Platypnea–orthodeoxia syndrome in a child: relief of symptoms after transcatheter closure of patent foramen ovale

Platypnea–orthodeoxia syndrome is a rare clinical entity characterised by positional dyspnoea and arterial desaturation while in the upright position, the symptoms generally occurring in adults. We describe a 12-year-old girl diagnosed with platypnea–orthodeoxia syndrome associated with patent foramen ovale. The symptoms resolved following percutaneous patent foramen ovale closure.

A nest for new Lithuanians: Hostels, discipline and nation-building in Ober Ost and Russia, 1914–1919

World War I represented a turning point not only for the emergence of the Lithuanian nation-state but also for the implementation of nation-building practices. Throughout wartime, the Lithuanian War Relief Committee profited from its position as a tool to develop a network of facilities devoted to children assistance. While having unprecedented rights to autonomously administer relief facilities, the Committee, as far as financial conditions allowed it, supported isolation in hostels as the favourite child relief format. Through formal and informal educational activities as well as the adoption of particular hygiene norms and, later, children relocation, the Lithuanian élite tried and transformed hostels and relief in veritable tools of nation-building aimed at transforming children in would-be conscious nationals. The goal to create prototypical Lithuanians, however, at least partially failed due by children’s alternative (if not opposite) agency.

Sustained effectiveness of automatic chlorinators installed in community-scale water distribution systems during an emergency recovery project in Haiti

In 2012 and 2013, as part of relief-to-recovery programming, Child Relief International partnered with Haiti Philanthropy to install automatic tablet-based chlorinators in 79 gravity-fed water distribution systems in Southeast Department, Haiti. We carried out a mixed methods evaluation to assess sustained effectiveness of chlorinators approximately two years after installation, including 18 site assessments of chlorinators and distribution systems, 180 surveys of households served by those systems and 17 key informant interviews. We tested for free chlorine residual and Escherichia coli in samples collected from sources, reservoirs, water access points, and treated and untreated household stored water. We found: 83% of chlorinators were in operational condition, although water pressure was sufficient to operate chlorinators at only 56% of sites; 0% of chlorinator sites had tablet stock; and, while 86% of households reported using water from distribution systems with a chlorinator, 0% of household drinking water was safe to drink because of chlorinators. Reasons why the chlorinator project did not achieve intended sustained effectiveness included: lack of accountability for infrastructure maintenance; lack of tablet access; and lack of effective community management systems. We recommend future implementers of centralized water treatment systems in relief-to-recovery contexts consider these three components necessary for sustainability.

HOW EFFECTIVE ARE PRONATALIST BENEFITS? A LITERATURE SURVEY AND A STUDY ON SINGAPORE'S QUALIFIED CHILD RELIEF

This paper reviews the existing literature on impacts of pronatalist benefits on fertility in various countries, and estimates the impact of the Qualified Child Relief (QCR) on the total fertility rate (TFR) of Singapore. The studies surveyed in this paper generally find that pronatalist incentives contribute to raising the fertility rate, but only to a limited extent. In Singapore, a 1% increase in the QCR is estimated to increase the TFR by 0.1–0.2%. Singapore's fertility rate is also found to be positively correlated with men's earnings and the infant mortality rate, while negatively correlated with women's earnings and the unemployment rate. Evidence that the New Population Policy of 1987 has been effective in raising the fertility rate is also found.