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Greetings!
Today we're pleased to bring you recently published research from two DGHI faculty members. Both studies have important implications for policy and for the health of two very different populations. See the latest research to be published from the Positive Outcomes for Orphans research by Kathryn Whetten and her research team, and Eric Finkelstein's food labeling research.
If you missed our recent Global Health Exchange lectures, you can now listen to the podcast by Brandon Kohrt on global mental health and watch the video of Alessandro Tarozzi on micro-loans and bednets. A correction from last week's newsletter: The correct title of new faculty member Bei Wu is professor of nursing and global health.
Until next week,
Geelea Seaford and Everyone at DGHI
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DGHI Study Finds Child Labor is Prevalent Among Orphans
One in seven orphaned and abandoned children (OAC) in low- and middle-income countries is engaged in child labor, according to new research by DGHI researchers. With such organizations as UNICEF declaring that child labor is harmful  and should be eliminated, the cross-cultural study calls on policy makers and social service providers to pay close attention to the demands being placed on orphaned and abandoned children, particularly in rural areas and poor households with limited income sources. The Positive Outcomes for Orphans (POFO) research project led by Kathryn Whetten at DGHI's Center for Health Policy, is among the first to quantify the prevalence of child labor among OAC in low- and middle-income countries. The study includes 1,480 orphaned and children abandoned by one or both parents ages 6-12 living in family settings in Cambodia, Ethiopia, India, Kenya and Tanzania.
In a newly published paper in BioMed Central by lead author Rachel Whetten, POFO researchers found that children who tended to work more were female, healthy, lived in rural settings, and/or had caregivers who had no income. Another significant finding is a strong association between increased child labour and decreased school attendance. Whetten's research team conservatively found 60% of OAC engaged in work during the past week, and of those who worked, about 18% worked 28 or more hours. More than a fifth of the total children sampled met UNICEF's definition of child labor, which is work that exceeds a minimum number of hours depending on the age of the child and type of work.
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Study Finds Menu Labeling Had No Effect on Purchasing Behavior at Fast Food Chain
A study led by Eric Finkelstein, associate research professor of health services and global health at Duke-NUS and DGHI , found that nutrition facts labeling on fast food menus had no effect on consumer behavior.
As part of a comprehensive effort to stem the rise in obesity, King County, Washington State had imposed a mandatory menu labeling regulation on all restaurant chains with 15 or more locations beginning in January 2009. Restaurants had to disclose calorie information at the point of purchase.
Finkelstein worked with the public health department of Seattle and King County to carry out the food-purchasing behavior study at Taco Time locations, which found that in the 13 months after the legislation went into effect, purchasing behavior was identical to the locations where menu boards remained unchanged.
"Given the results of prior studies, we had expected the results to be small, but we were surprised that we could not detect even the slightest hint of changes in purchasing behavior as a result of the legislation," said Finkelstein. "The results suggest that mandatory menu labeling, unless combined with other interventions, may be unlikely to significantly influence the obesity epidemic."
As part of health care reform, the federal government has plans for a nationwide launch of mandatory nutrition information at the point of purchase for fast-food chains with 20 or more outlets.
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DGHI Hosts Talks on Global Mental Health and Development Economics
 Developing and executing a research intervention that is based on locally-identified needs, demonstrates cross-cultural collaboration and has long-term impact is vital for making sustainable gains in global health. This point is according to Emory University psychiatry resident Brandon Kohrt who shared his research with DGHI in last Wednesday's Global Health Exchange.
Kohrt's work is focused on the mental health and psychosocial care of former child soldiers of Nepal's Maoist Army. After the war which ended in 2006, Kohrt found that former child soldiers returned to communities where they were feared, stigmatized, and vulnerable to a myriad of abuses, including torture. Kohrt said children exposed to torture are six times more likely to develop mental health problems than other children.
In another Global Health Exchange held last week, senior research scholar in the Duke Department of Economics Alessandro Tarozzi shared his research on micro-loans and insecticide-treated bednets (ITNs), in which he found surprising results.
The randomized-controlled trial was conducted in 141 villages in the Indian state of Orissa, where malaria is a major public health problem. It involved the distribution of ITNs to 1,800 households, some who received ITNs for free and others who had to purchase them on credit with a one-year repayment.
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Appointments
Mohanan Now Holds Public Policy Appointment
DGHI faculty member Manoj Mohanan has accepted a new role as assistant professor of public policy at the Sanford School of Public Policy, effective July 1, 2011. This appointment complements his other positions at the Duke Global Health Institute, Department of Economics and the Department of Community and Family Medicine.
Mohanan's current research focuses on health systems in low- and middle-income countries, which includes an evaluation of health insurance, measurement of quality of care in primary care settings, and an impact evaluation of voucher programs for maternal and child health in India. Mohanan also leads DGHI's health systems strengthening research initiative, and teaches a course on the topic in DGHI's Master of Science in Global Health program.
 Paul Farmer Appointed University Professor
Global health leader and humanitarian Paul Farmer, who is also a member of the Duke Global Health Institute Board of Advisors, has been named a University Professor, Harvard's highest distinction for a faculty member. Farmer is an anthropologist and physician whose research has helped to revolutionize the strategies for treating infectious disease in some of the poorest corners of the world. Farmer is widely known as co-founder of Partners In Health, the international humanitarian organization that works cooperatively with communities to combat disease in resource-poor settings. Farmer becomes the first Kolokotrones University Professor, a chair established through a gift from Wendy and Theo Kolokotrones, M.B.A. '70.
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