Advancing Early Childhood Development : from Science to Scale. An Executive Summary for The Lancet’s Series

The 2016 Lancet Early Childhood Development Series highlights early childhood development at a time when it has been universally endorsed in the 2030 Sustainable Development Goals.1-3 This Series considers new scientific evidence for interventions, building on the findings and recommendations of previous Lancet Series on child development (2007, 2011), and proposes pathways for implementation of early childhood development at scale. The Series emphasises “nurturing care”, especially of children below three years of age, and multi-sectoral interventions starting with health which can have wide reach to families and young children through health and nutrition

“Rapid-Impact Interventions”: How a Policy of Integrated Control for Africa's Neglected Tropical Diseases Could Benefit the Poor

Controlling seven tropical infections in Africa would cost just 40 cents per person per year, and would permanently benefit hundreds of millions of people

A comparison of trends in caesarean section rates in former communist (transition) countries and other European countries

Caesarean section rates are rising across Europe, and concerns exist that increases are not clinically indicated. Societal, cultural and health system factors have been identified as influential. Former communist (transition) countries have experienced radical changes in these potential determinants, and we, therefore, hypothesized they may exhibit differing trends to non-transition countries. By analysing data from the WHO Europe Health for All Database, we find transition countries had a relatively low caesarean section rate in 2000 but have since experienced more rapid increases than other countries (average annual percentage change 7.9 vs. 2.4)

The Impact of COVID-19 and “Emergency Remote Teaching” on the UK Computer Science Education Community

The COVID-19 pandemic has imposed "emergency remote teaching" across education globally, leading to the closure of institutions across a variety of settings, from early-years through to higher education. This paper looks specifically at the impact of these changes to those teaching the discipline of computer science in the UK. Drawing on the quantitative and qualitative findings from a large- scale survey of the educational workforce (N=2,197) conducted in the immediate aftermath of institutional closures in March 2020 and the shift to online delivery, we report how those teaching computer science in various UK settings (n=214) show significantly more positive attitudes towards the move to online learning, teaching and assessment than those working in other disciplines; these perceptions were consistent across schools, colleges and higher education institutions. However, whilst practitioners noted the opportunities of these changes for their respective sector — especially a renewed focus on the importance of digital skills — they raised a number of generalisable concerns on the impact of this shift to online on their roles, their institutions and their sectors as a whole; for example, the impact on workload, effective pedagogy and job fragility. More specifically for computer science practitioners, curricula and qualifications, there were concerns raised regarding the ability to meaningfully deliver certain core topics such as mathematical foundations and programming, as well as the impact on various types of formal examinations and assessment. Based on the data obtained from this rapid response survey, we offer informed commentary, evaluation and recommendations for emerging learning and teaching policy and practice in the UK computer science community as we move into the 2020-2021 academic year and beyond

Tracking official development assistance for reproductive health in conflict-affected countries: 2002-2011.

OBJECTIVE: To provide information on trends on official development assistance (ODA) disbursement patterns for reproductive health activities in 18 conflict-affected countries. DESIGN: Secondary data analysis. SAMPLE: 18 conflict-affected countries and 36 non-conflict-affected countries. METHODS: The Creditor Reporting System (CRS) database was analyzed for ODA disbursement for direct and indirect reproductive health activities to 18 conflict-affected countries (2002-2011). A comparative analysis was also made with 36 non-conflict-affected counties in the same 'least-developed' income category. Multivariate regression analyses examined associations between conflict status and reproductive health ODA and between reproductive needs and ODA disbursements. MAIN OUTCOME MEASURES: Patterns of ODA disbursements (constant U.S. dollars) for reproductive health activities. RESULTS: The average annual ODA disbursed for reproductive health to 18 conflict-affected countries from 2002 to 2011 was US$ 1.93 per person per year. There was an increase of 298% in ODA for reproductive health activities to the conflict-affected countries between 2002 and 2011; 56% of this increase was due to increases in HIV/AIDS funding. The average annual per capita reproductive health ODA disbursed to least-developed non-conflict-affected countries was 57% higher than to least-developed conflict-affected countries. Regression analyses confirmed disparities in ODA to and between conflict-affected countries. CONCLUSIONS: Despite increases in ODA for reproductive health for conflict-affected countries (albeit largely for HIV/AIDS activities), considerable disparities remains. TWEETABLE ABSTRACT: Study tracking 10 years of aid for reproductive aid shows major disparities for conflict-affected countries

Endodontic treatment-related antibiotic prescribing patterns of South African oral health professionals

AIMTo assess the antibiotic prescribing patterns of South African dentists for patients undergoing endodontic treatment. METHODOLOGY This study used data from 2013 health insurance claims submitted by South African oral health professionals to determine the antibiotic prescribing patterns related to endodontic treatment. A logistic regression model was used to test the fully adjusted statistical significance of the association between the exploratory variables (gender, age group, event type, abscess treatment, chronic health) and the dependent variable (antibiotic prescription). Odds ratios with 95% confidence intervals (CI) are reported, and a 95% CI excluding 1 was considered statistically significant. RESULTS Almost 10% of endodontic treatments were prescribed an antibiotic. There were no significant differences in prescribing patterns by gender, age and chronic health status. Prescriptions were more common at the preparatory stage (9.4%) of root canal treatment compared to the therapy (4.7%) and canal filling (2%) stages. Patients who received apical surgery (OR = 2.28; 95% CI 1.38–3.76) and treatment of an abscess (OR = 2.57; 95% 1.82–3.63) had a significantly increased odds of being prescribed an antibiotic. Almost three-quarters of prescriptions were for narrow spectrum antibiotics. CONCLUSION The frequency of antibiotic prescribing by South African dental practitioners for patients undergoing endodontic treatment is relatively low and predominantly involved narrow spectrum antibiotics. It, however, remains important that antibiotics are only prescribed when clinically essential, such as when there are obvious systemic effects. These include fever above 37 degrees, malaise, lymphadenopathy, trismus, increase swelling, cellulitis, osteomyelitis and persistent infection. The wider dissemination and adherence to clear evidence-based prescribing guidelines for antibiotics in this clinical area are important.IS

Is the Alma Ata vision of comprehensive primary health care viable? Findings from an international project

BACKGROUND: The 4-year (2007 2011) Revitalizing Health for All international research program (http://www. globalhealthequity.ca/projects/proj_revitalizing/index.shtml) supported 20 research teams located in 15 lowand middle-income countries to explore the strengths and weaknesses of comprehensive primary health care (CPHC) initiatives at their local or national levels. Teams were organized in a triad comprised of a senior researcher, a new researcher, and a 'research user' from government, health services, or other organizations with the authority or capacity to apply the research findings. Multiple regional and global team capacityenhancement meetings were organized to refine methods and to discuss and assess cross-case findings. OBJECTIVE: Most research projects used mixed methods, incorporating analyses of qualitative data (interviews and focus groups), secondary data, and key policy and program documents. Some incorporated historical case study analyses, and a few undertook new surveys. The synthesis of findings in this report was derived through qualitative analysis of final project reports undertaken by three different reviewers. RESULTS: Evidence of comprehensiveness (defined in this research program as efforts to improve equity in access, community empowerment and participation, social and environmental health determinants, and intersectoral action) was found in many of the cases. CONCLUSION: Despite the important contextual differences amongst the different country studies, the similarity of many of their findings, often generated using mixed methods, attests to certain transferable health systems characteristics to create and sustain CPHC practices. These include: 1. Well-trained and supported community health workers (CHWs) able to work effectively with marginalized communities 2. Effective mechanisms for community participation, both informal (through participation in projects and programs, and meaningful consultation) and formal (though program management structures) 3. Co-partnership models in program and policy development (in which financial and knowledge supports from governments or institutions are provided to communities, which retain decision-making powers in program design and implementation) 4. Support for community advocacy and engagement in health and social systems decision making These characteristics, in turn, require a political context that supports state responsibilities for redistributive health and social protection measures.IS