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Spanning humanitarian responses from all over the world, Shelter Projects 2015-2016 is the sixth in a series of compilations of shelter case studies, overviews of emergencies and opinion pieces. The projects represent responses to conflict, natural disasters and complex or multiple crises, demonstrating some of the implementation and response options available. The book is intended to support learning by highlighting the strengths, weaknesses and some of the lessons that can be learned from different projects, which try to maximize emergency funds to safeguard the health, security and dignity of affected people, whilst – wherever possible – supporting longer-term shelter needs and sustainable recovery. The target audience is humanitarian managers and shelter programme staff from local, national and international organizations at all levels of experience. Shelter Projects is also a useful resource for advocacy purposes, showcasing the work done by the sector, as well as for research and capacity-building activities.

Background: One of the millennium development goals is to improve the quality of women’s health through choice accessibility and gender equality. Contraception plays an important role to reduce maternal and child mortality by avoiding unwanted pregnancies. Objectives: To study the acceptability success rate and short term side effects of sub-dermal contraceptive implants (SCI) available as SINO Implant (II) and to determine the reasons for its discontinuation. Study design settings and duration Descriptive prospective study conducted at a Private Medical Centre Trameri Islamabad from February 2015– February 2016. Subjects and Methods: All women aged between 25-45 years wishing to use sub-dermal contraceptive implants were included in the study. Women with bleeding disorders and those weighing > 80kg were excluded. All women were explained about the study and written informed consent was taken. The contraceptive implants SINO (II) containing Levonorgestrel were placed under local anesthesia. A questionnaire was used to collect information on demography and study specific variables e.g. side effects implant acceptability satisfaction and reasons for discontinuation. Women were followed at the clinic and also telephonically at interval of one and six month post insertion. Results: Out of 105 women 08 did not meet the criteria for insertion and were excluded while 97 women were enrolled for the study. Their mean age was 31 years (SD ± 5.34). Minimum parity was 01 and maximum 07. Mean period of last child birth (LCB) before implant insertion was 25.35 months (SD ± 32.86 range 1-156 months). Out of 97 women 51 (53.4%) were using some kind of contraception prior to the placement of implant. Most common side effect of implant were spotting 17 (18%) followed by irregular vaginal bleeding and weight gain in 11 (12.2%) each. At 6 months rate of continuation of implant was 82.7% with 62 (64%) women having no complaints at all while 35 (36%) experienced some. After 6 months 77 women (79%) continued to use the implant while 12 discontinued it (5 had removed in first 3 months 7 between 3 and 6 month after insertion). Conclusion: Sub-dermal contraceptive implants were safe and convenient to use with high acceptability. They can be used as the method of choice for long term reversible contraception.

The ways in which cell architecture is modelled to meet cell function is a poorly understood facet of cell biology. To address this question, we have studied the cytoarchitecture of a cell with highly specialised organisation, the cochlear inner hair cell (IHC), using multiple hierarchies of 3D electron microscopy analyses. We show that synaptic terminal distribution on the IHC surface correlates with cell shape, and the distribution of a highly organised network of membranes and mitochondria encompassing the infranuclear region of the cell. This network is juxtaposed to a population of small vesicles and represents a potential new source of neurotransmitter vesicles for replenishment of the synapses. Structural linkages between organelles that underlie this organisation were identified by high resolution imaging. Together these results describe a cell-encompassing network of membranes and mitochondria present in IHCs which support efficient coding and transmission of auditory signals. Such techniques also have the potential for clarifying functionally specialised cytoarchitecture of other cell types.

The lateral membrane of mammalian cochlear outer hair cells contains prestin, a protein which can act as a fast voltage-driven actuator responsible for electromotility and enhanced sensitivity to sound. The protein belongs to the SLC26 family of transporters whose members are characterised as able to exchange halides for SO(4)(2-) or HCO(3)(-) yet previous analyses of mammalian prestin have suggested that such exchange functions were minimal. Here anion transport is investigated both in guinea-pig outer hair cells (OHCs) and in an expression system where we employ a sensitive intracellular pH (pH(i)) probe, pHluorin, to report HCO(3)(-) transport and to monitor the small pH(i) changes observable in the cells. In the presence of extracellular HCO(3)(-), pH(i) recovered from an acid load 4 times faster in prestin-transfected cells. The acceleration required a chloride gradient established by reducing extracellular chloride to 2 mm. Similar results were also shown using BCECF as an alternative pH(i) sensor, but with recovery only found in those cells expressing prestin. Simultaneous electrophysiological recording of the transfected cells during bicarbonate exposure produced a shift in the reversal potential to more negative potentials, consistent with electrogenic transport. These data therefore suggest that prestin can act as a weak Cl(-)/HCO(3)(-) antiporter and it is proposed that, in addition to participating in wide band cochlear sound amplification, prestin may also be involved in the slow time scale (10 s) phenomena where changes in cell stiffness and internal pressure have been implicated. The results show the importance of considering the effects of the endogenous bicarbonate buffering system in evaluating the function of prestin in cochlear outer hair cells.