Small Island Research Articles

ІСТОРІЯ ВИНИКНЕННЯ ТА ПЕРСПЕКТИВИ РОЗВИТКУ ПЛЯЖНОГО ГАНДБОЛУ

Every year more and more new sports appear in the world, which are rapidly developing and becoming popular. Among them is beach handball. Due to its spectacularity, it attracts more and more people and arouses great interest around the world. Scientific research is necessary for its development, as it is an under-researched sport, although the number of studies has recently increased. The purpose of the study. To study the history of origin and prospects of development of beach handball. Research methods: in accordance with the purpose of the study, the methods of theoretical analysis and generalization of scientific and methodological literature and information resources of the Internet were used. Results of the research and their discussion. The first idea about the creation of beach handball arose in the Italian Olympic committee in 1990, which tried to create a kind of handball on the sand, based on the success of beach volleyball. On June 20, 1992, beach handball was first played on Isola di Ponza, a small island in southern Italy. The idea of beach handball as a sport was realized gradually, over many years, by players and coaches. A huge step in the development of the discipline was the participation of beach handball in the Youth Olympic Games in 2018 in Buenos Aires (Argentina). And this year, beach handball made its debut at the Summer Games in Paris, where the world stars of the sport were present within the framework of an exhibition event. Conclusions. Beach handball originates from classic handball. Today, beach handball is represented at almost all sporting events of global importance, which indicates the growing popularity of the sport in the world. The main goal is to be in the official program at the Olympic Games and become an Olympic sport.

Effect of Pandemic Covid-19 on Tropical Forest Cover in Small Island: Case Mansinam Island Papua using Google Earth Imagery

Covid-19 became a global pandemic in 2020 and has multiple impacts on the economy, social, culture, food systems, and also the environment, especially on tropical forest cover in small island. This study aims to determine the impact of the Covid-19 pandemic on the forest cover of small populated islands. Using remote sensing and geographic information system technology based on high-resolution satellite imagery from google earth imagery, land cover was observed in 2018, 2020, and 2023. This study found that during the 2020 pandemic, tropical forest cover on small populated islands has decreased. Mansinam's forest cover decreased by 4.3%, bare land increased by 80.6%, agricultural land increased by 75.3%, and shrubs increased by 54.9%. Another important finding is that 78.9% of the total deforestation was due to forest conversion to bare land and agricultural land. Land and forest utilization on small islands will increase when accessibility is limited, especially during the pandemic. Future studies will be on the structure and composition of species in locations that experienced deforestation during the pandemic and detailed studies related to changes in the occupations of Mansinam people due to the pandemic that have a relationship with forests.

Beyond Energy Access: How Renewable Energy Fosters Resilience in Island Communities

People, communities, and economies in small island developing states are extremely vulnerable to climate change, disasters, and other crises. Renewable energy can play an important part in building the resilience of these communities. Three case studies were conducted in Fiji (i.e., a grid-connected secondary school with roof-top solar PV and biogas, an off-grid community with solar home systems, and a farm that uses solar PV for irrigation) to demonstrate how renewable energy initiatives build community resilience. This study used the community resilience framework, RETScreen tool, information gathered from key informants’ interviews, and secondary data sources to conduct qualitative and quantitative analyses. It found that seven community assets, i.e., human, social, cultural, financial, natural, built, and political assets, are enhanced, leading to an increase in absorptive, adaptive, and transformative capacities for these communities. Furthermore, current research shows that human capital is one of the key instruments in the adoption of new innovative technologies. The results from this study can be used by decisionmakers to promote and implement similar technologies in communities, which not only provide clean electricity and clean cooking energy for climate change mitigation but also build community resilience.

INDIGENOUS COMMUNITY EMPOWERMENT POLICY FOR STRENGTHENING NATIONAL MARITIME DEFENSE

Community participation is mandatory as stipulated in Law Number 1 of 2014 which amends Law Number 27 of 2007 concerning the Management of Coastal Areas and Small Islands. Challenges still occur in the implementation of this regulation, particularly regarding the suboptimal involvement of coastal Indigenous communities in managing their territories. This research examines how coastal Indigenous communities contribute to national maritime defense and how Government policies can empower them to enhance national defense. Utilizing a normative juridical approach, the research reviews and analyzes existing literature. The findings indicate that empowering coastal Indigenous communities plays a crucial role in preserving marine ecosystems, monitoring coastal areas, and identifying maritime threats, thereby strengthening national defense. Effective empowerment requires synergy between the central and regional Governments in policy formulation, ensuring community involvement. The novelty of this research lies in its proposal to formally integrate coastal Indigenous communities as a central element in national maritime defense, thus enhancing Indonesia’s maritime resilience.

Reconstructing the long-term ecological history of Long Island, Furneaux Group (Bass Strait), Lutruwita/Tasmania

The Bass Strait islands are the elevated remnants of a now-submerged continental land bridge that connected the mainland of Australia to Lutruwita/Tasmania during low sea level phases of the Quaternery period. The Furneaux Group is made up of around 100 islands, harbouring a rich diversity of plants derived from glacial refugia and stepping-stone dispersal as millennial-scale climate change altered the land and seascape configuration of the land bridge. Despite the region’s significance, long-term ecological and environmental dynamics of most of these islands remain poorly known. We present the first palaeoecological study of Long Island, a small granite island of the Furneaux group, currently covered by extensive grasslands in the west and patches of forest and woodland in the east and north of the island. We use decadal to centennial-scale resolution palaeoecological evidence for vegetation, animal and fire dynamics, alongside historical accounts of vegetation changes inferred from aerial photo analysis, to develop a comprehensive record of the island’s long-term ecology. Results show that grasslands have been an important feature of the island for at least the last 1000 years, and are reminiscent of Last Glacial Maximum grasslands of the now-submerged Bassian Plain. Both aerial photo analysis and the palaeoecological record show increases in forest cover on the island’s eastern corner over the past four decades. We discuss these ecological dynamics in the context of environmental and climatic shifts. This study emphasises the importance of palaeoecological studies, specifically their value in understanding modern ecosystems in their historic context. This data is critical in understanding the island’s current landscape and how this might change into the future.

Assessing the potential effects of climate change on the morphodynamics of the tropical coral reef islands in the Gulf of Mannar, Indian Ocean.

Low-lying and small tropical coral reef islands around the world are extremely vulnerable to the effects of global environmental change caused by the combination of anthropogenic climate change and escalating extreme hydrodynamic events. Erosion and inundation are anticipated to physically destabilize the tropical coral reef islands, rendering them uninhabitable within the next century. Therefore, it is crucial to assess the repercussions of these hazardous events on the delicate reef island ecosystem in order to conserve and ensure sustainable management. Multitemporal remotely sensed Landsat satellite imageries were utilized to investigate the net and decadal morphological transformation of tropical coral reef islands in the Gulf of Mannar, Indian Ocean. Over the past half-century, these islands have consistently adapted to global environmental changes, even while local sea levels rise at a rate of 3.38mm per year. Advanced statistical techniques, such as net shoreline movement (NSM), end point rate (EPR), and linear regression rate (LRR), were employed for estimating the shoreline change rate using a Digital Shoreline Analysis System (DSAS). In addition, the GIS-based overlay analysis methods were applied to examine the net and decadal areal (planform) changes and also utilized for estimating the inundation trajectories of reef islands under the sea level rise scenarios of 1m and 2m. Furthermore, time series analysis was performed to analyze the variability of critical climate-induced factors using archived reanalysis oceanographic data. In addition, linear and polynomial statistical techniques were applied to investigate the driving factors behind the coral reef island morphological transition. The findings show that two islands have already disappeared, while others have experienced a dramatic reduction in their footprint. Approximately 62.64% of the shoreline experienced significant erosion, while 36.91% witnessed gradual accretion. The Tuticorin group confronted the severe reduction in island footprint, with a significant decrease of 83.04%, followed by Keelakarai groups (33.35%), Mandapam groups (29.60%), Vembar groups (28.14%), and Rameswaram islands (3.43%). The study also predicts that the island footprint could submerge in an area of 627.30ha and 1284.21ha within the next century, with an expected sea level rise (SLR) of 1m and 2m, respectively. The study emphasizes that the combination of human-induced factors and regional coastal processes such as sea level rise and swells are the key drivers engendering the stress on the physical resilience of the coral reef islands. Urgent and continual monitoring of the reef islands is crucial for a better understanding of their dynamic trajectories and for developing nature-based solutions to catastrophic erosion. These nature-based solutions (NbS) for minimizing island erosion are initiatives that use natural ecosystems to safeguard islands while enhancing biodiversity, climate resilience, and community livelihoods. The interactions between nature-based solutions (NbS) for combating erosion, reef island resilience, and Sustainable Development Goals are evaluated based on the positive correlation, our expert knowledge, and Griggs et al.'s 2017 seven-point scale framework. The outcomes of this study may provide comprehensive insights to decision-makers and administrators for formulating and implementing policies for long-term resilience building and sustainable island management.

Personal reflection on my fieldwork experience in a small island developing state

ABSTRACT This practice paper is a reflexive account of my fieldwork experience in a small island developing state (SIDS). I present some of my lived experiences during the fieldwork through recollected memories of observations, fieldnotes, and personal reflections, and their implications for ethnographic fieldwork. My study explored how aid functioned on the ground in the SIDS, focusing on the interactions between local actors, aid beneficiaries, and donor agencies, referred to here as Donor 1 and Donor 2. The reflections underscore the complexities of aid localisation efforts, particularly within the context of broader humanitarian and development architecture. They also reflect the growing appetite of local actors and beneficiaries to take the driver’s seat in the aid development process. By presenting these insights, the paper contributes to understanding the practical realities of aid delivery in SIDS and emphasises the importance of local engagement and leadership in development efforts.

Metaverse through the integrated theoretical lenses of task technology fit theory, social capital theory, and social cognitive theory: the case of SMEs

The rapid evolution of technology and the business landscape has introduced the Metaverse, a virtual realm with immense potential for transforming communication and collaboration. The pandemic accelerated the shift to online channels, making the Metaverse a crucial investment for businesses in the digital age. However, there remains a lack of understanding regarding how small and medium enterprises (SMEs) perceive the Metaverse. This study aims to bridge this gap by investigating the factors driving Metaverse adoption, using task-technology fit theory, social capital theory, and social cognitive theory. By analyzing data from 264 SMEs in Fiji, it was revealed that task-technology compatibility and social factors significantly influence the intention to adopt the Metaverse. Additionally, self-efficacy is critical in determining the performance outcomes associated with eventual adoption. These findings offer valuable insights for SMEs, policymakers, and platform developers in the post-pandemic landscape. Additionally, they support inclusive growth and partnerships for small island developing states like Fiji, contributing to the United Nations’ Sustainable Development Goals.

Perturbations in Microbial Communities at Hydrothermal Vents of Panarea Island (Aeolian Islands, Italy).

Marine hydrothermal ecosystems represent extreme environments connected to submarine volcanic areas characterized by vents, having high temperatures and particular chemical compositions. The hydrothermal marine system of Panarea, located in one of the seven small islands belonging to the Aeolian Archipelago (southern Tyrrhenian Sea), is characterized by a range of vents exhibiting diverse physical and chemical conditions. We aimed to analyze the microbial community of a peculiar hot spring belonging to the Panarea hydrothermal field, known as "Black Point" (BP), in two separate sampling expeditions (May and August). Our results demonstrated that the chemical-physical variations within this hydrothermal vent, such as temperature fluctuations, mineral content, and hydrothermal fluid dynamics, play a role in shaping the structure and diversity of microbial communities. The differences between the two sampling expeditions suggest that seasonal changes, i.e., in temperature, pH, and redox potential (Eh), could drive microbial community shifts over time.

Addressing ‘Loss and Damage’ For Climate Justice in The Global South: An Analysis

Determining climate related loss and damage and identifying historical responsibility for it is a highly debated topic in the climate change discourse. There are various critical aspects to this issue - agreeing on the contours and criteria of what ‘loss and damage’ is, acceptance of historical responsibility by big emitters, fixing compensation for the loss and damage, and the encompassing concern of equity and justice. A proper resolution of the issue must also account for the justice concerns of developing and small island states who, though having contributed the least in creating the climate change problem, are the most affected victims of loss and damage due to their geographical location, climatic conditions and limited adaptive capacities. Since the beginning of the United Nations Framework Convention on Climate Change (UNFCCC) negotiations, developed and developing countries have struggled to frame the concept of loss and damage, and the issue remains. This article explores how developed countries have succeeded in containing progression of the concept of loss and damage and avoiding ‘historical responsibility’ for it. The launch of the Loss and Damage Fund in UNFCCC Conference of Parties 28 is no doubt a milestone for developing countries, but its constitution as a voluntary fund without compulsory contribution from the well-known and highest emitters creates skepticism as to whether it will bring any justice for the Global South. By employing an analytical method and examining both primary and secondary sources, this article concludes that the current framing of the loss and damage issue is unlikely to usher in climate justice for the Global South because it does not associate climate related loss and damage with historical responsibility of the carbon polluters – without their association, a liability framework will not take off.

Simultaneous Toughening and Strengthening of Ductile Polymer by Rigid Polymeric Fillers: The Role of Interfacial Entanglement.

The modification of thermoplastic polymers is frequently impeded by the inherent contradiction between their toughness and strength. In this study, an effective strategy to significantly improve the mechanical properties of ductile polymers by simply adding a complimentary rigid polymer is introduced. This work uses a semi-crystalline polymer aliphatic polyketone (POK) as the matrix material and a small quantity of polymethyl methacrylate (PMMA) as the rigid polymer, through establishing molecular chain entanglements at the interface to produce POK/PMMA blends with exceptional mechanical property. The experimental study shows that PMMA as a small island phase is homogeneously dispersed in the POK matrix, while the interfacial adhesion between the POK matrix and PMMA island is enhanced by the high-density molecular chain entanglement between PMMA and the POK matrix. The strong entanglements and high concentration of PMMA domains promote uniform crazes and overall shear yielding. As a result, the POK/PMMA blend exhibits exceptional mechanical properties with notched impact strength, elongation at break, tensile strength, and Young's modulus, of 20kJm-2, 326%, 60 and 2185MPa, respectively. A universal approach is further suggested for enhancing the toughness and strength of ductile polymers using a complimentary rigid polymer.

Numerical investigation of neoclassical tearing mode in toroidal plasma

Abstract The neoclassical tearing mode (NTM) is numerically investigated with the three-dimensional toroidal MHD model (CLT). Both the linear and nonlinear behaviors are simulated and compared with the theory. It is found that in the large aspect ratio condition, the growth rate for a small island limit and the saturated island width for 2/1 NTMs are in good agreement with the MRE theory. However, in the toroidal geometry, the toroidal effect will alter the NTM behaviors. In the small island region, the island growth rate is significantly reduced due to the GGJ effect, because the poloidal asymmetry of the perturbed bootstrap current and the perturbed Pfirsch–Schlüter current are resulted from the Grad-Shafranov shift. As the magnetic island grows, the poloidal asymmetry is substantially reduced, and the growth rate increases significantly.

Islands, Enclaves, and the Offshoring of Clerical Sexual Abuse

Abstract Between 1952 and 1968, a Roman Catholic religious order known as the Servants of the Paraclete sought, bought, and finally sold several small islands in the Caribbean for priests said to be unable to stop “sin[ning] repeatedly with little children.” This article, in response, details the Servants of the Paraclete’s mid-twentieth-century efforts at offshoring sexually abusive priests in and then beyond the Caribbean. It is an historical account that pushes scholars of clerical sexual abuse to engage the interstitial spaces that Church leaders have long sought for its perpetrators while at the same time flagging for students of sovereignty and the nation-state that mid-century practices of offshoring shaped not only the history of capitalism but also the history of the Roman Catholic Church.

The ITLOS advisory opinion on climate change: Revisiting the relationship between the United Nations convention on the law of the sea and the Paris agreement

AbstractThe International Tribunal for the Law of the Sea (ITLOS) has issued its highly anticipated Advisory Opinion on Climate Change and International Law, following a request from the Commission of Small Island States on Climate Change and International Law (COSIS). The landmark Advisory Opinion elucidated numerous contentious issues around the interplay between the climate change and the law of the sea regimes. This article critically examines the ITLOS Advisory Opinion with respect to the relationship between the Paris Agreement and the United Nations Convention on the Law of the Sea (UNCLOS), contextualising them within the extensive academic and political discourse preceding the Opinion. In particular, the lex specialis question is brought into sharper focus. The Tribunal rejected the notion that the Paris Agreement is lex specialis with respect to climate change impacts on the ocean and clarified the nexus between adaptation measures and the overarching obligation to protect and preserve the marine environment. The analysis reveals that the Advisory Opinion conveys a generally critical view of the Paris Agreement, and may, despite its imposition of far‐reaching obligations upon States to mitigate marine pollution from greenhouse gases, inadvertently undermine global efforts to combat climate change. However, by articulating concrete legal obligations for States under the UNCLOS to prevent, control and reduce marine pollution from greenhouse gas emissions, the Advisory Opinion could further strengthen the legal foundations for domestic and international climate change litigation and elevate the profile of the oceans in global climate change negotiations.

Small islands: living laboratories revealing global climate and sustainable development challenges

Small islands, while hosting only about 1% of the global population, are among the most vulnerable regions to climate change. Their critical importance in climate adaptation is often overlooked, and their value as natural laboratories is frequently lost in discussions on sustainable development and climate adaptation. Beyond their well-documented vulnerabilities, small islands serve as invaluable scientific laboratories, illustrating the interconnected impacts of water, environment, society, and economy. Due to their small size and “islandness,” these provide a condensed and accelerated view of natural and anthropogenic phenomena, which are harder to observe in larger, more distributed geographies. Investing in research and adaptation strategies for these communities addresses their immediate needs and offers critical insights and early warning signs for broader global climate challenges. This paper argues for increased attention and resources for small islands, emphasising their role as microcosms that reflect broader environmental trends and highlighting the urgent need for targeted adaptation measures.

Assessing blue carbon in mangrove ecosystems of Seychelles.

Mangrove forests play an important role in climate change mitigation and adaptation, globally recognized as natural climate solution. The protection and restoration of mangrove ecosystems are especially important to Small Island Developing States, like Seychelles, due to their vulnerability to the impacts of climate change, such as sea level rise and tropical cyclones. Therefore, it is crucial for countries like Seychelles to develop baseline information on the status of their mangrove forests to guide conservation and management actions. In this study, we conducted a field campaign to collect local data on plant (i.e., aboveground and belowground) and soil carbon from representative mangrove forests in the inner and outer islands of Seychelles. We used this data to develop, for the first time, a blue carbon assessment for Seychelles' mangrove ecosystems. Seychelles holds 2195ha of mangrove forests, with ∼80% of them found on the outer island of Aldabra Atoll. Seychelles mangrove ecosystems store 688,091±18,353 tonnes of organic carbon (or 2.5 million tonnes CO2e) and an average of 477.0±16.2 tonnes of carbon per hectare, with 70% of their total carbon stocks stored in their soils. Aldabra Atoll holds the highest total carbon stocks, accounting for 67% of Seychelles' mangrove stocks, despite having a relatively shallow soil organic layer (∼40cm) due to the dominance of limestone and 'coral champignon' below 40cm depth. Seychelles currently protects ∼85% of its mangrove extent including the Aldabra Atoll, a UNESCO World Heritage and Ramsar site, and Port Launay, a Ramsar site. Overall, field data from this study demonstrates the important climate mitigation potential of Seychelles' mangrove forests and the important role they play in supporting Seychelles in achieving its Nationally Determined Contributions (NDCs) commitments.

Aposematism vs. scavenging? camera trapping unveils low and seasonal-dependent consumption of toxic salamander carcasses by wild boars

Abstract Aposematic species rely on primary and secondary antipredator strategies. Yet, some opportunistic and generalist species may consume them, although this has been largely supported by indirect evidence such as dietary analyses or clay model experiments. Here, we studied the role of the wild boar, Sus scrofa, as a consumer and possible predator of an aposematic and toxic salamander, Salamandra salamandra gallaica. We investigated this behaviour using camera traps and salamander carcasses on a small island where both species co-occur. Our results show a very low proportion of salamanders consumed by wild boars (3.8%), which indicates that fire salamanders might not completely rely on their aposematic strategy to avoid being consumed by this generalist species. The number of predation events does not differ between wild boar age classes, but it does between seasons, with a higher consumption in spring, which can be associated with an increase in animal consumption when fruits (e.g., acorns) are no longer available on this island. We also highlight the need for temporal studies targeting predator-prey interactions through behavioural data and complementary approaches to better understand the possible impact of opportunistic and generalist species in the ecosystem. This is particularly important in management plans involving the control of generalist species such as the wild boar, which is considered one of the most invasive species globally and a threat to countless species worldwide.

Km-scale climate simulations over Madeira and Canary Islands under present and future conditions: a model intercomparison study

This study seeks to explore two new km-scale regional climate simulations prepared through the European Climate Prediction project over the Madeira and Canary islands, which are Portuguese and Spanish archipelagos located in the North Atlantic, off the African coast. The simulations are based on two models using different modelling approaches: COSMO-CLM with a three-step nesting at 50, 25 and 3 km grid spacing using a time-slice approach driven by a global climate model, and COSMO-crCLIM with a two-step nesting at 12 and 1 km grid spacing using the pseudo-global warming approach, where the current-day simulations are driven by ERA-Interim reanalysis. Although the modelling approaches are different, several findings are highlighted: (1) the use of km-scale simulation is essential to properly represent temperature and precipitation mean and extremes over small islands that are characterized by complex topography; (2) the projected changes in temperature and precipitation mean and extremes are qualitatively similar in all seasons except autumn; (3) the differences in the autumn projections are shown to be due to the large-scale driving conditions. Small islands, such as the Canary and Madeira ones, are often neglected by large modelling initiatives, so the presented simulations contribute to filling this gap for local policy makers, stakeholders and climate services. The encouraging results highlight the need for further coordinated km-scale projections.

Potential Sustainability of Integrated Household Constructed Wetlands (IHCWS) implementation in small island as an effort to mitigate marine pollution due to greywater domestic wastewater (A case study in Bungin Island, Indonesia)

The potential for surface marine water pollution from domestic greywater wastewater poses a threat to small, densely populated islands. This condition will affect the sustainability of the ecosystem in the surrounding environment. This research was conducted on Bungin Island, located in Sumbawa Regency, Indonesia. The island is one of the most densely populated islands with an area of only 8.5 ha and a population of 3,400 people. This research aims to map the potential sustainability of the application of Integrated Household Constructed Wetlands (IHCWS) on Bungin Island, Indonesia as an alternative to managing greywater from household activities. There are six dimensions and thirty sustainability attributes studied including ecology, socio-culture, economy, technology, policy, and public health. The data obtained were analyzed using the RAPFISH MDS method. The results showed that the potential application of IHCWS on Bungin Island in each aspect, ecology (88.68%), socio-culture (79.13%), economy (99.66%), technology (99.71%), policy (99.71%), and public health (88.68%). In conclusion, the IHCWS is classified as sustainable. The application of technology that requires maintenance is not by the conditions of small island communities. This is one of the sustainable solutions to mitigate environmental pollution, especially marine in small islands that have a high population density.

Integrating post-validation surveillance of lymphatic filariasis with the WHO STEPwise approach to non-communicable disease risk factor surveillance in Niue, a study protocol.

Lymphatic filariasis (LF), a mosquito-borne parasitic disease caused by three species of filarial worms, was first detected in Niue, a small Pacific Island nation of approximately 1,600 people, in 1954. After extensive efforts involving multiple rounds of Mass Drug Administration, Niue was validated by the World Health Organization (WHO) as having e4liminated LF as a public health problem in 2016. However, no surveillance has been conducted since validation to confirm infection rates have remained below WHO's elimination threshold. WHO has encouraged an integrated approach to disease surveillance and integrating LF post-validation surveillance (PVS) with existing surveys is an anticipated recommendation of the upcoming WHO LF-PVS guidelines. This paper describes a protocol for the implementation of an integrated approach to LF-PVS in Niue as cost-efficient and operationally feasible means of monitoring the disease in the population. The LF-PVS will be implemented as part of a planned national population-based WHO STEPwise approach to non-communicable disease (NCD) risk factor surveillance (STEPS) in Niue. Integration between the LF-PVS and STEPS will occur at multiple points, including during pre-survey community awareness raising and engagement, when obtaining informed consent, during the collection of demographics, risk factor, and location data, and when collecting finger-prick blood samples (for glucose as part of the STEPS survey and LF as part of the LF-PVS). The primary outcome measure for LF transmission will be antigen positivity. Microfilaria slides will be prepared for any antigen-positive cases. Dried blood spots will be prepared for all participants for Multiplex Bead Assays-based analysis to detect anti-filarial antibodies. We estimate a total sample size of 1,062 participants aged 15-69, representing approximately 66% of the population. The results of this study will provide insight into the status of LF in Niue and evaluate the advantages, challenges, and opportunities offered by integrated approaches to disease surveillance.