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The lack of adequate safe drinking-water together with poor sanitation and hygiene imposes an extremely high disease burden on millions of children and adults. This compromises well-being and productivity, and aggravates the cycle of poverty. Cultivating capacity for change is an important element of practically every policy reform, development programme, and country strategy aiming to improve well-being of its citizens, and with it also, e.g., water services and sanitation. The purpose of this dissertation was to recommend ways for rural water and sanitation sector specific programmes and projects to inspire capacity change for continued learning, adaptation, and innovation in the face of ever-new challenges in a volatile and unpredictable local and global environment, while the system in itself was assumed to be complex and wicked already at the present time. The specific objective was to develop futures-oriented frame of reference that can be applied for policy, programme, and project purposes. It draws from a wide range of action research the author has been involved with in Nepal, Guyana, Tanzania, and Bangladesh. It consists of six international peer-reviewed scientific articles and three case studies. The approach is constructivist and actororiented, it pays attention to agency and institutions, is plural rather than singular, differentiating rather than generalizing. The frame of reference is based on three analytical levels: 1) individual, 2) organizational/institutional, and 3) enabling environment. Rural water sector must pay attention to rural livelihoods and cross-sectoral issues to truly benefit rural development and well-being. This can be done through the multiple-use water services paradigm, adding ecological sanitation. Two of the articles studied a bi-lateral water project in Nepal that combined water supply, sanitation, irrigation, and hydro-energy with livelihoods, small cottage industries and micro-finance (cooperatives) within one project operating through local government.Conceptually and policy-wise complex system translated into tangible benefits and positive impacts in the poorest and remotest corners of Nepal once the enabling environment was conducive to allow this. It proved out to be a useful instrument for making change happen, empowering communities and encouraging continuous learning, innovation, and adaptation. Empowerment is here defined as group's or individuals' capacity to make effective choices and then transform these choices into desired actions and outcomes and with these, into services and benefits. Capacity related interventions need to have a vision that goes further than just the present state of affairs. Appreciating the complexity and dynamic nature of the rural water sector, the system should not be split into individual components or activities, such as individual training courses or narrow mandates that do not consider the broader framework within which they must operate and change. The 'capacity cube' in this dissertation represents the 'present' that moves across its different dimensions simultaneously and is in constant change in time. Framing the 'cube' allows the project or programme planners to establish the external layers of reference to give shape for the time dimension, the expected results ('services'), the external and internal drivers and barriers to change in terms of enabling environment, and the institutions and humans therein. Among others, it recommended to further study scale application of multiple use water services with ecological sanitation in the livelihoods context and the rural water service delivery paradigm.

This is a conference paper. ; Nepal has been using the Community-Led Total Sanitation (CLTS) approach since 2003/04. However, success has been varied. In some cases, the emphasis has slipped back to hardware (constructing toilets) rather than behaviour change (using toilets). Where behaviour change has occurred, it has not always been sustained. The Rural Water Supply and Sanitation Project in Western Nepal Phase II, a bilateral project of the Governments of Nepal and Finland, has developed a Step-By-Step approach to behaviour change to guide local staff, local governments and community to implement CLTS approaches sustainably. The framework strengthens pre-triggering and triggering through identifying barriers and supporting factors, and stimulates site-specific thinking on priorities to achieve true behaviour change at scale. Mobile phones are used to ensure accurate up-to-date data for the purpose.

This article examines community-driven multiple use water services (MUS) as pioneered by the Rural Village Water Resources Management Project (RVWRMP) in the Far and Mid-Western development regions of Nepal. These regions are characterised by poverty, remoteness, rugged terrain, food insecurity, water scarcity, and post-conflict legacy. Water provision for domestic and productive uses provides opportunities to address poverty and livelihoods in environments with highly decentralised governance. This study explores the first-hand lessons learned in the RVWRMP in Nepal since 2006. This project is embedded within the local government. Key project entry points are decentralisation, participation and empowerment. This article reflects how the community-managed systems are used for multiple uses whether they were designed for it or not. It focuses on household- and community-level changes and related institution building and participatory planning through Water Use Master Plans and a Step-by-Step approach. Recommendations are made for scaling up multiple use services

Eight years have passed since the European Central Bank (ECB) launched its Survey of Professional Forecasters (SPF). The SPF asks a panel of approximately 75 forecasters located in the European Union (EU) for their short- to longer-term expectations for macroeconomic variables such as euro area inflation, growth and unemployment. This paper provides an initial assessment of the information content of this survey. First, we consider shorter-term (i.e., one- and two-year ahead rolling horizon) forecasts. The analysis suggests that, over the sample period, in common with other private and institutional forecasters, the SPF systematically under-forecast inflation but that there is less evidence of such systematic errors for GDP and unemployment forecasts. However, these findings, which generally hold regardless of whether one considers the aggregate SPF panel or individual responses, should be interpreted with caution given the relatively short sample period available for the analysis. Second, we consider SPF respondents' assessment of forecast uncertainty using information from heir probability distributions. The results suggest that, particularly at the individual level, SPF respondents do not seem to fully capture the overall level of macroeconomic uncertainty. Moreover, even at the aggregate level, a more sophisticated evaluation of the SPF density forecasts using the probability integral transform largely confirms this assessment. Lastly, we consider longer-term macroeconomic expectations from the SPF, where, as expectations cannot yet be assessed against so few actual realisations, we provide a mainly qualitative assessment. With regard to inflation, the study suggests that the ECB has been successful at anchoring longterm expectations at rates consistent with its primary objective to ensure price stability over the medium term. Long-term GDP expectations - which should provide an indication of the private sector's assessment of potential growth - have declined over the sample period and the balance of risks reported by respondents has generally been skewed to the downside.

Eight years have passed since the European Central Bank (ECB) launched its Survey of Professional Forecasters (SPF). The SPF asks a panel of approximately 75 forecasters located in the European Union (EU) for their short- to longer-term expectations for macroeconomic variables such as euro area inflation, growth and unemployment. This paper provides an initial assessment of the information content of this survey. First, we consider shorter-term (i.e., one- and two-year ahead rolling horizon) forecasts. The analysis suggests that, over the sample period, in common with other private and institutional forecasters, the SPF systematically under-forecast inflation but that there is less evidence of such systematic errors for GDP and unemployment forecasts. However, these findings, which generally hold regardless of whether one considers the aggregate SPF panel or individual responses, should be interpreted with caution given the relatively short sample period available for the analysis. Second, we consider SPF respondents' assessment of forecast uncertainty using information from heir probability distributions. The results suggest that, particularly at the individual level, SPF respondents do not seem to fully capture the overall level of macroeconomic uncertainty. Moreover, even at the aggregate level, a more sophisticated evaluation of the SPF density forecasts using the probability integral transform largely confirms this assessment. Lastly, we consider longer-term macroeconomic expectations from the SPF, where, as expectations cannot yet be assessed against so few actual realisations, we provide a mainly qualitative assessment. With regard to inflation, the study suggests that the ECB has been successful at anchoring longterm expectations at rates consistent with its primary objective to ensure price stability over the medium term. Long-term GDP expectations – which should provide an indication of the private sector's assessment of potential growth – have declined over the sample period and the balance of risks reported by respondents has generally been skewed to the downside.

Water really does matter: presently some 1.2 billion people do not have access to clean water and more than 2.6 billion lack access to proper sanitation. Water-borne diseases cause the death of five to six million people in developing countries each year ­ some fifteen thousand a day! Enormous efforts will be needed to meet the set goal of wider access to water and sanitation. In the last 10 years more children have died from diarrhoea than all the people lost in armed conflicts since WWII. Improved water and sanitation services have many positive direct and indirect effects on public health and the national economy. Healthier people living to adulthood increase human resources and ultimately the productivity and well-being of nations. Besides, as regards the various water use purposes, a recent study showed that community water supply should be the first priority in all societies. The United Nations General Assembly declared the period of 2005-2015 as the International Water Decade to raise awareness and to galvanise people into action for better management and protection of our most crucial resource. "Water matters" is what the UN said in 2002. Through the Johannesburg Plan of Implementation, countries have committed themselves to the millennium target ­ to halve the proportion of people lacking access to clean water and proper sanitation by 2015. Enormous efforts will be needed to meet the goal. How can it be achieved? Lessons learned from earlier industrialised and urbanised societies might help us understand the present crisis. This book is based on the multidisciplinary research project "Governance of water and environmental services in long-term perspectives (GOWLOP) ­ A Comparative Study" funded by the Academy of Finland (project number 210816). The study explores the long-term development of the relationships between water supply and sanitation, environmental health, and social change in a global context with a special focus on Kenya, Nepal, South Africa and Finland. The general objective of the project was to enhance our knowledge and understanding of the development of water use, water supply, water pollution control and sanitation services, and their overall long-term political, economic, social, cultural, technological, environmental and health impacts. The study aimed to explain the strategic decisions made over the years and to identify the key drivers ­- strategies, principles and practices ­ which have resulted in historically significant changes in public health and overall development of community water supply and sanitation services, their governance, social importance and impacts during two urbanisation periods in Africa (Kenya, South Africa), Asia (Nepal) and Europe (Finland). Some key findings of the GOWLOP project are presented in this book.

Poster presented at the European Fuel Cell Conference 2017 (EFC2017 - 12-15 December 2017, Naples - Italy) resuming main objective and results of the European project qSOFC (Automated mass-manufacturing and quality assurance of Solid Oxide Fuel Cell stacks). This project has received funding from the Fuel Cells and Hydrogen 2 Joint Undertaking grant agreement No 735160. This Joint Undertaking receives support from The European Union's Horizon 2020 Research and Innovation programme.

The Constitution of Nepal 2015 enshrines everyone's right of access to clean water for drinking and the right to food. The common operationalization of the right to water for drinking is providing access to infrastructure that brings water for drinking and other basic domestic uses near and at homesteads. Challenges to achieving this goal in rural areas include: low functionality of water systems; expansion of informal self supply for multiple uses; widespread de facto productive uses of water systems designed for domestic uses; growing competition for finite water resources; and male elite capture in polycentric decision-making. This paper traces how the Nepali government and nongovernmental organizations in the water, sanitation and hygiene (WASH), irrigation and other sectors have joined forces since the early 2000s to address these challenges by innovating community-led multiple use water services (MUS). The present literature review of these processes complemented by field research supported by the Water for Women Fund focuses on women in vulnerable households. Overcoming sectoral silos, these organizations support what is often seen as the sole responsibility of the WASH sector: targeting infrastructure development to bring sufficient water near and at homesteads of those left behind. Women's priorities for using this water are respected and supported, which often includes productive uses, also at basic volumes. In line with decentralized federalism, inclusive community-led MUS planning processes build on vulnerable households' self supply, commonly for multiple uses, and follow their priorities for local incremental infrastructure improvements. Further, community-led MUS builds on community-based arrangements for 'sharing in' and 'sharing out' the finite water resources in and under communities' social territories. This realizes the constitutional right to food in line with the Nepal Water Resources Act, 1992, which prioritizes core minimum volumes of water for everyone's domestic uses and many households' irrigation. Evidence shows how the alleviation of domestic chores, women's stronger control over food production for nutrition and income, and more sustainable infrastructure mutually reinforce each other in virtuous circles out of gendered poverty. However, the main challenge remains the inclusion of women and vulnerable households in participatory processes.

BACKGROUND: Sepsis is an increasingly common condition, which continues to be associated with unacceptably high mortality. A large number of association studies have investigated susceptibility to, or mortality from, sepsis for variants in the functionally important immune-related gene MBL2. These studies have largely been underpowered and contradictory. METHODS: We genotyped and analyzed 4 important MBL2 single nucleotide polymorphisms (SNPs; rs5030737, rs1800450, rs1800451, and rs7096206) in 1839 European community-acquired pneumonia (CAP) and peritonitis sepsis cases, and 477 controls from the United Kingdom. We analyzed the following predefined subgroups and outcomes: 28-day and 6 month mortality from sepsis due to CAP or peritonitis combined, 28-day mortality from CAP sepsis, peritonitis sepsis, pneumococcal sepsis or sepsis in younger patients, and susceptibility to CAP sepsis or pneumococcal sepsis in the United Kingdom. RESULTS: There were no significant associations (all P-values were greater than .05 after correction for multiple testing) between MBL2 genotypes and any of our predefined analyses. CONCLUSIONS: In this large, well-defined cohort of immune competent adult patients, no associations between MBL2 genotype and sepsis susceptibility or outcome were identified. ; The GenOSept study was supported by the European Union and benefits from the 6th framework programme of Research and Technology Development funding. This study was also funded by the GRACE project (6th Framework Programme of the European Commission Reference: LSHM-CT-2005-518226) and the Wellcome Trust Core Award (Grant Number 090532/Z/09/Z). We acknowledge the support of the National Institute for Health Research (NIHR), through the Comprehensive Clinical Research Network for patient recruitment in the UK and A. C. G. as an NIHR Clinician Scientist award holder ; The GenOSept study was supported by the European Union and benefits from the 6th framework programme of Research and Technology Development funding. This study was also funded by the GRACE project (6th Framework Programme of the European Commission Reference: LSHM-CT-2005-518226) and the Wellcome Trust Core Award (Grant Number 090532/Z/09/Z). We acknowledge the support of the National Institute for Health Research (NIHR), through the Comprehensive Clinical Research Network for patient recruitment in the UK and A. C. G. as an NIHR Clinician Scientist award holder

Sepsis is the dysregulated host response to an infection which leads to life-threatening organ dysfunction that varies by host genomic factors. We conducted a genome-wide association study (GWAS) in 740 adult septic patients and focused on 28day mortality as outcome. Variants with suggestive evidence for an association (p≤10-5) were validated in two additional GWA studies (n=3470) and gene coding regions related to the variants were assessed in an independent exome sequencing study (n=74). In the discovery GWAS, we identified 243 autosomal variants which clustered in 14 loci (p≤10-5). The best association signal (rs117983287; p=8.16×10-8) was observed for a missense variant located at chromosome 9q21.2 in the VPS13A gene. VPS13A was further supported by additional GWAS (p=0.03) and sequencing data (p=0.04). Furthermore, CRISPLD2 (p=5.99×10-6) and a region on chromosome 13q21.33 (p=3.34×10-7) were supported by both our data and external biological evidence. We found 14 loci with suggestive evidence for an association with 28day mortality and found supportive, converging evidence for three of them in independent data sets. Elucidating the underlying biological mechanisms of VPS13A, CRISPLD2, and the chromosome 13 locus should be a focus of future research activities. ; The project was supported by the Paul-Martini-Sepsis Research Group, funded by the Thuringian Ministry of Education, Science and Culture (ProExcellence; grant PE 108-2); the public funded Thuringian Foundation for Technology, Innovation and Research (STIFT) and the German Sepsis Society (GSS); the Jena Center of Sepsis Control and Care (CSCC), funded by the German Ministry of Education and Research (BMBF; 01 EO 1002, 01 EO 1502). The VISEP and MAXSEP trials from the SepNet Study Group had been supported by a BMBF grant (01 KI 0106) and by unrestricted grants from B. Braun, HemoCue, Novo Nordisk, Astra Zeneca GmbH, Wedel, Germany and Bayer HealthCare, Leverkusen, Germany. The exome sequencing study was funded in part by the Hellenic Institute for the Study of Sepsis. The GenOSept study was supported by the European Union and benefits from the 6th framework programme of RTD funding. The PROGRESS study is supported by the German Federal Ministry of Education and Research, grant numbers 01KI07110 (Giessen), 01KI07111 (Jena), 01KI07113 (Leipzig), 01KI07114 (Berlin), 01KI1010I (Leipzig), and 01KI1010D (Greifswald).