This research examines the relationship between violent conflict and childhood wasting in Northeast Nigeria, where residents have been subjected to fighting between the Nigerian government and Boko ...Haram - an extremist Islamist movement - since 2009.
Using two Demographic and Health Surveys from before and after the Boko Haram insurgency started, a double-difference (difference-in-difference) approach is used to assess the impact of the conflict on mean weight-for-height z-scores and the likelihood of wasting.
Results suggest that if children exposed to the conflict had not been exposed, their mean weight-for-height z-score would be 0.49 standard deviations higher (
< 0.001) than it is, increasing from - 0.74 to - 0.25. Additionally, the likelihood of wasting would be 13 percentage points lower (mean z-statistic - 4.2), bringing the proportion down from 23% to 10%.
Descriptive evidence suggests that poor child health outcomes in the conflict areas of Northeast Nigeria may be due to disruptions to social services and increased food insecurity in an already resource poor area. Although other unidentified factors may contribute to both conflict and wasting, the findings underscore the importance of appropriate programs and policies to support children in conflict zones.
•Multiple satellite and census-based measures are needed to fully capture urban form.•Landsat-based GHSL can be used to detect lateral change in the urban extent of Greater Saigon.•In-migration is ...strongly associated with lateral change.•Satellite Dense Sampling Method can monitor volumetric change in Greater Saigon.•Increases in population drive volumetric change.
In this case study of Greater Saigon, two types of satellite data are used to estimate the rate of change in urban spatial expansion, both horizontally and volumetrically (horizontal and vertical components), and integrates them with socioeconomic data to examine the correlates and potential causes of both kinds of change. We employ new data products – the Global Human Settlement Layer (GHSL) derived largely from Landsat and a Dense Sampling Method (DSM) product based on QuikSCAT – in combination with data from the 1999 and 2009 censuses of Vietnam. Unlike past studies, we examine horizontal and volumetric changes in urban form and pay particular attention to the role of migration in locations experiencing those different types of change. We find these two types of urban change occur at different rates and in different localities, with the highest rates of horizontal change occurring to the north of administrative Saigon. In contrast, we find the highest rates of volumetric change in the areas north of the central districts but mostly within administrative Saigon. In-migration is strongly associated with horizontal change, whereas increases in population density appears to drive volumetric change, controlling for other factors. Positive volumetric change is associated with necessary amenities of modern urban living, often in high-rise buildings found in dense population centers like Saigon: the increasing presence in households of computers, air conditioners, piped water, and gas fuel. Use of these new integrated data hold promise to shed new light on both the built-environment and social dimensions of urbanization in low- and middle-income settings.
Extreme heat has been responsible for more deaths in the United States than any other weather-related phenomenon over the past decade. The frequency and intensity of extreme heat events are projected ...to increase over the course of this century. In this work, we examine historical patterns of extreme heat exposure and mortality in the continental United States. We examine spatial variation in the mortality response to exposure, consider the contribution of key demographic and socio-economic factors in driving heat-related mortality, and test three different extreme heat thresholds using a national-level spatial autoregressive model and a geographically weighted regression approach. We find that the mortality response to exposure is higher in areas that do not routinely experience heat extremes, and that exposure itself is a stronger driver of heat-related mortality across the larger urban areas of the Midwest and Northeast. The importance of demographic/socio-economic factors varies substantially over space, and results are robust across alternative measures of heat extremes, suggesting that no single definition is necessarily superior. The baseline relationships established here are potentially useful for future predictions of exposure and heat-related mortality under alternative population and climate change scenarios, and may aid policy makers and planners in implementing effective adaptation and mitigation strategies.
•Cluster analysis detects statistically significant areas of heightened risk of childhood diarrheal disease in West Africa.•The clusters are partially explained by household and climatic factors such ...as mother's education and rainfall.•Remaining clusters highlight areas where specific development and adaptation interventions are still required.
Diarrhea is a major cause of morbidity and mortality among children in West Africa. To determine whether there are areas of heightened risk and if so, how they may be influenced by household and climatic variables, we describe the geo-spatial distribution of childhood diarrhea in ten countries of West Africa for the period 2008–2013 using data from Demographic and Health Surveys. The purely spatial scan statistic was applied, where the observed diarrhea cases were modeled as a Poisson variable and were compared to expected cases predicted from non-spatial logistic regression. Covariate-adjusted cluster analysis detected statistically significant clusters (p < 0.05) in ten cities and thirteen largely rural areas. Areas with particularly high relative risk included Cotonou, Benin (7.16), and Kaduna, Nigeria (7.21). The study demonstrates the importance of development and adaptation measures to protect child health, and that these interventions should be tailored to meet the needs of specific populations.
Diarrhea is a major contributor to child morbidity and mortality in West Africa. Non-spatial regression and geographically weighted Poisson regression applied to data from 10 Demographic and Health ...Surveys conducted in West Africa from 2008 to 2013 show that water source, toilet type, mother's education, latitude, temperature, rainfall, altitude, and population density influence the risk of diarrhea. The risk associated with these factors is dependent on location and may be higher or lower than the rest of the study area. Areas with increased relative risk for diarrhea include several urban centers, low-elevation areas (coastal and along rivers), remote areas such as western Mali, and conflict zones (northeast Nigeria).
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The study investigated factors associated with internalising emotional and behavioural problems among adolescents displaced during the most recent Chechen conflict. A cross‐sectional survey (N=183) ...examined relationships between social support and connectedness with family, peers and community in relation to internalising problems. Levels of internalising were higher in displaced Chechen youth compared to published norms among non‐referred youth in the United States and among Russian children not affected by conflict. Girls demonstrated higher problem scores compared to boys. Significant inverse correlations were observed between family, peer and community connectedness and internalising problems. In multivariate analyses, family connectedness was indicated as a significant predictor of internalising problems, independent of age, gender, housing status and other forms of support evaluated. Sub‐analyses by gender indicated stronger protective relationships between family connectedness and internalising problems in boys. Results indicate that family connectedness is an important protective factor requiring further exploration by gender in war‐affected adolescents.
Objectives: This dissertation aims to contribute to our understanding of how climate variability and armed conflict impacts diarrheal disease and malnutrition among young children in West Africa. Two ...studies examine the associations between climate and diarrheal disease across the whole study area—ten countries in West Africa during the period 2008–2013. The third study examines diarrheal disease and malnutrition in Northeast Nigeria before (2008) and after (2013) the start of the current armed conflict in the area. Methods: Outcome variables and child, caregiver, and household characteristics for these studies are from the Demographic and Health Surveys. Additional datasets include specialized products for rainfall, temperature, climate class, population density, and urban population ranking. The first two studies use geo-spatial techniques to 1) determine if there are areas of elevated risk after controlling for climatic and other covariates and 2) determine whether there is spatial variation in the associations between diarrheal disease and climatic and other covariates. The third study uses a double-difference methodology to study both diarrheal disease and malnutrition and their associations with conflict. Results: The first study found statistically significant clusters of elevated risk in 10 urban areas and 13 largely rural areas after adjusting for household and climatic factors with a relative risk range of 1.5 to 7.2. Results from the second study indicate that the associations between diarrheal disease and key household, environmental, and climatic factors vary according to location—a phenomenon which is masked by global models - and that the associations are both positive and negative (increase and decrease risk). The third study found that if children exposed to the conflict in Northeast Nigeria had not been exposed, their mean weight-for-height z-scores would be nearly half a standard deviation higher, the proportion of moderately and severely wasted children would be 13 percentage points lower, and the prevalence of diarrhea would be 8 percentage points lower than they are. Conclusions: The studies in this dissertation provide additional evidence for the relationships between climate variability, conflict, and child health in West Africa. Previous studies have provided mixed evidence for the role of factors such as rainfall on child health outcomes. Here, geo-spatial methods identify both areas of heightened risk and the role of specific risk factors in particular locations. For example, the first study found elevated risk of diarrheal disease in northern Cameroon and the second study indicates that two risk factors in that area are low coverage of improved sanitation facilities and low rainfall at the time of the survey. The effects of conflict on child health are conceptually inherent and have been quantified with different methods and outcomes. The research here furthers those efforts by quantifying the impact of a particular conflict—the Boko Haram insurgency—on the health and growth of young children. The findings from this research support on-going development goals which aim to improve modifiable factors including increased coverage of improved water sources and sanitation facilities, increased educational attainment, the alleviation of poverty and food insecurity, and resolving on-going conflicts around the world. The results also support adaptation measures, which are aimed at factors that are difficult to change in themselves, such as living in areas where temperatures are increasing due to climate change. Such measures include promoting income diversification and access to goods and services for farmers and pastoralists and improving infrastructure and public services in urban areas. Limitations, including spatial, temporal, and methodological issues with the data sources are discussed, as are suggestions for future research.
Purpose: A pharmacokinetic study in children to determine plasma flumazenil concentrations after the intranasal administration of 40 µg·kg−1.Methods: Following institutional approval and informed ...written consent, II ASA physical status I–II patients, aged two to six years, undergoing general anesthesia for dental surgery were recruited. After induction, 40 µg·kg−1 flumazenil Anexate®, Roche, 0.1 mg·mL−1 (0.4 mL·kg−1)) were administered via a syringe as drops, prior to nasal intubation. Venous plasma samples were drawn prior to administration of flumazenil (t=0), and then at 2, 4, 6, 8, 10, 15, 20, 30, 40, 60, and 120 min thereafter. The plasma samples were immediately processed by the onsite laboratory and then stored at −70°C, before batch analysis via high performance liquid chromatography assay. Pharmacokinetic data calculations were performed using WinNonLin software (Scientific Consulting Inc.).Results: Eleven patients were studied, but data for one patient were discarded due to insufficient sampling. The median age was 4.3 yr (range 3 to 6), with a median weight of 18.9 kg (range 14.9 to 22.2). There were seven boys and three girls. Mean Cmax was 67.8 ng·mL−1 (SD 41.9), with Tmax at two minutes. The calculated half-life was 122 min (SD 99).Conclusion: The mean plasma concentrations of flumazenil attained were similar to those reported after intravenous administration, and may be sufficient to antagonize the side-effects of benzodiazepines. This route of administration may be useful when the intravenous route is not readily available.
To compare the analgesic effects of preoperative oral clonidine with intraoperative intravenous fentanyl in children undergoing tonsillectomy or adenotonsillectomy.
This randomized, controlled, ...double-blind study of 36 ASA I-II children, age 7-12 yr undergoing adenotonsillectomy was conducted at a tertiary care paediatric teaching hospital. Either 4 micrograms.kg-1 clonidine po was given 60-90 min preoperatively or 3 micrograms.kg-1 fentanyl i.v. was given intraoperatively. Postoperatively visual analog pain scores (VAS) were recorded at rest and on swallowing every 10 min for the first 30 min and then every 15 min for two hours. Morphine 0.05 mg.kg-1 i.v. was given for VAS > or = 5. If > 3 doses were required, 1.5 mg.kg-1 codeine po and 20 mg.kg-1 acetaminophen po were given. Sedation and anxiety scores were recorded preoperatively. Haemodynamic changes, blood loss, recovery scores, and the incidence of vomiting, hypotension, and airway obstruction were recorded.
Children who received clonidine had a higher incidence of preoperative sedation (63%) than those receiving fentanyl (6%). Preinduction mean arterial pressure was lower in the clonidine group but required no intervention. VAS scores were similar throughout the observation period. There was no difference either in the number of morphine or codeine rescue doses administered or in the incidence of side effects.
Oral clonidine is an effective analgesic and sedative for children undergoing tonsillectomy or adenotonsillectomy.
ROMAN GLASS VESSELS Gillian Dunn
The Roman Amphitheatre of Chester, Volume 1,
12/2017
Book Chapter
A total of 671 fragments of vessel glass was recovered from Areas A, B and C. This equates to 412 from Roman phases, 252 from post-Roman phases and seven which are unphased (see Table 63).
The vast ...majority of the glass falls within the date range of mid-1st to late-2nd century and in many cases only a broad date of 1st to 3rd century can be assigned. There is very little obvious late Roman material. A high proportion of the assemblage is re-deposited material which is reflected in the small size of the fragments. A total of 340 fragments (82.5
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