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In the face of increasingly frequent extreme weather events, the need to manage climate risk becomes more urgent, especially for the most vulnerable countries and communities. With the aim of reducing vulnerability, climate risk transfer in the form of climate risk insurance (CRI) has been gaining attention in climate policy discussions. When properly designed, CRI acts as a safety net against climate change impacts by providing financial support after an extreme weather event. Two main types of insurance enable payouts: indemnity (traditional) insurance or predefined parameters (index-based) insurance. Individuals, groups, or even governments may take out policies with either type of insurance and receive payouts directly (insurer to beneficiary payout) or indirectly (insurer to aggregator to beneficiary payout). Direct insurance is usually implemented at the micro-level with individual policyholders. Indirect insurance is usually implemented through group contracts at the meso-level through risk aggregators and at the macro-level through the state. While promising, risk transfer in the form of CRI also has its share of challenges. Within the United Nations Framework Convention on Climate Change, the lack of accessibility and affordability of CRI for poor and vulnerable groups have been identified as barriers to uptake. In light of climate justice, asking the poor and climate-vulnerable groups - most of whom do not contribute substantially to anthropogenic climate change - to solely carry the financial burden of risk transfer is anything but just. Employing a human rights-based approach to CRI may ensure that the resilience of poor and climate-vulnerable groups is enhanced in a climate-just manner. Indigenous peoples are some of the poorest and most climate vulnerable groups. Often marginalised, they rarely have access to social protection. The strong communal relationship of indigenous peoples facilitates their participation in community-based organisations (CBOs). CBOs are a suitable vehicle for meso-insurance, in which risk is aggregated and an insurance policy belongs to a group. In this way, CBOs can facilitate service provision that would otherwise be beyond the reach of individuals. Conclusions of this briefing paper draw on a conceptual analysis of meso-insurance and the results of field research conducted in March 2018 with indigenous Palaw’ans in the Philippines. We find that CRI needs to be attuned to the differential vulnerabilities and capacities of its beneficiaries. This is particularly true for poor and vulnerable people, for whom issues of accessibility and affordability need to be managed, and human rights and pro-poor approaches need to be ensured. In this context, meso-insurance is a promising approach when it provides accessibility and affordability and promotes a pro-poor and human rights-based approach of risk transfer by: Properly identifying and involving target beneficiaries and duty-bearers by employing pro-poor and human rights principles. Employing measures to improve the financial literacy of target beneficiaries. Designing insurance models from the bottom up. Briefing Paper

Endemic and imported vector- and rodent-borne infectious agents can be linked to high morbidity and mortality. Therefore, vector- and rodent-borne human diseases and the effects of climate change are important public health issues.For this review, the relevant literature was identified and evaluated according to the thematic aspects and supplemented with an analysis of surveillance data for Germany.Factors such as increasing temperatures, changing precipitation patterns, and human behaviour may influence the epidemiology of vector- and rodent-borne infectious diseases in Germany.The effects of climatic changes on the spread of vector- and rodent-borne infectious diseases need to be further studied in detail and considered in the context of climate adaptation measures.

Antimicrobial Resistance (AMR) is one of the top ten global public health threats facing humanity, alongside climate change. Here, we aim to summarise the effects of climate change (i.e. raise of temperature, change in humidity or precipitation) on spread of antibiotic resistance and on infections with antibiotic-resistant bacteria in Germany.We conducted a literature search with articles published between January 2012 and July 2022. Two authors screened titles, abstracts and full texts and extracted the data systematically.From originally 2,389 titles, we identified six studies, which met our inclusion criteria. These studies show that an increase in temperature may lead to higher antibiotic resistance rates and an increased risk of colonisation as well as spread of pathogens. Furthermore, the number of healthcare-associated infections increases with increased temperature. Data indicate that higher antibiotic use is present in areas with warmer mean temperature.European data are scarce, but all studies identified point towards an increasing AMR burden due to climate change. However, further studies are needed to draw attention to the links between climatic factors and AMR and develop targeted preventive measures.

This paper investigates the environmental conditions of nineteenth-century Istanbul’s healthscape. A hydroclimate June/July reconstruction of the Old World Drought Atlas (OWDA) shows the city repeatedly suffered from hot and arid summers throughout the century. Excessive heat produced swamps. Vector-borne diseases and waterborne diseases increased. Because of water scarcity and soaring temperatures, sanitary conditions deteriorated. Animals suffered and perished, the workforce declined, transportation costs increased, and living costs became extravagant. In particular, high firewood prices and water scarcity especially increased the costs of public baths. Climate change had destructive effects on the city’s early industrial period. The following text presents the long-term, cumulative stress on living beings and highlights how excessive summer temperatures affected the landscape and economy of nineteenth-century Istanbul.

In the debates over environmental impacts on migration, migration as adaptation has been acknowledged as a potential risk management strategy based on risk spreading and mutual insurance of people living spatially apart: migrants and family members that are left behind stay connected through a combination of financial and social remittances, joint decision-making and mutual commitment. Conceptualizing migration as adaptation through the lens of translocal livelihood systems enables us to identify the differentiated vulnerabilities of households and communities. COVID-19 and the restrictions on public life and mobility imposed by governments worldwide constituted a complex set of challenges for translocal systems and strategies, especially in the Global South. Focusing on examples, we highlight two points: first, the COVID-19 crisis shows the limits of migration and translocal livelihoods for coping with, and adapting to, climate and environmental risks. Second, as these restrictions hit on a systemic level and affect places of destination as well as origin, the crisis reveals specific vulnerabilities of the translocal livelihood systems themselves. Based on the translocal livelihoods approach, we formulate insights and recommendations for policies that move beyond the narrow, short-term focus on the support of migrant populations alone and address the longer-term root causes of the vulnerabilities in translocal livelihoods systems. Advances in Southeast Asian Studies, Vol. 16 No. 1 (2023): The COVID-19 Pandemic, (Im)Mobilities, and Migration in Southeast Asia

Snakes are threatened by habitat degradation and anthropogenic impacts, while accidental encounters between humans and snakes may result in snakebite incidents. Thus, the conservation of snakes snakebite problem, a global public health emergency, are interconnected. I found four primary needs for a combined solution to satisfy both above causes. A species distribution model was employed to identify the ecological niches of 29 venomous snake species from Bangladesh and of ten cobra species (Naja) from Asia. At the local scale, flood events, forest types, ecosystems, and climatic parameters were found to shape the range of snake species in Bangladesh. At the regional scale, anthropogenic factors, like snake habitat destruction, trade, exploitation, and snake killings are likely to be the main causes for the decrease in populations of Asian Naja. At both levels, climate change causes shrinking and fragmenting the ecological niches of snake species in Bangladesh and Asia. In Bangladesh, the studied species may lose more than 90% of their current climatic niche within the next 50 years. In the same timeframe, Asiatic Naja may lose an average of 56% (12- 100%) of the area of suitable climatic niches. If favourable niches cannot be preserved, many snake species might go extinct from several countries in Asia in a few decades, including Bangladesh. In addition, the present study estimated that there might be more than double the amount of annual snakebite incidents in Bangladesh than previously estimated. As climate change may cause geographical shifting of favourable niches, this change may also have consequences for the frequency of snakebites, so snakebite should be considered a climate driven dynamic public health problem. While analysing venom variations and the efficacy of antivenom, I found that venom should be sampled from geographically or ecologically isolated populations of each venomous snake, because isolated populations have shown distinct intraspecific venom variations. Im Fokus dieser Dissertation steht die Zerstörung des Lebensraumes von Schlangen durch anthropogene Einflüsse im Zusammenhang mit dem Auftreten von Schlangenbissen bei Menschen. Zum Schutz der Schlangen und dem Problem der Schlangenbisse wurden vier wesentliche Anforderungen erarbeitet. Mit Hilfe eines Artenverteilungsmodells wurden die ökologischen Nischen von 29 Giftschlangenarten aus Bangladesch und von zehn Kobraarten (Naja) aus Asien ermittelt. Auf lokaler Ebene wurde festgestellt, dass Überschwemmungen, Waldtypen, Ökosysteme und klimatische Parameter das Verbreitungsgebiet der Schlangenarten in Bangladesch beeinflussen. Auf regionaler Ebene sind anthropogene Faktoren wie die Zerstörung von Schlangenlebensräumen, Handel, Ausbeutung und Tötung von Schlangen wahrscheinlich die Hauptursachen für den Rückgang der Populationen der asiatischen Naja. Auf beiden Ebenen führt der Klimawandel zu einer Verkleinerung der ökologischen Nischen von Schlangenarten in Bangladesch und Asien. In Bangladesch könnten die untersuchten Arten innerhalb der nächsten 50 Jahre mehr als 90 % ihren derzeitigen Lebensraum verlieren (Asiatische Naja durchschnittlich 56 % (12 bis 100 %)). Wenn günstige Nischen nicht erhalten werden können, könnten viele Schlangenarten in einigen Ländern Asiens, darunter Bangladesch, in wenigen Jahrzehnten aussterben. Darüber hinaus wurde in der vorliegenden Studie geschätzt, dass die Zahl der jährlichen Schlangenbisse in Bangladesch mehr als doppelt so hoch sein könnte wie bisher angenommen. Da der Klimawandel zu einer geografischen Verschiebung günstiger Nischen führen kann, kann sich diese Veränderung auch auf die Häufigkeit von Schlangenbissen auswirken. Bei der Analyse von Giftvariationen und der Wirksamkeit von Antivenomen wurde festgestellt, dass isolierte Populationen deutliche intraspezifischere Giftvariationen zeigen.

Electronic health or E-Health is spreading extensively nowadays. E-Health solutions help to achieve the sustainability goal of increasing the expected lifetime while improving the quality of life by providing a constant healthcare monitoring. The focus of this work is on studying the detection of one of the cardiovascular diseases – Atrial Fibrillation (AF) arrhythmia, which has a severe influence on the heart health conditions and could even increase the risk of death. Therefore, it is important to detect it as early as possible. In this thesis we focused on studying various machine learning techniques for AF detection using short single lead ECG recordings. A web-based solution was built as a final prototype, which first simulates the reception of a recorded signal, conducts the preprocessing, makes a prediction of the AF presence, and visualizes the result. For the AF detection the relatively high accuracy score was achieved comparable to the one of the state-of-the-art. The work was based on the investigation of the proposed architectures and the usage of the database of signals from the 2017 PhysioNet/CinC Challenge. However, an additional constraint was introduced to the original problem formulation, since the idea of a future deployment on the resource-limited devices places the restrictions on the complexity of the computations being performed for achieving the prediction. Therefore, this constraint was considered during the development phase of the project.

Water treatment technologies are seen as the best alternative to be considered for adoption in developing countries where access to portable water supply that is free of pathogens is yet a challenge. This study intended to assess impact brought forth by a project, which employed a water treatment technology in rural settings of Morogoro Region in Tanzania. The project used solar photovoltaic panels to trap solar energy, converted to mechanical power to treat water with the help of sterilization ultraviolet membrane. A comparative analysis was used as an assessment framework to study impacts of the project with respect to the quality of approach used during the project life cycle. Determinants of impacts took into account social, economic and environment aspects whereas determinants of the quality of approaches taken considered six elements which are: character of participation; success, nature of institution and capacity building efforts; diversity, multiplicity and adaptability of ideas promoted by the project; accounting for heterogeneity and dynamism; understanding and use of local knowledge, skills, initiative and constraints; and recognizing the influence of external conditions, markets and policies. Results indicate that the project has intervened positively in the provision of safe portable water to the selected project sites. The quality of approaches taken had profound effect to the delivered impacts. These impacts are seen in the reduced recurring outburst of water-borne diseases such as typhoid and diarrhea. Another impact observed is in the downturn to a certain extent in the use of wood fuel for boiling. Reduced recurring of waterborne diseases has boosted pupils’ attendance at school. Furthermore, the study argues that adoption of water treatment technologies in rural settings has a potential to conserve the environment, improve health of people through the provision of safe portable water, which ultimately contribute to rural development. However, sustainability of the installed purification systems is in question if it will continue to function over the long run. Observed barriers are lack of solid economic means for sustaining operations and maintenances.

Die Planung klinischer Studien zur Überprüfung medizinischer Hypothesen erfordert die Spezifikation von Ein- und Ausschlusskriterien, um potenzielle Studienteilnehmer zu identifizieren. Elektronisch verfügbare Patientendaten ermöglichen es, die Rekrutierung von Patienten für Studien zu unterstützen. Das Konsortium Smart Medical Information Technology for Healthcare (SMITH) hat sich zum Ziel gesetzt, Datenintegrationszentren zu etablieren, um die innovative Nutzung verfügbarer Gesundheitsdaten für Forschung und Behandlungsoptimierung zu ermöglichen. Die Daten aus elektronischen Gesundheitsakten von Patienten in den teilnehmenden Krankenhäusern werden in einem Health Data Storage integriert, der auf dem von HL7 entwickelten Fast Healthcare Interoperability Resources Standard (FHIR) basiert. In SMITH wird FHIR Search verwendet, um die integrierten Daten abzufragen. Eine Untersuchung hat die Vor- und Nachteile der Verwendung von FHIR Search zur Spezifikation von Ein- und Ausschlusskriterien aufgezeigt. Dieser Artikel präsentiert einen Ansatz zur Modellierung von Ein- und Ausschlusskriterien sowie zur Generierung und Ausführung von FHIR Search Queries. Unsere Lösung basiert auf dem Phenotype Manager, einem allgemeinen ontologischen Phänotypisierungs-Framework zur Modellierung und Berechnung von Phänotypen unter Verwendung der Core Ontology of Phenotypes. Planning clinical studies to check medical hypotheses requires the specification of eligibility criteria in order to identify potential study participants. Electronically available patient data allows to support the recruitment of patients for studies. The Smart Medical Information Technology for Healthcare (SMITH) consortium aims to establish data integration centres to enable the innovative use of available healthcare data for research and treatment optimization. The data from the electronic health record of patients in the participating hospitals is integrated into a Health Data Storage based on the Fast Healthcare Interoperability Resources standard (FHIR), developed by HL7. In SMITH, FHIR Search is used to query the integrated data. An investigation has shown the advantages and disadvantages of using FHIR Search for specifying eligibility criteria. This paper presents an approach for modelling eligibility criteria as well as for generating and executing FHIR Search queries. Our solution is based on the Phenotype Manager, a general ontological phenotyping framework to model and calculate phenotypes using the Core Ontology of Phenotypes. GMS Medizinische Informatik, Biometrie und Epidemiologie; 17(2):Doc05