BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 21 November 2015)

.
Research article
Improving access to medicines through centralised dispensing in the public sector: a case study of the Chronic Dispensing Unit in the Western Cape Province, South Africa
Bvudzai Magadzire, Bruno Marchal, Kim Ward
BMC Health Services Research 2015, 15:513 (17 November 2015)

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 21 November 2015)

.
Research article
Comparison of registered and published outcomes in randomized controlled trials: a systematic review
Christopher Jones, Lukas Keil, Wesley Holland, Melissa Caughey, Timothy Platts-Mills BMC Medicine 2015, 13:282 (18 November 2015)
Abstract
Background
Clinical trial registries can improve the validity of trial results by facilitating comparisons between prospectively planned and reported outcomes. Previous reports on the frequency of planned and reported outcome inconsistencies have reported widely discrepant results. It is unknown whether these discrepancies are due to differences between the included trials, or to methodological differences between studies. We aimed to systematically review the prevalence and nature of discrepancies between registered and published outcomes among clinical trials.
Methods
We searched MEDLINE via PubMed, EMBASE, and CINAHL, and checked references of included publications to identify studies that compared trial outcomes as documented in a publicly accessible clinical trials registry with published trial outcomes. Two authors independently selected eligible studies and performed data extraction. We present summary data rather than pooled analyses owing to methodological heterogeneity among the included studies.
Results
Twenty-seven studies were eligible for inclusion. The overall risk of bias among included studies was moderate to high. These studies assessed outcome agreement for a median of 65 individual trials (interquartile range [IQR] 25–110). The median proportion of trials with an identified discrepancy between the registered and published primary outcome was 31 %; substantial variability in the prevalence of these primary outcome discrepancies was observed among the included studies (range 0 % (0/66) to 100 % (1/1), IQR 17–45 %). We found less variability within the subset of studies that assessed the agreement between prospectively registered outcomes and published outcomes, among which the median observed discrepancy rate was 41 % (range 30 % (13/43) to 100 % (1/1), IQR 33–48 %). The nature of observed primary outcome discrepancies also varied substantially between included studies. Among the studies providing detailed descriptions of these outcome discrepancies, a median of 13 % of trials introduced a new, unregistered outcome in the published manuscript (IQR 5–16 %).
Conclusions
Discrepancies between registered and published outcomes of clinical trials are common regardless of funding mechanism or the journals in which they are published. Consistent reporting of prospectively defined outcomes and consistent utilization of registry data during the peer review process may improve the validity of clinical trial publications

BMC Public Health
http://www.biomedcentral.com/bmcpublichealth/content
(Accessed 21 November 2015)

.
Research article
Perceptions and plans for prevention of Ebola: results from a national survey
Bridget Kelly, Linda Squiers, Carla Bann, Alexander Stine, Heather Hansen, Molly Lynch BMC Public Health 2015, 15:1136 (16 November 2015)
Abstract
Background
Literature suggests that Americans may have higher levels of perceived threat to Ebola than are warranted.
Methods
We surveyed 1018 U.S. adults from a nationally representative Internet panel about their knowledge, perceived threat, and behavioral intentions during the 2014 Ebola outbreak.
Results
Eighty-six percent of respondents knew that Ebola could be transmitted through blood and bodily fluids. However, a large percentage had some inaccurate knowledge and 19 % believed Ebola would spread to the U.S. Respondents favored mandatory quarantine (63 %) and travel bans (55 %). Confidence in the ability of the media and government to accurately report on or prevent a U.S. epidemic was low. Fifty-two percent intended to engage in behaviors such as avoiding public transportation.
Discussion
Despite low perceived susceptibility, half intended to engage in behaviors to prevent transmission and large numbers favored policies not currently recommended by health officials. The extreme nature of Ebola virus likely motivated people to engage in behaviors and favor policies that were not necessary given the low risk of transmission in the U.S.
Conclusions
Health officials should ensure the public has accurate information about Ebola and bolster confidence in the government’s ability to control infectious diseases in case of a future outbreak in the U.S.

.

Research article
Prevalence and determinants of stunting in under-five children in central Tanzania: remaining threats to achieving Millennium Development Goal 4
Innocent Semali, Anna Tengia-Kessy, Elia Mmbaga, Germana Leyna BMC Public Health 2015, 15:1153 (21 November 2015)

.

Research article
Eradicating female genital mutilation and cutting in Tanzania: an observational study
Moses Galukande, Joseph Kamara, Violet Ndabwire, Elisabeth Leistey, Cecilia Valla, Sam Luboga BMC Public Health 2015, 15:1147 (19 November 2015)
Abstract
Background
Female genital mutilation and cutting (FGM/C) has long been practiced in various parts of the world. The practice is still prevalent in 29 countries on the African continent despite decades of campaigning to eradicate it. The approaches for eradication have been multi-pronged, including but not limited to, health risk campaigns teaching about the health consequences for the girls and the women, recruitment of change agents from within the communities and the enforcement of legal mechanisms.
The purpose of this study was to analyse the impact of an 18 month long campaign to eradicate or reduce FGM/C in a rural predominantly Masai community.
Methods
An observational study involving mixed methods, quantitative and qualitative was conducted in Arusha region, Tanzania. A household survey, key informant interviews, focus group discussions, school children’s group discussions and project document reviews for both baseline and endline assessments were used. Same tools were used for both baseline and endline assessements. Comparison of baseline and endline findings and conclusions were drawn.
Results
The prevalence of self reported FGM/C at endline was 69.2 %. However, physical obstetric examination of women in labour revealed a prevalence of over 95 % FGM/C among women in labour.
Those in favour of FGM/C eradication were 88 %. Nearly a third of the 100 FGM practitioners had denounced the practice; they also formed a peer group that met regularly comparing baseline and endline. Knowledge about FGM/C health risks increased from 16 to 30 % (p < 0.001). The practice is currently done secretly to an uncertain extent.
Conclusion
This multifaceted educational campaign achieved moderate success in increasing knowledge of the health risks and changing attitudes despite a short period of intervention. However, its effectiveness in reducing FGM/C prevalence was uncertain.

British Medical Journal
21 November 2015 (vol 351, issue 8034)
http://www.bmj.com/content/351/8034

.
Maternal vaccination against H1N1 influenza and offspring mortality: population based cohort study and sibling design
BMJ 2015; 351 :h5585 (Published 16 November 2015)
Abstract
Study question
What is the mortality in offspring of mothers who had influenza A(H1N1)pdm09 vaccination during pregnancy?
Methods
This was a prospective population based cohort study in seven healthcare regions in Sweden based on vaccinations taking place between 2 October 2009 and 26 November 2010. H1N1 vaccination data were linked with pregnancy and birth characteristics and offspring mortality data in 275 500 births (of which 1203 were stillbirths) from 137 886 mothers. Of these offspring, 41 183 had been exposed to vaccination with Pandemrix, a monovalent AS03 adjuvanted H1N1 influenza vaccine, during fetal life. A primary comparison group consisted of pregnancies of women who were not vaccinated during the same calendar period. In a second comparison, non-exposed siblings of infants prenatally exposed to vaccination were used as controls. Cox regression was used to estimate hazard ratios for stillbirth, early neonatal mortality (days 0-6 after birth), and subsequent mortality (beginning on day 7) in vaccinated versus non-vaccinated women, adjusting for mother’s age at delivery, body mass index, parity, smoking, country of birth, and disposable income and for sex of offspring.
Study answer and limitations
The results of this study suggest that AS03 adjuvanted H1N1 vaccination during pregnancy does not affect the risk of stillbirth, early neonatal death, or later mortality in the offspring. During follow-up, 1172 stillbirths, 380 early neonatal deaths, and 706 deaths thereafter occurred. Compared with general population controls, this corresponded to adjusted hazard ratios of 0.83 (95% confidence interval 0.65 to 1.04) for stillbirth, 0.71 (0.44 to 1.14) for early neonatal death, and 0.97 (0.69 to 1.36) for later death. When siblings were used as controls, adjusted hazard ratios were 0.88 (0.59 to 1.30) for stillbirth, 0.82 (0.46 to 1.49) for early neonatal death, and 0.78 (0.52 to 1.19) for later death. Limitations of the study include lack of data on miscarriage before gestational week 22, inability to ascertain which mothers had pandemic flu during pregnancy, and lack of data on factors influencing the decision to vaccinate during pregnancy.
What this study adds
H1N1 vaccination during pregnancy is not associated with adverse fetal outcome or offspring mortality, including when familial factors are taken into account.
Funding, competing interests, data sharing
This project was supported by grants from the Swedish Research Council and the Swedish Council for Working Life and Social Research. NF was employed at the Swedish Medical Product Agency at the time of the study.

Conflict and Health
http://www.conflictandhealth.com/
[Accessed 21 November 2015]
Research
Coping among trauma-affected youth: a qualitative study
Cherewick M, Kohli A, Remy MM, Murhula CM, Kurhorhwa AKB, Mirindi AB, Bufole NM, Banywesize JH et al. Conflict and Health 2015, 9:35 (17 November 2015)
Abstract
Background
Eastern Democratic Republic of Congo has endured decades of conflict resulting in widespread experiences of conflict related trauma and destruction to health and social infrastructure. The aim of this qualitative study was to provide a context specific understanding of youth exposure to violence (ages 10–15 years) and use of cognitive and behavioral coping strategies.
Methods
A purposive sampling strategy based on age, gender and exposure to traumatic events was used to identify eligible youth in an ongoing parent study from four villages in the Walungu Territory, Eastern Democratic Republic of Congo. These four villages were selected from a total of 10 participating in the parent study because of the reported high exposure to conflict-related trauma. The interview guide consisted of broad open-ended questions related to the following topics, 1) identification of traumatic experiences, 2) methods for coping and changes in coping behavior 3) gender and age differences in coping, 4) sources of psychosocial support. A grounded theory approach was used to identify emergent themes.
Results
Of the 48 eligible participants identified, 30 youth completed the interview, 53 % were female (n = 16) and 47 % were male (n = 14). Youth ranged in age from 10–15 (mean age = 13.07). Exposures to different forms of violence and stress were reported among youth participants. Exposures to traumatic stressors occur at the individual, family and community level. In response to traumatic stress, youth reported both cognitive and behavioral coping strategies. Cognitive coping strategies included trying to forget and praying. Behavioral coping strategies included social support seeking and risk-taking behavior. These strategies may be used in mutually reinforcing ways, with youth employing more than one coping strategy.
Conclusion
This qualitative research provides important, culturally grounded information on coping strategies used by youth in rural post-conflict settings where limited psychosocial support services are available. Understanding use of cognitive and behaviors coping strategies may inform local community and international development programs to support youth mental health along adaptive trajectories resulting in promotion of well-being and reduced risk taking behaviors.

Food Policy
Volume 57, In Progress (November 2015)
http://www.sciencedirect.com/science/journal/03069192

.
Farmers’ beliefs and voluntary vaccination schemes: Bluetongue in Dutch dairy cattle
Original Research Article
Pages 40-49
J. Sok, H. Hogeveen, A.R.W. Elbers, A.G.J.M. Oude Lansink
Abstract
Background
This research utilizes the Reasoned Action Approach framework to study which beliefs drive the intention of farmers to participate in a voluntary vaccination scheme against Bluetongue.
Scope and approach
Knowing the driving beliefs can help in selecting an appropriate mix of policy instruments to enhance the participation rate and thereby improve the cost-effectiveness and efficiency of voluntary vaccination strategies. Results are used to evaluate the policy instruments used by the Dutch government in their 2008 vaccination strategy (communicative intervention and vaccine subsidization).
Key findings and conclusions
The paper posits that social interaction mechanisms, such as peer group pressure, might advance the design of voluntary vaccination strategies.

.
Mobile phones and market information: Evidence from rural Cambodia
Original Research Article
Pages 135-141
Daichi Shimamoto, Hiroyuki Yamada, Martin Gummert
Abstract
Local agricultural markets in developing countries are often characterised as oligopsonistic markets, forcing famers to sell their products below the wholesale price. However, this situation appears to be changing with the diffusion of mobile phones. We investigate how access to market information through mobile phone use affects the selling price of rice in Cambodia. We differentiate the use of mobile phones to obtain market information from household mobile phone ownership. Our results indicate that improved access to market information through mobile phone use is associated with an increase in the selling price of rice.

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 21 November 2015]

.
Research
‘They hear “Africa” and they think that there can’t be any good services’ – perceived context in cross-national learning: a qualitative study of the barriers to Reverse Innovation
Harris M, Weisberger E, Silver D and Macinko J Globalization and Health 2015, 11:45 (19 November 2015)

.

Research
Rethinking health care commercialization: evidence from Malaysia
Nwagbara VC and Rasiah R Globalization and Health 2015, 11:44 (19 November 2015)
Abstract
Background
Against the backdrop of systemic inefficiency in the public health care system and the theoretical claims that markets result in performance and efficiency improvement, developing countries’ governments have been rapidly commercializing health care delivery. This paper seeks to determine whether commercialization through an expansion in private hospitals has led to performance improvements in public hospitals.
Methods
Inpatient utilization records of all public hospitals in Peninsular Malaysia over the period 2006–2010 were used in this study. These records were obtained from the Ministry of Health. The study relied on utilization ratios, bed occupancy rates (BOR), bed turnover rates (BTR) and average length of stay (ALOS). The data were analyzed using SPSS 22 Statistical Software and the Pabon Lasso technique.
Results
Over 60 % of public hospitals in Malaysia are inefficient and perform sub-optimally. Average BOR among the public hospitals was 56 % in 2006 and 61 % in 2010. There was excessive BTR of 65 and 73 times within the period. Overall, the ALOS was low, falling from 3.4 days in 2006 to 3.1 days in 2010.
Conclusions
This study demonstrates that commercialization has not led to performance improvements in the public health care sector in Malaysia. The evidence suggests that efforts to improve performance will require a focus directly on public hospitals.

Human Service Organizations Management, Leadership & Governance
Volume 39, Issue 5, 2015
http://www.tandfonline.com/toc/wasw21/current

.
The Individual, Group, Organizational, and Community Outcomes of Capacity-Building Programs in Human Service Nonprofit Organizations: Implications for Theory and Practice
Tara Kolar Bryan & Catherine H. Brown
pages 426-443
DOI:10.1080/23303131.2015.1063555
Abstract
This exploratory article offers a multilevel framework for understanding the outcomes of capacity-building initiatives in human service nonprofit organizations. Four distinct levels were considered: the individual, group-cohort, organization, and community levels. The findings suggest there are outcomes associated with each level as well as linkages between the levels. Respondents stated that the outcomes associated with the individual and group-cohort levels were strongest, although participants described benefits at the organizational level as well. Interviewees’ responses also suggest that the outcomes at the community level were least apparent. Further research should focus specifically on the linkage between such programs and community-level outcomes.

.

Measuring Organizational Change Tactics to Improve Child Welfare Programs: Experiences in 13 Counties
Thomas Packard, Julie McCrae, Jon Phillips & Maria Scannapieco
pages 444-458
DOI:10.1080/23303131.2015.1067268
Abstract
This study introduces a new measure that assesses the extent of organizational change tactics usage within a human service organization. The Organizational Change Tactics Questionnaire (OCTQ) was developed based on a comprehensive review of effective organizational change tactics and adapted to the unique needs of human service organizations. This study presents the psychometric properties of the OCTQ using the tool with 13 large child welfare organizations experiencing organizational change. Respondents who saw a greater use of change tactics and those who were more involved with the change process were significantly more likely to perceive the change process as successful.

.

The Determinant of Nonprofit External and Internal Effectiveness: The Role of Knowledge Sharing, Collaborative Culture, and Beneficiary Participation
Nurul Hidayana Mohd Noor, Siti A. B. Hajar & Mohd Awang Idris
pages 459-474
DOI:10.1080/23303131.2015.1076550
Abstract
Determining the factors that contribute to nonprofit effectiveness is a problematic and puzzling task. In that respect, utilizing the intellectual capital (IC) concept, this paper proposes an analysis of knowledge sharing, collaborative culture, and beneficiary participation as determinants of nonprofit effectiveness. Drawn from quantitative research strategy, a cross-sectional survey and a structured questionnaire have been employed. The final valid data consist of 271 participants from Malaysian nonprofits located in the Klang Valley area, Malaysia. The main analysis used structural equation modeling (SEM). The findings revealed that knowledge sharing and beneficiary participation significantly predict both external and internal effectiveness. However, collaborative culture fails to act as a predictor of either nonprofit external or internal effectiveness.

International Human Rights Law Review
Volume 4, Issue 2, 2015
http://booksandjournals.brillonline.com/content/journals/22131035/4/2

.
Research Article
The Development of Economic, Social and Cultural Rights under the African Charter on Human and Peoples’ Rights by the African Commission on Human and Peoples’ Rights
Manisuli Ssenyonjo
pp.: 147–193 (47)
Abstract
During the last thirty years the African Commission on Human and Peoples’ Rights (African Commission) has decided several communications on economic, social and cultural (ESC) rights protected under the African Charter on Human and Peoples’ Rights (African Charter). While the Commission was initially reluctant to develop the content of these rights, it has since 2001 been developing, at an expanding pace, the scope, content and nature of state obligations under African Charter to respect, protect and fulfil ESC rights. This article seeks to provide a critical analysis of the burgeoning case law concerning the development of ESC rights by the African Commission and the legal impact thus far it has had on the enjoyment of ESC rights in Africa, encompassing rights of hitherto marginalised and excluded individuals and groups, a topic which is relatively given less attention in the existing literature. The article examines the legal bases and content of key communications decided by the African Commission. Conclusions are then drawn concerning the reasons for the development of ESC rights obligations by the African Commission and areas of potential clarification and expansion are identified.

.

Research Article
Re-Conceptualizing the Right to Seek and Obtain Asylum in International Law
Salvatore Fabio Nicolosi
pp.: 303–332 (30)
Abstract
Over the past few years the issue of asylum has progressively become interrelated with human rights. Asylum-related stresses, including refugee flows and mass displacements, have mitigated the traditional idea of asylum as an absolute state right, in so far as international human rights standards of protection require that states may have the responsibility to provide asylum seekers with protection. Following this premise, the article argues that the triggering factor of such overturning is significantly represented by the judicial approach to the institution of asylum by regional human rights courts. After setting the background on the interrelation of asylum with human rights, this article conceptualises the right to asylum as derived from the principle of non-refoulement and to this extent it delves into the role of the two regional human rights courts, notably the European Court of Human Rights (ECtHR) and the Inter-American Court of Human Rights (IACtHR), in order to explore whether an emerging judicial cross-fertilisation may contribute to re-conceptualisation of the right to asylum from a human rights perspective.

Journal of the Pediatric Infectious Diseases Society (JPIDS)
Volume 4 Issue 4 December 2015
http://jpids.oxfordjournals.org/content/current

.
Efficacy of a Tetravalent Dengue Vaccine in Children in Latin America
Rana F. Hamdy
Author Affiliations
Division of Infectious Diseases, The Children’s Hospital of Philadelphia
Received July 9, 2015.
Accepted August 1, 2015.
Villar L, Dayan GH, Arredondo-Garcia JL, et al. Efficacy of a tetravalent dengue vaccine in children in Latin America. N Engl J Med 2015; 372:113–23.
Extract
Dengue is a mosquito-borne disease caused by 1 of 4 virus serotypes from the flavivirus genus present in tropical and subtropical regions. This study reports the results from a phase 3 randomized, blinded, placebo-controlled efficacy trial of a recombinant, live, attenuated, tetravalent dengue vaccine (CYD-TDV) involving healthy children ages 9 to 16 years in 5 Latin American countries.
The study, sponsored by Sanofi Pasteur, took place in 22 centers in Colombia, Brazil, Mexico, Puerto Rico, and Honduras from June 2011 to March 2012. The investigational vaccine consists of 4 recombinant dengue vaccine viruses, which were constructed by replacing the genes that encode the premembrane and envelope proteins of the yellow fever 17D vaccine virus with those from wild-type dengue viruses…

The Lancet
Nov 21, 2015 Volume 386 Number 10008 p2029-2116
http://www.thelancet.com/journals/lancet/issue/current

.
Editorial
Violence against women and girls: how far have we come?
The Lancet
DOI: http://dx.doi.org/10.1016/S0140-6736(15)01029-6
Summary
A year ago, The Lancet published a Series on violence against women and girls ahead of the International Day for the Elimination of Violence against Women on Nov 25. The day marks the start of the 16 Days of Activism against Gender-Based Violence, which this year, for the first time, has prevention as its theme. This focus is encouraging. One in three women will experience physical and/or sexual violence in their lifetime but, as evidence in the Series showed, such violence is preventable. The authors found that community and group interventions involving men and women can shift entrenched social norms and attitudes to reduce the risk of violence against women and girls, but concerted efforts were needed for change

.
Comment
Towards therapeutic vaccination against cervical precancer?
Mark Schiffman, Nicolas Wentzensen
Published Online: 16 September 2015
DOI: http://dx.doi.org/10.1016/S0140-6736(15)00240-8
Summary
In The Lancet, Cornelia Trimble and colleagues1 report the results of a double-blind, randomised controlled trial of therapeutic human papillomavirus (HPV) vaccination. Three doses of an intramuscular HPV-16 and HPV-18 plasmid vaccine significantly increased histological regression of cervical precancers caused by HPV types 16 and 18. At 36 weeks after the first dose, regression of cervical intraepithelial neoplasia 2/3 was 48·2% compared with a spontaneous rate in the placebo group of 30·0% (difference 18·2%, 95% CI 1·3–34·4).

.
Safety, efficacy, and immunogenicity of VGX-3100, a therapeutic synthetic DNA vaccine targeting human papillomavirus 16 and 18 E6 and E7 proteins for cervical intraepithelial neoplasia 2/3: a randomised, double-blind, placebo-controlled phase 2b trial
Cornelia L Trimble, Matthew P Morrow, Kimberly A Kraynyak, Xuefei Shen, Michael Dallas, Jian Yan, Lance Edwards, R Lamar Parker, Lynette Denny, Mary Giffear, Ami Shah Brown, Kathleen Marcozzi-Pierce, Divya Shah, Anna M Slager, Albert J Sylvester, Amir Khan, Kate E Broderick, Robert J Juba, Timothy A Herring, Jean Boyer, Jessica Lee, Niranjan Y Sardesai, David B Weiner, Mark L Bagarazzi
Summary
Background
Despite preventive vaccines for oncogenic human papillomaviruses (HPVs), cervical intraepithelial neoplasia (CIN) is common, and current treatments are ablative and can lead to long-term reproductive morbidity. We assessed whether VGX-3100, synthetic plasmids targeting HPV-16 and HPV-18 E6 and E7 proteins, delivered by electroporation, would cause histopathological regression in women with CIN2/3.
Methods
Efficacy, safety, and immunogenicity of VGX-3100 were assessed in CIN2/3 associated with HPV-16 and HPV-18, in a randomised, double-blind, placebo-controlled phase 2b study. Patients from 36 academic and private gynaecology practices in seven countries were randomised (3:1) to receive 6 mg VGX-3100 or placebo (1 mL), given intramuscularly at 0, 4, and 12 weeks. Randomisation was stratified by age (<25 vs ≥25 years) and CIN2 versus CIN3 by computer-generated allocation sequence (block size 4). Funder and site personnel, participants, and pathologists were masked to treatment. The primary efficacy endpoint was regression to CIN1 or normal pathology 36 weeks after the first dose. Per-protocol and modified intention-to-treat analyses were based on patients receiving three doses without protocol violations, and on patients receiving at least one dose, respectively. The safety population included all patients who received at least one dose. The trial is registered at ClinicalTrials.gov (number NCT01304524) and EudraCT (number 2012-001334-33).
Findings
Between Oct 19, 2011, and July 30, 2013, 167 patients received either VGX-3100 (n=125) or placebo (n=42). In the per-protocol analysis 53 (49·5%) of 107 VGX-3100 recipients and 11 (30·6%) of 36 placebo recipients had histopathological regression (percentage point difference 19·0 [95% CI 1·4–36·6]; p=0·034). In the modified intention-to-treat analysis 55 (48·2%) of 114 VGX-3100 recipients and 12 (30·0%) of 40 placebo recipients had histopathological regression (percentage point difference 18·2 [95% CI 1·3–34·4]; p=0·034). Injection-site reactions occurred in most patients, but only erythema was significantly more common in the VGX-3100 group (98/125, 78·4%) than in the placebo group (24/42, 57·1%; percentage point difference 21·3 [95% CI 5·3–37·8]; p=0·007).
Interpretation
VGX-3100 is the first therapeutic vaccine to show efficacy against CIN2/3 associated with HPV-16 and HPV-18. VGX-3100 could present a non-surgical therapeutic option for CIN2/3, changing the treatment outlook for this common disease.
Funding
Inovio Pharmaceuticals.

Nature
Volume 527 Number 7578 pp275-404 19 November 2015
http://www.nature.com/nature/current_issue.html

.
Comment
Sustainability: Transfer project cannot meet China’s water needs
Better local water management is the way to keep pace with escalating demands, not pumping water across the country, warn Jon Barnett and colleagues.

.
Nature | Supplement Open
Global research challenges and opportunities for mental health and substance-use disorders
Florence Baingana, Mustafa al’Absi, Anne E. Becker & Beverly Pringle
Affiliations
Corresponding author
Nature 527, S172–S177 (19 November 2015)
doi:10.1038/nature16032
Published online 18 November 2015
Abstract
The research agenda for global mental health and substance-use disorders has been largely driven by the exigencies of high health burdens and associated unmet needs in low- and middle-income countries. Implementation research focused on context-driven adaptation and innovation in service delivery has begun to yield promising results that are improving the quality of, and access to, care in low-resource settings. Importantly, these efforts have also resulted in the development and augmentation of local, in-country research capacities. Given the complex interplay between mental health and substance-use disorders, medical conditions, and biological and social vulnerabilities, a revitalized research agenda must encompass both local variation and global commonalities in the impact of adversities, multi-morbidities and their consequences across the life course. We recommend priorities for research — as well as guiding principles for context-driven, intersectoral, integrative approaches — that will advance knowledge and answer the most pressing local and global mental health questions and needs, while also promoting a health equity agenda and extending the quality, reach and impact of scientific enquiry

New England Journal of Medicine
November 19, 2015 Vol. 373 No. 21
http://www.nejm.org/toc/nejm/medical-journal

.
Editorials
Vaccine-Resistant Malaria
C.V. Plowe
[Free Full Text]
To ensure efficacy against wild poliovirus, Jonas Salk methodically classified circulating polio strains before choosing three to use in his inactivated vaccine.1 Several other successful vaccines against viruses and bacteria have likewise included immunogen variants that were selected through careful assessments of pathogen genetic diversity and strain-specific protective immunity.

In contrast, virtually all vaccines against the malaria parasite Plasmodium falciparum, including RTS,S/AS01, have been designed with the use of genetic sequences that are derived from a single, well-characterized reference strain thought to be of West African origin — 3D7. In light of the extreme diversity of malaria parasites, could this “freezer epidemiology” approach to vaccine development be one reason it has been so hard to make an effective malaria vaccine?

Phase 2 field trials of two malaria vaccines targeting highly polymorphic blood-stage antigens have shown strain-specific efficacy — that is, parasites that are genetically divergent from the strain used in the vaccine escaped its effect.2,3 However, field trials of RTS,S, which is based on the pre-erythrocytic P. falciparum circumsporozoite protein, showed no clear evidence of strain-specific efficacy.4,5 Circumsporozoite protein has polymorphism within two major T-cell epitopes, and although there is some variation in the immunodominant central repeat region, for decades it has been hoped that antibodies targeting a single dominant epitope based on the tetrapeptide repeat NANP would provide strain-transcending immunity. A molecular epidemiologic study showed no evidence of naturally acquired strain-specific immunity to different variants of circumsporozoite protein in African children,6 which added to the hope that RTS,S might not be threatened by “vaccine-resistant malaria.”7

These previous studies each examined malaria parasites in a few hundred children at a single African site and were constrained by the challenges of sequencing the long central repeat region of the circumsporozoite protein. Neafsey et al.8 now describe in the Journal how they used next-generation sequencing to measure strain-specific efficacy in a phase 3 trial of RTS,S/AS01 involving 15,000 children at 11 study sites across Africa. Parasite DNA was extracted from several thousand dried blood spots collected from children who were randomly assigned to receive the malaria vaccine or a control vaccine, and the efficacy of the vaccine against infection and clinical malaria with circumsporozoite protein identical to, or different from, the vaccine strain 3D7 was measured by means of a sieve analysis.9

The approach is straightforward: if vaccine-induced immunity is acting like a sieve that filters out parasites that are identical to the vaccine strain at immunologically important polymorphic amino acid positions, then less vaccine-type malaria should occur among vaccinated children, as compared with the control group. The large sample size was needed — vaccine-type parasites were in the minority at all study sites. Several predetermined analyses examining different variant components of circumsporozoite protein showed that, at least in older children, RTS,S/AS01 was indeed better at protecting against malaria caused by vaccine-type parasites. There was no such allele-specific efficacy in young infants, a group in which RTS,S efficacy was lower and in which there may have been different immune responses to both vaccination and malaria infection.

The effect of parasite genetic diversity on efficacy in older children was modest. Various measures of efficacy were approximately 10 to 15 percentage points lower when they were evaluated against non–vaccine-type parasites. This is a much smaller blow to efficacy than the more than 40-point deficit seen with a blood-stage vaccine.3

If we had a vaccine with 80% or 90% efficacy, we might be willing to accept a loss of this magnitude. But RTS,S/AS01 starts off with about 50 to 60% efficacy at best; the efficacy is lower in younger children, and it wanes over time. As this first malaria vaccine moves toward licensure, the results of this study should give pause to those considering whether, where, and when to deploy it. If RTS,S/AS01 is introduced into wide use, over time the loss of efficacy could be more profound than that seen during just a year of follow-up among children who are exposed to a large surrounding population of malaria parasites that are not under selection pressure from vaccine-induced immunity. The most prudent course may be to use RTS,S/AS01 in the specific populations that will benefit most, while redoubling efforts to improve this pioneering vaccine on the basis of new understanding provided by this study of the strain-specific basis of its partial efficacy.

The news is not all bad. The modest loss of efficacy against divergent parasites implies that RTS,S/AS01 offers some degree of cross-protection — vaccine escape is not complete. A multivalent version of RTS,S with carefully chosen circumsporozoite protein variants, possibly combined with additional antigens, might offer broader protection.10 The large set of molecular epidemiologic data on the prevalence of circumsporozoite protein variants across Africa that was generated for this study should provide the evidence needed to select a combination of strains for a more broadly efficacious, next-generation malaria vaccine.

Nonprofit and Voluntary Sector Quarterly
December 2015; 44 (6)
http://nvs.sagepub.com/content/current

.
To Volunteer or Not: The Influence of Individual Characteristics, Resources, and Social Factors on the Likelihood of Volunteering by Older Adults
Sarah Dury, Liesbeth De Donder, Nico De Witte, Tine Buffel, Wolfgang Jacquet, and Dominique Verté
Nonprofit and Voluntary Sector Quarterly December 2015 44: 1107-1128, first published on November 13, 2014 doi:10.1177/0899764014556773
Abstract
The study examines a hybrid theory containing individual characteristics, resources, and social factors and volunteering of older adults living in Belgium. As scholars have pointed out the under-researched importance of taking the recruitment potential of older adults into account, this study investigates whether potential volunteers, actual volunteers, and non-volunteers in later life are different from each other in terms of individual characteristics (e.g., religiosity), resources (e.g., socioeconomic status), and social factors (e.g., social networks and social roles). Data for the present research were derived from the Belgian Aging Studies, a sample of 31,581 individuals aged 65 to 80 years. Logistic regression analyses indicate that altruistic and religious values, physical health, frequent contact with friends, and providing help to others are important predictors for potential volunteers as well as actual volunteers. Overall, the results indicate important insights for recruitment and retention of older volunteers.

.
The Effect of an Online Self-Assessment Tool on Nonprofit Board Performance
Yvonne D. Harrison1, Vic Murray2
1University at Albany, State University of New York, USA
2University of Victoria, British Columbia, Canada
Abstract
This article reports on perceptions of the effectiveness of nonprofit organization boards of directors and changes in governance behavior obtained from the first 1,446 users of a free online board performance self-assessment tool known as the Board Check-Up (www.boardcheckup.com), Board Effectiveness Survey Application (BESA). Respondents came from 122 organizations in Canada, the United States, Australia, and other countries. The article describes the conceptual framework for the study and the underlying theory of change on which it is based. It presents findings on the types of governance issues respondents perceived as most problematic in their boards. It also describes changes in governance behavior and practices reported by respondents, who completed an impact assessment some time after the use of the online self-assessment tool. The results provide empirical support for the value of utilizing the online board performance self-assessment application and insights into its impact as a means of making changes in the governance process. Next steps in this international longitudinal research study are discussed.

.
Fraud and Corruption in U.S. Nonprofit Entities
A Summary of Press Reports 2008-2011
Deborah S. Archambeault1, Sarah Webber1, Janet Greenlee1
1University of Dayton, OH, USA
Abstract
The charitable sector is vulnerable to fraud losses, with these losses negatively impacting the organization’s reputation, future funding, and ability to advance its mission. Research on nonprofit fraud is relatively scarce, due mainly to limited availability of data. We create a database that summarizes and describes basic facts (nature and timing of fraud, description of organization, magnitude of loss, and perpetrators) for 115 incidents of detected fraud occurring in U.S. nonprofit organizations. We find a disproportionately high incidence of nonprofit fraud in the Health and Human Services National Taxonomy of Exempt Entities Groups, a high percentage of females committing misappropriation frauds, and that the organizational role of the perpetrator is related to the size of the fraud loss. We also investigate whether organizations detecting a nonprofit fraud report this information, as required, on Internal Revenue Service Form 990, and find that many organizations do not comply.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 21 November 2015)

.
The First Use of the Global Oral Cholera Vaccine Emergency Stockpile: Lessons from South Sudan
Abdinasir Abubakar, Andrew S. Azman, John Rumunu, Iza Ciglenecki, Trina Helderman, Haley West, Justin Lessler, David A. Sack, Stephen Martin, William Perea, Dominique Legros, Francisco J. Luquero
Health in Action | published 17 Nov 2015 | PLOS Medicine
10.1371/journal.pmed.1001901
Summary Points
:: A global oral cholera vaccine (OCV) stockpile was established in 2013 to improve rapid access to the vaccine in outbreaks and emergencies in which cholera risk is high. The first deployment from the global OCV stockpile was to South Sudan in 2014 because of high cholera risk from massive population displacements within the civil war.
:: 256,700 doses of OCV were delivered, with high coverage, throughout the country as part of a comprehensive cholera prevention strategy by multiple agencies, some of which had little to no previous experience with this vaccine.
:: A cholera epidemic began during vaccination, and a basic comparison of epidemic curves in vaccinated and unvaccinated areas suggests little to no transmission occurred in vaccinated areas, though more in depth analysis is needed.
:: This deployment highlights the feasibility of effective deployments from the OCV stockpile and the importance of strong coordination between governmental and nongovernmental agencies in cholera prevention and control planning from the assessment of cholera risk to the deployment of the vaccines.
:: A larger global supply of OCV is urgently needed to cover those most in need. With limited vaccine availability now and likely in the upcoming years, more work is needed on deciding how to most efficiently use the vaccine, which may include alternative dosing regimens and targeting specific subpopulations.

PLoS One
http://www.plosone.org/
[Accessed 21 November 2015]

.
Developing and Optimising the Use of Logic Models in Systematic Reviews: Exploring Practice and Good Practice in the Use of Programme Theory in Reviews
Dylan Kneale, James Thomas, Katherine Harris
Research Article | published 17 Nov 2015 | PLOS ONE
10.1371/journal.pone.0142187
Abstract
Background
Logic models are becoming an increasingly common feature of systematic reviews, as is the use of programme theory more generally in systematic reviewing. Logic models offer a framework to help reviewers to ‘think’ conceptually at various points during the review, and can be a useful tool in defining study inclusion and exclusion criteria, guiding the search strategy, identifying relevant outcomes, identifying mediating and moderating factors, and communicating review findings.
Methods and Findings
In this paper we critique the use of logic models in systematic reviews and protocols drawn from two databases representing reviews of health interventions and international development interventions. Programme theory featured only in a minority of the reviews and protocols included. Despite drawing from different disciplinary traditions, reviews and protocols from both sources shared several limitations in their use of logic models and theories of change, and these were used almost unanimously to solely depict pictorially the way in which the intervention worked. Logic models and theories of change were consequently rarely used to communicate the findings of the review.
Conclusions
Logic models have the potential to be an aid integral throughout the systematic reviewing process. The absence of good practice around their use and development may be one reason for the apparent limited utility of logic models in many existing systematic reviews. These concerns are addressed in the second half of this paper, where we offer a set of principles in the use of logic models and an example of how we constructed a logic model for a review of school-based asthma interventions.

PLoS One
http://www.plosone.org/
[Accessed 21 November 2015]

.
Food Security Monitoring via Mobile Data Collection and Remote Sensing: Results from the Central African Republic
Markus Enenkel, Linda See, Mathias Karner, Mònica Álvarez, Edith Rogenhofer, Carme Baraldès-Vallverdú, Candela Lanusse, Núria Salse
Research Article | published 18 Nov 2015 | PLOS ONE
10.1371/journal.pone.0142030
Abstract
The Central African Republic is one of the world’s most vulnerable countries, suffering from chronic poverty, violent conflicts and weak disaster resilience. In collaboration with Doctors without Borders/Médecins Sans Frontières (MSF), this study presents a novel approach to collect information about socio-economic vulnerabilities related to malnutrition, access to resources and coping capacities. The first technical test was carried out in the North of the country (sub-prefecture Kabo) in May 2015. All activities were aimed at the investigation of technical feasibility, not at operational data collection, which requires a random sampling strategy. At the core of the study is an open-source Android application named SATIDA COLLECT that facilitates rapid and simple data collection. All assessments were carried out by local MSF staff after they had been trained for one day. Once a mobile network is available, all assessments can easily be uploaded to a database for further processing and trend analysis via MSF in-house software. On one hand, regularly updated food security assessments can complement traditional large-scale surveys, whose completion can take up to eight months. Ideally, this leads to a gain in time for disaster logistics. On the other hand, recording the location of every assessment via the smart phones’ GPS receiver helps to analyze and display the coupling between drought risk and impacts over many years. Although the current situation in the Central African Republic is mostly related to violent conflict it is necessary to consider information about drought risk, because climatic shocks can further disrupt the already vulnerable system. SATIDA COLLECT can easily be adapted to local conditions or other applications, such as the evaluation of vaccination campaigns. Most importantly, it facilitates the standardized collection of information without pen and paper, as well as straightforward sharing of collected data with the MSF headquarters or other aid organizations.

PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/
(Accessed 21 November 2015)

.
Biological Sciences – Sustainability Science:
Global impacts of energy demand on the freshwater resources of nations
Robert Alan Holland, Kate A. Scott, Martina Flörke, Gareth Brown, Robert M. Ewers, Elizabeth Farmer, Valerie Kapos, Ann Muggeridge, Jörn P. W. Scharlemann, Gail Taylor, John Barrett, and Felix Eigenbrod
PNAS 2015 ; published ahead of print November 16, 2015, doi:10.1073/pnas.1507701112
Significance
Understanding the role of international trade in driving pressures on freshwater resources is key to meeting challenges at the water–energy nexus. A coupled trade and hydrological model is used to examine pressures on freshwater resources associated with energy production across the global economy. While the electric and gas sectors induce freshwater consumption predominantly within countries where demand originates (91% and 81%, respectively), the petroleum sector exhibits a high international footprint (56%). Critical geographic areas and economic sectors are identified, providing focus for resource-management actions to ensure energy and freshwater security. Our analysis demonstrates the importance of broadening the discourse on energy policy to address issues including freshwater scarcity, the role of international trade, and wider environmental and societal considerations.
Abstract
The growing geographic disconnect between consumption of goods, the extraction and processing of resources, and the environmental impacts associated with production activities makes it crucial to factor global trade into sustainability assessments. Using an empirically validated environmentally extended global trade model, we examine the relationship between two key resources underpinning economies and human well-being—energy and freshwater. A comparison of three energy sectors (petroleum, gas, and electricity) reveals that freshwater consumption associated with gas and electricity production is largely confined within the territorial boundaries where demand originates. This finding contrasts with petroleum, which exhibits a varying ratio of territorial to international freshwater consumption, depending on the origin of demand. For example, although the United States and China have similar demand associated with the petroleum sector, international freshwater consumption is three times higher for the former than the latter. Based on mapping patterns of freshwater consumption associated with energy sectors at subnational scales, our analysis also reveals concordance between pressure on freshwater resources associated with energy production and freshwater scarcity in a number of river basins globally. These energy-driven pressures on freshwater resources in areas distant from the origin of energy demand complicate the design of policy to ensure security of fresh water and energy supply. Although much of the debate around energy is focused on greenhouse gas emissions, our findings highlight the need to consider the full range of consequences of energy production when designing policy.

Reproductive Health
http://www.reproductive-health-journal.com/content
[Accessed 21 November 2015]

.
Research
Factors associated with early resumption of sexual intercourse among postnatal women in Uganda
Alice Alum, Irene Kizza, Charles Osingada, Godfrey Katende, Dan Kaye Reproductive Health 2015, 12:107 (19 November 2015)

.
Research
“Once you join the streets you will have to do it”: sexual practices of street children and youth in Uasin Gishu County, Kenya
Lonnie Embleton, Juddy Wachira, Allan Kamanda, Violet Naanyu, Susanna Winston, David Ayuku, Paula Braitstein Reproductive Health 2015, 12:106 (1)

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
September 2015 Vol. 38, No. 3
http://www.paho.org/journal/

.
SERIES ON EQUITY IN HEALTH AND SUSTAINABLE DEVELOPMENT
Social determinants and inequalities in tuberculosis incidence in Latin America and the Caribbean [Determinantes sociales y desigualdades en la incidencia de tuberculosis en América Latina y el Caribe]
César V. Munayco, Oscar J. Mújica, Francisco X. León, Mirtha del Granado, and Marcos A. Espinal

La ventaja epidemiológica de la orientación preferencial del control de la tuberculosis hacia los pobres [The epidemiological advantage of preferential targeting of tuberculosis control at the poor]
J. R. Andrews, S. Basu, D. W. Dowdy, and M. B. Murray

.

SPECIAL REPORTS
Technology transfer for the implementation of a clinical trials network on drug abuse and mental health treatment in Mexico [Transferencia de tecnología para la implantación de una red de investigaciones clínicas sobre el tratamiento de la drogadicción y los problemas de salud mental en México]
Viviana E. Horigian, Rodrigo A. Marín-Navarrete, Rosa E. Verdeja, Elizabeth Alonso, María A. Perez, José Fernández-Mondragón, Carlos Berlanga, María Elena Medina-Mora, and José Szapocznik
Abstract
Low- and middle-income countries (LMIC) lack the research infrastructure and capacity to conduct rigorous substance abuse and mental health effectiveness clinical trials to guide clinical practice. A partnership between the Florida Node Alliance of the United States National Drug Abuse Treatment Clinical Trials Network and the National Institute of Psychiatry in Mexico was established in 2011 to improve substance abuse practice in Mexico. The purpose of this partnership was to develop a Mexican national clinical trials network of substance abuse researchers and providers capable of implementing effectiveness randomized clinical trials in community-based settings. A technology transfer model was implemented and ran from 2011–2013. The Florida Node Alliance shared the “know how” for the development of the research infrastructure to implement randomized clinical trials in community programs through core and specific training modules, role-specific coaching, pairings, modeling, monitoring, and feedback. The technology transfer process was bi-directional in nature in that it was informed by feedback on feasibility and cultural appropriateness for the context in which practices were implemented. The Institute, in turn, led the effort to create the national network of researchers and practitioners in Mexico and the implementation of the first trial. A collaborative model of technology transfer was useful in creating a Mexican researcher-provider network that is capable of changing national practice in substance abuse research and treatment. Key considerations for transnational technology transfer are presented.