Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH) – December 2014

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
December 2014 Vol. 36, No. 6
http://www.paho.org/journal/index.php?option=com_content&view=article&id=151&Itemid=266&lang=en

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ARTÍCULOS DE INVESTIGACIÓN ORIGINAL / ORIGINAL RESEARCH ARTICLES
Agendas de investigación priorizadas: un recurso estratégico para la salud en América Latina [Priority research agendas: a strategic resource for health in Latin America]
Francisco Becerra-Posada, Nelly Salgado de Snyder,Luis Gabriel Cuervo y Gabriela Montorzi

SPECIAL SECTION / SECCIÓN ESPECIAL
Preparación de los adultos mayores en los Estados Unidos para hacer frente a los desastres naturales: encuesta a escala nacional [Preparedness for natural disasters among older US adults: a nationwide survey]
Tala M. Al-rousan, Linda M. Rubenstein y Robert B. Wallace

Systems integration for global sustainability

Science
27 February 2015 vol 347, issue 6225, pages 921-1040
http://www.sciencemag.org/current.dtl

Review
Systems integration for global sustainability
Jianguo Liu1,*, Harold Mooney2, Vanessa Hull1, Steven J. Davis3, Joanne Gaskell4, Thomas Hertel5, Jane Lubchenco6, Karen C. Seto7, Peter Gleick8, Claire Kremen9, Shuxin Li1
Author Affiliations
1Center for Systems Integration and Sustainability, Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, USA.
2Department of Biology, Stanford University, Stanford, CA, USA.
3Department of Earth System Science, University of California, Irvine, CA, USA.
4World Bank, Washington, DC, USA.
5Department of Agricultural Economics, Purdue University, West Lafayette, IN, USA.
6Department of Integrative Biology, Oregon State University, Corvallis, OR, USA.
7School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA.
8The Pacific Institute, Oakland, CA, USA.
9Department of Environmental Science, Policy and Management, University of California, Berkeley, CA, USA.
Abstract
BACKGROUND
Many key global sustainability challenges are closely intertwined (examples are provided in the figure). These challenges include air pollution, biodiversity loss, climate change, energy and food security, disease spread, species invasion, and water shortages and pollution. They are interconnected across three dimensions (organizational levels, space, and time) but are often separately studied and managed. Systems integration—holistic approaches to integrating various components of coupled human and natural systems (for example, social-ecological systems and human-environment systems) across all dimensions—is necessary to address complex interconnections and identify effective solutions to sustainability challenges.

ADVANCES
One major advance has been recognizing Earth as a large, coupled human and natural system consisting of many smaller coupled systems linked through flows of information, matter, and energy and evolving through time as a set of interconnected complex adaptive systems. A number of influential integrated frameworks (such as ecosystem services, environmental footprints, human-nature nexus, planetary boundaries, and telecoupling) and tools for systems integration have been developed and tested through interdisciplinary and transdisciplinary inquiries. Systems integration has led to fundamental discoveries and sustainability actions that are not possible by using conventional disciplinary, reductionist, and compartmentalized approaches. These include findings on emergent properties and complexity; interconnections among multiple key issues (such as air, climate, energy, food, land, and water); assessment of multiple, often conflicting, objectives; and synergistic interactions in which, for example, economic efficiency can be enhanced while environmental impacts are mitigated. In addition, systems integration allows for clarification and reassignment of environmental responsibilities (for example, among producers, consumers, and traders); mediation of trade-offs and enhancement of synergies; reduction of conflicts; and design of harmonious conservation and development policies and practices.

OUTLOOK
Although some studies have recognized spillover effects (effects spilling over from interactions among other systems) or spatial externalities, there is a need to simultaneously consider socioeconomic and environmental effects rather than considering them separately. Furthermore, identifying causes, agents, and flows behind the spillover effects can help us to understand better and hence manage the effects across multiple systems and scales. Integrating spillover systems with sending and receiving systems through network analysis and other advanced analytical methods can uncover hidden interrelationships and lead to important insights. Human-nature feedbacks, including spatial feedbacks (such as those among sending, receiving, and spillover systems), are the core elements of coupled systems and thus are likely to play important roles in global sustainability. Systems integration for global sustainability is poised for more rapid development, and transformative changes aimed at connecting disciplinary silos are needed to sustain an increasingly telecoupled world.

Among Brazil, China, the Caribbean, and the Sahara Desert in Africa, there are complex human-nature interactions across space, time, and organizational levels. Deforestation in Brazil due to soybean production provides food for people and livestock in China. Food trade between Brazil and China also contributes to changes in the global food market, which affects other areas around the world, including the Caribbean and Africa, that also engage in trade with China and Brazil. Dust particles from the Sahara Desert in Africa—aggravated by agricultural practices—travel via the air to the Caribbean, where they contribute to the decline in coral reefs and soil fertility and increase asthma rates. These in turn affect China and Brazil, which have both invested heavily in Caribbean tourism, infrastructure, and transportation. Nutrient-rich dust from Africa also reaches Brazil, where it improves forest productivity.

Community Stabilization and Violence Reduction: Lessons from Darfur

Stability: International Journal of Security & Development
[accessed 28 February 2015]
http://www.stabilityjournal.org/articles

Community Stabilization and Violence Reduction: Lessons from Darfur
Zurab Elzarov
Abstract
Ravaged by years of conflict and environmental decline, Darfur’s economy has been unable to create sufficient opportunities for youth, creating a link between social instability and high concentration of youth without productive employment. In 2011, the United Nations-African Union Mission in Darfur (UNAMID) designed a community stabilization and violence reduction programme to bridge a critical gap between the increasing ‘youth bulge’ and the government’s capacity to deliver youth empowerment and job creation solutions to youth in Darfur, leading to militarization of youth. The programme offers vocational skills training and temporary employment of youth through implementation of community-based labour intensive projects (CLIPs). Youth are targeted in particular, since they are an essential part of the solution to resolving the conflict in Darfur. Youth tend to be directly involved in hostilities and are seen to be most likely to return to the battlefield. At the same time, youth are often the community members most open to engaging in post-conflict recovery and peacebuilding activities. Since the conception of the programme in 2011, a total of 58 projects were implemented in 45 communities, and directly targeted over 9,000 youth. In a situation where the peace agreement is non-inclusive and the level of violence against unarmed civilians is high, CLIPs have played an important role in community stabilization and violence reduction in Darfur, building trust, contributing to a secure environment and helping build the foundation for longer term peace and development. As recognition of its contribution to peace and stability in Darfur, in October 2014, UNAMID’s CLIPs programme received the UN 21 Award for Outstanding Vision.

Treatment-seeking Paths in the Management of Severe Malaria in Children under 15 Years of Age Treated in Reference Hospitals of Kinshasa, Democratic Republic of Congo

Tropical Medicine and Health
Vol. 43(2015) No. 1
https://www.jstage.jst.go.jp/browse/tmh/43/0/_contents

Original Papers
Treatment-seeking Paths in the Management of Severe Malaria in Children under 15 Years of Age Treated in Reference Hospitals of Kinshasa, Democratic Republic of Congo
Félicien Ilunga-Ilunga, Alain Levêque, Léon Okenge Ngongo, Samia Laokri, Michèle Dramaix
Released: February 04, 2015
Abstract
Background: In the Democratic Republic of Congo (DRC), few studies have focused on treatment-seeking paths selected by caretakers for the management of severe childhood malaria in an urban environment. The present study aims at describing the treatment-seeking paths according to the characteristics of households, as well as the subsequent impact on pre-hospitalisation delay and malarial fatality and on the main syndromes associated with severe childhood malaria. Methods: This descriptive study included data collected at nine hospitals in Kinshasa between January and November 2011. A total of 1,350 children, under 15 years of age and hospitalised for severe malaria, were included in the study. Results: Regarding the management of malaria, 31.5% of households went directly to the health centre or hospital while 68.5% opted for self-medication, church and/or traditional healing therapy. The most frequent first-line option was self-medication, adopted by more than 61.5% of households. Nevertheless, rational self-medication using antimalarial drugs recommended by the WHO (artemisinin-based combinations) was reported for only 5.5% of children. Only 12.5% of households combined 2 or 3 traditional options. The following criteria influenced the choice of a modern vs. traditional path: household socioeconomic level, residential environment, maternal education level and religious beliefs. When caretakers opted for traditional healing therapy, the pre-hospitalisation delay was longer and the occurrence of respiratory distress, severe anaemia and mortality was higher. Conclusion: The implementation of a malaria action plan in the Democratic Republic of Congo should take into account the diversity and pluralistic character of treatment-seeking behaviours in order to promote the most appropriate options (hospital and rational self-medication) and to avoid detrimental outcomes.