A One Health Framework for the Evaluation of Rabies Control Programmes: A Case Study from Colombo City, Sri Lanka

<div><p>Background</p><p>One Health addresses complex challenges to promote the health of all species and the environment by integrating relevant sciences at systems level. Its application to zoonotic diseases is recommended, but few coherent frameworks exist that combine approaches from multiple disciplines. Rabies requires an interdisciplinary approach for effective and efficient management.</p><p>Methodology/Principal Findings</p><p>A framework is proposed to assess the value of rabies interventions holistically. The economic assessment compares additional monetary and non-monetary costs and benefits of an intervention taking into account epidemiological, animal welfare, societal impact and cost data. It is complemented by an ethical assessment. The framework is applied to Colombo City, Sri Lanka, where modified dog rabies intervention measures were implemented in 2007. The two options included for analysis were the control measures in place until 2006 (“baseline scenario”) and the new comprehensive intervention measures (“intervention”) for a four-year duration. Differences in control cost; monetary human health costs after exposure; Disability-Adjusted Life Years (DALYs) lost due to human rabies deaths and the psychological burden following a bite; negative impact on animal welfare; epidemiological indicators; social acceptance of dogs; and ethical considerations were estimated using a mixed method approach including primary and secondary data. Over the four years analysed, the intervention cost US $1.03 million more than the baseline scenario in 2011 prices (adjusted for inflation) and caused a reduction in dog rabies cases; 738 DALYs averted; an increase in acceptability among non-dog owners; a perception of positive changes in society including a decrease in the number of roaming dogs; and a net reduction in the impact on animal welfare from intermediate-high to low-intermediate.</p><p>Conclusions</p><p>The findings illustrate the multiple outcomes relevant to stakeholders and allow greater understanding of the value of the implemented rabies control measures, thereby providing a solid foundation for informed decision-making and sustainable control.</p></div

Is mindfulness Buddhist? (and why it matters).

Modern exponents of mindfulness meditation promote the therapeutic effects of "bare attention"--a sort of non-judgmental, non-discursive attending to the moment-to-moment flow of consciousness. This approach to Buddhist meditation can be traced to Burmese Buddhist reform movements of the first half of the 20th century, and is arguably at odds with more traditional Theravāda Buddhist doctrine and meditative practices. But the cultivation of present-centered awareness is not without precedent in Buddhist history; similar innovations arose in medieval Chinese Zen (Chan) and Tibetan Dzogchen. These movements have several things in common. In each case the reforms were, in part, attempts to render Buddhist practice and insight accessible to laypersons unfamiliar with Buddhist philosophy and/or unwilling to adopt a renunciatory lifestyle. In addition, these movements all promised astonishingly quick results. And finally, the innovations in practice were met with suspicion and criticism from traditional Buddhist quarters. Those interested in the therapeutic effects of mindfulness and bare attention are often not aware of the existence, much less the content, of the controversies surrounding these practices in Asian Buddhist history

Inscribing the Victor’s Land: Nationalistic Authorship in Sri Lanka’s Post-war Northeast

This article examines the nationalistic authorship of space in Sri Lanka’s post-conflict Northeast as part of the state’s nation-building strategy and as a continuation of a post-colonial process of Sinhala-Buddhist nationalistic revival. Exploring issues of historiography, conflict resolution, physical vehicles of ideology and collective memory, the article demonstrates how land policies, development and the tourism industry in a post-conflict context can go hand-in-hand with dispossession, militarisation and the humiliation of a ‘defeated’ minority community

The Talking Cure as Action: Freud's Theory of Ritual Revisited

Freud made creative use of late Victorian theories of ritual as empty modes of behavior, using the idea of seemingly meaningless ritual to offer a compelling comparison with obsessive behavior. However, analytic hours, with their repetitive frame and repetition of unconscious conflicts, have stronger links with rituals than Freud admitted. Recent theories highlight the extensive power of rituals to organize and instantiate models of effective action, especially in terms of the multifunctionality of language. These new theories of ritual offer in turn new tools for understanding the therapeutic action of analytic hours. © 2011 Association for the Advancement of Psychoanalysis