Protocol for integrated solutions for healthy birth, growth and development: a cluster-randomised controlled trial to evaluate the effectiveness of a mixed nutrition intervention package in reducing child undernutrition in Lao People's Democratic Republic.

Introduction: While Lao People's Democratic Republic has seen economic gains in recent years, one-third of children aged 5 years and under are stunted. There is a need for evidence around clinically effective and cost-effective integrated nutrition-specific and nutrition-sensitive interventions in the local context.

Methods And Analysis: We aim to conduct a cluster-randomised control trial to test the effectiveness of an integrated package of community-based nutrition-specific and nutrition-sensitive interventions compared with the standard government package of nutrition actions.

The introduction of a mandatory mask policy was associated with significantly reduced COVID-19 cases in a major metropolitan city.

Background: Whilst evidence of use of face masks in reducing COVID-19 cases is increasing, the impact of mandatory use across a large population has been difficult to assess. Introduction of mandatory mask use on July 22, 2020 during a resurgence of COVID-19 in Melbourne, Australia created a situation that facilitated an assessment of the impact of the policy on the epidemic growth rate as its introduction occurred in the absence of other changes to restrictions.

Methods And Findings: Exponential epidemic growth or decay rates in daily COVID-19 diagnoses were estimated using a non-weighted linear regression of the natural logarithm of the daily cases against time, using a linear spline model with one knot (lspline package in R v 3.

Centers for Disease Control and Prevention Public Health Response to Humanitarian Emergencies, 2007-2016.

Humanitarian emergencies, including complex emergencies associated with fragile states or areas of conflict, affect millions of persons worldwide. Such emergencies threaten global health security and have complicated but predictable effects on public health. The Centers for Disease Control and Prevention (CDC) Emergency Response and Recovery Branch (ERRB) (Division of Global Health Protection, Center for Global Health) contributes to public health emergency responses by providing epidemiologic support for humanitarian health interventions.

Extension of overall survival beyond objective responses in patients with metastatic renal cell carcinoma treated with high-dose interleukin-2.

Purpose: In metastatic renal cell carcinoma (mRCC), survival benefit associated with objective response rates of 16-20 % with high-dose interleukin-2 (HDIL-2) is well established and discussed. Based on recently emerged data on efficacy of cancer immunotherapy, we hypothesized that the survival benefit with HDIL-2 extends beyond those achieving objective responses, i.e.

Volunteering to help those less fortunate: Pathways for Australian GPs to acquire helpful knowledge and skills.

Background: The high number of postgraduate global health courses, websites such as Global Health Gateway, annual conferences such as the Global Ideas Forum, and global health interest groups in all 20 Australian medical schools are indicators of increased interest among Australian doctors in working overseas.

Objective: This article provides an overview of the health situation in low-income and middle-income countries, and summarises current approaches to improving the health of those living in countries with a developing economy. Opportunities for overseas assignments by generalist medical doctors in emergency and non-emergency settings are described, and appropriate pathways to prepare for such work are outlined.

So close: remaining challenges to eradicating polio.

The Global Polio Eradication Initiative, launched in 1988, is close to achieving its goal. In 2015, reported cases of wild poliovirus were limited to just two countries - Afghanistan and Pakistan. Africa has been polio-free for more than 18 months.

Potential for Early Fracture Risk Assessment in Patients with Metastatic Bone Disease using Parametric Response Mapping of CT Images.

Pathologic vertebral compression fractures (PVCF) cause significant morbidity in patients with bone metastases from breast cancer and other malignancies. Due to limitations of existing biochemical and imaging biomarkers, clinicians currently have no reliable metrics to identify patients with impending PVCF, impeding efforts to prevent this severe complication. To establish the feasibility of a new method for defining risk of PVCF, we retrospectively analyzed serial CT scans from five breast cancer patients using parametric response mapping (PRM) to quantify dynamic bone density changes that preceded an event.

The impact on child wasting of a capacity building project implemented by community and district health staff in rural Lao PDR.

Laos is a low-income food-deficit country with pockets of high levels of wasting in the highland areas. We implemented a 3-year health/nutrition project in 12 villages in the highlands of Savannakhet province to reduce acute malnutrition in children. Volunteer nutrition teams in each village monitored child growth and promoted healthy feeding practices; a multisectoral district committee conducted monthly outreach to assess child growth, manage acute malnutrition and deliver primary health care services.

Oncotype dx results in multiple primary breast cancers.

Purpose: To determine whether multiple primary breast cancers have similar genetic profiles, specifically Oncotype Dx Recurrence Scores, and whether obtaining Oncotype Dx on each primary breast cancer affects chemotherapy recommendations.

Methods: A database of patients with hormone receptor-positive, lymph node-negative, breast cancer was created for those tumors that were sent for Oncotype Dx testing from the University of Michigan Health System from 1/24/2005 to 2/25/2013. Retrospective chart review abstracted details of tumor location, histopathology, distance between tumors, Oncotype Dx results, and chemotherapy recommendations.

Radiation oncology quality: aggressiveness of cancer care near the end of life.

Purpose: Quality in cancer care is an issue that has come to the forefront over the past decade. Although the American Society of Clinical Oncology has developed extensive quality metrics and goals, such as limiting chemotherapy being provided within the last 14 days of a patient's life, there are no similar quality metrics, and few data, in the field of radiation oncology.

Methods: In this study, morbidity and mortality records from 2008 to 2011 were reviewed for patients at Indiana University who received radiation therapy (RT) within 30 days of death; 63 patients met those criteria.

Promoting safer sexual practices among expectant fathers in the Lao People's Democratic Republic.

Men's decisions and behaviours influence the sexual, reproductive and maternal health of women and the health of their families, but men are rarely included in reproductive and maternal health care services. Men's attendance at antenatal care has the potential to prevent women from becoming infected with HIV during pregnancy and post-partum, when they are more vulnerable to infection and have a high risk of transmission to the infant. Greater involvement of men requires an understanding of social, cultural and organisational barriers in different contexts.

The prevalence of sexually transmitted infections in Papua New Guinea: a systematic review and meta-analysis.

Background: The potential for an expanded HIV epidemic in Papua New Guinea (PNG) demands an effective, evidence-based and locally-appropriate national response. As sexually transmitted infections (STIs) may be important co-factors in HIV transmission nationally, it is timely to conduct a systematic review of STI prevalences to inform national policy on sexual health and HIV/STI prevention.

Methodology/principal Findings: We undertook a systematic review and meta-analysis of HIV and STI prevalences in PNG, reported in peer-reviewed and non-peer-reviewed publications for the period 1950-2010.

In rural Tibet, the prevalence of lower limb pain, especially knee pain, is high: an observational study.

Question: What is the point prevalence and 12-month prevalence of lower limb musculoskeletal pain in rural Tibet? Does this differ with gender or age? What factors that could contribute to lower limb musculoskeletal pain are commonly present?

Design: Observational study using an investigator-administered questionnaire and observation walks through villages.

Participants: 499 people aged 15 years and over living in 19 rural villages of Shigatse Municipality, Tibet.

Results: The point prevalence of lower limb musculoskeletal pain was 40% (95% CI 34 to 46) while the 12-month prevalence was 48% (95% CI 42 to 54).

The trajectories of Prevention through Design in construction.

Introduction: Construction Hazards Prevention through Design (CHPtD) is a process in which engineers and architects explicitly consider the safety of construction workers during the design process. Although articles on CHPtD have appeared in top construction journals, the literature has not addressed technical principles underlying CHPtD to help designers better perform CHPtD, to facilitate the development of additional CHPtD tools, and to predict the future path of CHPtD.

Method: This theoretical paper uses the existing literature on CHPtD and current action research associated with several CHPtD workgroups to analyze how CHPtD will likely evolve over the coming decades.

Influences on maternal and child nutrition in the highlands of the northern Lao PDR.

In two remote northern provinces of the Lao People's Democratic Republic, provincial and district teams were trained and subsequently conducted a qualitative study using a participatory approach to investigate people's knowledge, attitudes, beliefs and practices in relation to women's and children's nutrition. Using focus group discussions, key informant interviews, and structured observation, the teams found that certain nutrition behaviours, including food taboos, may contribute to the high prevalence of child malnutrition and micronutrient deficiencies in these northern provinces. Ethnic groups gave details of nutrition-related beliefs and practices; the teams found that many of these are likely to be amenable to change through relatively low-cost nutrition promotion informed by these findings.

District health programmes and health-sector reform: case study in the Lao People's Democratic Republic.

The Lao People's Democratic Republic (Lao PDR) is classified by the World Bank as a low-income country under stress. Development partners have sought to utilize effective aid instruments to help countries classified in this way achieve the Millennium Development Goals; these aid instruments include sector-wide approaches (SWAps) that support decentralized district health systems and seek to avoid fragmentation and duplication. In Asia and the Pacific, only Bangladesh, Papua New Guinea and the Solomon Islands have adopted SWAps.

Hepatitis E virus infection as a marker for contaminated community drinking water sources in Tibetan villages.

In April-May 2001, a study was conducted to determine the prevalence of antibodies against hepatitis E virus (HEV) among 426 persons 8-49 years of age randomly selected from two groups of rural villages in central Tibet. Group 1 villages were assessed in 1998 as having poor quality water sources; new water systems were then constructed prior to this study. Group 2 villages had higher quality water and were not designated as priority villages for new systems prior to the study.

Planning STI/HIV prevention among refugees and mobile populations: situation assessment of Sudanese refugees.

This article reflects an investigation of knowledge, attitudes and behaviours and HIV/STI prevalence of Sudanese refugees and Ethiopian sex workers in 1992. It represents one of the earliest such investigations within an African refugee population. The investigation took place in the Dimma refugee settlement in south-western Ethiopia and study participants included Sudanese refugee men and women and Ethiopian female sex workers.

Low back pain in rural Tibet.

In a baseline assessment of 30 rural villages surrounding Shigatse City, Tibet, many people, especially women, identified low back pain as a serious health problem. Consequently, we aimed to establish the prevalence of such pain and to develop appropriate interventions. We did a cross-sectional study of the prevalence of low back pain and related functional disability using two-stage random cluster sampling.