Effects of the Pelotas (Brazil) Peace Pact on violence and crime: a synthetic control analysis.

Background: City-led interventions are increasingly advocated to achieve the UN's Sustainable Development Goal to reduce violence for all. We used a new quantitative evaluation method to examine whether a flagship programme, called the "Pelotas Pact for Peace" (the Pacto), has been effective in reducing violence and crime in the city of Pelotas, Brazil. Methods: We used synthetic control methodology to assess the effects of the Pacto from August 2017 to December 2021, and separately before and during the COVID-19 pandemic. Outcomes included monthly rates of homicide and property crime, and yearly rates of assault against women and school drop-out. We constructed synthetic controls (counterfactuals) based on weighted averages from a donor pool of municipalities in Rio Grande do Sul. Weights were identified using pre-intervention outcome trends and confounders (sociodemographics, economics, education, health and development, and drug trafficking). Findings: The Pacto led to an overall 9% reduction in homicide and 7% reduction in robbery in Pelotas. These effects were not uniform across the full post-intervention period as clear effects were only seen during the pandemic period. A 38% reduction in homicide was also specifically associated with the criminal justice strategy of Focussed Deterrence. No significant effects were found for non-violent property crimes, violence against women, and school dropout, irrespective of the post-intervention period. Interpretation: City-level interventions that combine public health and criminal justice approaches could be effective in tackling violence in Brazil. Continued monitoring and evaluation efforts are increasingly needed as cities are proposed as key opportunities for reducing violence for all. Funding: This research was funded by the Wellcome Trust [grant number: 210735_Z_18_Z].

Covid-19 related factors to food security and dietary diversity among urban households in western Oromia, Ethiopia.

Background: This study aims to assess factors associated with food security and dietary diversity among poor urban households of western Oromia, Ethiopia, after the outbreak of the Covid-19 pandemic. Method: A cross-sectional, community-based study was conducted in May to June 2021 with 361 poor urban households in the Horo Guduru Wollega zone, western Oromia, Ethiopia. A pre-tested structured questionnaire was used to collect primary data. Twenty-four hour reminder points were used to assess household dietary diversity, and household food security was assessed using the Household Food Insecurity Access Scale tool. Data were evaluated using the statistical software SPSS version 25.0. Results: This study showed a prevalence of food insecurity in households of 59.6%. The mean and standard deviation of household dietary diversity values were 4.19 ± 1.844. Family size (AOR = 8.5; 95% CI:3.295-21.92), monthly income (AOR = 3.52; 95% CI; 1.771-6.986), dietary diversity (AOR = 8.5; 95% CI; 3.92-18.59), knowledge (AOR = 3.0, 95% CI = 1.08-)8.347), attitude (AOR = 8.35, 95% CI:3.112-22.39) and practices against Covid-19 (AOR = 2.12; 95% CI:1.299-11.4) were factors significantly associated with food insecurity. Variables like educational status (AOR = 3.46; 95% CI:1.44-8.312), increased family size after the Covid-19 pandemic (AOR = 2.26; 95% CI:1.02-5.04), food security (AOR = 6.7; 95% CI:4.01-19.01), knowledge (AOR = 3.96; 95% CI:1.57-10.0), attitude (AOR = 3.9; 95% CI:1.75-8.82) and practices toward coronavirus (AOR = 2.23; 95% CI:2.18-23.95) were predictors significantly associated with dietary diversity. Conclusion: This study concluded that family size, monthly income, and dietary diversity were factors contributed to household food security. On the other hand, variables such as educational status, family size, and food security were highly relevant factors for dietary diversity after the outbreak of the Covid-19 pandemic. Knowledge, attitudes, and practices were also variables related to both household food security and dietary diversity. Therefore, immediate interventions such as nutrition-specific interventions can be suggested to address food insecurity and problems of inadequate food intake in poor urban households. In addition, governmental and non-governmental organizations should raise awareness and policies to support those at higher risk by developing affordable, sustainable and targeted social protection systems that ensure food security and adequate dietary intake at the household level.

Digitalisation of birth registration system in Malaysia: Boon or bane for the hard-to-reach and marginalised?

Access to birth registration among the refugees, migrants, and undocumented or stateless individuals in Sabah and Peninsular Malaysia remains hindered largely due to their lack of legal status. This study identifies the barriers to birth registration faced by these communities, including during the COVID-19 pandemic, and explores the extent to which digital technologies may overcome or amplify these barriers. Findings are reported from a review of literature, websites, and media articles and semi-structured interviews with community-based organisations and community leaders representing the communities. The themes for the questions were structured based on Plan International's (2015) Step-by-step Guide for Identifying and Addressing the Risks to Children in Digitised birth registration systems. We identified that the digitalisation of birth registration poses more risks of exclusion than benefits to the marginalised communities without a secure and inclusive operating environment. Subject to an inequality assessment to evaluate and address the existing inequalities, a hybrid system that factors in the role of citizen facilitation hubs would be ideal for ensuring no one gets "left behind".

Healthcare system responses to non-communicable diseases' needs of Syrian refugees: The cases of Jordan and Lebanon.

Introduction: Since the start of the Syrian conflict in 2011, Jordan and Lebanon have hosted large refugee populations, with a high pre-conflict burden of non-communicable diseases (NCDs). We aimed to explore NCD service provision to Syrian refugees in these two host countries and to identify lessons learned that may inform the global response to the changing health needs of refugees. Methods: Between January 2017 and June 2018, we conducted 36 in-depth interviews with stakeholders from Jordan and Lebanon, as well as global stakeholders, to understand the context, the achievements, gaps and priorities in the provision and uptake of NCD prevention, testing and treatment services to Syrian refugees. Findings: Both countries succeeded in embedding refugee health care within national health systems, yet coverage and quality of NCD health services offered to Syrian refugees in both contexts were affected by under-funding and consequent policy constraints. Changes in policies relating to cost sharing, eligibility and vulnerability criteria led to difficulties navigating the system and increased out-of-pocket payments for Syrians. Funding shortages were reported as a key barrier to NCD screening, diagnosis and management, including at the primary care level and referral from primary to secondary healthcare, particularly in Lebanon. These barriers were compounded by suboptimal implementation of NCD guidelines and high workloads for healthcare providers resulting from the large numbers of refugees. Conclusions: Despite the extraordinary efforts made by host countries, provision and continuity of high quality NCD services at scale remains a tremendous challenge given ongoing funding shortfalls and lack of prioritization of NCD care for refugees. The development of innovative, effective and sustainable solutions is necessary to counter the threat of NCDs.

Stock market response to COVID-19 pandemic: A comparative evidence from two emerging markets.

This paper presents the first comparative study of emerging stock markets' response to the COVID-19 pandemic with evidence from Ghana and Botswana. Using daily time-series data from March 1, 2020, to September 30, 2021, the study estimates parametric, semi-parametric and non-parametric models, and provides evidence to support the negative effects of the COVID-19 pandemic (i.e., the total number of reported COVID-19 cases and deaths) on the stock market performances of Ghana and Botswana. Interestingly, the study shows that the impact of the pandemic on Ghana's stock market is quantitatively greater than the stock market of Botswana. The study calls for fiscal and monetary policies to help firms on the stock market to survive the shock. Going forward, measures aimed at building a robust stock market to withstand such external shocks are critical.

Land use efficiency of functional urban areas: Global pattern and evolution of development trajectories.

The application of last-generation spatial data modelling, integrating Earth Observation, population, economic and other spatially explicit data, enables insights into the sustainability of the global urbanisation processes with unprecedented detail, consistency, and international comparability. In this study, the land use efficiency indicator, as developed in the Sustainable Development Goals, is assessed globally for the first time at the level of Functional Urban Areas (FUAs). Each FUA includes the city and its commuting zone as inferred from statistical modelling of available spatial data. FUAs represent the economic area of influence of each urban centre. Hence, the analysis of land consumption within their boundary has significance in the fields of spatial planning and policy analyses as well as many other research areas. We utilize the boundaries of more than 9,000 FUAs to estimate the land use efficiency between 1990 and 2015, by using population and built-up area data extracted from the Global Human Settlement Layer. This analysis shows how, in the observed period, FUAs in low-income countries of the Global South evolved with rates of population growth surpassing the ones of land consumption. However, in almost all regions of the globe, more than half of the FUAs improved their land use efficiency in recent years (2000-2015) with respect to the previous decade (1990-2000). Our study concludes that the spatial expansion of urban areas within FUA boundaries is reducing compactness of settlements, and that settlements located within FUAs do not display higher land use efficiency than those outside FUAs.

Analysis of health overseas development aid for internally displaced persons in low- and middle-income countries.

Background: There are an estimated 55 million internally displaced persons (IDPs) globally. IDPs commonly have worse health outcomes than host populations and other forcibly displaced populations such as refugees. Official development assistance (ODA) is a major source of the global financial response for health in low- and middle-income countries (LMICs), including for populations affected by armed conflict and forced displacement. Analysis of ODA supports efforts to improve donor accountability, transparency and the equitable use of ODA. The aim of this study is to examine international donor support and responsiveness to IDP health needs through analysis of ODA disbursements to LMICs between 2010 and 2019. Methods: ODA disbursement data to LMICs from 2010 to 2019 were extracted from the Creditor Reporting System (CRS) database and analysed with Stata software using a combination of: (i) text searching for IDP and refugee related terms; and (ii) relevant health and humanitarian CRS purpose codes. Descriptive analysis was used to examine patterns of ODA disbursement, and nonlinear least squared regression analysis was used to examine responsiveness of ODA disbursement to recipient country IDP population size and health system capacity and health characteristics. Findings: The study highlighted declining per IDP capita health ODA from USD 5.34 in 2010 to USD 3.72 in 2019 (with annual average decline of -38% from the 2010 baseline). In contrast, health ODA for refugees in LMICs increased from USD 18.55 in 2010 to USD 23.31 in 2019 (with an annual average increase of +14%). Certain health topics for IDPs received very low ODA, with only 0.44% of IDP health ODA disbursed for non-communicable diseases (including mental health). There was also weak evidence of IDP health ODA being related to recipient country IDP population size, and health system capacity and health characteristics. The paper highlights the need for increased investment by donors in IDP health ODA and to ensure that it is responsive to their health needs.

Approach to assess the performance of waste management systems towards a circular economy: waste management system development stage concept (WMS-DSC).

In this paper a novel holistic approach to assess the performance of waste management systems (WMSs) is presented. The so called WMS development stage concept (WMS-DSC) can be used by practitioners or decision makers to assess primarily the WMS at the municipal level. The WMS categorization into development stages notably enables a clear identification of symptoms, the causes of possible waste mismanagement and potential measures for improvement. The concept can be used to (i) assess the status quo of a WMS and, based on this, identify possible measures for implementation; (ii) check whether relevant system conditions to implement a specific measure are met; (iii) monitor the progress of a WMS; and (iv) compare the WMSs of different cities. The concept consists of five development stages: stage 1 - absence or lack of essential elements of waste management; stage 2 - reliable collection and improved landfill sites; stage 3 - separate collection and sorting; stage 4 - expansion of the recycling industry; and stage 5 - circular economy (CE), waste as a resource. While stage 1 describes the absence of or a very immature and malfunctioning WMS, stage 5 stands for a fully implemented CE. By equating the highest stage to the objectives that have evolved today globally for a sustainable CE, this concept can be used to identify targets and the most suitable steps for an individual WMS towards a future best practice of CE.•A holistic approach to assess waste management systems' performance is presented.•A benchmarking tool to estimate the circular economy (CE) evolvement in cities.•Usable for cities both in the Global North and South to identify CE potentials.

The dawn of digital public health in Europe: Implications for public health policy and practice.

The COVID-19 pandemic has highlighted the importance of digital health technologies and the role of effective surveillance systems. While recent events have accelerated progress towards the expansion of digital public health (DPH), there remains significant untapped potential in harnessing, leveraging, and repurposing digital technologies for public health. There is a particularly growing need for comprehensive action to prepare citizens for DPH, to regulate and effectively evaluate DPH, and adopt DPH strategies as part of health policy and services to optimise health systems improvement. As representatives of the European Public Health Association's (EUPHA) Digital Health Section, we reflect on the current state of DPH, share our understanding at the European level, and determine how the application of DPH has developed during the COVID-19 pandemic. We also discuss the opportunities, challenges, and implications of the increasing digitalisation of public health in Europe.

Paediatric Hypertension in Africa: A Systematic Review and Meta-Analysis.

BACKGROUND: The burden of cardiovascular disease (CVD) and hypertension is rapidly increasing in low- and middle-income countries. This is evident not only in adults, but also in children. Recent estimates of prevalence in children are lacking, particularly in Africa. As such, we conducted a systematic review and meta-analysis to provide updated estimates of paediatric hypertension in Africa. METHODS: We searched PubMed and EBSCO to identify articles published from January 2017 to November 2020. Studies were assessed for quality. We combined results for meta-analyses using a random effects model (Freeman-Tukey arcsine transformation). Heterogeneity was quantified using the I2 statistic. FINDINGS: In the narrative synthesis of 53 studies, publication bias was low for 28, moderate for 24, and high for one study. Hypertension prevalence ranged substantially (0·2%-38·9%). Meta-analysis included 41 studies resulting in data on 52918 participants aged 3 to 19 years from ten countries. The pooled prevalence for hypertension (systolic/diastolic BP≥95th percentile) was 7·45% (95%CI 5·30-9·92, I2=98.96%), elevated blood pressure (BP, systolic/diastolic BP≥90th percentile and <95th percentile) 11·38% (95%CI 7·94-15·33, I2=98.97%) and combined hypertension/elevated BP 21·74% (95%CI 15·5-28·69, I2=99.48%). Participants categorized as overweight/with obesity had a higher prevalence of hypertension (18·5% [95%CI 10·2-28·5]) than those categorized as underweight/normal (1·0% [95%CI 0·1-2·6], 4·8% [95%CI 2·9-7·1], p<0·001). There were significant differences in hypertension prevalence when comparing BP measurement methods and classification guidelines. INTERPRETATION: Compared to a previous systematic review conducted in 2017, this study suggests a continued increase in prevalence of paediatric hypertension in Africa, and highlights the potential role of increasing overweight/obesity. FUNDING: This research was funded in part by the Wellcome Trust [Grant number:214082/Z/18/Z]. LJW and SAN are supported by the DSI-NRF Centre of Human Development at the University of the Witwatersrand.

One health approach in Nepal: Scope, opportunities and challenges.

One Health (OH) is a collaborative effort to attain optimal health for people, animals and the environment. The concept of OH is still in its infancy in Nepal but is increasingly growing. The Government of Nepal (GoN) has taken some initiatives to tackle burgeoning problems such as antimicrobial resistance, highly pathogenic avian influenza and rabies using OH approach but there are several challenges at the level of implementation. Few non-governmental organizations support GoN to promote an OH approach. The major bottlenecks in implementing OH in Nepal include poor organizational structure to support OH, absence of a legal framework to implement OH, poor coordination among different governmental agencies, insufficient technical expertise, poor data sharing mechanism across sectors, limited budget and poor understanding at political level. We encourage GoN to address these gaps and prioritize the health problems where OH approach would give the best outcome. Institutional and legal frameworks need to be created to effectively implement an OH approach in Nepal. Increasing awareness among policy makers including political leadership and increasing regular government budget for OH activities would be helpful to promote OH in Nepal.

Trends and Characteristics of Security Incidents Involving Aid Workers in Health Care Settings: A 20-Year Review.

INTRODUCTION: In recent years, several high-profile attacks on hospitals providing medical aid in conflict settings have raised international concern. The International Humanitarian Law prohibits the deliberate targeting of health care settings. Violation of this law is considered a war crime and impacts both those delivering and receiving medical aid. PROBLEM: While it has been demonstrated that both aid workers and health care settings are increasingly being targeted, little is known about the trends and characteristics of security incidents involving aid workers in health care compared to non-health care settings. METHODS: Data from the publicly available Aid Worker Security Database (AWSD) containing security incidents involving humanitarian aid workers world-wide were used in this study. The security incidents occurring from January 1, 1997 through December 31, 2016 were classified by two independent reviewers as having occurred in health care and non-health care settings, and those in health care settings were further classified into five categories (hospital, health clinic, mobile clinic, ambulance, and vaccination visit) for the analysis. A stratified descriptive analysis, χ2 Goodness of Fit test, and Cochran-Armitage test for trend were used to examine and compare security incidents occurring in health care and non-health care settings. RESULTS: Among the 2,139 security incidents involving 4,112 aid workers listed in the AWSD during the study period, 74 and 2,065 incidents were in health care settings and non-health care settings, respectively. There was a nine-fold increase from five to 45 incidents in health care settings (χ2 = 56.27; P < .001), and a five-fold increase from 159 to 852 incidents in non-health care settings (χ2 = 591.55; P < .001), from Period 1 (1997-2001) to Period 4 (2012-2016). Of the 74 incidents in health care settings, 23 (31.1%) occurred in ambulances, 15 (20.3%) in hospitals, 13 (17.6%) in health clinics, 13 (17.6%) during vaccination visits, and six (8.1%) in mobile clinics. Bombings were the most common means of attack in hospitals (N = 9; 60.0%), followed by gun attacks (N = 3; 20.0%). In health care settings, 184 (95.3%) were national staff and nine (4.7%) were international staff. CONCLUSION: Security threats are a growing occupational health hazard for aid workers, especially those working in health care settings. There is a need for high-quality data from the field to better monitor the rapidly changing security situation and improve counter-strategies so aid workers can serve those in need without having to sacrifice their lives.

Ecosystem services accounts: Valuing the actual flow of nature-based recreation from ecosystems to people.

Natural capital accounting aims to measure changes in the stock of natural assets (i.e., soil, air, water and all living things) and to integrate the value of ecosystem services into accounting systems that will contribute to better ecosystems management. This study develops ecosystem services accounts at the European Union level, using nature-based recreation as a case study and following the current international accounting framework: System of Environmental-Economic Accounting - Experimental Ecosystem Accounting (SEEA EEA). We adapt and integrate different biophysical and socio-economic models, illustrating the workflow necessary for ecosystem services accounts: from a biophysical assessment of nature-based recreation to an economic valuation and compilation of the accounting tables. The biophysical assessment of nature-based recreation is based on spatially explicit models for assessing different components of ecosystem services: potential, demand and actual flow. Deriving maps of ecosystem service potential and demand is a key step in quantifying the actual flow of the service used, which is determined by the spatial relationship (i.e., proximity in the case of nature-based recreation) between service potential and demand. The nature-based recreation accounts for 2012 show an actual flow of 40 million potential visits to 'high-quality areas for daily recreation', with a total value of EUR 50 billion. This constitutes an important contribution of ecosystems to people's lives that has increased by 26% since 2000. Practical examples of ecosystem services accounts, as shown in this study, are required to derive recommendations and further develop the conceptual and methodological framework proposed by the SEEA EEA. This paper highlights the importance of using spatially explicit models for ecosystem services accounts. Mapping the different components of ecosystem services allows proper identification of the drivers of changes in the actual service flow derived from ecosystems, socio-economic systems and/or their spatial relationship. This will contribute to achieving one of the main goals of ecosystem accounts, namely measuring changes in natural capital, but it will also support decision-making that targets the enhancement of ecosystems, their services and the benefits they provide.

A Facebook Page Created Soon After the Amatrice Earthquake for Deaf Adults and Children, Families, and Caregivers Provides an Easy Communication Tool and Social Satisfaction in Maxi-Emergencies.

Although international and Italian conventions have issued numerous communication protocols to assist people with disabilities during earthquakes or other maxi-emergencies, no tailored strategies exist to create and disseminate information online to deaf people. On August 24, 2016, a devastating earthquake destroyed Amatrice in Central Italy. This natural disaster underlined the lack of information on disabled people possibly involved and the lack of tailored, online communication tools. Having various registries listing disabled residents in the earthquake area might have benefitted emergency procedures. To access information easily and expedite risk management, the authors developed an online information tool for deaf persons, their families, and caregivers. Within hours after the earthquake, they published a Facebook page (Facebook, Inc.; Menlo Park, California USA) including a video provided with subtitles, Italian sign language, and service numbers. Those who accessed the Facebook page spread the information to other social media. Although no registry yet specifies figures, the annual incidence of approximately three to five/1,000 new deaf persons diagnosed in Italy implies that around 5.4% of the total 43,507 Italian deaf people live in the earthquake territory, and presumably 1.3% are younger than 18 years of age. The Facebook page obtained unexpectedly numerous accesses and satisfaction from deaf adults and families with deaf children, as well as hearing family relatives and caregivers. A total of 60% deaf and 10% hearing people asked for more information. Despite limitations, the effort to develop a page for deaf people and their families, via a world-wide social media, permits fast access, outlines safety precautions during maxi-emergencies, and disseminates essential information designed for deaf people on civil protection services. The Facebook page provides a replicable example for developing similar, user-friendly, online tools for disabled groups to disseminate important safety information after earthquakes or other maxi-emergencies.Rotondi L, Zuddas M, Marsella P, Rosati P. A Facebook page created soon after the Amatrice Earthquake for deaf adults and children, families, and caregivers provides an easy communication tool and social satisfaction in maxi-emergencies. Prehosp Disaster Med. 2019;34(2):137-141.

Portable Health Care Facilities in Disaster and Rescue Zones: Characteristics and Future Suggestions.

IntroductionNatural and man-made disasters are becoming global concerns. Natural disasters appear to be growing in number and intensity due to global warming, population explosion, increased travel, and overcrowding of cities. In addition, man-made disasters do not seem to be diminishing.At disaster sites, an immediate response is needed. National and international organizations; nongovernmental, military, and commercial organizations; and even private donors enlist to provide humanitarian and medical support and to send supplies, shelters, and temporary health care facilities to disaster zones.ProblemThe literature is sparse regarding the design of portable health care facilities intended for disaster zones and their adaptability to the tasks required and site areas. METHODS: Data were collected from peer-reviewed literature, scientific reports, magazines, and websites regarding health care facilities at rescue and salvage situations. Information was grouped according to categories of structure and properties, and relative strengths and weaknesses. Next, suggestions were made for future directions. RESULTS: Permanent structures and temporary constructed facilities were the two primary categories of health care facilities functioning at disaster zones. Permanent hospitals were independent functioning medical units that were moved or transported to and from disaster zones as complete units, as needed. These facilities included floating hospitals, flying (airborne) hospitals, or terrestrial mobile facilities. Thus, these hospitals self-powered and contained mobility aids within their structure using water, air, or land as transporting media.Temporary health care facilities were transported to disaster zones as separate, nonfunctioning elements that were constructed or assembled on site and were subsequently taken apart. These facilities included the classical soft-type tents and solid containers that were organized later as hospitals in camp configurations. The strengths and weaknesses of the diverse hospital options are discussed. CONCLUSIONS: Future directions include the use of innovative materials, advanced working methods, and integrated transportation systems. In addition, a holistic approach should be developed to improve the performance, accessibility, time required to function, sustainability, flexibility, and modularity of portable health care facilities.Bitterman N, Zimmer Y. Portable health care facilities in disaster and rescue zones: characteristics and future suggestions. Prehosp Disaster Med. 2018;33(4):411-417.

Vascular robustness: The missing parameter in cardiovascular risk prediction.

Undetected high risk for premature death of cardiovascular disease (CVD) among individuals with low-to-moderate risk factor scores is an acknowledged obstacle to CVD prevention. The vasculature's functional robustness against risk factor derailment may serve as a novel discriminator of mortality risk under similar risk factor loads. To test this assumption, we hypothesized that the expected inverse robustness-mortality association is verifiable as a significant trend along the age spectrum of risk factor-challenged cohorts. This is a retrospective cohort study of 372 adults (mean age 56.1 years, range 21-92; 45% female) with a variety of CV risk factors. An arterial model (VascAssist 2, iSYMED GmbH, Germany) was used to derive global parameters of arterial function from non-invasively acquired pulse pressure waves. Participants were stratified by health status: apparently healthy (AH; n = 221); with hypertension and/or hypercholesterolemia (CC; n = 61); with history of CV event(s) (CVE; n = 90). Multivariate linear regression was used to derive a robustness score which was calibrated against the CVD mortality hazard rate of a sub-cohort of the LURIC study (n = 1369; mean age 59.1 years, range 20-75; 37% female). Robustness correlated linearly with calendar age in CC (F(1, 59) = 10.42; p < 0.01) and CVE (F(1, 88) = 40.34; p < 0.0001) but not in the AH strata, supporting the hypothesis of preferential elimination of less robust individuals along the aging trajectory under risk factor challenges. Vascular robustness may serve as a biomarker of vulnerability to CVD risk factor challenges, prognosticating otherwise undetectable elevated risk for premature CVD mortality.

Sustainable diet policy development: implications of multi-criteria and other approaches, 2008-2017.

The objective of the present paper is to draw lessons from policy development on sustainable diets. It considers the emergence of sustainable diets as a policy issue and reviews the environmental challenge to nutrition science as to what a 'good' diet is for contemporary policy. It explores the variations in how sustainable diets have been approached by policy-makers. The paper considers how international United Nations and European Union (EU) policy engagement now centres on the 2015 Sustainable Development Goals and Paris Climate Change Accord, which require changes across food systems. The paper outlines national sustainable diet policy in various countries: Australia, Brazil, France, the Netherlands, Qatar, Sweden, UK and USA. While no overarching common framework for sustainable diets has appeared, a policy typology of lessons for sustainable diets is proposed, differentiating (a) orientation and focus, (b) engagement styles and (c) modes of leadership. The paper considers the particularly tortuous rise and fall of UK governmental interest in sustainable diet advice. Initial engagement in the 2000s turned to disengagement in the 2010s, yet some advice has emerged. The 2016 referendum to leave the EU has created a new period of policy uncertainty for the UK food system. This might marginalise attempts to generate sustainable diet advice, but could also be an opportunity for sustainable diets to be a goal for a sustainable UK food system. The role of nutritionists and other food science professions will be significant in this period of policy flux.

Health Outcomes for Children in Haiti Since the 2010 Earthquake: A Systematic Review.

BACKGROUND: Haiti remains the poorest country in the Americas and one of the poorest in the world. Children in Haiti face many health concerns, some of which were exacerbated by the 2010 earthquake. This systematic review summarizes published research conducted since the 2010 earthquake, focusing on health outcomes for children in Haiti, including physical, psychological, and socioeconomic well-being. METHODS: A literature search was conducted identifying articles published from January 2010 through May 2016 related to pediatric health outcomes in Haiti. Two reviewers screened articles independently. Included research articles described at least one physical health, psychological health, or socioeconomic outcome among children less than 18 years of age in Haiti since the January 2010 earthquake. RESULTS: Fifty-eight full-length research articles were reviewed, covering infectious diseases (non-cholera [N=12] and cholera [N=7]), nutrition (N=11), traumatic injuries (N=11), mental health (N=9), anemia (N=4), abuse and violence (N=5), and other topics (N=3). Many children were injured in the 2010 earthquake, and care of their injuries is described in the literature. Infectious diseases were a significant cause of morbidity and mortality among children following the earthquake, with cholera being one of the most important etiologies. The literature also revealed that large numbers of children in Haiti have significant symptoms of posttraumatic stress disorder (PTSD), peri-traumatic stress, depression, and anxiety, and that food insecurity and malnutrition continue to be important issues. CONCLUSIONS: Future health programs in Haiti should focus on provision of clean water, sanitation, and other measures to prevent infectious diseases. Mental health programming and services for children also appear to be greatly needed, and food insecurity/malnutrition must be addressed if children are to lead healthy, productive lives. Given the burden of injury after the 2010 earthquake, further research on long-term disabilities among children in Haiti is needed. Dube A , Moffatt M , Davison C , Bartels S . Health outcomes for children in Haiti since the 2010 earthquake: a systematic review. Prehosp Disaster Med. 2018;33(1):77-88.