The missing half of the Sendai framework: Gender and women in the implementation of global disaster risk reduction policy

The Sendai Framework for Disaster Risk Reduction 2015–2030 (SFDRR) is the guiding international policy structure for disaster risk reduction activities, shaping DRR strategies and practices across the world. Its targets, priorities, and supporting documents are critical in influencing the direction of programming and funding streams for national and local level DRR interventions, and its indicators play a vital role in setting benchmarks and monitoring progress. The Framework has made progress by drawing attention to the diverging ways in which women experience disasters, and highlighted their increased vulnerability in certain disaster situations. But how far does the Sendai Framework really go towards delivering a gender responsive strategy for disaster risk reduction? Five years into its implementation, this paper analyses the relevance of the SFDRR for women in the context of disasters. It argues that although the framework has made headway in promoting the inclusion of women and girls in disaster policy and programming, on the whole it represents a missed opportunity for addressing fundamental gender based issues in DRR. Recommendations are offered for mitigating several SFDRR shortcomings during its current process of implementation. These include outlining a more refined conceptualization of gender, improved inclusion of women and sexual minorities in its indicators and implementation documents, and greater alignment with parallel policy frameworks and other indicator systems

Promoting smoking cessation in Pakistani and Bangladeshi men in the UK: pilot cluster randomised controlled trial of trained community outreach workers

<p>Abstract</p> <p>Background</p> <p>Smoking prevalence is high among Pakistani and Bangladeshi men in the UK, but there are few tailored smoking cessation programmes for Pakistani and Bangladeshi communities. The aim of this study was to pilot a cluster randomised controlled trial comparing the effectiveness of Pakistani and Bangladeshi smoking cessation outreach workers with standard care to improve access to and the success of English smoking cessation services.</p> <p>Methods</p> <p>A pilot cluster randomised controlled trial was conducted in Birmingham, UK. Geographical lower layer super output areas were used to identify natural communities where more than 10% of the population were of Pakistani and Bangladeshi origin. 16 agglomerations of super output areas were randomised to normal care controls vs. outreach intervention. The number of people setting quit dates using NHS services, validated abstinence from smoking at four weeks, and stated abstinence at three and six months were assessed. The impact of the intervention on choice and adherence to treatments, attendance at clinic appointments and patient satisfaction were also assessed.</p> <p>Results</p> <p>We were able to randomise geographical areas and deliver the outreach worker-based services. More Pakistani and Bangladeshi men made quit attempts with NHS services in intervention areas compared with control areas, rate ratio (RR) 1.32 (95%CI: 1.03-1.69). There was a small increase in the number of 4-week abstinent smokers in intervention areas (RR 1.30, 95%CI: 0.82-2.06). The proportion of service users attending weekly appointments was lower in intervention areas than control areas. No difference was found between intervention and control areas in choice and adherence to treatments or patient satisfaction with the service. The total cost of the intervention was £124,000; an estimated cost per quality-adjusted life year (QALY) gained of £8,500.</p> <p>Conclusions</p> <p>The intervention proved feasible and acceptable. Outreach workers expanded reach of smoking cessation services in diverse locations of relevance to Pakistani and Bangladeshi communities. The outreach worker model has the potential to increase community cessation rates and could prove cost-effective, but needs evaluating definitively in a larger, appropriately powered, randomised controlled trial. These future trials of outreach interventions need to be of sufficient duration to allow embedding of new models of service delivery.</p> <p>Trial registration</p> <p>Current Controlled Trials <a href="http://www.controlled-trials.com/ISRCTN82127540">ISRCTN82127540</a></p

Small-animal SPECT and SPECT/CT: application in cardiovascular research

Preclinical cardiovascular research using noninvasive radionuclide and hybrid imaging systems has been extensively developed in recent years. Single photon emission computed tomography (SPECT) is based on the molecular tracer principle and is an established tool in noninvasive imaging. SPECT uses gamma cameras and collimators to form projection data that are used to estimate (dynamic) 3-D tracer distributions in vivo. Recent developments in multipinhole collimation and advanced image reconstruction have led to sub-millimetre and sub-half-millimetre resolution SPECT in rats and mice, respectively. In this article we review applications of microSPECT in cardiovascular research in which information about the function and pathology of the myocardium, vessels and neurons is obtained. We give examples on how diagnostic tracers, new therapeutic interventions, pre- and postcardiovascular event prognosis, and functional and pathophysiological heart conditions can be explored by microSPECT, using small-animal models of cardiovascular disease

Psychological distress increases the risk of falling into poverty amongst older Australians: the overlooked costs-of-illness

Abstract Background This paper aimed to identify whether high psychological distress is associated with an increased risk of income and multidimensional poverty amongst older adults in Australia. Methods We undertook longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian (HILDA) survey using modified Poisson regression models to estimate the relative risk of falling into income poverty and multidimensional poverty between 2010 and 2012 for males and females, adjusting for age, employment status, place of residence, marital status and housing tenure; and Population Attributable Risk methodology to estimate the proportion of poverty directly attributable to psychological distress, measured by the Kessler 10 scale. Results For males, having high psychological distress increased the risk of falling into income poverty by 1.68 (95% CI: 1.02 to 2.75) and the risk of falling into multidimensional poverty by 3.40 (95% CI: 1.91 to 6.04). For females, there was no significant difference in the risk of falling into income poverty between those with high and low psychological distress (p = 0.1008), however having high psychological distress increased the risk of falling into multidimensional poverty by 2.15 (95% CI: 1.30 to 3.55). Between 2009 and 2012, 8.0% of income poverty cases for people aged 65 and over (95% CI: 7.8% to 8.4%), and 19.5% of multidimensional poverty cases for people aged 65 and over (95% CI: 19.2% to 19.9%) can be attributed to high psychological distress. Conclusions The elevated risk of falling into income and multidimensional poverty has been an overlooked cost of poor mental health