UNESCO [to 29 November 2014]
http://en.unesco.org/

Director-General Addresses Organization of American States 28 November 2014
Addressing the Organization of American States in Washington D.C. on 19 April, UNESCO Director-General Irina Bokova stated that “the key question we need to ask is how education can contribute to mitigate inequality.”
“Fundamentally, quality education must craft the societies we aspire to – inclusive, dynamic and sustainable societies, free of poverty, societies anchored in respect for cultural diversity and human rights”, said Mrs Bokova, giving the 51st Lecture of the Americas on the theme of promoting human development and quality education in the region…

Assessment of inclusive policies: UNESCO supports evidence-based approaches and the participation of the populations concerned
28 November 2014
Organized within the framework of UNESCO’s Management of Social Transformations Programme (MOST), a workshop of experts on the measurement and assessment of social inclusion policies was held on 25 and 26 March 2013 at UNESCO Headquarters in Paris, with the aim to assist the work of the Organization’s Secretariat in the study and mapping of available indexes and methodologies to measure social inclusion and assess the level of inclusiveness of public policies.
Concretely, this expert workshop had as final goal the identification of the most effective methods of measuring and assessing in order to adapt or develop those that are likely to have a real impact on public policy-making and on the process of evaluating policies in all UNESCO Member States.
Held before the 11th session of the MOST Intergovernmental Council, this expert meeting focused on one of the two thematic priorities identified for 2012-2013 by the Member States of this Council and brought together, for a day and a half, more than sixty participants, all experts and stakeholders in the implementation, measurement and assessment of social inclusion policies…
…The main reflections and recommendations made during this international workshop of experts were delivered to the 35 Member States of the MOST Intergovernmental Council that met in Paris on 27 and 28 March 2013.
The entire workshop via the following links:
Sessions of 25 March 2013 – mms://stream.unesco.org/vod/most_25032013_floor.wmv
Session of 26 March 2013 – mms://stream.unesco.org/vod/most_26032013_floor.wmv

OECD [to 29 November 2014]
http://www.oecd.org/

Most Asia/Pacific countries need to improve affordable access to healthcare, says OECD
27 November 2014
Countries in the Asia/Pacific region need to step up their efforts to give more people access to affordable, quality health care. Too many people, especially women, cannot get the medical treatment they need due to high costs, difficulties in getting permission to see a doctor or a lack of health care providers in rural areas, according to a new OECD report:

Health at a Glance Asia/Pacific 2014, a joint publication with the World Health Organisation, presents key indicators on health status, determinants of health, health care resources and utilisation, health expenditure and financing, and quality of care for 27 Asia/Pacific countries and economies. This report offers a comprehensive and user-friendly framework to help policy makers design and implement better policies to support countries’ progress towards universal health coverage – and improve the health of their populations.

ICRC – International Committee of the Red Cross [to 29 November 2014]
http://www.icrc.org/eng/resources/index.jsp

Internment in armed conflict: Basic rules and challenges
25 November 2014
Deprivation of liberty – detention – is a common and lawful occurrence in armed conflict that is governed by a large number of provisions of international humanitarian law (IHL). Like other bodies of law, IHL prohibits arbitrary detention.
Provided below is an outline of the basic concepts and rules related to detention in both international and non-international armed conflict with, subsequently, a particular focus on internment, i.e. detention for security reasons in situations of armed conflict. The similarities and differences between IHL and the corresponding rules of international human rights law are also addressed where relevant.
pdf: https://www.icrc.org/en/download/file/1980/security-detention-position-paper-icrc-11-2014.pdf

PATH [to 29 November 2014]
:: PATH names Dr. David Fleming as vice president for Public Health Impact
Global public health expert to serve on PATH executive leadership team and oversee diverse portfolio

Seattle, November 24, 2014—PATH has named Dr. David Fleming as its vice president for Public Health Impact. Dr. Fleming will begin January 5, 2015 and be based in PATH’s Seattle headquarters.

Dr. Fleming will lead PATH’s Public Health Impact division, which houses the organization’s reproductive health, maternal and child health and nutrition, noncommunicable diseases, malaria control and elimination, and HIV/AIDS and tuberculosis programs. He also will oversee cross-programmatic collaboration at PATH, which seeks to maximize the impact of the organization’s work across the value chain in critical health areas, including maternal and neonatal health, diarrheal disease, and malaria….

Disasters Emergency Committee [to 29 November 2014]
http://www.dec.org.uk/
[Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Oxfam, Plan UK, Save the Children, Tearfund and World Vision]

DEC publishes review of member agency assurance mechanisms
27/11/2014
The Disasters Emergency Committee (DEC) has published today an independent report which shows how its member agencies provide assurance that they are following agreed ways of working when they respond to emergencies.

The report “DEC Accountability Self-Assessment Validation 2013-14” was prepared for the DEC by consultants from One World Trust who validated members’ self-assessed performance against 21 ‘Ways of Working’ [PDF] which DEC members are committed to following.

The report shows that DEC member agencies continue to report performance improvements and that the large majority of these self-assessments were likely to be accurate. Importantly however it also drew the attention of a minority of members to areas where their self-assessments were insufficiently supported by evidence.

DEC Chief Executive Saleh Saeed said: “The DEC Accountability Framework shows that our members do not simply sign up to commitments to observe best practice, they also put in place systems to ensure they live up to these commitments.”

“The process members go through to demonstrate they are following the agreed DEC ways of working can seem very abstract because it is about assurance mechanisms that provide evidence that policy and procedures are appropriate and systematically implemented. In reality, this approach is at the heart of the way the DEC works because it helps ensure our members are consistently working to the highest possible standards and continually seeking systematic improvements in their work.

“What it comes down to in the end is that getting aid work right isn’t just about good people who know what they doing delivering good work. If you want to ensure you are delivering consistently excellent work you also need good processes.”…

GAVI Watch [to 29 November 2014]
http://www.gavialliance.org/library/news/press-releases/

:: Canada commits C$ 500 million to support immunisation in developing countries
28 November 2014
Gavi welcomed the announcement by Canada of a C$ 500 million contribution to support immunisation in developing countries between 2016 and 2020.

:: International Finance Facility for Immunisation issues first Sukuk, raising US$ 500 million
Dubai, UAE, 27 November 2014 – The International Finance Facility for Immunisation Company (IFFIm) today issued its inaugural Sukuk, raising US$ 500 million for children’s immunisation in the world’s poorest countries through Gavi, the Vaccine Alliance. This landmark transaction is the first socially responsible Sukuk with funds to be utilised for this purpose. This successful transaction marks the largest Sukuk al-Murabaha issuance in the public markets and is also the largest inaugural Sukuk offering from a Supranational.

The 3-year Sukuk – a financial certificate that complies with Islamic law – provides institutional investors with a socially responsible investment that will help protect tens of millions of children against preventable diseases

:: Foundation/Major Donor Watch
We will monitor media releases announcing key initiatives and new research from a growing number of global foundations and donors engaged in the human rights, humanitarian response and development spheres of action. This Watch section is not intended to be exhaustive, but indicative.
.

Kellogg Foundation
http://www.wkkf.org/news-and-media#pp=10&p=1&f1=news
Nov. 24, 2014
Statement on Ferguson: Our nation must reject violence, strive toward racial equity, and embrace the common good in all
.

MacArthur Foundation
http://www.macfound.org/
Publication
Evaluation of the Digital Media & Learning Competition
Published November 26, 2014

Increasing availability and accessibility of digital media have changed the ways in which young people learn, socialize, play, and engage in civic life. Seeking to understand how learning environments and institutions should transform to respond to these changes, the MacArthur Foundation (the Foundation) launched the Digital Media and Learning (DML) Initiative in 2005. The DML Competition (the Competition), one component of the DML Initiative, identifies innovators and invests in prototypes of games, mobile phone applications, virtual worlds, social networks, digital badge platforms, and more in support of connected learning. The Competition completed four cycles between 2007 and 2014, awarding over $10 million to individuals, universities, for-profit organizations, and nonprofit organizations within and outside the United States.

In 2013, the Foundation engaged Informing Change to evaluate the DML Competition, assessing the Competition’s goals, processes, and impacts on awardees, awarded projects, the DML landscape, and the Foundation. Along with site visits and a review of relevant Competition and grantee documents, the mixed-methods evaluation incorporated interview and survey data collected from Foundation staff, HASTAC (Humanities, Arts, Science, and Technology Alliance and Collaboratory) staff who implement the Competition, Competition awardees and finalists, and key field leaders…

American Journal of Infection Control
Volume 42, Issue 12, p1255-1346 December 2014
http://www.ajicjournal.org/current

Commentary
Nebraska Biocontainment Unit perspective on disposal of Ebola medical waste
John J. Lowe, Shawn G. Gibbs, Shelly S. Schwedhelm, John Nguyen, Philip W. Smith
p1256–1257
Preview
Clinical practices surrounding the current Ebola epidemic have been center stage in discourse concerning research and practice of care. As the medical community becomes more sophisticated in understanding the many facets of treating and containing this virus, the Nebraska Biocontainment Unit has identified Ebola medical waste disposal as a key area of concern for U.S. hospitals. The requirements for processing Ebola medical waste stand to impact most U.S. hospitals currently preparing readiness plans to receive and treat patients with suspected or confirmed Ebola virus disease (EVD).

Middle East respiratory syndrome coronavirus infection control: The missing piece?
Ziad A. Memish, Jaffar A. Al-Tawfiq
p1258–1260
Preview
Since the initial occurrence of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012,1,2 the disease had caused 837 cases, with a case fatality rate of 34.7%.3 As with any emerging infectious diseases of pandemic potential there is a concern of the global spread of the disease. It is therefore the first priority of the global public health community to develop and implement the required infection control practices to prevent the dissemination of these emerging organisms within health care facilities (HCFs) and worldwide based on the best available evidence and previous experience with similar or related groups of pathogens.

Middle East respiratory syndrome coronavirus: Implications for health care facilities
Helena C. Maltezou, MD, PhD, Sotirios Tsiodras, MD, PhD
DOI: http://dx.doi.org/10.1016/j.ajic.2014.06.019
Highlights
:: Health care–associated transmission plays a pivotal role in the Middle East respiratory syndrome coronavirus epidemic.
:: Gaps in infection control were noted in all health care–associated events.
:: There is a need to increase infection control capacity.
:: Studies about the effectiveness of infection control measures are needed.
:: Vaccines and antiviral agents against Middle East respiratory syndrome coronavirus are urgently needed.
Abstract
Background
Middle East respiratory syndrome coronavirus (MERS-CoV) is a novel coronavirus that causes a severe respiratory disease with high case fatality rate. Starting in March 2014, a dramatic increase of cases has occurred in the Arabian Peninsula, many of which were acquired in health care settings. As of May 9, 2014, 536 laboratory-confirmed cases and 145 deaths have been reported globally.
Methods
Review of publicly available data about MERS-CoV health care–associated transmission.
Results
We identified 11 events of possible or confirmed health care–associated transmission with high morbidity and mortality, mainly among patients with comorbidities. Health care workers are also frequently affected; however, they tend to have milder symptoms and better prognosis. Gaps in infection control were noted in all events. Currently, health care–associated outbreaks are playing a pivotal role in the evolution of the MERS-CoV epidemic in countries in the Arabian Peninsula.
Conclusion
There is a need to increase infection control capacity in affected areas and areas at increased risk of being affected to prevent transmission in health care settings. Vaccines and antiviral agents are urgently needed. Overall, our knowledge about the epidemiologic characteristics of MERS-CoV that impact health care transmission is very limited. As the MERS-CoV epidemic continues to evolve, issues concerning best infection control measures will arise, and studies to better define their effectiveness in real life are needed.

Environmental sampling for respiratory pathogens in Jeddah airport during the 2013 Hajj season
Ziad A. Memish, MD, Malak Almasri, RN, Abdullah Assirri, MD, Ali M. Al-Shangiti, PhD, Gregory C. Gray, MD, John A. Lednicky, PhD, Saber Yezli, PhD
DOI: http://dx.doi.org/10.1016/j.ajic.2014.07.027
Abstract
Background
Respiratory tract infections (RTIs) are common during the Hajj season and are caused by a variety of organisms, which can be transmitted via the air or contaminated surfaces. We conducted a study aimed at sampling the environment in the King Abdul Aziz International (KAAI) Airport, Pilgrims City, Jeddah, during Hajj season to detect respiratory pathogens.
Methods
Active air sampling was conducted using air biosamplers, and swabs were used to sample frequently touched surfaces. A respiratory multiplex array was used to detect bacterial and viral respiratory pathogens.
Results
Of the 58 environmental samples, 8 were positive for at least 1 pathogen. One air sample (1 of 18 samples, 5.5%) tested positive for influenza B virus. Of the 40 surface samples, 7 (17.5%) were positive for pathogens. These were human adenovirus (3 out of 7, 42.8%), human coronavirus OC43/HKU1 (3 out of 7, 42.8%), Haemophilus influenzae (1 out of 7, 14.2%), and Moraxella catarrhalis (1 out of 7, 14.2%). Chair handles were the most commonly contaminated surfaces. The handles of 1 chair were cocontaminated with coronavirus OC43/HKU1 and H influenzae.
Conclusion
Respiratory pathogens were detected in the air and on surfaces in the KAAI Airport in Pilgrims City. Larger-scale studies based on our study are warranted to determine the role of the environment in transmission of respiratory pathogens during mass gathering events (eg, Hajj) such that public health preventative measures might be better targeted.

American Journal of Preventive Medicine
Volume 47, Issue 6, p689-852, e11-e14 December 2014
http://www.ajpmonline.org/current

Adult Vaccination Disparities Among Foreign-Born Populations in the U.S., 2012
Peng-jun Lu, MD, PhD, Alfonso Rodriguez-Lainz, PhD, DVM, MPVM, Alissa O’Halloran, MSPH, Stacie Greby, DVM, Walter W. Williams, MD, MPH
Published Online: October 06, 2014
DOI: http://dx.doi.org/10.1016/j.amepre.2014.08.009
Abstract
Background
Foreign-born persons are considered at higher risk of undervaccination and exposure to many vaccine-preventable diseases. Information on vaccination coverage among foreign-born populations is limited.
Purpose
To assess adult vaccination coverage disparities among foreign-born populations in the U.S.
Methods
Data from the 2012 National Health Interview Survey were analyzed in 2013. For non-influenza vaccines, the weighted proportion vaccinated was calculated. For influenza vaccination, Kaplan–Meier survival analysis was used to assess coverage among individuals interviewed during September 2011–June 2012 and vaccinated in August 2011–May 2012.
Results
Overall, unadjusted vaccination coverage among U.S.-born respondents was significantly higher than that of foreign-born respondents: influenza, age ≥18 years (40.4% vs 33.8%); pneumococcal polysaccharide vaccine (PPV), 18–64 years with high-risk conditions (20.8% vs 13.7%); PPV, ≥65 years (62.6% vs 40.5%); tetanus vaccination, ≥18 years (65.0% vs 50.6%); tetanus, diphtheria, and acellular pertussis (Tdap), ≥18 years (15.5% vs 9.3%); hepatitis B, 18–49 years (37.2% vs 28.4%); shingles, ≥60 years (21.3% vs 12.0%); and human papilloma virus (HPV), women 18–26 years (38.7% vs 14.7%). Among the foreign born, vaccination coverage was generally lower for non-U.S. citizens, recent immigrants, and those interviewed in a language other than English. Foreign-born individuals were less likely than U.S.-born people to be vaccinated for pneumococcal (≥65 years), tetanus, Tdap, and HPV (women) after adjusting for confounders.
Conclusions
Vaccination coverage is lower among foreign-born adults than those born in the U.S. It is important to consider foreign birth and immigration status when assessing vaccination disparities and planning interventions.

BMC Public Health
(Accessed 29 November 2014)
http://www.biomedcentral.com/bmcpublichealth/content

Research article
Health economic analysis of human papillomavirus vaccines in women of Chile: perspective of the health care payer using a Markov model
Jorge Alberto Gomez, Alejandro Lepetic and Nadia Demarteau
Author Affiliations
BMC Public Health 2014, 14:1222 doi:10.1186/1471-2458-14-1222
Published: 26 November 2014
Abstract (provisional)
Background
In Chile, significant reductions in cervical cancer incidence and mortality have been observed due to implementation of a well-organized screening program. However, it has been suggested that the inclusion of human papillomavirus (HPV) vaccination for young adolescent women may be the best prospect to further reduce the burden of cervical cancer. This cost-effectiveness study comparing two available HPV vaccines in Chile was performed to support decision making on the implementation of universal HPV vaccination.
Methods
The present analysis used an existing static Markov model to assess the effect of screening and vaccination. This analysis includes the epidemiology of low-risk HPV types allowing for the comparison between the two vaccines (HPV-16/18 AS04-adjuvanted vaccine and the HPV-6/11/16/18 vaccine), latest cross-protection data on HPV vaccines, treatment costs for cervical cancer, vaccine costs and 6% discounting per the health economic guideline for Chile.
Results
Projected incremental cost-utility ratio (ICUR) and incremental cost-effectiveness ratio (ICERs) for the HPV-16/18 AS04-adjuvanted vaccine was 116 United States (US) dollars per quality-adjusted life years (QALY) gained or 147 US dollars per life-years (LY) saved, while the projected ICUR/ICER for the HPV-6/11/16/18 vaccine was 541 US dollars per QALY gained or 726 US dollars per LY saved. Introduction of any HPV vaccine to the present cervical cancer prevention program of Chile is estimated to be highly cost-effective (below 1X gross domestic product [GDP] per capita, 14278 US dollars). In Chile, the addition of HPV-16/18 AS04-adjuvanted vaccine to the existing screening program dominated the addition of HPV-6/11/16/18 vaccine. In the probabilistic sensitivity analysis results show that the HPV-16/18 AS04-adjuvanted vaccine is expected to be dominant and cost-saving in 69.3% and 77.6% of the replicates respectively.
Conclusions
The findings indicate that the addition of any HPV vaccine to the current cervical screening program of Chile will be advantageous. However, this cost-effectiveness model shows that the HPV-16/18 AS04-adjuvanted vaccine dominated the HPV-6/11/16/18 vaccine. Beyond the context of Chile, the data from this modelling exercise may support healthcare policy and decision-making pertaining to introduction of HPV vaccination in similar resource settings in the region.

Research article
The evolution of health literacy assessment tools: a systematic review
Sibel Vildan Altin, Isabelle Finke, Sibylle Kautz-Freimuth and Stephanie Stock
Author Affiliations
BMC Public Health 2014, 14:1207 doi:10.1186/1471-2458-14-1207
Published: 24 November 2014
Abstract (provisional)
Background
Health literacy (HL) is seen as an increasingly relevant issue for global public health and requires a reliable and comprehensive operationalization. By now, there is limited evidence on how the development of tools measuring HL proceeded in recent years and if scholars considered existing methodological guidance when developing an instrument.
Methods
We performed a systematic review of generic measurement tools developed to assess HL by searching PubMed, ERIC, CINAHL and Web of Knowledge (2009 forward). Two reviewers independently reviewed abstracts/ full text articles for inclusion according to predefined criteria. Additionally we conducted a reporting quality appraisal according to the survey reporting guideline SURGE.
Results
We identified 17 articles reporting on the development and validation of 17 instruments measuring health literacy. More than two thirds of all instruments are based on a multidimensional construct of health literacy. Moreover, there is a trend towards a mixed measurement (self-report and direct test) of health literacy with 41% of instruments applying it, though results strongly indicate a weakness of coherence between the underlying constructs measured. Overall, almost every third instrument is based on assessment formats modeled on already existing functional literacy screeners such as the REALM or the TOFHLA and 30% of the included articles do not report on significant reporting features specified in the SURGE guideline.
Conclusions
Scholars recently developing instruments that measure health literacy mainly comply with recommendations of the academic circle by applying multidimensional constructs and mixing up measurement approaches to capture health literacy comprehensively. Nonetheless, there is still a dependence on assessment formats, rooted in functional literacy measurement contradicting the widespread call for new instruments. All things considered, there is no clear “consensus” on HL measurement but a convergence to more comprehensive tools. Giving attention to this finding can help to offer direction towards the development of comparable and reliable health literacy assessment tools that effectively respond to the informational needs of populations.

British Medical Journal
29 November 2014(vol 349, issue 7985)
http://www.bmj.com/content/349/7985

Research
Selective reporting bias of harm outcomes within studies: findings from a cohort of systematic reviews
BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g6501 (Published 21 November 2014) Cite this as: BMJ 2014;349:g6501
Pooja Saini, research associate1, Yoon K Loke, professor2, Carrol Gamble, professor3, Douglas G Altman, professor4, Paula R Williamson, professor3, Jamie J Kirkham, lecturer3
Abstract
Objective
To determine the extent and nature of selective non-reporting of harm outcomes in clinical studies that were eligible for inclusion in a cohort of systematic reviews.
Design
Cohort study of systematic reviews from two databases.
Setting
Outcome reporting bias in trials for harm outcomes (ORBIT II) in systematic reviews from the Cochrane Library and a separate cohort of systematic reviews of adverse events.
Participants 92 systematic reviews of randomised controlled trials and non-randomised studies published in the Cochrane Library between issue 9, 2012 and issue 2, 2013 (Cochrane cohort) and 230 systematic reviews published between 1 January 2007 and 31 December 2011 in other publications, synthesising data on harm outcomes (adverse event cohort).
Methods
A 13 point classification system for missing outcome data on harm was developed and applied to the studies.
Results
86% (79/92) of reviews in the Cochrane cohort did not include full data from the main harm outcome of interest of each review for all of the eligible studies included within that review; 76% (173/230) for the adverse event cohort. Overall, the single primary harm outcome was inadequately reported in 76% (705/931) of the studies included in the 92 reviews from the Cochrane cohort and not reported in 47% (4159/8837) of the 230 reviews in the adverse event cohort. In a sample of primary studies not reporting on the single primary harm outcome in the review, scrutiny of the study publication revealed that outcome reporting bias was suspected in nearly two thirds (63%, 248/393).
Conclusions
The number of reviews suspected of outcome reporting bias as a result of missing or partially reported harm related outcomes from at least one eligible study is high. The declaration of important harms and the quality of the reporting of harm outcomes must be improved in both primary studies and systematic reviews.

Conflict and Health
[Accessed 29 November 2014]
http://www.conflictandhealth.com/

Research
Evaluating the use of locally-based health facility assessments in Afghanistan: a pilot study of a novel research method
Jack S Rowe, Kayhan Natiq, Olakunle Alonge, Shivam Gupta, Anubhav Agarwal and David H Peters
Author Affiliations
Conflict and Health 2014, 8:24 doi:10.1186/1752-1505-8-24
Published: 25 November 2014
Abstract (provisional)
Background
Through the Balanced Scorecard program there have been independent, annual and nationwide assessments of the Afghan health system from 2004 to 2013. During this period, Afghanistan remained in a dynamic state of conflict, requiring innovative approaches to health service evaluation in insecure areas. The primary objective of this pilot study was to evaluate the reliability of health facility assessments conducted by a novel, locally-based data collection method compared to a standard survey team.
Methods
In this cross-sectional study, one standard survey team of clinicians and multiple rapidly trained locally-based survey teams of teachers conducted health facility assessments in Badghis province, Afghanistan from March – August, 2010. Outpatient facilities covered under the country’s Basic Package of Health Services were eligible for inclusion. Both approaches attempted to survey as many health facilities as safely possible, up to 25 total facilities per method. Each facility assessed was scored on 23 health services indicators used to evaluate performance in the annual Balanced Scorecard national assessment. For facilities assessed by both survey methods, the indicator scores produced by each method were compared using Spearman’s correlation coefficients and linear regression analysis with generalized estimating equations.
Results
The standard survey team was able to assess 11 facilities; the locally-based approach was able to assess these 11 facilities, as well as 13 additional facilities in areas of greater insecurity. Among the 11 facilities assessed by both approaches, 19 of 23 indicators were statistically similar by survey method (p < .05). Spearman’s coefficients varied widely from (-0.39) to (0.71). The differences were greatest for items requiring specialized data collector knowledge on reviewing patient records, patient examination and counseling, and health worker reported satisfaction.
Conclusions
This pilot study of a novel method of data collection in health facility assessments showed that an approach using locally-based survey teams provided markedly increased access to areas of insecurity. Though analysis was limited by small sample size, indicator scores used for facility evaluation were relatively comparable overall, but less reliable for items requiring clinical knowledge or when asking health worker opinions, suggesting that alternative approaches may be needed to assess these parameters in insecure environments.

Cost Effectiveness and Resource Allocation
(Accessed 29 November 2014)
http://www.resource-allocation.com/

Research
System dynamics model of cervical cancer vaccination and screening interventions in Kenya
Lucy W Kivuti-Bitok, Geoff McDonnell, Roudsari Abdul and Ganesh P Pokhariyal
Author Affiliations
Cost Effectiveness and Resource Allocation 2014, 12:26 doi:10.1186/1478-7547-12-26
Published: 27 November 2014
Abstract (provisional)
Objectives
This paper presents a simulation model for evaluating the possible effects of a screening and vaccination campaign against Human Papillomavirus [HPV] in Kenya.
Method
A System Dynamics model was developed using the iThinkTM computer simulation package. The model was based on data extracted from epidemiological, demographic and published research and where data was not available, expert opinion was sought. The deterministic model stratified the population by vaccination status, screening status and HPV infection status. The model was simulated to estimate outputs for the next 50 years from 2011. Cost Utility indicators of Disability Adjusted Life Years (DALYs) and cost per averted DALY were used for economic evaluation.
Results
The model predicted that catch up vaccination had the greatest impact in reducing the prevalence of cervical cancer. This was followed by Primary vaccination, with early detection through Screening having the lowest impact of the three choices of interventions in respect of averted cases of cervical cancer and DALY estimates.
Conclusion
Kenya as a country should consider adoption of secondary /catch up vaccination as an immediate measure to curb cervical cancer followed by primary vaccination of pre-adolescent girls. Screening should be a complementary measure(s). This model provides a policy decision support vehicle that can allow for choice between different interventions based on their expected outcomes. It also allows modification to accommodate new research results and information to assess the clinical impact of different policies and interventions in cervical cancer management in Kenya.

Emergency Medicine Journal
December 2014, Volume 31, Issue 12
http://emj.bmj.com/content/current

The view from here
Typhoon Haiyan disaster in the Philippines: paediatric field hospital perspectives
Dov Albukrek1,2, Joseph Mendlovic1,2, Tal Marom1,3
Author Affiliations
1Israeli Defense Forces Medical Corps, Tel Hashomer, Israel
2Israel Ministry of Health, Jerusalem, Israel
3Department of Otolaryngology—Head & Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Holon, Israel
Extract
In November 2013, super-typhoon Haiyan made several landfalls in the Philippines archipelago. It was one of the strongest cyclones ever recorded, with gusting winds and giant waves that left enormous damage in its wake: more than 6000 people were killed, almost 28 000 were injured and over four million lost their homes. Most basic infrastructure ceased to function, including electricity and water supplies, transportation and communication. Ten million Filipinos were affected overall.
Our medical task force
Following a formal aid request from the Filipino government, the Israeli Defense Forces (IDF) mobilised a medical response team to the island of Cebu, some 10 000 kms away. Because of the immense destruction, there were many casualties and only a few injured patients alive at the scene, making trauma care less a priority than ambulatory medical services for acute and chronic diseases. Of the 148 IDF mission participants, 56 were medical personnel. Others included logistics, support and rescue personnel from the IDF Home Front Command. Among 24 physicians, there were four paediatricians (including an emergency medicine specialist) and three paediatric nurses. Portable facilities included an imaging unit (portable digital X-ray and ultrasound machines), clinical laboratory (chemistry and haematology analyses, bacterial cultures and virology studies) and a fully supplied pharmacy.
Integrated field hospital
In coordination with the Filipino authorities, we reached our destination of Bogo city, in the northern part of the island of Cebu. We were the first medical task force and the only paediatric multidisciplinary team operating in the area, where most primary clinics were destroyed or closed. Unlike other paediatric field hospitals in disaster areas,1 ,2 we decided to create an integrated paediatric emergency unit (PEU), together with the staff of Bogo district hospital. This 80-bed urban hospital, staffed by four physicians (including one paediatrician) and 15 nurses, had already admitted more than 100 patients by the time of our arrival…

Review
Critical care paramedics: where is the evidence? a systematic review
Johannes von Vopelius-Feldt1, John Wood2, Jonathan Benger1,3
Author Affiliations
1Academic Department of Emergency Care, Emergency Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
2South Western Ambulance Service NHS Trust, Bristol, UK
3Faculty of Health and Life Sciences, University of the West of England, Bristol, UK
Abstract
Objectives Paramedic-delivered prehospital critical care is an established concept in a number of emergency medical services around the world and, more recently, has been introduced to the UK. This review identifies and describes the available evidence relating to paramedics who routinely provide prehospital critical care as primary scene response (critical care paramedics, or CCP).
Methods A systematic search of electronic databases was performed: CENTRAL, EMBASE, MEDLINE (through EMBASE and Web of Knowledge) and Web of Science (through Web of Knowledge).
Results The search identified 12 relevant publications, one of which was a randomised controlled trial. The remaining 11 were retrospective studies. Five studies compared CCPs with physician-led care. Three of these publications demonstrated improved outcomes with physician care, while two showed no difference. Four further publications examined CCPs versus non-physician-led care and found improved outcomes (two studies), mixed effects (one study) and no difference (one study) for CCPs. Finally, three publications addressed the addition of skills to CCP competencies. A randomised controlled trial of CCP rapid sequence induction (RSI) and tracheal intubation demonstrated improved neurologic outcomes. CCP tube thoracostomy was shown to have similar complication rates to the same procedure performed in the emergency department, while addition of a non-invasive ventilation protocol to CCP practice had no effect on long-term mortality.
Conclusions There is limited evidence to support the concept of paramedic-delivered prehospital critical care. The best available evidence suggests a benefit from prehospital RSI carried out by CCPs in patients with severe traumatic brain injury, but the impact of CCPs remains unclear for many conditions. Further high-quality research in this area would be welcome.

The European Journal of Public Health
Volume 24, Issue 6, 01 December 2014
http://eurpub.oxfordjournals.org/content/24/6

Cultures of evidence across policy sectors: systematic review of qualitative evidence
Theo Lorenc, Elizabeth F. Tyner, Mark Petticrew, Steven Duffy, Fred P. Martineau, Gemma Phillips, Karen Lock
DOI: http://dx.doi.org/10.1093/eurpub/cku038 1040-1046 First published online: 28 March 2014
Abstract
Background: It is important to understand the decision-making process, and the role of research evidence within it, across sectors other than health, as interventions delivered within these sectors may have substantial impacts on public health and health inequalities. Methods: Systematic review of qualitative evidence. Twenty-eight databases covering a range of sectors were searched. Studies were eligible if they included local decision-makers in a policy field relevant to the social determinants of health (including housing, transport, urban planning and regeneration, crime, licensing or trading standards), were conducted in a high-income country, and reported primary qualitative data on perceptions of research evidence. Study quality was assessed and a thematic synthesis undertaken. Results: Sixteen studies were included, most using interview designs, and most focusing on planning or transport policy. Several factors are seen to influence decision-makers’ views of evidence, including practical factors such as resources or organizational support; the credibility of the evidence; its relevance or applicability to practice; considerations of political support or feasibility; and legislative constraints. There are limited data on how evidence is used: it is sometimes used to not only support decision-making, but also to lend legitimacy to decisions that have already been made. Conclusion: Although cultures of evidence in non-health sectors are similar to those in health in some ways, there are some key differences, particularly as regards the political context of decision-making. Intersectoral public health research could benefit from taking into account non-health decision makers’ needs and preferences, particularly around relevance and political feasibility.

Human Service Organizations Management, Leadership & Governance
Volume 38, Issue 5, 2014
http://www.tandfonline.com/toc/wasw21/current#.U0sFzFcWNdc

Guest Editorial
Leadership Challenges Facing Nonprofit Human Service Organizations in a Post-Recession Era
Karen Hopkins, Megan Meyer, Wes Shera & S. Colby Peters
pages 419-422
[No abstract]

Multiple Relationship-Management Roles Among Communicators in Not-For-Profit Organizations
Wenjun June Zhua & Monit Cheunga*
DOI:10.1080/23303131.2014.943918
pages 423-434
Accepted author version posted online: 11 Nov 2014
Published online: 24 Nov 2014
Abstract
This qualitative study explores communication strategies and the multiple roles of 13 communicators at the agency and in nonprofit sector. Interview data were grouped into six themes with three factors: antecedent factors of organizational behaviors, contextual factors of the environment, and convergent factors that determine internal and external communication strategies. The communicators attended to internal and external dimensions of their roles when working on interpersonal strategies that fall into the areas of balancing their multiple roles to establish public relationships. Resolving conflicts created by these roles is an area for nonprofit leaders to consider in future staff training.

Journal of Sustainable Development
Vol 7, No 6 (2014) December 2014
http://www.ccsenet.org/journal/index.php/jsd/issue/current

Potential Benefits of Introducing Integrated Solid Waste Management Approach in Developing Countries: A Case Study in Kathmandu City
Rajeev K. Singh, Helmut Yabar, Takeshi Mizunoya, Yoshiro Higano, Randeep Rakwal

Women’s Participation in Nigeria’s Industrial Development Process: Obstacles and Options for Change
Grace Reuben Etuk, Felicitas Gabriel Coker, Abdul Joshua Ogrimah

Improving the Management and Use of Water Resources for Small-Scale Irrigation Farming in the Garu Tempane District of Ghana
Amosah Jonah, Tanko Daniel Dawda

Infectious Diseases of Poverty
[Accessed 29 November 2014]
http://www.idpjournal.com/content

Opinion
Human Ebola virus infection in West Africa: a review of available therapeutic agents that target different steps of the life cycle of Ebola virus
Kang Yiu Lai, Wing Yiu Ng and Fan Fanny Cheng
Author Affiliations
Infectious Diseases of Poverty 2014, 3:43 doi:10.1186/2049-9957-3-43
Published: 28 November 2014
Abstract (provisional)
The recent outbreak of the human Zaire ebolavirus (EBOV) epidemic is spiraling out of control in West Africa. Human EBOV hemorrhagic fever has a case fatality rate of up to 90%. The EBOV is classified as a biosafety level 4 pathogen and is considered a category A agent of bioterrorism by Centers for Disease Control and Prevention, with no approved therapies and vaccines available for its treatment apart from supportive care. Although several promising therapeutic agents and vaccines against EBOV are undergoing the Phase I human trial, the current epidemic might be outpacing the speed at which drugs and vaccines can be produced. Like all viruses, the EBOV largely relies on host cell factors and physiological processes for its entry, replication, and egress. We have reviewed currently available therapeutic agents that have been shown to be effective in suppressing the proliferation of the EBOV in cell cultures or animal studies. Most of the therapeutic agents in this review are directed against non-mutable targets of the host, which is independent of viral mutation. These medications are approved by the Food and Drug Administration (FDA) for the treatment of other diseases. They are available and stockpileable for immediate use. They may also have a complementary role to those therapeutic agents under development that are directed against the mutable targets of the EBOV.