In the mid‐1990s, several critical texts raised concerns about the social, political, and epistemological implications of GIS. Subsequent responses to these critiques have fundamentally altered the ...technological, political, and intellectual practices of GIScience. Participatory GIS, for instance, has intervened in multiple ways to try to ameliorate uneven access to GIS and digital spatial data and diversify the forms of spatial knowledge and spatial logic that may be incorporated in a GIS. While directly addressing core elements of the ‘GIS & Society’ critique, these reconstructions of a critical GIScience introduce their own ambiguities with respect to access, equity, digital representation of spatial knowledge, and epistemologies of new GIS research practices. In this paper, I examine some of the new and persistent ambiguities of participatory GIS that bear inclusion in future critical GIScience research.
This paper investigates the unique challenges of an expanding group of stakeholders making demands upon shared geospatial data resources: non governmental organisations participating in local ...governance. In spite of efforts to improve local data integration in spatial data infrastructures and development of strategies from public participation GIS to expand access to geospatial data and technologies, grassroots data users still experience difficulties with the accessibility, quality, and usefulness of local government data resources. Drawing from extended ethnographic research conducted in Chicago, Illinois, I illustrate these problems and how they are shaped by grassroots groups' resource constraints, knowledge systems, and socio-political positions; and assess the feasibility and impacts of proposed alternatives for better meeting grassroots spatial data needs. I contend that the needs and challenges of these stakeholders are unique from those of other users, but are nonetheless rooted in central dilemmas of spatial data handling, and so might be addressed through stronger engagement with GIScience research in this arena.
Digitality is deeply implicated in sociospatial processes of exclusion, adverse incorporation, impoverishment and enrichment. Theorizing digital practices of life and thriving is politically and ...epistemologically urgent, and more robustly intersectional theory in digital geographies scholarship offers crucial pathways. I argue for theorizing digital geographies at the intersection of feminist relationality and Black, queer and feminist code studies. I demonstrate these theoretical horizons through an analysis of ‘glitch politics’ that refuse normative digital-social-spatial relations of technocapitalist urban life, and catalyze sociospatial relations of thriving otherwise, drawing examples from digital practices of street newspapers sold by unsheltered people in cities worldwide.
Emerging pandemics threaten global health and economies and are increasing in frequency. Globally coordinated strategies to combat pandemics, similar to current strategies that address climate ...change, are largely adaptive, in that they attempt to reduce the impact of a pathogen after it has emerged. However, like climate change, mitigation strategies have been developed that include programs to reduce the underlying drivers of pandemics, particularly animal-to-human disease transmission. Here, we use real options economic modeling of current globally coordinated adaptation strategies for pandemic prevention. We show that they would be optimally implemented within 27 y to reduce the annual rise of emerging infectious disease events by 50% at an estimated one-time cost of approximately $343.7 billion. We then analyze World Bank data on multilateral “One Health” pandemic mitigation programs. We find that, because most pandemics have animal origins, mitigation is a more cost-effective policy than business-as-usual adaptation programs, saving between $344.0.7 billion and $360.3 billion over the next 100 y if implemented today. We conclude that globally coordinated pandemic prevention policies need to be enacted urgently to be optimally effective and that strategies to mitigate pandemics by reducing the impact of their underlying drivers are likely to be more effective than business as usual.
Significance Emerging pandemics are increasing in frequency, threatening global health and economic growth. Global strategies to thwart pandemics can be classed as adaptive (reducing impact after a disease emerges) or mitigation (reducing the causes of pandemics). Our economic analysis shows that the optimal time to implement a globally coordinated adaptive policy is within 27 y and that given geopolitical challenges around pandemic control, these should be implemented urgently. Furthermore, we find that mitigation policies, those aimed at reducing the likelihood of an emerging disease originating, are more cost effective, saving between $344.0 billion and $360.8 billion over the next 100 y if implemented today.
Stunting among children in low-resource settings is associated with enteric pathogen carriage and micronutrient deficiencies. Our goal was to test whether administration of scheduled antimicrobials ...and daily nicotinamide improved linear growth in a region with a high prevalence of stunting and enteric pathogen carriage.
We performed a randomized, 2 × 2 factorial, double-blind, placebo-controlled trial in the area around Haydom, Tanzania. Mother-child dyads were enrolled by age 14 days and followed with monthly home visits and every 3-month anthropometry assessments through 18 months. Those randomized to the antimicrobial arm received 2 medications (versus corresponding placebos): azithromycin (single dose of 20 mg/kg) at months 6, 9, 12, and 15 and nitazoxanide (3-day course of 100 mg twice daily) at months 12 and 15. Those randomized to nicotinamide arm received daily nicotinamide to the mother (250 mg pills months 0 to 6) and to the child (100 mg sachets months 6 to 18). Primary outcome was length-for-age z-score (LAZ) at 18 months in the modified intention-to-treat group. Between September 5, 2017 and August 31, 2018, 1,188 children were randomized, of whom 1,084 (n = 277 placebo/placebo, 273 antimicrobial/placebo, 274 placebo/nicotinamide, and 260 antimicrobial/nicotinamide) were included in the modified intention-to-treat analysis. The study was suspended for a 3-month period by the Tanzanian National Institute for Medical Research (NIMR) because of concerns related to the timing of laboratory testing and the total number of serious adverse events (SAEs); this resulted in some participants receiving their final study assessment late. There was a high prevalence of stunting overall (533/1,084, 49.2%). Mean 18-month LAZ did not differ between groups for either intervention (mean LAZ with 95% confidence interval CI: antimicrobial: -2.05 CI -2.13, -1.96, placebo: -2.05 CI -2.14, -1.97; mean difference: 0.01 CI -0.13, 0.11, p = 0.91; nicotinamide: -2.06 CI -2.13, -1.95, placebo: -2.04 CI -2.14, -1.98, mean difference 0.03 CI -0.15, 0.09, p = 0.66). There was no difference in LAZ for either intervention after adjusting for possible confounders (baseline LAZ, age in days at 18-month measurement, ward, hospital birth, birth month, years of maternal education, socioeconomic status (SES) quartile category, sex, whether the mother was a member of the Datoga tribe, and mother's height). Adverse events (AEs) and SAEs were overall similar between treatment groups for both the nicotinamide and antimicrobial interventions. Key limitations include the absence of laboratory measures of pathogen carriage and nicotinamide metabolism to provide context for the negative findings.
In this study, we observed that neither scheduled administration of azithromycin and nitazoxanide nor daily provision of nicotinamide was associated with improved growth in this resource-poor setting with a high force of enteric infections. Further research remains critical to identify interventions toward improved early childhood growth in challenging conditions.
ClinicalTrials.gov NCT03268902.
The convergence of newly interactive Web-based technologies with growing practices of user-generated content disseminated on the Internet is generating a remarkable new form of geographic ...information. Citizens are using handheld devices to collect geographic information and contribute it to crowd-sourced data sets, using Web-based mapping interfaces to mark and annotate geographic features, or adding geographic location to photographs, text, and other media shared online. These phenomena, which generate what we refer to collectively as volunteered geographic information (VGI), represent a paradigmatic shift in how geographic information is created and shared and by whom, as well as its content and characteristics. This article, which draws on our recently completed inventory of VGI initiatives, is intended to frame the crucial dimensions of VGI for geography and geographers, with an eye toward identifying its potential in our field, as well as the most pressing research needed to realize this potential. Drawing on our ongoing research, we examine the content and characteristics of VGI, the technical and social processes through which it is produced, appropriate methods for synthesizing and using these data in research, and emerging social and political concerns related to this new form of information.
This review examines emerging research on the geoweb, particularly recent efforts to assess the social, political and disciplinary shifts associated with it. The rise of the geoweb is associated with ...shifts in the processes and power relations of spatial data creation and use, reconfigurations in previously bounded disciplinary knowledge sets, and shifts in the subjectivities and social relations that are produced through the geoweb’s technologies, data, and practices. This early research on the societal implications of the geoweb is drawing productively upon conceptual frameworks from critical GIS, public participation GIS, and spatial data infrastructure research, but must also theorize beyond these existing bodies of work.
Information on the causes of deaths from diarrhoea in children younger than 5 years is needed to design improved preventive and therapeutic approaches. We aimed to conduct a systematic analysis of ...studies to report estimates of the causes of deaths from diarrhoea in children younger than 5 years at global and regional levels during 2000–21.
For this systematic review and Bayesian multinomial analysis, we included 12 pathogens with the highest attributable incidence in the Global Enteric Multicenter Study. We searched PubMed, Scopus, Embase, Web of Science, Global Health Index Medicus, Global Health OVID, IndMed, Health Information Platform for the Americas (PLISA), Africa-Wide Information, and Cochrane Collaboration for articles published between Jan 1, 2000, and Dec 31, 2020, using the search terms “child”, “hospital”, “diarrhea”, “diarrhoea”, “dysentery”, “rotavirus”, “Escherichia coli”, “salmonella”, “shigella”, “campylobacter”, “Vibrio cholerae”, “cryptosporidium”, “norovirus”, “astrovirus”, “sapovirus”, and “adenovirus”. To be included, studies had to have a patient population of children younger than 5 years who were hospitalised for diarrhoea (at least 90% of study participants), at least a 12-month duration, reported prevalence in diarrhoeal stools of at least two of the 12 pathogens, all patients with diarrhoea being included at the study site or a systematic sample, at least 100 patients with diarrhoea, laboratory tests done on rectal swabs or stool samples, and standard laboratory methods (ie, quantitative PCR qPCR or non-qPCR). Studies published in any language were included. Studies were excluded if they were limited to nosocomial, chronic, antibiotic-associated, or outbreak diarrhoea or to a specific population (eg, only children with HIV or AIDS). Each article was independently reviewed by two researchers; a third arbitrated in case of disagreement. If both reviewers identified an exclusion criterion, the study was excluded. Data sought were summary estimates. Data on causes from published studies were adjusted when necessary to account for the poor sensitivity of non-qPCR methods and for attributable fraction based on quantification of pathogens in children who are ill or non-ill. The causes of deaths from diarrhoea were modelled on the causes of hospitalisations for diarrhoea. We separately modelled studies reporting causes of diarrhoea in children who were hospitalised in low-income and middle-income countries (LMICs) and in high-income countries (HICs).
Of 74 282 papers identified in the initial database search, we included 138 studies (91 included data from LMICs and 47 included data from HICs) from 73 countries. We modelled estimates for 194 WHO member states (hereafter referred to as countries), including 42 HICs and 152 LMICs. We could attribute a cause to 1 003 448 (83·8%) of the estimated 1 197 044 global deaths from diarrhoea in children younger than 5 years in 2000 and 360 730 (81·3%) of the estimated 443 833 global deaths from diarrhoea in children younger than 5 years in 2021. The cause with the largest estimated global attribution was rotavirus; in LMICs, the proportion of deaths from diarrhoea due to rotavirus in children younger than 5 years appeared lower in 2021 (108 322 24·4% of 443 342, 95% uncertainty interval 21·6–29·5) than in 2000 (316 382 26·5% of 1 196 134, 25·7–28·5), but the 95% CIs overlapped. In 2000, the second largest estimated attribution was norovirus GII (95 817 8·0% of 1 196 134 in LMICs and 225 24·7% of 910 in HICs); in 2021, Shigella sp had the second largest estimated attribution in LMICs (36 082 8·1% of 443 342), but norovirus remained with the second largest estimated attribution in HICs (84 17·1% of 490).
Our results indicate progress in the reduction of deaths from diarrhoea caused by 12 pathogens in children younger than 5 years in the past two decades. There is a need to increase efforts for prevention, including with rotavirus vaccine, and treatment to eliminate further deaths.
Bill & Melinda Gates Foundation via Johns Hopkins University and the University of Virginia.
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