, respectively. The calculated performance indices allow countries to be compared against each other regardless of whether they have only begun to make progress or whether they have almost achieved the target. This paper is the first to use frontier analysis to determine the maximum achievable rates as a function of coverage level and to calculate performance indices for public health, human rights, and international development indicators. The method can be applied to multiple fields and settings, for example health targets such as cessation in smoking or specific vaccine immunizations, and offers both a new approach to analyze existing data and a new data source for consideration when assessing progress achieved.

Science
29 January 2016 Vol 351, Issue 6272
http://www.sciencemag.org/current.dtl

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EDITORIAL
Global science engagement
Geraldine Richmond
Summary
In rural Laos, more than 50% of newborns will be stunted by age 2 due to chronic malnourishment. Worldwide, 161 million children under the age of 5, many of them in Africa and Asia, suffered irreversible stunting as of 2013. The developed world is not immune. As recently as 2010, stunting affected 8 to 9% of babies enrolled in U.S. federal food-subsidy programs. Next week in Washington, DC, the American Association for the Advancement of Science (AAAS is the publisher of Science) will convene its annual meeting (11 to 15 February), where world leaders will discuss food security and other major challenges that lie ahead in both the science and international policy arenas.

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Policy Forum
Conservation Ecology
How can higher-yield farming help to spare nature?
Ben Phalan1,*, Rhys E. Green1,2, Lynn V. Dicks1, Graziela Dotta3, Claire Feniuk1, Anthony Lamb1, Bernardo B. N. Strassburg4,5, David R. Williams1, Erasmus K. H. J. zu Ermgassen1,
Andrew Balmford1
Summary
Expansion of land area used for agriculture is a leading cause of biodiversity loss and greenhouse gas emissions, particularly in the tropics. One potential way to reduce these impacts is to increase food production per unit area (yield) on existing farmland, so as to minimize farmland area and to spare land for habitat conservation or restoration. There is now widespread evidence that such a strategy could benefit a large proportion of wild species, provided that spared land is conserved as natural habitat (1). However, the scope for yield growth to spare land by lowering food prices and, hence, incentives for clearance (“passive” land sparing) can be undermined if lower prices stimulate demand and if higher yields raise profits, encouraging agricultural expansion and increasing the opportunity cost of conservation (2, 3). We offer a first description of four categories of “active” land-sparing mechanisms that could overcome these rebound effects by linking yield increases with habitat protection or restoration (table S1). The effectiveness, limitations, and potential for unintended consequences of these mechanisms have yet to be systematically tested, but in each case, we describe real-world interventions that illustrate how intentional links between yield increases and land sparing might be developed.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
__________________________________________________
Week ending 23 January 2016

This weekly digest is intended to aggregate and distill key content from a broad spectrum of practice domains and organization types including key agencies/IGOs, NGOs, governments, academic and research institutions, consortia and collaborations, foundations, and commercial organizations. We also monitor a spectrum of peer-reviewed journals and general media channels. The Sentinel’s geographic scope is global/regional but selected country-level content is included. We recognize that this spectrum/scope yields an indicative and not an exhaustive product. Comments and suggestions should be directed to:

David R. Curry
Editor &
Founding Managing Director
GE2P2 – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

pdf version: The Sentinel_ week ending 23 January 2016

blog edition: comprised of the 35+ entries  posted below on 24 January 2016

An appeal to end the suffering in Syria
21 January 2016, ongoing
More than 120 humanitarian organizations and United Nations agencies issued a joint appeal today urging the world to raise their voices and call for an end to the Syria crisis and to the suffering endured by millions of civilians. The appeal also outlines a series of immediate, practical steps that can improve humanitarian access and the delivery of aid to those in need inside Syria. You are invited to “sign” the appeal simply by liking, sharing, and retweeting it.

Three years ago, the leaders of UN humanitarian agencies issued an urgent appeal to those who could end the conflict in Syria. They called for every effort to save the Syrian people. “Enough”, they said, of the suffering and bloodshed.

That was three years ago.

Now, the war is approaching its sixth brutal year. The bloodshed continues. The suffering deepens.

So today, we — leaders of humanitarian organisations and UN agencies — appeal not only to governments but to each of you — citizens around the world — to add your voices in urging an end to the carnage. To urge that all parties reach agreement on a ceasefire and a path to peace.

More than ever before, the world needs to hear a collective public voice calling for an end to this outrage. Because this conflict and its consequences touch us all.

It touches those in Syria who have lost loved ones and livelihoods, who have been uprooted from their homes, or who live in desperation under siege. Today, some 13.5 million people inside Syria need humanitarian assistance. That is not simply a statistic. These are 13.5 million individual human beings whose lives and futures are in jeopardy.

It touches the families who, with few options for a better future, set out on perilous journeys to foreign lands in search of refuge. The war has seen 4.6 million people flee to neighbouring countries and beyond.

It touches a generation of children and young people who — deprived of education and traumatized by the horrors they have experienced — increasingly see their future shaped only by violence.

It touches those far beyond Syria who have seen the violent repercussions of the crisis reach the streets, offices and restaurants closer to their homes.

And it touches all those around the world whose economic wellbeing is affected, in ways visible and invisible, by the conflict.

Those with the ability to stop the suffering can — and therefore should — take action now. Until there is a diplomatic solution to the fighting, such action should include:
– Unimpeded and sustained access for humanitarian organizations to bring immediate relief to all those in need inside Syria
– Humanitarian pauses and unconditional, monitored ceasefires to allow food and other urgent assistance to be delivered to civilians, vaccinations and other health campaigns, and for children to return to school
– A cessation of attacks on civilian infrastructure — so that schools and hospitals and water supplies are kept safe
– Freedom of movement for all civilians and the immediate lifting of all sieges by all parties

These are practical actions. There is no practical reason they could not be implemented if there is the will to do so.

In the name of our shared humanity… for the sake of the millions of innocents who have already suffered so much… and for the millions more whose lives and futures hang in the balance, we call for action now….Now.

U.S. – Strengthening the International Response to the Global Refugee Crisis
Fact Sheet
Department of State – Office of the Spokesperson
Washington, DC
January 22, 2016

U.S. Secretary of State John Kerry announced today in Davos, Switzerland, that the United States is seeking significant new international commitments to strengthen the international response to the global refugee crisis. This effort responds to the growing numbers and needs of refugee populations around the world, and reflects our sense of urgency about expanding the humanitarian safety net and creating more long-term, durable opportunities for refugees.

The United States will work with partners to advance the initiative over the coming months, culminating in a high-level event to be hosted by President Obama on the margins of the 71st session of the UN General Assembly. Event participants will be asked to make commitments in the following areas:

Broader and Deeper Commitment to Funding UN Humanitarian Appeals:
In order to create a stronger and more sustainable funding base for UN humanitarian appeals, we are seeking commitments to regular contributions from at least 10 new nations. In tandem with that effort, we will seek at least a 30 percent increase in financing for global humanitarian appeals, from $10 billion in 2015 to $13 billion this year.

Expanded Resettlement and Other Legal Channels for Humanitarian Admissions:
In order to create a brighter future for some of the world’s most vulnerable people, our goal is for nations with existing legal pathways for refugee admission to make commitments that double the global number of resettled refugees and those afforded other legal channels of admission, and for nations without such programs to establish them.

Facilitating Refugee Inclusion and Self-Reliance:
In order to enable refugees to meet their own needs and contribute to communities that host them, the United States seeks commitments to increase the number of refugees worldwide in school by one million, and the number of refugees granted the legal right to work by one million. We believe that at least 10 nations must strengthen their refugee policies and practices to help reach these goals.

The United States will announce significant new commitments over the coming months and will strongly encourage other nations to do the same. The President’s Summit will convene those nations that have made significant new commitments toward achieving the Summit’s core goals throughout the course of 2016, encouraging the international community to do more than we have in the past.

New multi-year initiative launched to step up global response to trafficking in persons and the smuggling of migrants
21 January 2016, Brussels – The European Union (EU) and the United Nations Office on Drugs and Crime (UNODC) today launched the Global Action to Prevent and Address Trafficking in Persons and the Smuggling of Migrants. A four-year joint initiative between the EU and UNODC, the programme will be implemented in partnership with the International Organization for Migration (IOM) and the United Nations Children’s Fund (UNICEF) through to 2019.

The programme forms part of a joint response to assist countries to develop and implement effective responses to trafficking in persons and the smuggling of migrants. UNODC, together with IOM and UNICEF, will focus efforts on assistance to governmental authorities, civil society organizations, victims of trafficking and smuggled migrants.

John Brandolino, UNODC’s Director of the Division for Treaty Affairs, welcomed this initiative and stated that the global action signalled the continuing positive relationship between UNODC and the EU. Mr. Brandolino further added that “UNODC’s collaboration with IOM and UNICEF is key to successful global action. It will help provide a comprehensive prevention and protection approach to addressing the issue of trafficking in persons and the smuggling of migrants.”

Fernando Frutuoso de Melo, Director General of the European Union’s Directorate-General for International Cooperation and Development, added: “Trafficking in human beings is one of the most severe violations of human rights. This new project will help with the prevention efforts and will support the fight against this scourge.”

The programme is expected to be delivered across Africa, Asia, Eastern Europe and Latin America in 13 countries, namely: Belarus, Brazil, Colombia, Egypt, Kyrgyzstan, the Lao People’s Democratic Republic, Mali, Morocco, Nepal, Niger, Pakistan, South Africa and Ukraine.

Too important to fail—addressing the humanitarian financing gap
High-Level Panel on Humanitarian Financing
Report to the Secretary-General
January 2016 :: 41 pages
Report Pdf

[Excerpts from Executive Summary]
The world today spends around US$ 25 billion to provide life-saving assistance to 125 million people devastated by wars and natural disasters. While this amount is twelve times greater than fifteen years ago, never before has generosity been so insufficient. Over the last years conflicts and natural disasters have led to fast-growing numbers of people in need and a funding gap for humanitarian action of an estimated US$ 15 billion. This is a lot of money, but not out of reach for a world producing US$ 78 trillion of annual GDP. Closing the humanitarian
financing gap would mean no one having to die or live without dignity for the lack of money. It would be a victory for humanity at a time when it is much needed.

The UN Secretary-General has appointed a nine-person group of experts (“the panel”) to work on finding solutions about this widening financial gap. The panel identified and examined three important and interdependent aspects of the humanitarian financing challenge: reducing the needs, mobilising additional funds through either traditional or innovative mechanisms, and improving the efficiency of humanitarian assistance.

The panel’s work aims to help inform and shape the objectives of the World Humanitarian Summit (WHS) in Istanbul in May 2016. It is also highly relevant in the context of adopting the Sustainable Development Goals (SDGs)—only by focusing the world’s attention on the rapidly growing numbers of people in desperate need will we be able to achieve the SDGs…

…Improve delivery: a Grand Bargain on efficiency
The panel concurs with a widely shared view among stakeholders that systemic change in humanitarian aid delivery is needed in order to raise new money and use it more effectively. Greater efficiency will create a virtuous circle by drawing in more funding. Since the status quo is not an option, the panel calls on donors and implementing organisations to come together in a Grand Bargain. As part of that agreement, donors would not simply give more but give better, by being more flexible, and aid organisations would reciprocate with greater transparency and cost-consciousness.

The elements of a Grand Bargain include provision of more cash-based assistance, where appropriate, and recognition of the comparative advantages of local, national and international implementing organisations for delivery of services. To improve response time the panel suggests the creation of a repository of pre-qualified organisations to dispense with repeated screening of NGOs, as well as more work on strengthening local capacity.

The panel wants donors to commit to more multiyear funding and less earmarking, since flexible funding is the lifeblood of humanitarian operations. And donors should simplify and harmonise their reporting requirements, leaving aid workers more time to perform their life-saving activities. And we need greater transparency from implementing organisations so that everyone can “follow the money” on its journey from donor to recipient. A global data platform to provide open and transparent data would help reduce transaction costs and increase effectiveness.

By committing to joint needs assessments, such as those carried out in northern Syria and during the Nepal earthquake, humanitarian organisations would increase donors’ trust. True transparency is within our grasp thanks to digital technology and this should be extended to include communities receiving aid: humanitarian organisations can learn and improve by listening to the people they serve.

If we are to move towards a model of collaborative efficiency, the panel would like government donors and aid organisations to agree to a Grand Bargain. By doing so, they will clearly demonstrate a common commitment to the greater good.

The panel presents this report conscious that the implementation of its recommendations will depend upon the will of many to carry them forward. Panel members are committed to continuing to offer their assistance in the process of making these proposals a reality.
[Table, Excerpt from Grand Bargain discussion, p.24]
The panel recommends:
That by the World Humanitarian Summit donors and aid organisations work towards a collective roadmap for stretching available money to reach more people in need.

The main elements of a Grand Bargain are:
For aid organisations and donors to work more closely together towards:
…More financial transparency.
…More support and funding tools to national first responders.
…Scale up use of cash-based programming and more coordination in its delivery.

For aid organisations to commit to:
…Reduce duplication and management costs.
…Periodic functional expenditure reviews.
…More joint and impartial needs assessments.
…A Participation Revolution: listen more to and include beneficiaries in decisions that affect them.

For donors to commit to:
…More multi-year humanitarian funding.
…Less earmarks to humanitarian aid organisations.
…More harmonized and simplified reporting requirements.
Panel Members
Co-Chairs
Ms. Kristalina Georgieva, Bulgaria, Vice President for Budget and Human Resources, the European Commission
HRH Sultan Nazrin Shah, Malaysia, Ruler of Perak, Malaysia
Panelists in alphabetical order
Ms. Hadeel Ibrahim, the United Kingdom, Executive Director, Mo Ibrahim Foundation
Mr. Badr Jafar, the United Arab Emirates, Managing Director, the Crescent Group
Mr. Walt Macnee, Canada, Vice Chairman, MasterCard
Mr. Trevor Manuel, South Africa, Senior Advisor, Rothschild Group
Ms. Linah Mohohlo, Botswana, Governor, Bank of Botswana
Mr. Dhananjayan Sriskandarajah, Sri Lanka, Secretary-General, CIVICUS
Ms. Margot Wallström, Sweden, Minister for Foreign Affairs