Reconstruction Program Research Articles

P–436 Identification of ovarian cell subpopulations by multicolor flow cytometry and its potential impact on ovarian reconstruction programs

Abstract Study question How could multicolor flow cytometry (MFC) help to identify ovarian subpopulations that could be used for ovarian reconstruction with isolated follicles? Summary answer MFC is useful to identify ovarian cell subpopulations in the ovarian cortex. What is known already Ovarian tissue cryopreservation is a fertility preservation option for women before gonadotoxic chemo- and/or radiotherapy. However, graft of cryopreserved ovarian tissue must be performed with caution in women suffering from malignancies that may metastasize to the ovaries. For this purpose, functional ovarian tissue qualification is essential to identify ovarian cell subpopulations that could be used for ovary reconstruction in combination with isolated follicles. Furthermore, ischemic tissue damage occurring after the graft is currently another important issue to be resolved for successful ovarian reuse. Study design, size, duration We developed an automated ovarian tissue dissociation method to obtain ovarian cell suspensions. Then, we used MFC for the identification of different cell subpopulations in the cell suspension thus obtained. Participants/materials, setting, methods Human ovarian tissues from patients undergoing surgery for polycystic ovary syndrome were used in this study. Biopsies of ovarian cortex (fresh or frozen-thawed) were dissociated using an automated dissociation method. We used FVS780 and SYTO13 markers to gate viable ovarian cells by MFC. Variable markers were chosen to differentiate and identify cell subpopulations among the viable ovarian cells. Main results and the role of chance The dissociation yield was on average 1.59 ± 1.58 x 106 and 0.78 ± 0.72 x 106 viable ovarian cells per 100 mg of fresh (n = 17) and frozen-thawed (n = 43) ovarian cortical tissue, respectively. On average, 35.4 ± 13.1% of viable ovarian cells were CD34 + (n = 61, stromal phenotype). Concerning endothelial phenotype, 7.8 ± 5.5% of CD31+ cells (n = 51) and 5.3 ± 3.6% of CD144+ cells (n = 29) were identified among viable ovarian cells. Vimentin marker is found in 25.6 ± 10.8% of viable ovarian cells (n = 23) and CD326 (EpCAM expression) in 0.6 ± 0.8% (n = 16). Finally, pericyte phenotype (CD34-/Vimentin-/CD31-/CD146+/ CD140b+) was identified in 4.6 ± 4.3% of viable ovarian cells (n = 7). Limitations, reasons for caution We do not know how these ovarian cell subpopulations could be a factor associated or not with time for ovarian function recovery in vivo after ovarian tissue graft and the impact of these ovarian cells on the ovarian microenvironment of an artificial ovary. Wider implications of the findings: Functional qualification of ovarian tissue can be performed by MFC. MFC is a promising tool for ovarian cortex qualification before reuse of cryopreserved ovarian tissue. Cell sorting could be used to separate and isolate cell subpopulations and add these cells with isolated follicles in an ovarian reconstruction program. Trial registration number Not applicable

To Rebuild or Relocate? Long-Term Mobility Decisions of Hazard Mitigation Grant Program (HMGP) Recipients

Limited funds and the demand for disaster assistance call for a broader understanding of how homeowners decide to either rebuild or relocate from their disaster-affected homes. This study examines the long-term mobility decisions of homeowners in Lumberton, North Carolina, USA, who received federal assistance from the Hazard Mitigation Grant Program (HMGP) for property acquisition, elevation, or reconstruction following Hurricane Matthew in 2016. The authors situate homeowners’ decisions to rebuild or relocate in the context of property attributes and neighborhood characteristics. Logit and probit regressions reveal that homeowners with lower-value properties are less likely to relocate, and those subjected to higher flood and inundation risks are more likely to relocate. Additionally, homeowners in neighborhoods of higher social vulnerability—those with a higher proportion of minorities and mortgaged properties—are more likely to rebuild their disaster-affected homes. The authors discuss homeowners’ mobility decisions in the context of the social vulnerability of neighborhoods. Our results contribute to an ongoing policy discussion that seeks to articulate the housing and neighborhood attributes that affect the long-term mobility decisions of recipients of HMGP assistance. The authors suggest that local governments prioritize the mitigation of properties of homeowners of higher physical and social vulnerability to reduce socioeconomic disparities in hazard mitigation and build equitable community resilience.

Determining the depth of households' participation influencing the level of their residential satisfaction in a post-Haiyan resettlement

Households' participation has been unanimously advocated by various frameworks and guidelines but has also been rarely post-evaluated to prove its importance in the post-disaster reconstruction programs. This study examined the depth of households' participation and its influence to the level of residential satisfaction in Pope Francis Village – a post-Haiyan resettlement in Tacloban City, Philippines. Data were derived through surveys, key informant interviews, and focus group discussion. Using Pearson's correlation, households' depth of participation and the level of residential satisfaction were found to have a significant, strong, and positive linear relationship, r (160) = 0.36, p = .000. Through multiple linear regression, it was identified that participation during the construction phase influenced the level of residential satisfaction with housing condition (R2 = 0.113) and social environment (R2 = 0.133), whereas participation during the design phase influenced satisfaction with institutional services (R2 = 0.073). This study, however, suggests reframing the notion of participation to “compromise and collaboration” rather than majorly as beneficiary control or mere collaborative pursuit due to the realities of participation encountered. This offers a more pragmatic lens in appraising how participation is important in practice and in theory as it encompasses both its inherent limitations and opportunities.

Musiré: multimodal simulation and reconstruction framework for the radiological imaging sciences.

A software-based workflow is proposed for managing the execution of simulation and image reconstruction for SPECT, PET, CBCT, MRI, BLI and FMI packages in single and multimodal biomedical imaging applications. The workflow is composed of a Bash script, the purpose of which is to provide an interface to the user, and to organize data flow between dedicated programs for simulation and reconstruction. The currently incorporated simulation programs comprise GATE for Monte Carlo simulation of SPECT, PET and CBCT, SpinScenario for simulating MRI, and Lipros for Monte Carlo simulation of BLI and FMI. Currently incorporated image reconstruction programs include CASToR for SPECT and PET as well as RTK for CBCT. MetaImage (mhd) standard is used for voxelized phantom and image data format. Meshlab project (mlp) containers incorporating polygon meshes and point clouds defined by the Stanford triangle format (ply) are employed to represent anatomical structures for optical simulation, and to represent tumour cell inserts. A number of auxiliary programs have been developed for data transformation and adaptive parameter assignment. The software workflow uses fully automatic distribution to, and consolidation from, any number of Linux workstations and CPU cores. Example data are presented for clinical SPECT, PET and MRI systems using the Mida head phantom and for preclinical X-ray, PET and BLI systems employing the Digimouse phantom. The presented method unifies and simplifies multimodal simulation setup and image reconstruction management and might be of value for synergistic image research. This article is part of the theme issue 'Synergistic tomographic image reconstruction: part 2'.

Upholding public institutions in the midst of conflicts: the threat of political corruption

ABSTRACT Scholars and international organizations engaged in institutional reconstruction converge in recognizing political corruption as a cause or a consequence of conflicts. Anticorruption is thus generally considered a centrepiece of institutional reconstruction programmes. A common approach to anticorruption within this context aims primarily to counter the negative political, social, and economic effects of political corruption, or implement legal anticorruption standards and punitive measures. We offer a normative critical discussion of this approach, particularly when it is initiated and sustained by external entities. We recast the focus from an outward to an inward perspective on institutional action and failure centred on the institutional interactions between officeholders. In so doing, we offer the normative tools to reconceptualize anticorruption in terms of an institutional ethics of ‘office accountability’ that draws on an institution’s internal resources of self-correction as per the officeholders’ interrelated work.

Auto-activity: Decolonization and the Politics of Knowledge in Early Postwar Indonesia, ca.1920-1955

This article presents a history of decolonization and its politics of knowledge by examining rural reconstruction programs in the first decade of Indonesian independence. It traces the roots of Indonesia’s first two agricultural development schemes to late-colonial criticism of state policy. In these criticisms and schemes, “auto-activity” emerged as a key concept. This paper argues that in the writings of planners and politicians, “auto-activity” facilitated the process of decolonization in various ways. The notion of auto-activity affirmed Indonesian know-how over foreign technical assistance; those who developed it would overcome subjective legacies of colonial subjugation; it encouraged the institutionalization of a benevolent state that helped rural communities to help themselves, and would thus contribute to the materialization of a fair and just society. This article concludes that despite these practices of decolonization, programs of “auto-activity” also opened up possibilities to overrule farmers’s individual choices in new ways.

Quality management of RDP housing construction: myth or reality?

PurposeSouth Africa has a large social housing scheme to provide primary housing for less privileged citizens who obtain an average monthly income of less than R 3,500.00. The government seeks to promote an integrated society by developing sustainable human settlements and quality housing within a subsidy system for different income groups. This study aims to examine whether quality management is applied to the reconstruction and development programme (RDP) housing programme during construction.Design/methodology/approachA quantitative survey approach was selected for this study. This involved using a close-ended questionnaire to collect data amongst 1,893 households who are currently residing in government housing units in the city of Bloemfontein, in the Free State province. The questionnaires were self-administered amongst randomly selected respondents based on their availability at the time of the visit to the above area. However, only the occupants of a household were included in the study. The data gathered were analysed by making use of R-programming software.FindingsThe findings revealed that a low level of quality is evident in the already constructed RDP housing units. Most of the inspected units were built with low-quality building materials or were not well-constructed, with derelict structural frames and finishes being evident in most houses. Respondents also indicated that they were not satisfied with the quality of some aspects of the units, such as the plaster and paint finishes, door frames built into walls and uneven floors and floor finishes. These complaints indicate that little to no quality management was applied at the time of construction or even afterwards during the latent defects period.Research limitations/implicationsThe survey was limited to responses amongst randomly selected government RDP housing occupants in seven communities in Bloemfontein’s periphery, in the Free State Province of South Africa.Practical implicationsThe empirical results from the findings indicate that the South African Government should ensure that quality management is applied during the housing units’ construction. This may mean that a new strategy for verifying the units’ quality will need to be developed, considering the respondents’ concerns by improving the quality of the construction materials and methods used to erect these units. The government should also consider improving contractors’ tender selection criteria to ensure higher quality construction methods, materials and management.Originality/valueThe study has identified quality challenges in constructing the social housing and stated recommendations that will address the identified issues if implemented by the programme implementers. This will help achieve the programme's objective, which is to improve the living conditions of previously disadvantaged individuals through social housing scheme.

Devaluation of Cultural Life: A Study of Reconstruction-Resilience Practices of an Earthquake Displaced Community

This article investigates how earthquake reconstruction was practiced without considering socio-cultural values in the dislocated community after the 2015 earthquake. The process of disaster resilience tended to focus only on technical structures like the number of houses and school buildings as the main indicators of recovery from earthquake. The resilience programs conducted by the government and NGOs did not pay due attention to caste/ethnic tensions, religious division, political clash, and cultural loss among the villagers. In this study I thus wanted to know what were the meanings/ interpretations of reconstruction and community resilience; how reconstruction programs considered socio-cultural resilience; what socio-cultural aspects in practices of reconstruction were missing, and what were the challenges of cultural resilience among the displaced communities. The study was done at Kunchok-Nabalpur of Sidhupalchok. Local people’s perspectives of reconstruction, values, cultural life (ethnographic study) and narratives were collected by using observation, interview, case study and field visit methods. The study found that caste/ethnic, religious and cultural cohesion had not been reinstalled. Socio-cultural diversity and diverse social needs of displaced people were ignored by the resilience programs of the government. This shows how technocratic reconstruction programs were not as effective as expected due to the devaluation of socio-cultural life of the disaster displaced people who otherwise could contribute to the policy and programs of sustainable and inclusive development of the society.

Model independent approach to the study of f(R) cosmologies with expansion histories close to ΛCDM

We propose a new framework for studying the cosmology of $f(R)$ gravity which completely avoids using the reconstruction programme. This allows us to easily obtain a qualitative feel of how much the $\Lambda$CDM model differs from other $f(R)$ theories of gravity at the level of linear perturbation theory for theories that share the same background dynamics. This is achieved by using the standard model independent cosmographic parameters to develop a new dynamical system formulation of $f(R)$ gravity which is free from the limitation of having to first specify the functional form of $f(R)$. By considering a set of representative trajectories, which are indistinguishable from $\Lambda$CDM, we use purely qualitative arguments to determine the extent to which these models deviate from the standard model by including an analysis of the linear growth rate of density fluctuations and also whether or not they suffer from the Dolgov-Kawasaki instability. We find that if one demands that a late time $f(R)$ cosmology is observationally close to the $\Lambda$CDM model, there is a higher risk that it suffers from a Dolgov-Kawasaki instability. Conversely, the more one tries to construct a physically viable late time $f(R)$ cosmology, the more likely it is observationally different from the $\Lambda$CDM model.

Society in the realities of the pandemic: challenges and scenarios for further development of countries in the post-quarantine period

The article presents an analysis of the unprecedented humanitarian crisis that arose as a result of COVID-19, and affected such important areas for society as health care, economics and labor relations. The purpose of the article was to analyze the challenges facing the world community through COVID-19, to describe the scenarios for further development of society in the post-quarantine period and to identify ways to solve the problems caused by the pandemic. The author did not set the task to outline a real program of action and change. These key issues are the subject of constant discussion. States still have the opportunity to rethink the social contract, placing environmental sustainability, justice and humanitarian solidarity at the heart of the post-quarantine reconstruction and renewal program. It is shown that the humanitarian crisis has been complicated by the instability of the economic situation, growing inequality and instability, both domestically and internationally, which threatens to increase social protests and dismantle the usual ways. It has been shown that policies aimed at denationalizing the economy, supporting large capital, reducing budget spending on social programs, and establishing the dominance of transnational corporations have failed to respond adequately to the challenges of the pandemic, and have exposed large-scale problems a single person. The problems that arose as a result of COVID-19 and affected international institutions were analyzed; were caused by vulnerability and unpreparedness for a health pandemic; have led to growing socio-economic inequality both within countries and internationally; exacerbated food security issues for developing countries; gender issues, labor relations issues, etc. It is shown that the principles of neoliberalism, on which the developed countries of Europe and America have been based for the last 70 years, were questioned, which actualized the search for models, scenarios and ways of further development of individual states and the world community as a whole. The article presents scenarios for further development of states in the post-quarantine period. These scenarios range from the preservation of the principles of neo-liberalism to the spread of left-wing models of social development. In addition, the article identifies conditions that can help countries embark on the trajectory of an optimistic scenario.

Perceptual-Motor Skills Reconstruction Program Improves Executive Functions in Children with Attention-Deficit/Hyperactivity Disorder

Objective: Many children suffering from attention-deficit/hyperactivity disorder (ADHD) show problems in executive functions (EF), which reflect neuronal pathways from perception to controlled action. Treatment approaches that improve executive functions may prevent a negative cycle of failures in students. Hence, this research aims to study the efficacy of the perceptual-motor skills reconstruction program on EF in children with ADHD while considering cognitive flexibility, abstract verbal skills, response inhibition, and working memory. Also, its effect on clinical ADHD symptoms should be considered. Method: The research design included pretest, posttest, and a follow-up after six months. The sample included third-grade school children with ADHD (50 students, aged 8–10 years, boys and girls) who were referred to the Child Psychology Clinic, Iran, Mashhad 2018–2019. After clinical assessment for ADHD, children were randomly assigned to an experimental (n = 25) and a waiting control (n = 25) group. The experimental group received the perceptual-motor skills reconstruction program for 16 sessions (three times per week, i.e., five weeks and one session in the sixth week). Delis–Kaplan executive function system (D-KEFS) was applied at three measurement points (M1–3) in order to test for changes over time. Results: Data analysis (analysis of covariance (ANCOVA) with post-hoc-testing) showed that there was a significantly better performance of experimental versus waiting control group at posttest (M2) and follow-up (M3) for cognitive flexibility (t(24) = 4.9, df = 14, p < 0.0001), abstract verbal skills (t(24) = 3.5, df = 14, p < 0.004), response inhibition (t(24) = 7.54, df = 14, p < 0.0001) and working memory (t(24) = 12.69, df = 14, p < 0.004). Further, Conners-Scales-Score improved for the experimental group. Conclusions: Training with perceptual-motor skills reconstruction program clearly improved the trained variables (i.e., cognitive flexibility, abstract verbal skills, response inhibition, and working memory) and clinical symptoms of the children with ADHD. The obtained training may lead in practice to better preconditions for successfully handling daily tasks at school and in society.

In Search of Workforce Diversity? A Program's Successful Approach.

The persistence of health care disparities along racial and ethnic lines highlights the complex and multifactorial nature of this national concern. The paucity of physicians ethnically underrepresented in medicine to treat an ever-growing heterogeneous population inherently contributes to these ongoing disparities. The authors proposed an approach to improve the representation of physicians underrepresented in medicine in their plastic surgery residency program. With a renewed commitment to ethnic diversity and inclusion, a multifaceted recruitment and retention approach was implemented at the University of Pennsylvania plastic and reconstructive surgery residency program from 2015 to 2020 (5 academic years). A retrospective review of the demographics of the program's residents was then assessed over the past 9 academic years for comparison (2011 to 2020). The representation of underrepresented-in-medicine residents within the plastic and reconstructive surgery residency program steadily increased with the implementation of this multifaceted approach, reaching an unprecedented high. Currently, 29 percent of all residents are underrepresented in medicine and 29 percent are female, some of whom are also underrepresented in medicine. Although the female representation is on par with the national average, the underrepresented-in-medicine representation is far greater than the national average. As a result of this multifaceted approach, the representation of African American and Latino plastic surgery residents at the University of Pennsylvania now far exceeds current national averages. Unfortunately, the representation of Native American and Alaskan Natives is still lacking, despite the program's broadened recruitment efforts. The success of this experience describes a successful strategy that institutions can implement to enhance underrepresented-in-medicine representation among its plastic surgery trainees.

Surgical Outcomes in Urogynecology—Assessment of Perioperative and Postoperative Complications Relative to Preoperative Hemoglobin A1c—A Fellows Pelvic Research Network Study

Poor control of diabetes mellitus is a known predictor of perioperative and postoperative complications. No literature to date has established a hemoglobin A1c (HbA1c) cutoff for risk stratification in the urogynecology population. We sought to identify an HbA1c threshold predictive of increased risk for perioperative and postoperative complications after pelvic reconstructive surgery. This multicenter retrospective cohort study involving 10 geographically diverse U.S. female pelvic medicine and reconstructive surgery programs identified women with diabetes who underwent prolapse and/or stress urinary incontinence surgery from September 1, 2013, to August 31, 2018. We collected information on demographics, preoperative HbA1c levels, surgery type, complications, and outcomes. Sensitivity analyses identified thresholds of complications stratified by HbA1c. Multivariate logistic regression further evaluated the association between HbA1c and complications after adjustments. Eight hundred seven charts were identified. In this diabetic cohort, the rate of overall complications was 44.1%, and severe complications were 14.9%. Patients with an am HbA1c value of 8% or greater (reference HbA1c, <8%) had an increased rate of both severe (27.1% vs 12.8%, P < 0.001) and overall complications (57.6% vs 41.8%, P = 0.002) that persisted after multivariate logistic regression (odds ratio, 2.618; 95% confidence interval, 1.560-4.393 and odds ratio, 1.931; 95% confidence interval, 1.264-2.949, respectively). Mesh complications occurred in 4.6% of sacrocolpopexies and 1.7% of slings. The average HbA1c in those with mesh exposures was 7.5%. Preoperative HbA1c of 8% or higher was associated with a 2- to 3-fold increased risk of overall and severe complications in diabetic patients undergoing pelvic reconstructive surgery that persisted after adjustments.

Self-Esteem, Socioeconomic Status and Social Participation of Persons with Disabilities Living in Areas Affected by Armed Conflict in Colombia

This cross-sectional study explored the association between self-esteem and social participation of persons with disabilities living in two municipalities affected by armed conflict in Colombia. We studied the socioeconomic status, communication level, social participation, and self-esteem of the participants. The Rosenberg Self-Esteem Scale (RSES) was used to evaluate the level of self-esteem. We performed bivariate analysis and multiple regression analysis to identify the determinants of higher self-esteem in the target populations. In total, there were 579 participants in the study. The mean RSES score was 28.8 (SD = 4.5). Self-esteem was associated with monthly household income (β = 0.45, p = 0.028), education level (β = 0.65, p = 0.048), current job (β = 1.00, p = 0.017), type of disability (β = −1.17, p = 0.002), frequency of communication with neighbors or friends (β = 0.53, p = 0.013), and participation in community organization activities (β = 0.89, p = 0.019). Frequent communication with their own community, higher levels of school education, and having a job were determinants of higher self-esteem in persons with disabilities. We suggest the importance of an active inclusive reconstruction program to support persons with disabilities in local municipalities affected by armed conflict in developing countries.

Validation of a PC-Crash Multibody Sport Bike Motorcycle Model

&lt;div class="section abstract"&gt;&lt;div class="htmlview paragraph"&gt;PC-Crash is an accident reconstruction program allowing the user to perform simulations with multibody objects that collide or interact with 3D vehicle mesh models. The multibody systems can be a pedestrian, a motorcycle, or a motorcycle with a rider. The multibody systems are comprised of individual rigid bodies connected by joints. The bodies can be of various size and stiffness along with varying coefficients of friction and restitution. Additionally, the joints can be tailored to define pivot types and range of motion. The current motorcycle models in PC-Crash are generic and do not resemble a sport bike type motorcycle. They are only globally scalable such that you cannot adjust length, width, or height independently. However, the user can adjust each body and/or joint individually as needed.&lt;/div&gt;&lt;div class="htmlview paragraph"&gt;A model was created that resembled a modern sport bike motorcycle. In addition, a multibody rider was mounted on the motorcycle in a typical sport bike riding position. The model was validated using the three instrumented tests that were the subject of previous research (SAE 2020-01-0885). The aforementioned tests involved moving motorcycles striking moving cars. Impact configurations involved the classic T-bone type accident, while others were more complex in nature involving significant longitudinal and lateral impact forces to the motorcycle.&lt;/div&gt;&lt;div class="htmlview paragraph"&gt;The test results were compared to parameters calculated in PC-Crash. Results such as Delta-V, yaw rate and overall post impact trajectories of the motorcycle, rider and movement of the target vehicle were compared to the data from the instrumented test vehicles. In total the multibody rider/motorcycle model was able to simulate the three staged crash tests very well. The overall trajectories of both the rider and motorcycle aligned very well with the overall motion seen in the crash test.&lt;/div&gt;&lt;/div&gt;

Automated picking of amyloid fibrils from cryo-EM images for helical reconstruction with RELION

Cryogenic electron microscopy (cryo-EM) is an important tool for determining the molecular structure of proteins and protein assemblies, including helical assemblies such as amyloid fibrils. In reconstruction of amyloid fibril structures from cryo-EM images, an important early step is the selection of fibril locations. This fibril picking step is typically done by hand, a tedious process when thousands of images need to be analyzed. Here we present a computer program called FibrilFinder that identifies the locations and directions of fibril segments in cryo-EM images, by using the properties that the fibrils should be linear objects and have widths within a specified range. The program outputs the fibril locations in text files compatible with the RELION density reconstruction program. After RELION is used to extract the particle image boxes contained in the fibril segments identified by FibrilFinder, a second program called FibrilFixer removes boxes that contain more than one fibril, for instance because two fibrils cross each other. As concrete and realistic examples, we describe the application of the two programs to cryo-EM images of two different amyloid fibrils, namely 40-residue amyloid-β fibrils derived from human brain tissue by seeded growth and fibrils formed by the C-terminal half of the low-complexity domain of the RNA-binding protein FUS. Both examples of amyloid fibrils can be picked from cryo-EM images using the same set of FibrilFinder and FibrilFixer parameters, showing that this software does not require re-optimization for each sample. A set of 1337 cryo-EM images was analyzed in 17 min with one multi-core computer. The new fibril picking software should enable the rapid analysis and comparison of more helical structures using cryo-EM, and perhaps serve as part of the greater automation of the entire structure determination process.

Bulk reconstruction in rotating BTZ black hole

The bulk reconstruction program aims to obtain representations of bulk fields as operators in the boundary CFT. In this paper we extend the program by obtaining the boundary representation for a scalar field in a rotating BTZ black hole. We find that the representation of the field near the inner horizon shows novel features. We also obtain a representation for fields inside the horizon as operators in a single boundary CFT using mirror operator construction.

Inclusion of the poor and vulnerable: Learning from post-earthquake housing reconstruction in Nepal

The poor and vulnerable people are the most affected in any disaster and find recovery extremely challenging. After the 2015 Nepal earthquake, the need for inclusive and targeted policy provisions and socio-technical facilitation was well identified. Nepal's post-earthquake housing reconstruction is world's largest owner driven reconstruction program under which nearly 700,000 houses are being constructed. This paper examines policies, and implementation mechanisms for ensuring social inclusion in this post-earthquake housing reconstruction process in Nepal, specifically examining provisions and delivery mechanisms for finance, land, design and technology for addressing recovery needs of the most vulnerable houseowners in terms of achievements, effectiveness, and challenges of implementation. The paper uses mixed methodology and is informed by the primary survey data of 26,912 houseowners in eight municipalities of the Gorkha district and overall reconstruction data from National Reconstruction Authority and other relevant sources of the Government of Nepal. Data is analysed and interpreted to gain insights on the specific issues of the poor and vulnerable. Top-up grant assistance and subsidized loan scheme have not yet benefited the vulnerable households despite the policy provisions. At the same time, housing reconstruction process in Nepal has helped a significant number of landless households get ownership of homestead land, which is a remarkable achievement. Shift in building typologies needs to be deliberated in context of affordability, sustainability and disaster risk reduction in the future. While policy provisions are the first step for the inclusion of the vulnerable, the desired outcome is difficult and challenging to achieve without enabling environment for their own agency and targeted socio-technical facilitation. Experience of post disaster housing reconstruction in Nepal strengthens our understanding of ‘owner driven reconstruction’ to make it more inclusive.

Contestations of cultural memory at a disaster monument: the case of the Aceh Tsunami Museum in Indonesia

ABSTRACT In any post-disaster contexts, the affected societies will inevitably be involved in tensions between remembering and forgetting the past disaster experiences. They need to forget the disaster in order to return to their daily lives; at the same time, they also need to remember the disaster, which will usually involve canonization programs of the cultural memory of disaster. This study explores, how these programs, manifested in post-disaster monuments and commemorations, entail meaning contestations, through which the cultural interpretations of the disaster are formed and disputed. This paper uses the example of the Aceh Tsunami Museum in Indonesia as a part of a canonization program of the cultural memory of a tsunami. This museum was erected as a memorial to the success of the post tsunami reconstruction programs lead by the Indonesian government. While the monuments’ managers have proposed certain narratives by which to remember the disaster, the visitors construct their interpretation of these through their daily practices. Hence, the shaping of the cultural memory of a disaster involves the social functions of the disaster monuments. For the locals, this museum has diverse functions: recreational, memorial, educational, and economic ones; however, the memory of the success of the post-tsunami reconstruction programs has been forgotten by the locals.

Genitourinary reconstructive surgery curriculum and postgraduate training program development in the Caribbean

Objectives: To describe the development of a genitourinary reconstructive fellowship curriculum and the establishment of the first genitourinary reconstructive and pelvic floor postgraduate training program in the Caribbean. Methods: In an effort to respond to the need for specialty-trained reconstructive urologists in the Dominican Republic, we developed an18-month fellowship program to train local surgeons. The process began with creation of a curriculum and partnership with in-country physicians, societies, hospitals, and government officials. We sought accreditation via a well-established local university, and fellowship candidates were selected. A database was maintained to track outcomes. Subjective and objective reviews were performed of the fellows. Results: The first fellow graduated in 2018, the second in 2020, and the third is currently in training. The curriculum was created and implemented. The fellowship has been successfully integrated into the health system, and the fellows performed 199 and 235 cases, respectively, during the program, completing all rotations successfully. They have been appointed to the national health system. Both graduates are now docents in the program and in the public system. Additional staff including radiologists, radiology technicians, nurses, urology residents (both Dominican and American), urology attendings, operating room staff, and anesthesia residents were trained as a result of the program. Conclusions: To our knowledge, this is the first fellowship of its kind in the Caribbean. A novel curriculum was created and implemented, and the first 2 fellows have successfully completed all rotations. This training model may be transferable to additional sites.