An Ongoing Omission: Adolescent and Adult Malnutrition in Famine Situations

Prolonged famine causes malnutrition in all age groups. The under five age group is systematically targeted for nutritional interventions in the majority of complex emergencies where famine is a major component. Older children and adults however, are often not targeted systematically or are excluded completely. This is despite the past experience in Somalia, Angola and more recently southern Sudan, of sustained high adolescent and adult mortality rates assocaited with malnutrition. Using the recent example of southern Sudan, the authors analyze some of the reasons for this ommission, which include factors such as inadequate scientific literature, the bias of conventional nutritional epidemiology, agency inexperience and media and funding pressures. Finally the authors call for a greater amount of attention and resources to be targeted towards these age groups by the humanitarian community. Programmes should be accompanied by operational research within the framework of a common research agenda.La famine prolongée engendre la malnutrition dans tous les groupes d’âge. Le groupe des moins de cinq ans est systématiquement ciblé pour intervention nutritionnelle dans la majorité des situations d’urgences complexe où la famine est un composant majeur. Les autres enfants et les adultes, pour leur part, sont souvent ciblés très sporadiquement, ou même complètement exclus. Cette situation se perpétue malgré les expériences passées en Somalie, en Angola, et, plus récemment, au Sud-Soudan, où un taux constant de mortalité adolescente et adulte ont été associés à la malnutrition. En se basant sur l’exemple récent du Sud-Soudan, les auteurs analysent certaines des raisons de ces omissions, ce qui inclut des facteurs tels : une documentation scientifique inadéquate, le préjugés de l’épidémiologie nutritionnelle traditionnelle, l’inexpérience des agences et des médias, et les pressions issues des sources de financement. Les auteurs font un appel pour qu’une plus grande attention et de plus amples ressources soient consacrées, par la communauté humanitaire, à cibler les adolescents et les adultes dans les situations de famine. De plus, les programmes d’aide devraient s’accompagner d’investigations opérationnelles effectuées dans le cadre d’objectifs de recherche commun

Building health systems in fragile states: the instructive example of Afghanistan.

No abstract availabl

Olympic anti-doping laboratory:The analytical technological road from 2016 Rio De Janeiro to 2021 Tokyo

The summer Olympic Games is the major mega sports event since the first modern era Olympiad, held in Athens, Greece in 1896. International Olympic Committee (IOC) has the responsibility of the organization of the summer and winter Games ensuring the broadcast in all corners of earth. The World Anti-Doping Agency (WADA) is the responsible organization of the fight against doping in sports. IOC and WADA support the event's country WADA Accredited Laboratory to incorporate the maximum of the new analytical technologies to become applicable during the event's antidoping testing. The current study reviewed the last 5 years progresses of the antidoping system with emphasis on the laboratory field

Can religion kill? The association between membership of the Apostolic faith and child mortality in Zimbabwe

Existing literature has been equivocal about the effect of religion on utilization of health service and health outcomes. While followers of particularized theology hypothesis believe that doctrinal teachings, beliefs and values of religious groups directly influence health access and outcomes, the advocates of the selectivity hypothesis claim that the observed disparities between religious groups mainly reflect differential access to social and human capital which in turn determines health access and outcome rather than religion per se. Using household data from the Zimbabwe Multiple Indicator Monitoring Survey 2009, we find that household heads’ affiliation with apostolic faith put children under five years old at greater risk of death compared to other religious groups. This effect remains strong even after controlling for a wide range of socio-economic and demographics characteristics of the households in multivariate logit regressions

Occurrence and overlap of natural disasters, complex emergencies and epidemics during the past decade (1995–2004)

BACKGROUND: The fields of expertise of natural disasters and complex emergencies (CEs) are quite distinct, with different tools for mitigation and response as well as different types of competent organizations and qualified professionals who respond. However, natural disasters and CEs can occur concurrently in the same geographic location, and epidemics can occur during or following either event. The occurrence and overlap of these three types of events have not been well studied. METHODS: All natural disasters, CEs and epidemics occurring within the past decade (1995–2004) that met the inclusion criteria were included. The largest 30 events in each category were based on the total number of deaths recorded. The main databases used were the Emergency Events Database for natural disasters, the Uppsala Conflict Database Program for CEs and the World Health Organization outbreaks archive for epidemics. ANALYSIS: During the past decade, 63% of the largest CEs had ≥1 epidemic compared with 23% of the largest natural disasters. Twenty-seven percent of the largest natural disasters occurred in areas with ≥1 ongoing CE while 87% of the largest CEs had ≥1 natural disaster. CONCLUSION: Epidemics commonly occur during CEs. The data presented in this article do not support the often-repeated assertion that epidemics, especially large-scale epidemics, commonly occur following large-scale natural disasters. This observation has important policy and programmatic implications when preparing and responding to epidemics. There is an important and previously unrecognized overlap between natural disasters and CEs. Training and tools are needed to help bridge the gap between the different type of organizations and professionals who respond to natural disasters and CEs to ensure an integrated and coordinated response

The Role of Polycyclic Aromatic Hydrocarbons in Ultraviolet Extinction. I. Probing small molecular PAHs

We have obtained new STIS/HST spectra to search for structure in the ultraviolet interstellar extinction curve, with particular emphasis on a search for absorption features produced by polycyclic aromatic hydrocarbons (PAHs). The presence of these molecules in the interstellar medium has been postulated to explain the infrared emission features seen in the 3-13 $\mu$m spectra of numerous sources. UV spectra are uniquely capable of identifying specific PAH molecules. We obtained high S/N UV spectra of stars which are significantly more reddened than those observed in previous studies. These data put limits on the role of small (30-50 carbon atoms) PAHs in UV extinction and call for further observations to probe the role of larger PAHs. PAHs are of importance because of their ubiquity and high abundance inferred from the infrared data and also because they may link the molecular and dust phases of the interstellar medium. A presence or absence of ultraviolet absorption bands due to PAHs could be a definitive test of this hypothesis. We should be able to detect a 20 \AA wide feature down to a 3$\sigma$ limit of $\sim$0.02 A$_V$. No such absorption features are seen other than the well-known 2175 \AA bump.Comment: 16 pages, 3 figure, ApJ in pres

Adsorption of 4-n-Nonylphenol, Carvacrol, and Ethanol onto Iron Oxide from Nonaqueous Hydrocarbon Solvents.

The adsorption of 4-n-nonylphenol (4NP), carvacrol, and ethanol onto the surface of iron oxide from nonaqueous solutions is presented. It is found that adsorption of 4NP from alkanes is strong and proceeds to monolayer formation, where the molecules are essentially "upright". However, at high relative concentrations, ethanol successfully out-competes 4NP for the iron oxide surface. Estimates of the enthalpy and entropy of binding of 4NP were found to be exothermic and entropically disfavored. Sum frequency generation vibrational spectroscopy data indicate some evidence of binding through a phenolate anion, despite the nonpolar, nonaqueous solvent. Carvacrol is also found to adsorb as a monolayer where the molecules are lying "flat". The adsorption of ethanol onto iron oxide from dodecane was investigated through the use of quantitative NMR, which is a convenient analytical technique for measuring adsorption isotherms. It was concluded that ethanol does not form adsorbed monolayers on the surface. Instead, it partitions onto the surface as a surface-enhanced local phase separation related to its poor solubility in alkane solvents.B

Vulnerability to episodes of extreme weather: Butajira, Ethiopia, 1998–1999

BACKGROUND: During 1999-2000, great parts of Ethiopia experienced a period of famine which was recognised internationally. The aim of this paper is to characterise the epidemiology of mortality of the period, making use of individual, longitudinal population-based data from the Butajira demographic surveillance site and rainfall data from a local site. METHODS: Vital statistics and household data were routinely collected in a cluster sample of 10 sub-communities in the Butajira district in central Ethiopia. These were supplemented by rainfall and agricultural data from the national reporting systems. RESULTS: Rainfall was high in 1998 and well below average in 1999 and 2000. In 1998, heavy rains continued from April into October, in 1999 the small rains failed and the big rains lasted into the harvesting period. For the years 1998-1999, the mortality rate was 24.5 per 1,000 person-years, compared with 10.2 in the remainder of the period 1997-2001. Mortality peaks reflect epidemics of malaria and diarrhoeal disease. During these peaks, mortality was significantly higher among the poorer. CONCLUSIONS: The analyses reveal a serious humanitarian crisis with the Butajira population during 1998-1999, which met the CDC guideline crisis definition of more than one death per 10,000 per day. No substantial humanitarian relief efforts were triggered, though from the results it seems likely that the poorest in the farming communities are as vulnerable as the pastoralists in the North and East of Ethiopia. Food insecurity and reliance on subsistence agriculture continue to be major issues in this and similar rural communities. Epidemics of traditional infectious diseases can still be devastating, given opportunities in nutritionally challenged populations with little access to health care

Introducing a sector-wide pooled fund in a fragile context: mixed-methods evaluation of the health transition fund in Zimbabwe.

IntroductionAid effectiveness and improving its impact is a central policy matter for donors and international organisations. Pooled funding is a mechanism, whereby donors provide financial contributions towards a common set of broad objectives by channelling finance through one instrument. The results of pooled funds as an aid mechanism are mixed, and there is limited data on both methodology for, and results of, assessment of effectiveness of pooled funding.MethodsThis study adapted a conceptual framework incorporating the Paris Principles of Aid Effectiveness and qualitative methods to assess the performance of the Health Transition Fund (HTF) Zimbabwe. 30 key informant interviews, and 20 focus group discussions were conducted with informants drawn from village to national level. Descriptive secondary data analysis of Demographic Health Surveys, Health Management Information Systems (HMIS) and policy reports complemented the study.ResultsThe HTF combined the most optimal option to channel external aid to the health sector in Zimbabwe during a period of socioeconomic and political crisis. It produced results quickly and at scale and enhanced coordination and ownership at the national and subnational level. Flexibility in using the funds was a strong feature of the HTF. However, the initiative compromised on the investment in local capacity and systems, since the primary focus was on restoring essential services within a nearly collapsed healthcare system, rather than building long-term capacity. Significant changes in maternal and newborn health outcomes were observed during the HTF implementation in Zimbabwe.ConclusionA framework which can be used to assess pooled funds was adapted and applied. Future assessments could use this or another framework to provide new evidence regarding effectiveness of pool donor funds although the frameworks should be properly tested and adapted in different contexts