1,721,084 research outputs found
Adaptation to climate change: a comparative analysis of modelling methods for heat-related mortality
Full text linkBackground: Multiple methods are employed for modelling adaptation when projecting the impact of climate change on heat-related mortality. The sensitivity of impacts to each is unknown because they have never been systematically compared. In addition, little is known on the relative sensitivity of impacts to “adaptation uncertainty” (i.e. the inclusion/exclusion of adaptation modelling), relative to using multiple climate models and emissions scenarios.
Objectives: (1) Compare the range in projected impacts that arises from using different adaptation modelling methods; (2) compare the range in impacts that arises from adaptation uncertainty to ranges from using multiple climate models and emissions scenarios; (3) recommend modelling method(s) to use in future impact assessments.
Methods: We estimated impacts for 2070-2099, for 14 European cities, applying six different methods for modelling adaptation; also with climate projections from five climate models, run under two emissions scenarios to explore the relative effects of climate modelling and emissions uncertainty.
Results: The range of the difference (%) in impacts between including and excluding adaptation, irrespective of climate modelling and emissions uncertainty, can be as low as 28% with one method and up to 103% with another (mean across 14 cities). In 13 of 14 cities the ranges in projected impacts due to adaptation uncertainty are larger than those associated with climate modelling and emissions uncertainty.
Conclusions: Researchers should carefully consider how to model adaptation because it is a source of uncertainty that can be greater than the uncertainty in emissions and climate modelling. We recommend absolute threshold shifts and reductions in slope
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
The relevance of global health in the context of the German health care system
No full textDie moderne Medizin ist eine der größten gesellschaftlichen Leistungen zum Schutz
der Gesundheit, zur Bekämpfung von Krankheiten und zur Verlängerung des Lebens.
Vor dem Hintergrund weltweiter Auswirkungen der Globalisierung, die sich über die
Grenzen von Nationalstaaten hinweg ausbreitet und sowohl die Gesundheit von
Menschen und Tieren sowie die Umwelt als auch nationalstaatliche
Gesundheitssysteme weltweit herausfordern, muss Gesundheit weltweit und
systematisch neu betrachtet und bewertet werden.
In Deutschland hat das Thema der Globalen Gesundheit bereits seit der Ebola
Epidemie 2014/15 in West-Afrika, aber insbesondere seit Beginn der COVID-19
Pandemie an politischer Aufmerksamkeit gewonnen. Durch diese sind die
Bedrohungen viraler Erkrankungen für die wirtschaftliche, politische und
gesellschaftliche Stabilität weltweit offensichtlich gewordenen.
Um zukünftigen Herausforderungen der Globalen Gesundheit begegnen zu können,
wird innovative und transformative Kapazität benötigt. Da sich die erwarteten
politischen, sozialen, wirtschaftlichen und ökologischen Veränderungen weltweit
immer schneller verändern, wird Innovation bereits heute notwendig. Gleichzeitig
muss bereits heute über zukünftige Herausforderungen nachgedacht werden, um in
der Lage zu sein, den zukünftigen und noch nicht vorhersehbaren Herausforderungen
(known unknowns) begegnen zu können. Dazu ist die Unterstützung und Finanzierung
von unabhängiger transdisziplinärer Wissenschaft zum Thema Globale Gesundheit im
ausschließlichen Interesse des Allgemeinwohls zwingend notwendig.
In diesem Prozess sollte überdacht werden, wo und wie das biomedizinische Modell
der krankheitsfokussierten Medizin durch sozialmedizinischen Innovationen sinnvoll
ergänzt werden kann. Das setzt auch voraus, dass die Curricula der medizinischen
und gesundheitswissenschaftlichen Lehre dahingehend überarbeitet werden.
Parallel müssen für Wissenschaftlerinnen und Wissenschaftler im Bereich der Globale
Gesundheit die Bedingungen geschaffen werden, die Kreativität und den Umgang mit
Risiken erlauben, denn sich auf etwas Neues einzulassen, bedeutet immer auch ein
Risiko einzugehen bedeutet (disruptive innovation).
Wissenschaftliche Einrichtungen wie die Charité-Universitätsmedizin Berlin könnten
dabei die Funktion eines Leuchtturms für die Gesundheitsaspekte in den Irren und
Wirren der gesellschaftlichen Transformationen übernehmen und damit eine Tradition
von über 300 Jahren an der Spitze des medizinischen Fortschritts und des
Gesundheitswesens für die Zukunft fortschreiben.
Dazu müsste die Globale Gesundheit im Verständnis Virchows unter den heutigen
gesellschaftlichen Bedingungen formuliert werden. Die Zukunft einer nachhaltigen
Globalen Gesundheit muss dabei zwingend innerhalb der Grenzen des „Systems
Erde“ formuliert werden und sollte sozialökonomisch, sozialökologisch und
sozialmedizinisch im Dienste der Allgemeinheit ausgerichtet sein
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Spatio-temporal child and maternal mortality patterns and associations with health interventions and health systems performance in sub-Saharan Africa
Full text linkIn 2000, the international community adopted eight Millennium Development Goals (MDGs). Three were devoted to health (reducing child mortality; improving maternal health; and combating HIV/AIDS, malaria, and other diseases). The MDGs facilitated the mobilisation of funds, implementation and assessment of cost-effective health interventions to reverse the high burden of diseases, particularly in low-and middle-income countries (LMICs). Indeed, under-5 and maternal mortality rates were unacceptably high, the pandemic of HIV/AIDS in full blow and the prevalence and incidence of malaria and other infectious diseases was rampant. The increase of financial and technical support in sub-Saharan Africa led to the scaling up of maternal and child health interventions. Furthermore, technical support enabled synergised efforts, regular monitoring of the progress and impact assessment. The “Countdown to 2015” initiative was set up to track the progress towards MDG 4 (reduce by two-thirds, between 1990 and 2015, the under-five mortality rate (U5MR) and MDG 5 (reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio (MMR)). A set of 20 priority health interventions targeting life stages (from pregnancy to childhood) was promoted in several high burdened low-and middle-income countries to achieve the MDGs 4 and 5 by 2015. The fundament of these selected set of health interventions was the concept of the “continuum of care” which integrates the life cycle and place of provision of health care. At the end of 2015, the coverage of maternal and child health interventions such as skilled birth attendance, antenatal care visit, family planning, post-natal care, exclusive breastfeeding, micronutrients, supplementation, immunization, use of insecticide-treated nets (ITNs) had increased significantly. Consequently, U5MR and MMR declined substantially. However, most sub-Saharan Africa countries did not achieve MDG 4 and MDG 5. Several weaknesses of their health systems hindered the optimal implementation of the cost effective-interventions. Furthermore, a lack of reliable data prevent efficient tracking of the progress.
In LMICs, U5MR and MMR are most often derived from household surveys conducted every 3 to 5 years. Data from health services are not as reliable because they are based on attendances of health facilities and exclude events occurring in the community. Data from demographic and health surveillance systems (DHSS) are reliable but they only cover the HDSS area. Besides, most data analysis are limited to national averages ignoring local heterogeneities.
Like most sub-Saharan countries, the scaling up of the priority health interventions, health system reforms (removal of user fees, subsidization, strengthening of infrastructure and equipment) improvements of access to water, sanitation and education significantly improved health indicators during the MDGs era in Burkina Faso. However, the country failed to achieve MDGs 4 and 5.
In 2015, the international community set up new global objectives namely the Sustainable Development Goals (SDGs). The ambitious SDGs 3.1 and 3.2 related to mother and under-5 aimed at reducing the global maternal mortality ratio to less than 70 per 100,000 live births and the under-5 mortality rate to at least as low as 25 per 1,000 live births by 2030, respectively. Taking advantages of lessons learned from the MDG era, there is a need to increase the pace of annual reduction in U5MR and MMR mortality rates to achieve child and women related SDGs by 2030. As mortality rates are reducing and clustering, the subnational scale estimates become most important to optimize the health intervention’s impact.
To this end, local factors driving mortalities such as climatic and environmental factors, economic, educational individual as well as community and family level risks should be taken into account. Furthermore, health system performance and health interventions coverages also influence the distribution of mortality rate within the country and their incorporation in the statistical analysis could benefit decision-making.
Goal and objectives:
The U5MR and MMR are extremely high in Burkina Faso. We aimed to contribute to accelerating their reduction by advanced statistical analysis providing evidence for decision-making. The overreaching goal was to assess the spatio-temporal mortality patterns and associations with health system performance and interventions in Burkina Faso. The specific objectives were (1) to assess the spatial distribution of child mortality and its associations with child, maternal and household health interventions in Burkina Faso; (2) to assess the spatial distribution of child mortality and its associations with child main causes of mortality; (3) to assess the association between malaria-related health service readiness and malaria mortality in under-5 years old in Burkina Faso; (4) to assess temporal changes in the association of malaria-related health service readiness and malaria mortality in under-5 years old between 2012 and 2014 in; and (5) assess the effect of maternal, socio-economic, education and health system factors on maternal mortality across sub-Saharan Africa.
Methods: In chapter 2, we fit Bayesian geostatistical Weibull proportional hazards survival models with spatially varying coefficients. Sixteen maternal, child and household health interventions were assessed to quantify their effect on under-5 survival at the national as well at the subnational scale (administrative regions). In chapter 3, we applied the same method to assess the associations between under-5 mortality and childhood diseases. The analyses were adjusted for health interventions, climatic and environmental confounders. In both chapters, we assumed spatially structured covariate effects at the regional level. That is, the effects of health interventions or diseases are more alike in regions close to each other than those far away. Conditionally autoregressive (CAR) models modeled the spatial structure of the effects.
In chapter 4 and chapter 5, we analyzed nationally representative health facility survey to assess the readiness of health facilities to perform malaria services. Specifically, in Chapter 4, we identified firstly from malaria and general service items of the service availability and readiness assessment (SARA) survey of 2014, the most important tracer items related to malaria deaths. The items are binary with the presence of the item corresponding to “1” and “0” if the item is absent. We fit Bayesian geostatistical variable selection using stochastic search and adopting a spike and slab prior distributions for the regression coefficients. The variables selection' were applied to two separated groups of health facilities namely peripheral health centres (low level) and medical centres (high level). Multiple correspondence analysis (MCA) was applied on the selected items of each level. The creation of the composite readiness score followed the approach proposed by Asselin to create a composite poverty index. The methodology ensures the monotone increasing or decreasing condition of the score for all indicators. The number of the factorial axes to be included is determined when a factorial axis has been selected for each indicator. The factorial axes with higher discrimination measure are those that are selected.
In Chapter 5, we combined the data of the SARA surveys of 2012 and 2014. We, again grouped the health facilities into 2 levels and followed the process of Chapter 4 to create the composite readiness score.
In both Chapters 4 and 5, we split the readiness score into 3 categorical ordered levels as readiness index. A geostatistical negative binomial model was fitted to assess the effect of the facility readiness index on malaria mortality adjusted for facility characteristics (type of health facility location and administrative status).
Finally, in chapter 6 we fit a negative binomial model to assess the association of maternal mortality rate with the change in the coverage of health intervention, socio-economic covariates, health financing and health human resources indicators within two rounds of demographic and health survey (DHS). We linked the mean count of maternal death and the covariates with the number of exposure years to death as offset via a log-linear regression equation.
Results: The results of chapter 2 showed uneven spatial distribution of the associations between U5MR and health interventions. At the national level, DPT3, immunization, and baby post-natal check within 24 hours after birth had the most important effect on U5MR (hazard ratio (HR)=0.89, 95% Bayesian credible interval (BCI): 0.86-0·98 and HR=0.89, 95% BCI: 0·86-0·92, respectively). At the subnational level, the most effective interventions were skilled birth attendance, and improved drinking water, followed by baby post-natal check within 24 hours after birth, vitamin A supplementation, antenatal care visit, and all-antigens immunization (including BCG, Polio3, DPT3, and measles immunization). Centre-Est, Sahel, and Sud-Ouest were the regions with the largest number of effective interventions. There was no intervention with a significant effect on child survival in the region of Hauts Bassins.
Concerning chapter 3, malaria positive parasitemia stands as the predominant childhood condition that affects the survival of under-5 in 6 regions out of 13. It was followed by low birth weight (4 regions) and severe anemia (3 regions). The regions of Centre and Centre-Est had the lowest under-five mortality rates and there was no association with none of the selected childhood diseases.
The results of chapter 4 and 5 showed that the composite readiness index captures more variability in the dataset than the first component. That is, in chapter 4, the composite score explained 30% of variability compared to 14% when used the first axis of MCA for medical centres. For peripheral health centres, the composite score explained 53% whereas the first axis explained 18%. Peripheral health centres with the higher readiness score were associated with a 59% of reduction of malaria mortality compared to the lowest level of readiness.
In Chapter 5, the readiness of malaria service increase from 2012 to 2014 for both health facilities levels. Peripheral health centres with higher readiness index were associated with a 52% of reduction of malaria mortality compared to the lowest level. For medical centres, the middle and highest level of readiness index were associated with 28 and 38% of reduction of mortality rate compared to the lowest readiness index group.
In chapter 6, our results revealed that the temporal trend of the decreasing of the MMR was associated with the increase of the coverage of skilled birth attendance, family planning and female education rate in 24 sub-Saharan countries.
Conclusion: The crucial implication of our results from Chapters 2 and 3, is the need of shifting from the nationally and uniformly allocation of resources to targeted subnational allocation. Indeed, our results show the administrative regions that lack the effectiveness of health interventions and regions with a high burden of diseases. Furthermore, we stressed the most important health interventions to be scaled up.
In Chapters 4 and 5, the clear effect of malaria related-service readiness to reduce malaria burden in under-5 years old suggests a need for a national policy of strengthening the health system, which is lacking. Importantly, all health programmes or projects should incorporate health system reinforcement as a core component. Undoubtedly, this policy will beneficiate to others health programme to reduce morbidity and mortality of other important diseases in under-5 as well in others population groups.
Our results in Chapter 6 suggest a need for multi-sectoral synergies at each country level to reduce optimize health interventions effects. Indeed, women empowerment (education), an alternative to health financing such as insurances, removal or subsidization of user’s fees related to maternal health services could increase the coverage of maternal health interventions that, in turn, will accelerate progress toward the attainment of SDG 3.1
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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