Health and well-being of young mothers displaced by conflict: Experiences from South Sudan and the Kurdistan Region of Iraq.

Giving birth during adolescence is linked to a variety of negative outcomes, including poor health and well-being. Girls who have been displaced by conflict are at increased risk for becoming young mothers. While prevalence rates and health outcomes have been documented, rarely have the complex personal narratives of early motherhood been examined from the perspectives of mothers themselves, particularly in the Global South. This study relies on in-depth, inductive, narrative analysis of qualitative interviews with 67 young mothers and 10 relatives in South Sudan and the Kurdistan Region of Iraq (KRI) who had been displaced by conflict. This study provides deep insights into the contributing circumstances and consequences of young motherhood from sexual and reproductive health and well-being perspectives, with additional insights on mothering in humanitarian crisis.

Partners under pressure: humanitarian action for the Syria crisis.

Partnerships between organisations in humanitarian crisis situations generally are challenging, but at the apex are those established as part of remote management in a context of extreme insecurity. To date, little systematic research has been conducted on arrangements between local organisations that have access to crisis-affected populations and international organisations that hold the purse strings. This paper presents the findings of nine months of qualitative research conducted with five Syrian local organisations and their international partners engaging in humanitarian action across the Turkey-Syria border, and presents insights into the components of successful partnerships. It redefines capacity along organisational and operational lines, and unpacks how monitoring and evaluation and donor requirements create tension and, at times, place local organisations at risk. The paper highlights the centrality of trust in successful partnerships, and describes the personalisation of the conflict by local organisations. Based on a historical case study of civil society in northern Iraq, it closes with some suggestions for long-term sustainability.

Mechanical Ventilation Antioxidant Trial.

BACKGROUND: Many patients each year require prolonged mechanical ventilation. Inflammatory processes may prevent successful weaning, and evidence indicates that mechanical ventilation induces oxidative stress in the diaphragm, resulting in atrophy and contractile dysfunction of diaphragmatic myofibers. Antioxidant supplementation might mitigate the harmful effects of the oxidative stress induced by mechanical ventilation. OBJECTIVE: To test the clinical effectiveness of antioxidant supplementation in reducing the duration of mechanical ventilation. METHODS: A randomized, prospective, placebo-controlled double-blind design was used to test whether enterally administered antioxidant supplementation would decrease the duration of mechanical ventilation, all-cause mortality, and length of stay in the intensive care unit and hospital. Patients received vitamin C 1000 mg plus vitamin E 1000 IU, vitamin C 1000 mg plus vitamin E 1000 IU plus N-acetylcysteine 400 mg, or placebo solution as a bolus injection via their enteral feeding tube every 8 hours. RESULTS: Clinical and statistically significant differences in duration of mechanical ventilation were seen among the 3 groups (Mantel-Cox log rank statistic = 5.69, df = 1, P = .017). The 3 groups did not differ significantly in all-cause mortality during hospitalization or in the length of stay in the intensive care unit or hospital. CONCLUSIONS: Enteral administration of antioxidants is a simple, safe, inexpensive, and effective intervention that decreases the duration of mechanical ventilation in critically ill adults.

The impact of pneumonia guidelines and core measures on patient-oriented outcomes.

Over the past decade, evidence-based guidelines have led to the development of national core measures for the management of pneumonia. Although it does not signify causation, implementation of these standards strongly correlates with a decrease in the incidence of pneumonia and with decreasing death rates from pneumonia.