Striving for sustainable global democracy through a group decision-making process: a critical review of an online course to model transformative praxis

The Journal is an open access journal. All articles are made freely available to readers.Our open access policy is in in accordance with the Budapest Open Access Initiative (BOAI) definition - it means that articles have free availability on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself.Sustainability is not simply about changing practices but more centrally about agreeing to change practices together’ (Flanagan et al. 2011). To achieve such ends, groups need to improve processes for making complex decisions together. The challenge faced recently in Copenhagen (including a large number of diverse participants in policy discussions) indicates the need for new ways to mprove discursive democracy. Poverty and climate change are ‘wicked’ problems (Rittel and Webber 1984) that comprise many diverse interrelated variables and that have a strong value and emotional dimension. The shortcomings of many approaches to these problems is that they are expert driven, do not involve the public in decision making, and have a narrow focus on technical issues. They do not consider issues in terms of their interrelated complexity with human cultural issues and values. This paper addresses the transboundary conundrum of how to address complex social and environmental challenges while engaging with people's diverse values and emotion

Serologic evidence for the presence in Pteropus bats of a paramyxovirus related to equine morbillivirus.

Two outbreaks of a previously unknown disease in horses and humans occurred in Queensland in 1994. The outbreaks occurred within 1 month of each other in Brisbane and Mackay, which are approximately 1000 km apart. In the Brisbane incident, 21 horses were infected of which 14 died or were euthanized after severe clinical signs of an acute respiratory disease. Two human cases were in patients with less well defined clinical signs; one patient died (1,2). In the Mackay incident two horses became seriously ill and died, and one person also died (3). Although it is now known that the two outbreaks occurred in August and September 1994, knowledge of the Mackay outbreak did not occur until late 1995 when the infected person died of a relapsing encephalitis. The name equine morbillivirus (EMV) has been proposed for a paramyxovirus isolated from four of the Brisbane horses and the first patient who died (2)

Integrated morbidity mapping of lymphatic filariasis and podoconiosis cases in 20 co-endemic districts of Ethiopia

Background: Lymphatic filariasis (LF) and podoconiosis are neglected tropical diseases (NTDs) that pose a significant physical, social and economic burden to endemic communities. Patients affected by the clinical conditions of LF (lymphoedema and hydrocoele) and podoconiosis (lymphoedema) need access to morbidity management and disability prevention (MMDP) services. Clear estimates of the number and location of these patients are essential to the efficient and equitable implementation of MMDP services for both diseases. Methodology/Principle findings: A community-based cross-sectional study was conducted in Ethiopia using the Health Extension Worker (HEW) network to identify all cases of lymphoedema and hydrocoele in 20 woredas (districts) co-endemic for LF and podoconiosis. A total of 612 trained HEWs and 40 supervisors from 20 districts identified 26,123 cases of clinical morbidity. Of these, 24,908 (95.3%) reported cases had leg lymphoedema only, 751 (2.9%) had hydrocoele, 387 (1.5%) had both leg lymphoedema and hydrocoele, and 77 (0.3%) cases had breast lymphoedema. Of those reporting leg lymphoedema, 89.3% reported bilateral lymphoedema. Older age groups were more likely to have a severe stage of disease, have bilateral lymphoedema and to have experienced an acute attack in the last six months. Conclusions/Significance: This study represents the first community-wide, integrated clinical case mapping of both LF and podoconiosis in Ethiopia. It highlights the high number of cases, particularly of leg lymphoedema that could be attributed to either of these diseases. This key clinical information will assist and guide the allocation of resources to where they are needed most

Community-based field implementation scenarios of a short message service reporting tool for lymphatic filariasis case estimates in Africa and Asia

BACKGROUND: Lymphatic filariasis (LF) is a neglected tropical disease (NTD) targeted for global elimination by 2020. Currently there is considerable international effort to scale-up morbidity management activities in endemic countries, however there remains a need for rapid, cost-effective methods and adaptable tools for obtaining estimates of people presenting with clinical manifestations of LF, namely lymphoedema and hydrocele. The mHealth tool 'MeasureSMS-Morbidity' allows health workers in endemic areas to use their own mobile phones to send clinical information in a simple format using short message service (SMS). The experience gained through programmatic use of the tool in five endemic countries across a diversity of settings in Africa and Asia is used here to present implementation scenarios that are suitable for adapting the tool for use in a range of different programmatic, endemic, demographic and health system settings. METHODS: A checklist of five key factors and sub-questions was used to determine and define specific community-based field implementation scenarios for using the MeasureSMS-Morbidity tool in a range of settings. These factors included: (I) tool feasibility (acceptability; community access and ownership); (II) LF endemicity (high; low prevalence); (III) population demography (urban; rural); (IV) health system structure (human resources; community access); and (V) integration with other diseases (co-endemicity). RESULTS: Based on experiences in Bangladesh, Ethiopia, Malawi, Nepal and Tanzania, four implementation scenarios were identified as suitable for using the MeasureSMS-Morbidity tool for searching and reporting LF clinical case data across a range of programmatic, endemic, demographic and health system settings. These include: (I) urban, high endemic setting with two-tier reporting; (II) rural, high endemic setting with one-tier reporting; (III) rural, high endemic setting with two-tier reporting; and (IV) low-endemic, urban and rural setting with one-tier reporting. CONCLUSIONS: A decision-making framework built from the key factors and questions, and the resulting four implementation scenarios is proposed as a means of using the MeasureSMS-Morbidity tool. This framework will help national LF programmes consider appropriate methods to implement a survey using this tool to improve estimates of the clinical burden of LF. Obtaining LF case estimates is a vital step towards the elimination of LF as a public health problem in endemic countries

Influence of river discharge on grass carp occupancy dynamics in south‐eastern Iowa rivers

Despite the longstanding presence of grass carp Ctenopharyngodon idella in the Upper Mississippi River (UMR) watershed, information regarding their populations remains largely unknown, in part because capture is difficult. Occupancy models are a popular wildlife assessment tool to account for imperfect detections but have been slow to be adopted in fisheries. Herein, we used occupancy modelling to evaluate the influence of two environmental covariates (river discharge and water temperature) on grass carp occupancy, extinction, colonization, and detection at nine sites within south‐eastern Iowa rivers from April to October 2014 and 2015. Grass carp were detected at least once at all but one site. The most parsimonious model indicated that grass carp colonization probability increased from 0.15 to 0.67 with increases in river discharge. In contrast, occupancy (0.20), extinction (0.29), and detection (0.50) probabilities were temporally constant. Models indicated that water temperatures did not influence grass carp extinction or colonization probabilities relative to river discharge. Cumulative grass carp detection probability approached 1.0, whereas conditional occupancy estimates were less than 0.1 when using five or more sampling transects. The use of a robust design occupancy model allowed us to estimate site occupancy rates of grass carp corrected for imperfect detections, while demonstrating the importance of river discharge for site colonization. These results can be used to assess the distribution of a cryptic fish while helping to guide grass carp sampling and removal efforts

Oral rehydration versus intravenous therapy for treating dehydration due to gastroenteritis in children: a meta-analysis of randomised controlled trials

BACKGROUND: Despite treatment recommendations from various organizations, oral rehydration therapy (ORT) continues to be underused, particularly by physicians in high-income countries. We conducted a systematic review of randomised controlled trials (RCTs) to compare ORT and intravenous therapy (IVT) for the treatment of dehydration secondary to acute gastroenteritis in children. METHODS: RCTs were identified through MEDLINE, EMBASE, CENTRAL, authors and references of included trials, pharmaceutical companies, and relevant organizations. Screening and inclusion were performed independently by two reviewers in order to identify randomised or quasi-randomised controlled trials comparing ORT and IVT in children with acute diarrhea and dehydration. Two reviewers independently assessed study quality using the Jadad scale and allocation concealment. Data were extracted by one reviewer and checked by a second. The primary outcome measure was failure of rehydration. We analyzed data using standard meta-analytic techniques. RESULTS: The quality of the 14 included trials ranged from 0 to 3 (Jadad score); allocation concealment was unclear in all but one study. Using a random effects model, there was no significant difference in treatment failures (risk difference [RD] 3%; 95% confidence intervals [CI]: 0, 6). The Mantel-Haenzsel fixed effects model gave a significant difference between treatment groups (RD 4%; 95% CI: 2, 5) favoring IVT. Based on the four studies that reported deaths, there were six in the IVT groups and two in ORT. There were no significant differences in total fluid intake at six and 24 hours, weight gain, duration of diarrhea, or hypo/hypernatremia. Length of stay was significantly shorter for the ORT group (weighted mean difference [WMD] -1.2 days; 95% CI: -2.4,-0.02). Phlebitis occurred significantly more often with IVT (number needed to treat [NNT] 33; 95% CI: 25,100); paralytic ileus occurred more often with ORT (NNT 33; 95% CI: 20,100). These results may not be generalizable to children with persistent vomiting. CONCLUSION: There were no clinically important differences between ORT and IVT in terms of efficacy and safety. For every 25 children (95% CI: 20, 50) treated with ORT, one would fail and require IVT. The results support existing practice guidelines recommending ORT as the first course of treatment in appropriate children with dehydration secondary to gastroenteritis

Social group membership before treatment for substance dependence predicts early identification and engagement with treatment communities

Social relationships play a major role in recovery from substance dependence. To date, greater attention has been paid to the role of important individuals in a person’s life and their contribution to recovery following treatment. This study is the first to examine both individual and wider group-based social connections in the lead up to residential treatment for substance misuse in a therapeutic community (TC), and their influence both on a person’s readiness to engage with the treatment community and with a recovery pathway. Participants were 307 adults interviewed early in treatment about their individual- and group-based social relationships prior to treatment entry, their social identification with the TC, as ‘a user’ and a person ‘in recovery’, their current recovery capital and quality of life. Correlational analysis showed that only pre-treatment group-based, and not individual, relationships, were significantly associated with developing social identification with the TC early in treatment. Moreover, results of hierarchical regression analyses indicated that identification with the TC was best predicted by the extent to which people saw themselves as being in recovery. Finally, mediation analysis indicated that TC identification was the mechanism through which social group memberships prior to treatment commencement protected quality of life in the early phases of treatment. These findings highlight the protective role that group memberships play in building early identification with the TC and supporting well-being in a critical period of transitioning to treatment

Tigers Need Cover: Multi-Scale Occupancy Study of the Big Cat in Sumatran Forest and Plantation Landscapes

The critically endangered Sumatran tiger (Panthera tigris sumatrae Pocock, 1929) is generally known as a forest-dependent animal. With large-scale conversion of forests into plantations, however, it is crucial for restoration efforts to understand to what extent tigers use modified habitats. We investigated tiger-habitat relationships at 2 spatial scales: occupancy across the landscape and habitat use within the home range. Across major landcover types in central Sumatra, we conducted systematic detection, non-detection sign surveys in 47, 17×17 km grid cells. Within each cell, we surveyed 40, 1-km transects and recorded tiger detections and habitat variables in 100 m segments totaling 1,857 km surveyed. We found that tigers strongly preferred forest and used plantations of acacia and oilpalm, far less than their availability. Tiger probability of occupancy covaried positively and strongly with altitude, positively with forest area, and negatively with distance-to-forest centroids. At the fine scale, probability of habitat use by tigers across landcover types covaried positively and strongly with understory cover and altitude, and negatively and strongly with human settlement. Within forest areas, tigers strongly preferred sites that are farther from water bodies, higher in altitude, farther from edge, and closer to centroid of large forest block; and strongly preferred sites with thicker understory cover, lower level of disturbance, higher altitude, and steeper slope. These results indicate that to thrive, tigers depend on the existence of large contiguous forest blocks, and that with adjustments in plantation management, tigers could use mosaics of plantations (as additional roaming zones), riparian forests (as corridors) and smaller forest patches (as stepping stones), potentially maintaining a metapopulation structure in fragmented landscapes. This study highlights the importance of a multi-spatial scale analysis and provides crucial information relevant to restoring tigers and other wildlife in forest and plantation landscapes through improvement in habitat extent, quality, and connectivity

Significant improvement in quality of life following surgery for hydrocoele caused by lymphatic filariasis in Malawi: A prospective cohort study

Lymphatic filariasis (LF) is a mosquito-borne parasitic infection that causes significant disabling and disfiguring clinical manifestations. Hydrocoele (scrotal swelling) is the most common clinical condition, which affects an estimated 25 million men globally. The recommended strategy is surgical intervention, yet little is known about the impact of hydrocoele on men’s lives, and how it may change if they have access to surger