Search

Introduction: Displaced populations face disproportionately high risk of communicable disease outbreaks given the strains of travel, health care circumstances in their country of origin, and limited access to health care in receiving countries. Study Objective: Understanding the role of demographic characteristics in outbreaks is important for timely and efficient control measures. Accordingly, this study assesses chickenpox outbreaks in three large refugee camps on mainland Greece from 2016 – 2017, using clinical line-list data from Médecins du Monde (MdM) clinics. Methods: Clinical line-list data from MdM clinics operating in Elliniko, Malakasa, and Raidestos camps in mainland Greece were used to characterize chickenpox outbreaks in these camps. Logistic regression was used to compare the odds of chickenpox by sex, camp, and yearly increase in age. Incidences were calculated for age categories and for sex for each camp outbreak. Results: Across camps, the median age was 19 years (IQR: 7.00 - 30.00 years) for all individuals and five years (IQR: 2.00 - 8.00 years) for cases. Males were 55.94% of the total population and 51.32% of all cases. There were four outbreaks of chickenpox across Elliniko (n = 1), Malakasa (n = 2), and Raidestos (n = 1) camps. The odds of chickenpox when controlling for age and sex was lower for Malakasa (OR = 0.46; 95% CI, 0.38 - 0.78) and Raidestos (OR = 0.36; 95% CI, 0.24 - 0.56) when compared Elliniko. Odds of chickenpox were comparable between Malakasa and Raidestos (OR = 1.49; 95% CI, 0.92 - 2.42). Across all camps, the highest incidence was among children zero-to-five years of age. The sex-specific incidence chickenpox was higher for males than females in Elliniko and Malakasa, while the incidence was higher among females in Raidestos. Conclusion: As expected, individuals five years of age and under made up the majority of chickenpox cases. However, 12% of cases were teenagers or older, highlighting the need to consider atypical age groups in vaccination strategies and control measures. To support both host and displaced populations, it is important to consider risk-reduction needs for both groups. Including host communities in vaccination campaigns and activities can help reduce the population burden of disease for both communities. [ABSTRACT FROM AUTHOR]

The interactions between household size, capital, and adaptation to social-ecological change has been widely studied; however, little is known about the differences in everyday adaptation to social-ecological change across household structures. Joint family households are increasing in contexts where the nuclear family had previously been the norm, and remains a prevalent structure throughout the world. Thus, it is important to understand how these structures influence adaptation decision-making processes and outcomes. We draw on a survey of 448 self-identified household heads in three communities in northwestern Pakistan to assess everyday adaptation to social-ecological change. We demonstrate that livelihood and adaptation strategies vary across joint and nuclear family household structures because, in part, of joint family households' greater access to natural and human capital in comparison to nuclear family households. Finally, household livelihood decision makers often include other family members to expand beyond the oftenassumed husband-wife dyad. Our work highlights how everyday adaptations are expressions of existing opportunities in the space in which households are located, access to capital and resources that differ across household structures, and of various dynamics associated with household decision making. This points to the need for a nuanced understanding of how household structure influences everyday adaptation to social-ecological change and thereby shows the ways in which adaptive capacity is embedded within existing social systems and relationships, such as household structures. [ABSTRACT FROM AUTHOR]

Preconceived notions exist about small-scale farmers in the U.S. Beyond research on new and beginning farmers, few empirical studies have learned directly from small-scale farmers in the U.S. about their perspectives and experiences. By analyzing semi-structured interviews of small-scale farmers in Indiana, this study develops an in-depth understanding of the multi-dimensional motivations and experiences of small-scale farmers and the interconnected, multi-scalar challenges they face. The lack of social infrastructure to support small-scale farmers becomes paramount as they contend with dilemmas of engaging in pluriactivity, securing reliable labor, and navigating relationship building with consumers and peers for both short-term profits and long-term social capital. This study contributes to understanding how small-scale farmers' motivations, experiences, challenges, and strategies interact to shape their relationship to the land, their farming enterprise, and their perception of and position in the larger agro-ecological-social-economic system, and highlights the need to improve social infrastructure to support small-scale farmers. [ABSTRACT FROM AUTHOR]