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Abbreviations: AEA, average expert agreement; CAH, World Health Organization Child and Adolescent Health and Development Department; CHNRI, Child Health Nutrition Research Initiative; MDG, Millennium Development Goal; NE, neonatal encephalopathy; NIH, US National Institutes of Health; RPS, research priority score; World Health Organization, Summary Points * Intrapartum-related neonatal deaths (previously called \"birth asphyxia\") are the fifth most common cause of deaths among children under 5 years of age, accounting for an estimated 814,000 deaths each year, and also associated with significant morbidity, resulting in a burden of 42 million disability adjusted life years (DALYs). * This paper uses a systematic process developed by the Child Health Nutrition Research Initiative (CHNRI) to define and rank research options to reduce mortality from intrapartum-related neonatal deaths by the year 2015, in order to advance Millennium Development Goal (MDG) 4 for child survival. * A list of 61 research questions was developed and scored by 21 technical experts. The top one-third of the ranked research investment options was dominated by delivery (implementation) research, whilst discovery (basic science) questions were not ranked highly, especially for expected reduction of mortality and inequity in the short time to 2015. * Among the top four research questions, two relate to generation of demand for facility care at birth with specific mechanisms (such as transport and communication schemes, or financial incentives and conditional cash transfers).

Little is known about the breadth of health care networks or the degree to which different insurers' networks overlap. To quantify network breadth and exclusivity (ie, overlap) among primary care physician (PCP), cardiology, and general acute care hospital networks for employer-based (large group and small group), individually purchased (marketplace), Medicare Advantage (MA), and Medicaid managed care (MMC) plans. This cross-sectional study included 1192 networks from Vericred. The analytic unit was the network-zip code-clinician type-market, which captured attributes of networks from the perspective of a hypothetical patient seeking access to in-network clinicians or hospitals within a 60-minute drive. Enrollment in a private insurance plan. Percentage of in-network physicians and/or hospitals within a 60-minute drive from a hypothetical patient in a given zip code (breadth). Number of physicians and/or hospitals within each network that overlapped with other insurers' networks, expressed as a percentage of the total possible number of shared connections (exclusivity). Descriptive statistics (mean, quantiles) were produced overall and by network breadth category, as follows: extra-small (<10%), small (10%-25%), medium (25%-40%), large (40%-60%), and extra-large (>60%). Networks were analyzed by insurance type, state, and insurance, physician, and/or hospital market concentration level, as measured by the Hirschman-Herfindahl index. Across all US zip code-network observations, 415 549 of 511 143 large-group PCP networks (81%) were large or extra-large compared with 138 485 of 202 702 MA (68%), 191 918 of 318 082 small-group (60%), 60 425 of 149 841 marketplace (40%), and 21 781 of 66 370 MMC (40%) networks. Large-group employer networks had broader coverage than all other network plans (mean [SD] PCP breadth: large-group employer-based plans, 57.3% [20.1]; small-group employer-based plans, 45.7% [21.4]; marketplace, 36,4% [21.2]; MMC, 32.3% [19.3]; MA, 47.4% [18.3]). MMC networks were the least exclusive (a mean [SD] overlap of 61.3% [10.5] for PCPs, 66.5% [9.8] for cardiology, and 60.2% [12.3] for hospitals). Networks were narrowest (mean [SD] breadth 42.4% [16.9]) and most exclusive (mean [SD] overlap 47.7% [23.0]) in California and broadest (79.9% [16.6]) and least exclusive (71.1% [14.6]) in Nebraska. Rising levels of insurer and market concentration were associated with broader and less exclusive networks. Markets with concentrated primary care and insurance markets had the broadest (median [interquartile range {IQR}], 75.0% [60.0%-83.1%]) and least exclusive (median [IQR], 63.7% [52.4%-73.7%]) primary care networks among large-group commercial plans, while markets with least concentration had the narrowest (median [IQR], 54.6% [46.8%-67.6%]) and most exclusive (median [IQR], 49.4% [41.9%-56.9%]) networks. In this study, narrower health care networks had a relatively large degree of overlap with other networks in the same geographic area, while broader networks were associated with physician, hospital, and insurance market concentration. These results suggest that many patients could switch to a lower-cost, narrow network plan without losing in-network access to their PCP, although future research is needed to assess the implications for care quality and clinical integration across in-network health care professionals and facilities in narrow network plans.

Natural disasters and rapidly aging populations are chronic problems for societies worldwide. We investigated the effects of an intervention in Japan known as Ibasho, which embeds elderly residents in vulnerable areas within larger social networks and encourages them to participate in leadership activities. This project sought to deepen the connections of these elderly residents to society and to build elderly leadership and community capacity for future crises. We carried out surveys of participants and nonparticipant residents across the city of Ofunato in Tohoku, Japan, 1 year after the intervention began. Our surveys included questions assessing participation levels in Ibasho, demographic characteristics, efficacy, social networks, and a sense of belonging. Regression analysis and propensity score matching of more than 1100 respondents showed that regular participation in the Ibasho project had a statistically significant and positive connection with various measures of social capital. Given its relatively low cost and focus on deepening cohesion, we suggest that this community-based project could be replicated and scaled up in other countries to deepen resilience, elder health, and social capital. Moving away from an emphasis on investing in physical infrastructure, we believe that disaster risk reduction strategies should center on social infrastructure. (Disaster Med Public Health Preparedness. 2017;11:120-126).

Personal disaster and emergency support networks of rural older adults are described before and after participation in a disaster preparedness intervention, PrepWise. At baseline, a total of 194 disaster support network members were identified by 27 older adults in a rural Midwest community. After the intervention, these participants identified 232 support network members. Multilevel logistic regression models were constructed to identify characteristics of the network members and social interactions associated with support providers at baseline as well as newly added support sources after the PrepWise intervention. Member and interaction characteristics associated with being identified as emergency support sources at baseline were as follows: family, lived in close proximity, weekly or more frequent contact, and being someone whom participants shared concerns with, trusted, and exchanged emotional support with. After receiving PrepWise, participants on average identified 3 new sources of emergency support within their networks. Support sources added at follow-up tended to be nonfamily members and those participants trusted. Enhancements in personal emergency support networks occurred after the intervention. Understanding characteristics of the network members and social interactions may assist in identifying additional emergency support sources. Larger studies investigating the impacts of enhanced support networks on disaster-related behaviors and outcomes will be beneficial. (Disaster Med Public Health Preparedness. 2017;11:110-119).

Cancer incidence and mortality are increasing in Africa, which is leading to greater demands for palliative care. There has been little progress in terms of research, pain management, and policies related to palliative care. Palliative care in Africa is scarce and scattered, with most African nations lacking the basic services. To address these needs, a guiding framework that identifies care needs and directs palliative care services could be utilized. Therefore, using the supportive care framework developed by Fitch (Fitch, 2009), we here review the literature on palliative care for patients diagnosed with cancer in Africa and make recommendations for improvement. The PubMed, Scopus, CINAHL, Web of Science, Embase, PsycINFO, Social Sciences Citation Index, and Medline databases were searched. Some 25 English articles on research from African countries published between 2004 and 2014 were selected and reviewed. The reviewed literature was analyzed and presented using the domains of the supportive care framework. Palliative care patients with cancer in Africa, their families, and caregivers experience increasing psychological, physical, social, spiritual, emotional, informational, and practical needs. Care needs are often inadequately addressed because of a lack of awareness as well as deficient and scattered palliative care services and resources. In addition, there is sparse research, education, and policies that address the dire situation in palliative care. Our review findings add to the existing body of knowledge demonstrating that palliative care patients with cancer in Africa experience disturbing care needs in all domains of the supportive care framework. To better assess and address these needs, holistic palliative care that is multidomain and multi-professional could be utilized. This approach needs to be individualized and to offer better access to services and information. In addition, research, education, and policies around palliative care for cancer patients in Africa could be more comprehensive if they were based on the domains of the supportive care framework.

Background Community-based interventions are a promising approach and an important component of a comprehensive response to obesity. In this paper we describe the Collaboration of CO mmunity-based O besity P revention S ites (CO-OPS Collaboration) in Australia as an example of a collaborative network to enhance the quality and quantity of obesity prevention action at the community level. The core aims of the CO-OPS Collaboration are to: identify and analyse the lessons learned from a range of community-based initiatives aimed at tackling obesity, and; to identify the elements that make community-based obesity prevention initiatives successful and share the knowledge gained with other communities. Methods Key activities of the collaboration to date have included the development of a set of Best Practice Principles and knowledge translation and exchange activities to promote the application (or use) of evidence, evaluation and analysis in practice. Results The establishment of the CO-OPS Collaboration is a significant step toward strengthening action in this area, by bringing together research, practice and policy expertise to promote best practice, high quality evaluation and knowledge translation and exchange. Future development of the network should include facilitation of further evidence generation and translation drawing from process, impact and outcome evaluation of existing community-based interventions. Conclusions The lessons presented in this paper may help other networks like CO-OPS as they emerge around the globe. It is important that networks integrate with each other and share the experience of creating these networks.

The organization of a regional system of care (RSC) for ST-elevation myocardial infarction (STEMI) is recommended by the Italian Federation of Cardiology (FIC) and international guidelines in order to increase the number of patients treated with primary coronary angioplasty and, more in general, with reperfusion therapy, speed up the diagnostic and therapeutic processes, and ultimately improve the outcome. The \"RETE IMA WEB\" survey was launched in 2007 from the Italian Society of Invasive Cardiology (SICI-GISE) in collaboration with the FIC, with the aim of evaluating the current state of RSC for STEMI in Italy. The personnel of the 118 Emergency System participated in the survey. Data collection was made using different electronic forms with access limited by personal passwords. We assessed the organization of the RSC together with local resource availability, with specific attention to the distance from a Hub center. The survey ended in December 31, 2008. We censored 701 hospitals admitting STEMI patients, 157 (22.4%) with uninterrupted access (h24/7 days) to the catheterization laboratory (2.67 per million inhabitants). An operative network was present in 36/103 (35.9%) provinces, with important geographic variability. Among hospitals without a full-time primary angioplasty facility, only 46% was within a RSC. ECG was available in 72% of the national territory, telemedicine in 50%. Prehospital fibrinolysis was available in 16% of the country. Overall, 92.4% of the Italian population resides within 60 min of a Hub center. In 2008, despite an adequate framework, the RSC for STEMI in Italy was heterogeneous and still suboptimal. Healthcare administrators, scientific societies and all operators involved in the process of care for STEMI should make efforts to implement current guidelines.

Earlier studies on the direct effect of social support and social network upon mental health have mostly been done in cross-sectional studies and the results have been conflicting. The direct effect of social network and social support upon mental distress was tested in population-based health surveys conducted in 1987, 1990 and 1993. The population consisted of all persons aged 40-62 years and a random sample of persons aged between 20 and 39 years living in five small municipalities in Finnmark, the northernmost county in Norway. The attendance rates were 77%, 74% and 70% for the three health surveys, respectively. All those who had attended the health surveys more than once and answered the key questions about mental distress, social support and social network were selected for analyses (966 persons who attended both the two first health surveys and 1425 persons attending both the two last surveys). A theoretical full cross-lagged panel model was used to search for the predictive effects of time 1 variables (mental distress, social network and social support) upon corresponding subsequent variables. Mental distress, social support and social network at time 1 strongly predicted the corresponding variable at the next time point. Emotional support at time 1 exerted a weak positive effect upon mental distress on the next time point, explaining approximately 1% of the variance. Neither the social network nor instrumental support at time 1 predicted degree of mental distress at the subsequent time point. We conclude that social network and social support have very little direct predictive effect upon mental distress 3 years later in this population.