Malaria burden and costs of intensified control in Bhutan, 2006-2014: A situational analysis

- Introduction Malaria cases have dwindled in Bhutan with aim of malaria elimination by 2016. The aims of this study are to determine the trends and burden of malaria, the costs of intensified control activities, the main donors of the control activities and the costs of different preventive measures in the pre-elimination phase (2006-2014). - Methods A descriptive analysis of malaria surveillance data from 2006-2014 was carried out, using data from the Vector-borne Disease Control Programme (VDCP), Bhutan. Malaria morbidity and mortality among local Bhutanese and foreign nationals were analysed. The cost of different control and preventive measures, and estimation of the average numbers of long-lasting insecticidal nests (LLINs) per person were calculated. - Findings There were 5,491 confirmed malaria cases from 2006 to 2014. By 2013, there was an average of one LLIN for every 1·51 individuals. The Global Fund was the main international donor accounting for > 80% of the total funds. The cost of procuring LLINs accounted for > 90% of the total cost of prevention measures. - Interpretation The malaria burden reduced significantly over the study period with high coverage of LLINs in Bhutan. This foreseeable challenges that require national attention to maintain malaria-free status after elimination are importation of malaria, particularly from India; continued protection of the population in endemic districts through complete coverage with LLINs and IRS; and exploration of local funding modalities post elimination in the event there is a reduction in international funding.

What is a “Christian” jurisprudence?

The term ‘jurisprudence’ is derived etymologically from the Latin juris, meaning law, and prudentia, meaning wisdom. So jurisprudence simply means the wisdom of the law, or, as it has come to mean in scholarly legal circles these days, the theory of law. It asks fundamental questions regarding the nature and definition of law. And so, the question I wish to pose to us today is what does a truly “Christian” theory of law look like? One that is faithful to, as taken from the conference brochure, the “historic Christian faith” in its “principles and practice”. To contextualise this question, I must give you a deceptively brief and superficial overview of prevailing theories of law – and for those of you who know more about the topic, I apologise for the crass nature of my summary – time prevents me from doing any more...

The Frontiers of India's Biological Diversity

India has a long and rich history of tropical science. But here, as elsewhere in the tropical world, there are surprises to be discovered. One thinks immediately of the description, in December 2004, of a new species of macaque from India - the Arunachal macaque Macaca munzala. I use the word description deliberately, because this species was long known to the local people, and the species name rightly reflects this knowledge. Mun zala means "deep-forest monkey" in the language of the Dirang Monpa people of Tawang and West Kameng Districts of Arunachal Pradesh, where this species lives. The new macaque was discovered by science during field trips to these areas by Indian scientists from the Nature Conservation Foundation in Mysore, the National Institute of Advanced Studies in Bangalore, the Wildlife Conservation Society in New York, and the International Snow Leopard Trust. In this habitat, the largely Buddhist local community abstains from killing wildlife for food or sport, although the monkey has been reportedly shot for crop raiding. This species, one of the world's highest-living primate species, lives at altitudes between 1,600 and 3,500m, and is thus a veritable yeti.

Effects of large-scale human land use on Capercaillie (Tetrao urogallus L.) populations in Finland

The Capercaillie (Tetrao urogallus L.) is often used as a focal species for landscape ecological studies: the minimum size for its lekking area is 300 ha, and the annual home range for an individual may cover 30 80 km2. In Finland, Capercaillie populations have decreased by approximately 40 85%, with the declines likely to have started in the 1940s. Although the declines have partly stabilized from the 1990s onwards, it is obvious that the negative population trend was at least partly caused by changes in human land use. The aim of this thesis was to study the connections between human land use and Capercaillie populations in Finland, using several spatial and temporal scales. First, the effect of forest age structure on Capercaillie population trends was studied in 18 forestry board districts in Finland, during 1965 1988. Second, the abundances of Capercaillie and Moose (Alces alces L.) were compared in terms of several land-use variables on a scale of 50 × 50 km grids and in five regions in Finland. Third, the effects of forest cover and fine-grain forest fragmentation on Capercaillie lekking area persistence were studied in three study locations in Finland, on 1000 and 3000 m spatial scales surrounding the leks. The analyses considering lekking areas were performed with two definitions for forest: > 60 and > 152 m3ha 1 of timber volume. The results show that patterns and processes at large spatial scales strongly influence Capercaillie in Finland. In particular, in southwestern and eastern Finland, high forest cover and low human impact were found to be beneficial for this species. Forest cover (> 60 m3ha 1 of timber) surrounding the lekking sites positively affected lekking area persistence only at the larger landscape scale (3000 m radius). The effects of older forest classes were hard to assess due to scarcity of older forests in several study areas. Young and middle-aged forest classes were common in the vicinity of areas with high Capercaillie abundances especially in northern Finland. The increase in the amount of younger forest classes did not provide a good explanation for Capercaillie population decline in 1965 1988. In addition, there was no significant connection between mature forests (> 152 m3ha 1 of timber) and lekking area persistence in Finland. It seems that in present-day Finnish landscapes, area covered with old forest is either too scarce to efficiently explain the abundance of Capercaillie and the persistence of the lekking areas, or the effect of forest age is only important when considering smaller spatial scales than the ones studied in this thesis. In conclusion, larger spatial scales should be considered for assessing the future Capercaillie management. According to the proposed multi-level planning, the first priority should be to secure the large, regional-scale forest cover, and the second priority should be to maintain fine-grained, heterogeneous structure within the separate forest patches. A management unit covering hundreds of hectares, or even tens or hundreds of square kilometers, should be covered, which requires regional-level land-use planning and co-operation between forest owners.

Impacts of agriculture on amphibians at multiple scales

Agriculture-mediated habitat loss and degradation together with climate change are among the greatest global threats to species, communities, and ecosystem functioning. During the last century, more than 50% of the world's wetlands have been lost and agricultural activities have subjected wetland species to increased isolation and decreased quality of habitats. Likewise, as a part of agricultural intensification, the use of pesticides has increased notably, and pesticide residues occur frequently in wetlands making the exposure of wetland organisms to pesticides highly probable. In this thesis, a set of ecotoxicological and landscape ecological studies were carried out to investigate pesticide-effects on tadpoles, and species-habitat relationships of amphibians in agricultural landscapes. The results show that the fitness of R. temporaria tadpoles can be negatively affected by sublethal pesticide concentrations, and that pesticides may increase the costs of response to natural environmental stressors. However, tadpoles may also be able to compensate for some of the negative effects of pesticides. The results further demonstrate that both historic and current-day agricultural land use can negatively impact amphibians, but that in some cases the costs of living in agricultural habitats may only become apparent when amphibians face other environmental stressors, such as drought. Habitat heterogeneity may, however, increase the persistence of amphibians in agricultural landscapes. Hence, the results suggest that amphibians are likely to be affected by agricultural processes that operate at several spatial and temporal scales, and that it is probable that various processes related to current-day agriculture will affect both larval and adult amphibians. The results imply that maintaining dense wetland patterns could enhance persistence of amphibian populations in agricultural habitats, and indicate that heterogeneous landscapes may lower the risk of regional amphibian population declines under extreme weather perturbations.

Phytoplankton ecology of subarctic lakes in Finnish Lapland

Climate is warming and it is especially seen in arctic areas, where the warming trend is expected to be greatest. Arctic freshwater ecosystems, which are a very characteristic feature of the arctic landscape, are especially sensitive to climate change. They could be used as early warning systems, but more information about the ecosystem functioning and responses are needed for proper interpretation of the observations. Phytoplankton species and assemblages could be especially suitable for climate-related studies, since they have short generation times and react rapidly to changes in the environment. In addition, phytoplankton provides a good tool for lake classifications, since different species have different requirements and tolerance ranges for various environmental factors. The use of biological indicators is especially useful in arctic areas, were many of the chemical factors commonly fall under the detection limit and therefore do not provide much information about the environment. This work brings new information about species distribution and dynamics of arctic freshwater phytoplankton in relation to environmental factors. The phytoplankton of lakes in Finnish Lapland and other European high-altitude or high-latitude areas were compared. Most lakes were oligotrophic and dominated by flagellated species belonging to chrysophytes, cryptophytes and dinoflagellates. In Finnish Lapland cryptophytes were of less importance, whereas desmids had high species richness in many of the lakes. In Pan-European scale, geographical and catchment-related factors were explaining most of the differences in species distributions between different districts, whereas lake water chemistry (especially conductivity, SiO2 and pH) was most important regionally. Seasonal and interannual variation of phytoplankton was studied in subarctic Lake Saanajärvi. Characteristic phytoplankton species in this oligotrophic, dimictic lake belonged mainly to chrysophytes and diatoms. The maximum phytoplankton biomass in Lake Saanajärvi occurs during autumn, while spring biomass is very low. During years with heavy snow cover the lake suffers from pH drop caused by melt waters, but the effects of this acid pulse are restricted to surface layers and last for a relatively short period. In addition to some chemical parameters (mainly Ca and nutrients), length of the mixing cycle and physical factors such as lake water temperature and thermal stability of water column had major impact on phytoplankton dynamics. During a year with long and strong thermal stability, the phytoplankton community developed towards an equilibrium state, with heavy dominance of only a few taxa for a longer period of time. During a year with higher windiness and less thermal stability, the species composition was more diverse and species with different functional strategies were able to occur simultaneously. The results of this work indicate that although arctic lakes in general share many common features concerning their catchment and water chemistry, large differences in biological features can be found even in a relatively small area. Most likely the lakes with very different algal flora do not respond in a similar way to differences in the environmental factors, and more information about specific arctic lake types is needed. The results also show considerable year to year differences in phytoplankton species distribution and dynamics, and these changes are most likely linked to climatic factors.

Development and evaluation of a spatial decision support system for malaria elimination in Bhutan

Background: Bhutan has reduced its malaria incidence significantly in the last 5 years, and is aiming for malaria elimination by 2016. To assist with the management of the Bhutanese malaria elimination programme a spatial decision support system (SDSS) was developed. The current study aims to describe SDSS development and evaluate SDSS utility and acceptability through informant interviews. Methods: The SDSS was developed based on the open-source Quantum geographical information system (QGIS) and piloted to support the distribution of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) in the two sub-districts of Samdrup Jongkhar District. It was subsequently used to support reactive case detection (RACD) in the two sub-districts of Samdrup Jongkhar and two additional sub-districts in Sarpang District. Interviews were conducted to ascertain perceptions on utility and acceptability of 11 informants using the SDSS, including programme and district managers, and field workers. Results: A total of 1502 households with a population of 7165 were enumerated in the four sub-districts, and a total of 3491 LLINs were distributed with one LLIN per 1.7 persons. A total of 279 households representing 728 residents were involved with RACD. Informants considered that the SDSS was an improvement on previous methods for organizing LLIN distribution, IRS and RACD, and could be easily integrated into routine malaria and other vector-borne disease surveillance systems. Informants identified some challenges at the programme and field level, including the need for more skilled personnel to manage the SDSS, and more training to improve the effectiveness of SDSS implementation and use of hardware. Conclusions: The SDSS was well accepted and informants expected its use to be extended to other malaria reporting districts and other vector-borne diseases. Challenges associated with efficient SDSS use included adequate skills and knowledge, access to training and support, and availability of hardware including computers and global positioning system receivers.

An introduction to ophthalmic biomaterials and their role in tissue engineering and regenerative medicine

This chapter presents a brief history of the development of ophthalmic biomaterials. Particularities in the development of ophthalmic biomaterials are discussed and some of their historic priorities within the general field of biomaterials are revealed or emphasized. The chapter then discusses the role and integration of ophthalmic biomaterials in tissue engineering and regenerative medicine applications.

The application of learning analytics to improve learning: Questions from the academy

Since 2007, close collaboration between the Learning and Teaching Unit’s Academic Quality and Standards team and the Department of Reporting and Analysis’ Business Objects team resulted in a generational approach to reporting where QUT established a place of trust. This place of trust is where data owners are confident in date storage, data integrity, reported and shared. While the role of the Department of Reporting and Analysis focused on the data warehouse, data security and publication of reports, the Academic Quality and Standards team focused on the application of learning analytics to solve academic research questions and improve student learning. Addressing questions such as: • Are all students who leave course ABC academically challenged? • Do the students who leave course XYZ stay within the faculty, university or leave? • When students withdraw from a unit do they stay enrolled on full or part load or leave? • If students enter through a particular pathway, what is their experience in comparison to other pathways? • With five years historic reporting, can a two-year predictive forecast provide any insight? In answering these questions, the Academic Quality and Standards team then developed prototype data visualisation through curriculum conversations with academic staff. Where these enquiries were applicable more broadly this information would be brought into the standardised reporting for the benefit of the whole institution. At QUT an annual report to the executive committees allows all stakeholders to record the performance and outcomes of all courses in a snapshot in time or use this live report at any point during the year. This approach to learning analytics was awarded the Awarded 2014 ATEM/Campus Review Best Practice Awards in Tertiary Education Management for The Unipromo Award for Excellence in Information Technology Management.

Disease control and management

Globally, the main contributors to morbidity and mortality are chronic conditions, including cardiovascular disease and diabetes. Chronic disease is costly and partially avoidable, with around 60% of deaths and nearly 50% of the global disease burden attributable to these conditions. By 2020, chronic illnesses will likely be the leading cause of disability worldwide. Existing healthcare systems that focus on acute episodic health conditions, both national and international, cannot address the worldwide transition to chronic illness; nor are they appropriate for the ongoing care and management of those already dealing with chronic diseases. As such, chronic disease management requires integrated approaches that incorporate interventions targeted at both individuals and populations, and emphasise the shared risk factors of different conditions. International and Australian strategic planning documents articulate similar elements to manage chronic disease, including the need for aligning sectoral policies for health, forming partnerships, and engaging communities in decision-making. Infectious diseases are also a common and significant contributor to ill health throughout the world. In many countries, this impact has been minimised by the combined efforts of preventative health measures and improved treatment methods. However, in low-income countries, infectious diseases remain the dominant cause of death and disability. The World Health Organization (WHO) estimates that infectious diseases (including respiratory infections) still account for around 23% (or around 14 million) of all deaths each year, and result in over 4.6 billion episodes of diarrhoeal disease and 243 million cases of malaria each year (Lozano et al. 2012, WHO 2009). In addition to the high level of mortality, infectious diseases disable many hundreds of millions of people each year, mainly in developing countries, with the global burden of disease from infectious diseases estimated to be around 300 million DALYs (disability-adjusted life years) (WHO 2012). The aim of this chapter is to outline the impact that infectious diseases and chronic diseases have on the health of the community, describe the public health strategies used to reduce the burden of those diseases, and discuss the historic and emerging disease risks to public health. This chapter examines the comprehensive approaches implemented to prevent both chronic and infectious diseases, and to manage and care for communities with these conditions.

Speilelungen/Reflections

[Book] In recent years "light architecture" has returned as an important component of contemporary architectural design. More and more architects work with lighting designers in order to develop concepts for the nocturnal appearance of their buildings. It is little known that, despite numerous recent technical developments, the vocabulary of today's lighting designers has a long history. The large world fairs of the nineteenth century were the first testing ground for architectural illumination." "This publication juxtaposes historic buildings and architectural visions with recent designs, as well as with contemporary paintings and photographs that reacted to the changing nocturnal skyline. Essays address different aspects of this aspect of architectural history.

Process makes perfect: High-performance design creates healthy environments for high-performance learning

Considering the staggering benefits of high-performance schools, it seems an obvious choice to “go green.” High-performance schools offer an exceptionally cost-effective means to enhance student learning, using on average 33 percent less energy than conventionally designed schools, and provide substantial health gains, including reduced respiratory problems and absenteeism. According to the 2006 study, Greening America's Schools, Costs and Benefits, co-sponsored by the American Institute of Architects (AIA) and Capital E, a green building consulting firm, high-performance lighting is a key element of healthy learning environments, contributing to improved test scores, reduced off-task behavior, and higher achievement among students. Few argue this point more convincingly than architect Heinz Rudolf, of Portland-Oregon-based Boora Architects, who has designed sustainable schools for more than 80 school districts in Oregon, Washington, Colorado, and Wyoming, and has pioneered the high-performance school movement. Boora's recently completed project, the Baker Prairie Middle School in Canby, Oregon is one of the most sustainable K-12 facilities in the state, and illustrates Rudolf's progressive and research-intensive approach to school design.

Macroseismology as a Component of Seismicity Assessments in an Intraplate Region: Studies of Northern Europe with Emphasis on Finland

This work focuses on the role of macroseismology in the assessment of seismicity and probabilistic seismic hazard in Northern Europe. The main type of data under consideration is a set of macroseismic observations available for a given earthquake. The macroseismic questionnaires used to collect earthquake observations from local residents since the late 1800s constitute a special part of the seismological heritage in the region. Information of the earthquakes felt on the coasts of the Gulf of Bothnia between 31 March and 2 April 1883 and on 28 July 1888 was retrieved from the contemporary Finnish and Swedish newspapers, while the earthquake of 4 November 1898 GMT is an example of an early systematic macroseismic survey in the region. A data set of more than 1200 macroseismic questionnaires is available for the earthquake in Central Finland on 16 November 1931. Basic macroseismic investigations including preparation of new intensity data point (IDP) maps were conducted for these earthquakes. Previously disregarded usable observations were found in the press. The improved collection of IDPs of the 1888 earthquake shows that this event was a rare occurrence in the area. In contrast to earlier notions it was felt on both sides of the Gulf of Bothnia. The data on the earthquake of 4 November 1898 GMT were augmented with historical background information discovered in various archives and libraries. This earthquake was of some concern to the authorities, because extra fire inspections were conducted in three towns at least, i.e. Tornio, Haparanda and Piteå, located in the centre of the area of perceptibility. This event posed the indirect hazard of fire, although its magnitude around 4.6 was minor on the global scale. The distribution of slightly damaging intensities was larger than previously outlined. This may have resulted from the amplification of the ground shaking in the soft soil of the coast and river valleys where most of the population was found. The large data set of the 1931 earthquake provided an opportunity to apply statistical methods and assess methodologies that can be used when dealing with macroseismic intensity. It was evaluated using correspondence analysis. Different approaches such as gridding were tested to estimate the macroseismic field from the intensity values distributed irregularly in space. In general, the characteristics of intensity warrant careful consideration. A more pervasive perception of intensity as an ordinal quantity affected by uncertainties is advocated. A parametric earthquake catalogue comprising entries from both the macroseismic and instrumental era was used for probabilistic seismic hazard assessment. The parametric-historic methodology was applied to estimate seismic hazard at a given site in Finland and to prepare a seismic hazard map for Northern Europe. The interpretation of these results is an important issue, because the recurrence times of damaging earthquakes may well exceed thousands of years in an intraplate setting such as Northern Europe. This application may therefore be seen as an example of short-term hazard assessment.

The Culture of Women's Housework : A Case Study of Bihar, India

This study examines gendered housework in India, particularly in Bihar. The perspective adopted in the study was in part derived from the data but also from sociological literature published both in Western countries and in India. The primary attention is therefore paid to modern and traditional aspects in housework. The aim is not to compare Indian practices to those of Western societies, but rather to use Western studies as a fruitful reference point. In that light, Indian housework practices appear to be traditional. Consequently, traditions are given a more significant role than is usually the case in studies on gendered housework, particularly in Western countries. The study approaches the topic mainly from the socio-cultural perspective; this provides the best means to understand the persistence of traditional habits in India. To get a wide enough picture of the division of labour, three methods were applied in the study: detailed time-use data, questionnaire and theme interviews. The data were collected in 1988 in two districts of Bihar, one rural and the other urban. The different data complement each other well but also bring to light contradictory findings: on a general level Biharian people express surprisingly modern views on gender equality but when talking in more detail (theme interviews) the interviewees told about how traditional housework practices still were in 1988. In the analysis of the data set four principal themes are discussed. Responsibility is the concept by which the study aims at understanding the logic of the argumentation on which the persistence of traditional housework practices is grounded. Contrary to the Western style, Biharian respondents appealed not to the principle of choice but to their responsibility to do what has to be done. The power of tradition, the early socialization of children to the traditional division of labour and the elusive nature of modernity are all discussed separately. In addition to the principle of responsibility, housework was also seen as an expression of affection. This was connected to housework in general but also to traditional practices. The purity principle was the third element that made Biharian interviewees favour housework in general, but as in the case of affection it too was interwoven with traditional practices. It seems to be so that if housework is in general preferred, this leads to preferring the traditional division of labour, too. The same came out when examining economic imperatives. However, the arguments concerning them proved to be rational. In analysing them it became clear that the significance of traditions is also much dependent on the economics: as far as the average income in India is very low, the prevalence of traditional practices in housework will continue. However, to make this work, cultural arguments are required: their role is to mediate more smoothly the iron rules of the economy. Key words: family, gendered housework, division of labour, responsibility, family togetherness, emotion, economy of housework, modernity, traditionality

Kaupungin savut ja käryt : Helsingin ilmansuojelu 1945-1982

The smoke and fumes of the city: Air protection in Helsinki from 1945 to 1982 This dissertation examines air pollution and air protection in post-war Helsinki. The period studied ends in 1982 when the Air Protection Act entered into force, thus institutionalising air protection in Finland as a socially governed environmental matter. The dissertation is based on the research traditions of environmental politics and urban environmental history. The development of air protection is approached from the perspectives of politicisation and institutionalisation. The dissertation also investigates how air pollution grew into a social issue and presents various discursive ways of analysing air pollution and protection. The primary research material consists of municipal documents and newspapers, while supplementary material includes journal articles and interviews. The event history of air protection is described through an analysis of the material, including source criticism. The social ways of dealing with air pollution and the emergence of air protection are analysed in the light of case-specific air quality disputes from both factual and discursive perspectives. This approach enables the contextualisation of the development of air protection as part of the local history of post-war Helsinki. The dissertation presents the major sources of air pollution in Helsinki and describes the deterioration of air quality in a society which emphasised the primacy of economic prosperity. The air issue emerged during the 1950s in neighbourhood disputes and was exacerbated into a larger problem in the late 1960s. Concurrent to the formation of the field of environmental protection in Finland, an air protection organisation was established in the 1970s in Helsinki. As a result, air protection became a regular part of municipal government. Air protection in Helsinki developed from small-scale policies focused on individual cases into a large, institutionalised air protection system managed by experts. The dissertation research material gave rise to the following major research themes: the economic dimension of the air issue, the role of science in the formation of the environmental problem, and the establishment of norms for acceptable air quality and reasonable limits to air pollution in the urban environment. The paper also discusses the inequitable distribution of the negative effects of air pollution between the residents of different districts. The dissertation concludes that air protection in Helsinki became a local success story although it was long marred by inefficiency and partial failure.