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Thursday’s Daily Brief: Albinism, displacement in Central America, family-friendly nations, updates on the Gulf and Darfur

ONU - aiuti umanitari - feed -

This Thursday, top stories includes: International Albinism Awareness Day; the UN refugee agency, UNHCR, appealing for regional talks on Central America forced displacement; updates on the latest attack on oil tankers in the Gulf and on recent clashes in Darfur; and a new report by UNICEF on the best and worst "family-friendly" nations.

La produzione industriale di materie prime agricole si mangia le foreste del Pianeta

Il Cambiamento - feed -

Tra il 2010 e il 2020 almeno 50 milioni di ettari di foresta, un'area delle dimensioni della Spagna, saranno stati distrutti per fare spazio alla produzione industriale di materie prime agricole. Questo è quanto emerge da “Conto alla rovescia verso l’estinzione”, il nuovo rapporto di Greenpeace, diffuso in occasione del vertice mondiale di Vancouver, che ha riunito le multinazionali.

Outcomes of patients enrolled in an antiretroviral adherence club with recent viral suppression after experiencing elevated viral loads

Medici Senza Frontiere - feed -

Outcomes of patients enrolled in an antiretroviral adherence club with recent viral suppression after experiencing elevated viral loads Sharp, J; Wilkinson, L; Cox, V; Cragg, C; van Custem, G; Grimsrud, A Background: Eligibility for differentiated antiretroviral therapy (ART) delivery models has to date been limited to low-risk stable patients. Objectives: We examined the outcomes of patients who accessed their care and treatment through an ART adherence club (AC), a differentiated ART delivery model, immediately following receiving support to achieve viral suppression after experiencing elevated viral loads (VLs) at a high-burden ART clinic in Khayelitsha, South Africa. Methods: Beginning in February 2012, patients with VLs above 400 copies/mL either on firstor second-line regimens received a structured intervention developed for patients at risk of treatment failure. Patients who successfully suppressed either on the same regimen or after regimen switch were offered immediate enrolment in an AC facilitated by a lay community health worker. We conducted a retrospective cohort analysis of patients who enrolled in an AC directly after receiving suppression support. We analysed outcomes (retention in care, retention in AC care and viral rebound) using Kaplan–Meier methods with follow-up from October 2012 to June 2015. Results: A total of 165 patients were enrolled in an AC following suppression (81.8% female, median age 36.2 years). At the closure of the study, 119 patients (72.0%) were virally suppressed and 148 patients (89.0%) were retained in care. Six, 12 and 18 months after AC enrolment, retention in care was estimated at 98.0%, 95.0% and 89.0%, respectively. Viral suppression was estimated to be maintained by 90.0%, 84.0% and 75.0% of patients at 6, 12 and 18 months after AC enrolment, respectively. Conclusion: Our findings suggest that patients who struggled to achieve or maintain viral suppression in routine clinic care can have good retention and viral suppression outcomes in ACs, a differentiated ART delivery model, following suppression support.

Monday’s Daily Brief: the future of food and digital tech, labour justice in focus, denuclearization, and Kosovo

ONU - aiuti umanitari - feed -

This Monday, top stories includes: a new report on risks and opportunities of digital technology; social justice for all at the centenary UN labour conference; updates on Iran’s and North Korea’s nuclear programmes; tackling today’s problems with food; and updates on the relations between Kosovo and Serbia.

Reproductive health in humanitarian settings in Lebanon and Iraq: results from four cross-sectional studies, 2014-2015.

Medici Senza Frontiere - feed -

Reproductive health in humanitarian settings in Lebanon and Iraq: results from four cross-sectional studies, 2014-2015. Balinska, MA; Nesbitt, R; Ghantous, Z; Ciglenecki, I; Staderini, N BACKGROUND: Reproductive health is an important component of humanitarian response. Displaced women need access to family planning, antenatal care, and the presence of a skilled birth attendant at delivery. Since the beginning of the Syrian conflict in 2011, Lebanon and Iraq have been hosting large numbers of refugees, thereby straining local capacities to provide these services. In order to identify salient health needs, Médecins Sans Frontières conducted a survey in several sites hosting refugees and internally displaced persons across the region. Here we describe the reproductive health profile of Syrian refugees, Iraqi displaced persons, and vulnerable Lebanese and their use of services. METHODS: We conducted four cross-sectional surveys in 2014-2015 in two sites in Lebanon and two sites in Iraq. Depending on the site, two-stage cluster sampling or systematic sampling was intended, but non-probability methods were employed at the second stage due to implementation challenges. We collected information on overall health (including reproductive health) and demographic information from heads of households on the basis of a standardized questionnaire. Pearson chi-square tests were used to compare proportions, and generalized linear models were used to calculate odds ratios with regard to risk factors. All analyses were performed using the survey suite of commands in Stata version 14.1. RESULTS: A total of 23,604 individuals were surveyed, including 5925 women of childbearing age. Overall, it was reported that 7.5% of women were currently pregnant and 12.8% had given birth within the previous 12 months. It was reported that pregnancy was unplanned for 57% of currently pregnant women and 66.7% of women who had delivered in the previous year. A slight majority of women from both groups had accessed antenatal care at least once. Amongst women who had delivered in the previous year, 84.5% had done so with a skilled birth attendant and 22.1% had had a cesarean section. Location and head of household education were predictors of unplanned pregnancy in multivariable analysis. Head of household education was also significantly associated with higher uptake of antenatal care. CONCLUSIONS: Considering the large number of pregnant women and women having recently delivered in these settings, addressing their sexual and reproductive health needs emerges as a crucial aspect of humanitarian response. This study identified unmet needs for family planning and high cesarean section rates at all sites, suggesting both lack of access to certain services (contraception, antenatal care), but also over-recourse to cesarean section. These specific challenges can impact directly on maternal and child health and need today to be kept high on the humanitarian agenda.

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