Search results for: Clinical Practice Guideline

Authors: Frederick Gooding

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This paper explores how many Hip Hop artists have intentionally and strategically invoked sustainability principles of people, planet and profits as a means to create community, compensate for and cope with structural inequalities in society. These themes not only create community within one's country, but the powerful display and demonstration of these narratives create community on a global plane. Listeners of Hip Hop are therefore able to learn about the political events occurring in another country free of censure, and establish solidarity worldwide. Hip Hop therefore can be an ingenious tool to create self-worth, recycle positive imagery, and serve as a defense mechanism from institutional and structural forces that conspire to make an upward economic and social trajectory difficult, if not impossible for many people of color, all across the world. Although the birthplace of Hip Hop, the United States of America, is still predominately White, it has undoubtedly grown more diverse at a breath-­taking pace in recent decades. Yet, whether American mainstream media will fully reflect America’s newfound diversity remains to be seen. As it stands, American mainstream media is seen and enjoyed by diverse audiences not just in America, but all over the world. Thus, it is imperative that further inquiry is conducted about one of the fastest growing genres within one of the world’s largest and most influential media industries generating upwards of $10 billion annually. More importantly, hip hop, its music and associated culture collectively represent a shared social experience of significant value. They are important tools used both to inform and influence economic, social and political identity. Conversely, principles of American exceptionalism often prioritize American political issues over those of others, thereby rendering a myopic political view within the mainstream. This paper will therefore engage in an international contextualization of the global phenomena entitled Hip Hop by exploring the creative genius and marketing appeal of Hip Hop within the global context of information technology, political expression and social change in addition to taking a critical look at historically racialized imagery within mainstream media. Many artists the world over have been able to freely express themselves and connect with broader communities outside of their own borders, all through the sound practice of the craft of Hip Hop. An empirical understanding of political, social and economic forces within the United States will serve as a bridge for identifying and analyzing transnational themes of commonality for typically marginalized or disaffected communities facing similar struggles for survival and respect. The sharing of commonalities of marginalized cultures not only serves as a source of education outside of typically myopic, mainstream sources, but it also creates transnational bonds globally to the extent that practicing artists resonate with many of the original themes of (now mostly underground) Hip Hop as with many of the African American artists responsible for creating and fostering Hip Hop's powerful outlet of expression. Hip Hop's power of connectivity and culture-sharing transnationally across borders provides a key source of education to be taken seriously by academics.

Keywords: culture, education, global, hip hop, mainstream music, transnational

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Authors: G. Kiran Kumar, K. Padmaja

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The rise of urban and peri-urban agriculture (UPA) is an important urban phenomenon that needs to be well understood before we pronounce a verdict whether it is beneficial or not. The challenge of supply of safe and nutritious food is faced by urban inhabitants. The definition of urban and peri-urban varies from city to city depending on the local policies framed with a view to bring regulated urban habitations as part of governance. Expansion of cities and the blurring of boundaries between urban and rural areas make it difficult to define peri-urban agriculture. The problem is further exacerbated by the fact that definition adopted in one region may not fit in the other. On the other hand the proportion of urban population is on the rise vis-à-vis rural. The rise of UPA does not promise that the food requirements of cities can be entirely met from this practice, since availability of enormous amounts of spaces on rooftops and vacant plots is impossible for raising crops. However, UPA reduces impact of price volatility, particularly for vegetables, which relatively have a longer shelf life. UPA improves access to fresh, nutritious and safe food for the urban poor. UPA provides employment to food handlers and traders in the supply chain. UPA can pose environmental and health risks from inappropriate agricultural practices; increased competition for land, water and energy; alter the ecological landscape and make it vulnerable to increased pollution. The present work is based on case studies in peri-urban agriculture in Hyderabad, India and relies on secondary data. This paper tries to analyze the need for more intensive production technologies without affecting the environment. An optimal solution in terms of urban-rural linkages has to be devised. There is a need to develop a spatial vision and integrate UPA in urban planning in a harmonious manner. Zoning of peri-urban areas for agriculture, milk and poultry production is an essential step to preserve the traditional nurturing character of these areas. Urban local bodies in conjunction with Departments of Agriculture and Horticulture can provide uplift to existing UPA models, without which the UPA can develop into a haphazard phenomenon and add to the increasing list of urban challenges. Land to be diverted for peri-urban agriculture may render the concept of urban and peri-urban forestry ineffective. This paper suggests that UPA may be practiced for high value vegetables which can be cultivated under protected conditions and are better resilient to climate change. UPA can provide models for climate resilient agriculture in urban areas which can be replicated in rural areas. Production of organic farm produce is another option for promote UPA owing to the proximity to informed consumers and access to markets within close range. Waste lands in peri-urban areas can be allotted to unemployed rural youth with the support of Urban Local Bodies (ULBs) and used for UPA. This can serve the purposes of putting wastelands to food production, enhancing employment opportunities and enhancing access to fresh produce for urban consumers.

Keywords: environment, food security, urban and peri-urban agriculture, zoning

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Authors: Mark Heads, Carrie Adamson

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Introduction This study evaluated the educational merits of the teaching activities of ‘Sheffield Anatomy Society,’ a student society with minimal faculty oversight which delivers near peer teaching in a range of formats to support students in their revision. Near peer, teaching is defined as teaching delivered by more senior students who have themselves recently completed the course content. This study was conducted between early April and late May 2022. This programme aims to improve student knowledge of anatomy, increase student confidence in their anatomy learning and cultivate a sense of community. The sessions were delivered by more senior medical students and by medical students undertaking an intercalated Master's degree in Human Anatomy with Education. Background: The majority of studies concerning near peer teaching focus on faculty designed programmes. Few studies have examined entirely student led near peer teaching of anatomy. Existing studies have been favourable but have limited qualitative examination of the benefits and weaknesses of near peer teaching. Various drawbacks have been proposed in the literature but not extensively investigated in practice. This study examines student led near peer anatomy teaching across a range of formats and considers these proposed criticisms. Methods: The teaching series consisted of 11 online lectures, a small group teaching session, two in person mock spotter examinations, and an online mock examination. Feedback forms were given for each session, and follow up interviews were conducted. Thematic analysis utilising an interpretivist epistemology was conducted on the feedback form responses and interview transcripts. Findings: 207 first year medical students, 34 second year biomedical science students, and 12 third year biomedical science students completed one or more feedback forms following these sessions, with 875 responses being collected in total. Six interviews were conducted. 99.5% of respondents said that they would recommend these sessions to other students. The quantitative results ranged from a mean of 4.6-4.8/5 per session when asked to rate how useful the students found it. Qualitative: analysis yielded numerous strengths and some weaknesses of the programme. The most commonly cited strength was that students found the explanations readily comprehensible. Students also praised the interactive nature of the sessions, with students frequently saying they felt more able to engage with interactive elements and ask questions in these sessions than in faculty teaching. Students did, however, raise some issues. The most common drawback students mentioned was a desire for more help preparing for their examinations, especially more examination style questions. Criticisms of the teaching itself were less prominent and typically reflected time constraints and limited resources. Conclusions : This study suggests student organised near peer teaching, utilising interactive online lectures, small group teaching, and mock examinations, can be an effective method for supporting students studying anatomy. Students reported improvements in their knowledge as a result of the sessions, greater confidence approaching their examinations, and this programme has helped foster an environment where students feel able to ask questions outside of sessions and even get involved with teaching themselves the following academic year.

Keywords: medical education, near peer teaching, anatomy teaching, online learning

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Authors: Mabel Y. C. Yau, Roy C. F. Lai, Hugo Y. H. Or

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This study is a pilot surveillance of hygiene compliance and food microbial safety of both licensed and mobile vendors selling Chinese ready–to-eat snack foods in Hong Kong. The study reflects similar situations in running mobile food vending business on trucks. Hong Kong is about to launch the Food Truck Pilot Scheme by the end of 2016 or early 2017. Technically, selling food on the vehicle is no different from hawking food on the street or vending food on the street. Each type of business bears similar food safety issues and cast the same impact on public health. Present findings demonstrate exemplarily situations that also apply to food trucks. 9 types of Cantonese style snacks of 32 samples in total were selected for microbial screening. A total of 16 vending sites including supermarkets, street markets, and snack stores were visited. The study finally focused on a traditional snack, the steamed rice cake with red beans called Put Chai Ko (PCK). PCK is a type of classical Cantonese pastry sold on push carts on the street. It used to be sold at room temperature and served with bamboo sticks in the old days. Some shops would have them sold steam fresh. Microbial examinations on aerobic counts, yeast, and mould, coliform, salmonella as well as Staphylococcus aureus detections were carried out. Salmonella was not detected in all samples. Since PCK does not contain ingredients of beef, poultry, eggs or dairy products, the risk of the presence of Salmonella in PCK was relatively lower although other source of contamination might be possible. Coagulase positive Staphylococcus aureus was found in 6 of the 14 samples sold at room temperature. Among these 6 samples, 3 were PCK. One of the samples was in an unacceptable range of total colony forming units higher than 105. The rest were only satisfactory. Observational evaluations were made with checklists on personal hygiene, premises hygiene, food safety control, food storage, cleaning and sanitization as well as waste disposals. The maximum score was 25 if total compliance were obtained. The highest score among vendors was 20. Three stores were below average, and two of these stores were selling PCK. Most of the non-compliances were on food processing facilities, sanitization conditions and waste disposal. In conclusion, although no food poisoning outbreaks happened during the time of the investigation, the risk of food hazard existed in these stores, especially among street vendors. Attention is needed in the traditional practice of food selling, and that food handlers might not have sufficient knowledge to properly handle food products. Variations in food qualities existed among supply chains or franchise eateries or shops. It was commonly observed that packaging and storage conditions are not properly enforced in the retails. The same situation could be reflected across the food business. It did indicate need of food safety training in the industry and loopholes in quality control among business.

Keywords: cantonese snacks, food safety, microbial, hygiene, street food

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Authors: May Bazzi, Shafik Tokmaj, Younes Saberi, Mats Geijer, Tony Jurkiewicz, Patrik Sund, Anna Bjällmark

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Mobile radiography, employing portable X-ray equipment, has become a routine procedure within hospital settings, with chest X-rays in intensive care units standing out as the most prevalent mobile X-ray examinations. This approach is not limited to hospitals alone, as it extends its benefits to imaging patients in various settings, particularly those too frail to be transported, such as elderly care residents in nursing homes. Moreover, the utility of mobile X-ray isn't confined solely to traditional healthcare recipients; it has proven to be a valuable resource for vulnerable populations, including the homeless, drug users, asylum seekers, and patients with multiple co-morbidities. Mobile X-rays reduce patient stress, minimize costly hospitalizations, and offer cost-effective imaging. While studies confirm its reliability, further research is needed, especially regarding image quality. Recent advancements in lightweight equipment with enhanced battery and detector technology provide the potential for nearly handheld radiography. The main aim of this study was to evaluate a new lightweight mobile X-ray system with two different detectors and compare the image quality with a modern stationary system. Methods: A total of 74 images of the chest (chest anterior-posterior (AP) views and chest lateral views) and pelvic/hip region (AP pelvis views, hip AP views, and hip cross-table lateral views) were acquired on a whole-body phantom (Kyotokagaku, Japan), utilizing varying image parameters. These images were obtained using a stationary system - 18 images (Mediel, Sweden), a mobile X-ray system with a second-generation detector - 28 images (FDR D-EVO II; Fujifilm, Japan) and a mobile X-ray system with a third-generation detector - 28 images (FDR D-EVO III; Fujifilm, Japan). Image quality was assessed by visual grading analysis (VGA), which is a method to measure image quality by assessing the visibility and accurate reproduction of anatomical structures within the images. A total of 33 image criteria were used in the analysis. A panel of two experienced radiologists, two experienced radiographers, and two final-term radiographer students evaluated the image quality on a 5-grade ordinal scale using the software Viewdex 3.0 (Viewer for Digital Evaluation of X-ray images, Sweden). Data were analyzed using visual grading characteristics analysis. The dose was measured by the dose-area product (DAP) reported by the respective systems. Results: The mobile X-ray equipment (both detectors) showed significantly better image quality than the stationary equipment for the pelvis, hip AP and hip cross-table lateral images with AUCVGA-values ranging from 0.64-0.92, while chest images showed mixed results. The number of images rated as having sufficient quality for diagnostic use was significantly higher for mobile X-ray generation 2 and 3 compared with the stationary X-ray system. The DAP values were higher for the stationary compared to the mobile system. Conclusions: The new lightweight radiographic equipment had an image quality at least as good as a fixed system at a lower radiation dose. Future studies should focus on clinical images and consider radiographers' viewpoints for a comprehensive assessment.

Keywords: mobile x-ray, visual grading analysis, radiographer, radiation dose

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Authors: Antonella Falanga, Armando Cartenì

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Today, an unprecedented amount of data coming from several sources, including mobile devices, sensors, tracking systems, and online platforms, characterizes our lives. The term “big data” not only refers to the quantity of data but also to the variety and speed of data generation. These data hold valuable insights that, when extracted and analyzed, facilitate informed decision-making. The 4Vs of big data - velocity, volume, variety, and value - highlight essential aspects, showcasing the rapid generation, vast quantities, diverse sources, and potential value addition of these kinds of data. This surge of information has revolutionized many sectors, such as business for improving decision-making processes, healthcare for clinical record analysis and medical research, education for enhancing teaching methodologies, agriculture for optimizing crop management, finance for risk assessment and fraud detection, media and entertainment for personalized content recommendations, emergency for a real-time response during crisis/events, and also mobility for the urban planning and for the design/management of public and private transport services. Big data's pervasive impact enhances societal aspects, elevating the quality of life, service efficiency, and problem-solving capacities. However, during this transformative era, new challenges arise, including data quality, privacy, data security, cybersecurity, interoperability, the need for advanced infrastructures, and staff training. Within the transportation sector (the one investigated in this research), applications span planning, designing, and managing systems and mobility services. Among the most common big data applications within the transport sector are, for example, real-time traffic monitoring, bus/freight vehicle route optimization, vehicle maintenance, road safety and all the autonomous and connected vehicles applications. Benefits include a reduction in travel times, road accidents and pollutant emissions. Within these issues, the proper transport demand estimation is crucial for sustainable transportation planning. Evaluating the impact of sustainable mobility policies starts with a quantitative analysis of travel demand. Achieving transportation decarbonization goals hinges on precise estimations of demand for individual transport modes. Emerging technologies, offering substantial big data at lower costs than traditional methods, play a pivotal role in this context. Starting from these considerations, this study explores the usefulness impact of big data within transport demand estimation. This research focuses on leveraging (big) data collected during the COVID-19 pandemic to estimate the evolution of the mobility demand in Italy. Estimation results reveal in the post-COVID-19 era, more than 96 million national daily trips, about 2.6 trips per capita, with a mobile population of more than 37.6 million Italian travelers per day. Overall, this research allows us to conclude that big data better enhances rational decision-making for mobility demand estimation, which is imperative for adeptly planning and allocating investments in transportation infrastructures and services.

Keywords: big data, cloud computing, decision-making, mobility demand, transportation

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Authors: William Ho, Agus Wicaksana

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Anecdotal evidence in the last decade shows that the occurrence of disruptive events and uncertainties in the supply chain is increasing. The coupling of these events with the nature of an increasingly complex and interdependent business environment leads to devastating impacts that quickly propagate within and across organizations. For example, the recent COVID-19 pandemic increased the global supply chain disruption frequency by at least 20% in 2020 and is projected to have an accumulative cost of $13.8 trillion by 2024. This crisis raises attention to organizational resilience to weather business uncertainty. However, the concept has been criticized for being vague and lacking a consistent definition, thus reducing the significance of the concept for practice and research. This study is intended to solve that issue by providing a comprehensive review of the conceptualization, measurement, and antecedents of operational resilience that have been discussed in the supply chain risk management literature (SCRM). We performed a Scholarly Network Analysis, combining citation-based and text-based approaches, on 252 articles published from 2000 to 2021 in top-tier journals based on three parameters: AJG ranking and ABS ranking, UT Dallas and FT50 list, and editorial board review. We utilized a hybrid scholarly network analysis by combining citation-based and text-based approaches to understand the conceptualization, measurement, and antecedents of operational resilience in the SCRM literature. Specifically, we employed a Bibliographic Coupling Analysis in the research cluster formation stage and a Co-words Analysis in the research cluster interpretation and analysis stage. Our analysis reveals three major research clusters of resilience research in the SCRM literature, namely (1) supply chain network design and optimization, (2) organizational capabilities, and (3) digital technologies. We portray the research process in the last two decades in terms of the exemplar studies, problems studied, commonly used approaches and theories, and solutions provided in each cluster. We then provide a conceptual framework on the conceptualization and antecedents of resilience based on studies in these clusters and highlight potential areas that need to be studied further. Finally, we leverage the concept of abnormal operating performance to propose a new measurement strategy for resilience. This measurement overcomes the limitation of most current measurements that are event-dependent and focus on the resistance or recovery stage - without capturing the growth stage. In conclusion, this study provides a robust literature review through a scholarly network analysis that increases the completeness and accuracy of research cluster identification and analysis to understand conceptualization, antecedents, and measurement of resilience. It also enables us to perform a comprehensive review of resilience research in SCRM literature by including research articles published during the pandemic and connects this development with a plethora of articles published in the last two decades. From the managerial perspective, this study provides practitioners with clarity on the conceptualization and critical success factors of firm resilience from the SCRM perspective.

Keywords: supply chain risk management, organizational resilience, scholarly network analysis, systematic literature review

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Authors: Carmen W. H. Chan, Helen Y. L. Chan, Kai Chow Choi, Ka Ming Chow, Cecilia W. M. Kwan, Nancy H. Y. Ng, Jackie Robinson

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Introduction: In Hong Kong, a significant number of deaths occur in acute care wards, which requires nurses in these settings to provide end-of-life care and lead ACP implementation. However, nurses in these settings, in fact, have very low-level involvement in ACP discussions because of limited training in ACP conversations. Objective: This study aims to assess the impact of a multi-media experiential ACP (MEACP) training program, which is guided by the experiential learning model and theory of planned behaviour, on nurses' knowledge and confidence in assisting patients with ACP. Methodology: The study utilizes a cluster randomized controlled trial with a 12-week follow-up. Eligible nurses working in acute care hospital wards are randomly assigned at the ward level, in a 1:1 ratio, to either the control group (no ACP education) or the intervention group (4-week MEACP training program). The training programme includes training through a webpage and mobile application, as well as a face-to-face training workshop with enhanced lectures and role play, which is based on the Theory of Planned Behavior and Kolb's Experiential Learning Model. Questionnaires were distributed to assess nurses' knowledge (a 10-item true/false questionnaire) and level of confidence (five-point Likert scale) in ACP at baseline (T0), four weeks after the baseline assessment (T1), and 12 weeks after T1 (T2). In this interim report, data analysis was mainly descriptive in nature. Result: The interim report focuses on the preliminary results of 165 nurses at T0 (Control: 74, Intervention: 91) over a 5-month period, 69 nurses from the control group who completed the 4-week follow-up and 65 nurses from the intervention group who completed the 4-week MEACP training program at T1. The preliminary attrition rate is 6.8% and 28.6% for the control and intervention groups, respectively, as some nurses did not complete the whole set of online modules. At baseline, the two groups were generally homogeneous in terms of their years of nursing practice, weekly working hours, working title, and level of education, as well as ACP knowledge and confidence levels. The proportion of nurses who answered all ten knowledge questions correctly increased from 13.8% (T0) to 66.2% (T1) for the intervention group and from 13% (T0) to 20.3% (T1) for the control group. The nurses in the intervention group answered an average of 7.57 and 9.43 questions correctly at T0 and T1, respectively. They showed a greater improvement in the knowledge assessment at T1 with respect to T0 when compared with their counterparts in the control group (mean difference of change score, Δ=1.22). They also exhibited a greater gain in level of confidence at T1 compared to their colleagues in the control group (Δ=0.91). T2 data is yet available. Conclusion: The prevalence of nurses engaging in ACP and their level of knowledge about ACP in Hong Kong is low. The MEACP training program can enrich nurses by providing them with more knowledge about ACP and increasing their confidence in conducting ACP.

Keywords: advance directive, advance care planning, confidence, knowledge, multi-media experiential, randomised control trial

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Authors: Pedro Llanos, Diego García

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This paper is addressed to expanding our understanding of the effects of hypoxia training on our bodies to better model its dynamics and leverage some of its implications and effects on human health. Hypoxia training is a recommended practice for military and civilian pilots that allow them to recognize their early hypoxia signs and symptoms, and Scientist Astronaut Candidates (SACs) who underwent hypobaric hypoxia (HH) exposure as part of a training activity for prospective suborbital flight applications. This observational-analytical study describes physiologic responses and symptoms experienced by a SAC group before, during and after HH exposure and proposes a model for assessing predicted versus observed physiological responses. A group of individuals with diverse Science Technology Engineering Mathematics (STEM) backgrounds conducted a hypobaric training session to an altitude up to 22,000 ft (FL220) or 6,705 meters, where heart rate (HR), breathing rate (BR) and core temperature (Tc) were monitored with the use of a chest strap sensor pre and post HH exposure. A pulse oximeter registered levels of saturation of oxygen (SpO₂), number and duration of desaturations during the HH chamber flight. Hypoxia symptoms as described by the SACs during the HH training session were also registered. This data allowed to generate a preliminary predictive model of the oxygen desaturation and O₂ pressure curve for each subject, which consists of a sixth-order polynomial fit during exposure, and a fifth or fourth-order polynomial fit during recovery. Data analysis showed that HR and BR showed no significant differences between pre and post HH exposure in most of the SACs, while Tc measures showed slight but consistent decrement changes. All subjects registered SpO₂ greater than 94% for the majority of their individual HH exposures, but all of them presented at least one clinically significant desaturation (SpO₂ < 85% for more than 5 seconds) and half of the individuals showed SpO₂ below 87% for at least 30% of their HH exposure time. Finally, real time collection of HH symptoms presented temperature somatosensory perceptions (SP) for 65% of individuals, and task-focus issues for 52.5% of individuals as the most common HH indications. 95% of the subjects experienced HH onset symptoms below FL180; all participants achieved full recovery of HH symptoms within 1 minute of donning their O₂ mask. The current HH study performed on this group of individuals suggests a rapid and fully reversible physiologic response after HH exposure as expected and obtained in previous studies. Our data showed consistent results between predicted versus observed SpO₂ curves during HH suggesting a mathematical function that may be used to model HH performance deficiencies. During the HH study, real-time HH symptoms were registered providing evidenced SP and task focusing as the earliest and most common indicators. Finally, an assessment of HH signs of symptoms in a group of heterogeneous, non-pilot individuals showed similar results to previous studies in homogeneous populations of pilots.

Keywords: slow onset hypoxia, hypobaric chamber training, altitude sickness, symptoms and altitude, pressure cabin

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Authors: U. S. Putro, L. Mayangsari, M. Siallagan, N. P. Tjahyani

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National Collective Management Institute (LKMN) in Indonesia stated that legal music products were about 77.552.008 unit while illegal music products were about 22.0688.225 unit in 1996 and this number keeps getting worse every year. Consequently, Indonesia named as one of the countries with high piracy levels in 2005. This study models people decision toward unlawful behavior, music content piracy in particular, using agent-based modeling and simulation (ABMS). The classification of actors in the model constructed in this study are legal consumer, illegal consumer, and neutral consumer. The decision toward piracy among the actors is a manifestation of the social norm which attributes are social pressure, peer pressure, social approval, and perceived prevalence of piracy. The influencing attributes fluctuate depending on the majority of surrounding behavior called social network. There are two main interventions undertaken in the model, campaign and peer influence, which leads to scenarios in the simulation: positively-framed descriptive norm message, negatively-framed descriptive norm message, positively-framed injunctive norm with benefits message, and negatively-framed injunctive norm with costs message. Using NetLogo, the model is simulated in 30 runs with 10.000 iteration for each run. The initial number of agent was set 100 proportion of 95:5 for illegal consumption. The assumption of proportion is based on the data stated that 95% sales of music industry are pirated. The finding of this study is that negatively-framed descriptive norm message has a worse reversed effect toward music piracy. The study discovers that selecting the context-based campaign is the key process to reduce the level of intention toward music piracy as unlawful behavior by increasing the compliance awareness. The context of Indonesia reveals that that majority of people has actively engaged in music piracy as unlawful behavior, so that people think that this illegal act is common behavior. Therefore, providing the information about how widespread and big this problem is could make people do the illegal consumption behavior instead. The positively-framed descriptive norm message scenario works best to reduce music piracy numbers as it focuses on supporting positive behavior and subject to the right perception on this phenomenon. Music piracy is not merely economical, but rather social phenomenon due to the underlying motivation of the actors which has shifted toward community sharing. The indication of misconception of value co-creation in the context of music piracy in Indonesia is also discussed. This study contributes theoretically that understanding how social norm configures the behavior of decision-making process is essential to breakdown the phenomenon of unlawful behavior in music industry. In practice, this study proposes that reward-based and context-based strategy is the most relevant strategy for stakeholders in music industry. Furthermore, this study provides an opportunity that findings may generalize well beyond music piracy context. As an emerging body of work that systematically constructs the backstage of law and social affect decision-making process, it is interesting to see how the model is implemented in other decision-behavior related situation.

Keywords: music piracy, social norm, behavioral decision-making, agent-based model, value co-creation

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Authors: Nataliya G. Olkhovik

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Nowadays in the system of Russian higher medical education there have been undertaken initiatives that resulted in focusing on the resources of e-learning in teaching foreign languages. Obviously, the face-to-face communication in foreign languages bears much more advantages in terms of effectiveness in comparison with the potential of e-learning. Thus, we’ve faced the necessity of strengthening the capacity of e-learning via integration of active methods into the process of teaching foreign languages, such as project activity of students. Successful project activity of students should involve the following components: monitoring, control, methods of organizing the student’s activity in foreign languages, stimulating their interest in the chosen project, approaches to self-assessment and methods of raising their self-esteem. The contemporary methodology assumes the project as a specific method, which activates potential of a student’s cognitive function, emotional reaction, ability to work in the team, commitment, skills of cooperation and, consequently, their readiness to verbalize ideas, thoughts and attitudes. Verbal activity in the foreign language is a complex conception that consolidates both cognitive (involving speech) capacity and individual traits and attitudes such as initiative, empathy, devotion, responsibility etc. Once we organize the project activity by the means of e-learning within the ‘Foreign language’ discipline we have to take into consideration all mentioned above characteristics and work out an effective way to implement it into the teaching practice to boost its educational potential. We have integrated into the e-platform Moodle the module of project activity consisting of the following blocks of tasks that lead students to research, cooperate, strive to leadership, chase the goal and finally verbalize their intentions. Firstly, we introduce the project through activating self-activity of students by the tasks of the phase ‘Preparation of the project’: choose the topic and justify it; find out the problematic situation and its components; set the goals; create your team, choose the leader, distribute the roles in your team; make a written report on grounding the validity of your choices. Secondly, in the ‘Planning the project’ phase we ask students to represent the analysis of the problem in terms of reasons, ways and methods of solution and define the structure of their project (here students may choose oral or written presentation by drawing up the claim in the e-platform about their wish, whereas the teacher decides what form of presentation to prefer). Thirdly, the students have to design the visual aids, speech samples (functional phrases, introductory words, keywords, synonyms, opposites, attributive constructions) and then after checking, discussing and correcting with a teacher via the means of Moodle present it in front of the audience. And finally, we introduce the phase of self-reflection that aims to awake the inner desire of students to improve their verbal activity in a foreign language. As a result, by implementing the project activity into the e-platform and project activity, we try to widen the frameworks of a traditional lesson of foreign languages through tapping the potential of personal traits and attitudes of students.

Keywords: active methods, e-learning, improving verbal activity in foreign languages, personal traits and attitudes

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Authors: Pia Ulvenblad, Henrik Barth, Jennie Cederholm BjöRklund, Maya Hoveskog, Per-Ola Ulvenblad

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The importance of business model innovation (BMI) is widely recognized. This is also valid for firms in the agri-food industry, closely connected to global challenges. Worldwide food production will have to increase 70% by 2050 and the United Nations’ sustainable development goals prioritize research and innovation on food security and sustainable agriculture. The firms of the agri-food industry have opportunities to increase their competitive advantage through BMI. However, the process of BMI is complex and the implementation of new business models is associated with high degree of risk and failure. Thus, managers from all industries and scholars need to better understand how to address this complexity. Therefore, the research presented in this paper (i) explores different categories of barriers in research literature on business models in the agri-food industry, and (ii) illustrates categories of barriers with empirical cases. This study is addressing the rather limited understanding on barriers for BMI in the agri-food industry, through a systematic literature review (SLR) of 570 peer-reviewed journal articles that contained a combination of ‘BM’ or ‘BMI’ with agriculture-related and food-related terms (e.g. ‘agri-food sector’) published in the period 1990-2014. The study classifies the barriers in several categories and illustrates the identified barriers with ten empirical cases. Findings from the literature review show that barriers are mainly identified as outcomes. It can be assumed that a perceived barrier to growth can often be initially exaggerated or underestimated before being challenged by appropriate measures or courses of action. What may be considered by the public mind to be a barrier could in reality be very different from an actual barrier that needs to be challenged. One way of addressing barriers to growth is to define barriers according to their origin (internal/external) and nature (tangible/intangible). The framework encompasses barriers related to the firm (internal addressing in-house conditions) or to the industrial or national levels (external addressing environmental conditions). Tangible barriers can include asset shortages in the area of equipment or facilities, while human resources deficiencies or negative willingness towards growth are examples of intangible barriers. Our findings are consistent with previous research on barriers for BMI that has identified human factors barriers (individuals’ attitudes, histories, etc.); contextual barriers related to company and industry settings; and more abstract barriers (government regulations, value chain position, and weather). However, human factor barriers – and opportunities - related to family-owned businesses with idealistic values and attitudes and owning the real estate where the business is situated, are more frequent in the agri-food industry than other industries. This paper contributes by generating a classification of the barriers for BMI as well as illustrating them with empirical cases. We argue that internal barriers such as human factors barriers; values and attitudes are crucial to overcome in order to develop BMI. However, they can be as hard to overcome as for example institutional barriers such as governments’ regulations. Implications for research and practice are to focus on cognitive barriers and to develop the BMI capability of the owners and managers of agri-industry firms.

Keywords: agri-food, barriers, business model, innovation

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Authors: Jihong Liang, Huiling Feng, Linqing Ma, Tianjiao Qi

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Confucius is the first sage in Chinese culture. Confucianism, the theories represented by Confucius, has long been at the core of Chinese traditional society, as the dominating political ideology of centralized feudal monarchy for more than two thousand years. Confucius Worship Ceremony held in the Confucian Temple in Qufu (Confucius’s birthplace), which is dedicated to commemorate Confucius and other 170 elites in Confucianism with a whole set of formal rites, pertains to “Auspicious Rites”, which worship heaven and earth, humans and ghosts. It was first a medium-scaled ritual activity but then upgraded to the supreme one at national level in the Qing Dynasty. As a national event, it was celebrated by Emperor as well as common intellectuals in traditional China. The Ceremony can be solemn and respectful, with prescribed and complicated procedures, well-prepared utensil and matched offerings operated in rhythm with music and dances. Each participant has his place, and everyone follows the specified rules. This magnificent ritual Ceremony, while embedded with rich culture connotation, actually symbolizes the social acknowledgment for orthodox culture represented by Confucianism. Rites reflected in this Ceremony, is one of the most important features of Chinese culture, serving as the key bond in the identification and continuation of Chinese culture. These rites and ritual ceremonies, as culture memories themselves, are not only treasures of China, but of the whole world. However, while the ancient Chinese Rite has been one of the thorniest and most complicated topics for academics, the more regrettable is that due to their interruption in practice and historical changes, these rites and ritual ceremonies have already become a vague language in today’s academic discourse and strange terms of the past for common people. Luckily, we, today, by virtue of modern digital technology, may be able to reproduce these ritual ceremonies, as most of them can still be found in ancient manuscripts, through which Chinese ancestors tell the beauty and gravity of their dignified rites and more importantly, their spiritual pursuits with vivid language and lively pictures. This research, based on review and interpretation of the ancient literature, intends to construct the ancient ritual ceremonies, with the Confucius Worship Ceremony as a case and by use of digital technology. Using 3D technology, the spatial scenes in the Confucian Temple can be reconstructed by virtual reality; the memorial tablet exhibited in the temple by GIS and different rites in the ceremonies by animation technology. With reference to the lyrics, melodies and lively pictures recorded in ancient scripts, it is also possible to reproduce the live dancing site. Also, image rendering technology can help to show the life experience and accomplishments of Confucius. Finally, lining up all the elements in a multimedia narrative form, a complete digitalized Confucius Worship Ceremony can be reproduced, which will provide an excellent virtual experience that goes beyond time and space by bringing its audience back to that specific historical time. This digital project, once completed, will play an important role in the inheritance and dissemination of cultural heritage.

Keywords: Confucius worship ceremony, multimedia narrative form, GIS, visual representation

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Authors: Rosemary R. Carlton, Roxane Caron

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Almost three decades ago, bell hooks (1994) identified the classroom as “the most radical space of possibility in the academy”. A feminist scholar, educator, and activist, hooks urged educators to transgress the boundaries of what might be customary or considered acceptable in teaching, thus encouraging the pursuit of new ways of knowing and different strategies for sharing knowledge. This paper reflects upon a particular response to hooks’ still relevant call for transgression in teaching. Specifically, this paper reports on the design, implementation, and preliminary analysis of a social work course integrating active pedagogy and transnational exchange to encourage students’ critical thinking and autonomous learning in their development as social workers in a global context. The bachelor’s level course, Pratiques spécifiques: Projet international, was developed collaboratively across three francophone institutions of higher learning in Belgium, Canada, and France: the Haute École de Namur-Liège-Luxembourg (Hénallux); the Université de Montréal; and, the Institut d’enseignement supérieur et professionnel, l’IRTS Paris Île-de-France. The driving aims of the course are to promote autonomous learning and critical thinking through a lens of transnational understandings of social problems -competencies indispensable to students’ development as social workers. The course is offered to two paired cohorts, one addressing the subject of “migrations” (Canada/France) and the other the subject of “sexual exploitation” (Canada/Belgium). Through the adaptation of a critical pedagogy of problem-based learning, students are called upon to actively engage in acquiring and applying knowledge to respond to “real life” social issues relating to migration or sexual exploitation. At the conclusion of the course, each cohort of students is brought together for a week-long intensive period of transnational exchange either at the Université de Montréal in Canada or at Hénallux in Belgium. Extending the bounds of the classroom across international borders allows students novel opportunities to deepen and expand their understandings of issues relating to predefined social issues and to critically examine associated social work practices. The paper opens with a presentation of the social work course. Specifically, the authors will outline their adaptation of a pedagogy of problem-based learning integrating transnational exchange in the design and implementation of the course. Returning to hooks’ notion of transgression in teaching, the paper offers a preliminary analysis of how and with what effect the course provides opportunities to transgress hierarchical student-teacher relationships; transgress conventional modes of learning to explore diverse sources of knowledge and transgress the walls of the university to engage with and learn from local and global partners. The paper concludes with a consideration of the potential influence of such transgressions in teaching for students’ development of critical thinking in their practice of social work in global context.

Keywords: active learning, critical pedagogy, social work intervention, transnational learning

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Authors: Sunil Chandra, Triparna Barman, Vikas Gusain, Himanshu Rawat

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Forest fires are a recurrent phenomenon in the Himalayan region owing to the presence of vulnerable forest types, topographical gradients, climatic weather conditions, and anthropogenic pressure. The present study focuses on the identification of forest fire-affected areas in a small part of the West Himalayan region using a differential normalized burnt ratio method and spectral unmixing methods. The study area has a rugged terrain with the presence of sub-tropical pine forest, montane temperate forest, and sub-alpine forest and scrub. The major reason for fires in this region is anthropogenic in nature, with the practice of human-induced fires for getting fresh leaves, scaring wild animals to protect agricultural crops, grazing practices within the reserved forest, and igniting fires for cooking and other reasons. The fires caused by the above reasons affect a large area on the ground, necessitating its precise estimation for further management and policy making. In the present study, two approaches have been used for carrying out a burnt area analysis. The first approach followed for burnt area analysis uses a differential burnt normalized ratio index (dNBR) approach that uses the burnt ratio values generated using Short Wave Infra Red (SWIR) band and Near Infra Red (NIR) bands of the Sentinel-2A image. The results of the dNBR have been compared with the outputs of the spectral mixing methods. It has been found that the dNBR is able to create good results in fire-affected areas having homogenous forest stratum and with slope degree <5 degrees. However, in a rugged terrain where the landscape is largely influenced by the topographical variations, vegetation types, tree density, the results may be largely influenced by the effects of topography, complexity in tree composition, fuel load composition, and soil moisture. Hence, such variations in the factors influencing burnt area assessment may not be effectively carried out using a dNBR approach which is commonly followed for burnt area assessment over a large area. Hence, another approach that has been attempted in the present study utilizes a spectral mixing method where the individual pixel is tested before assigning an information class to it. The method uses a neural network approach utilizing Sentinel 2A bands. The training and testing data are generated from the sentinel-2A data and the national field inventory, which is further used for generating outputs using ML tools. The analysis of the results indicates that the fire-affected regions and their severity can be better estimated in rugged terrain using spectral unmixing methods which have the capability to resolve the noise in the data and can classify the individual pixel to the precise burnt/unburnt class.

Keywords: dNBR, spectral unmixing, neural network, forest stratum

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Authors: Mary T. McKinley

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As socio-economic globalization impacts education and turns knowledge into a commodity, institutions of higher education are becoming more intentional about infusing a global and intercultural perspective into education via the recruitment of international students. Coming from dissimilar cultures, many of these students are evaluated and held accountable to Euro-American values of independence, self-reliance, and autonomy. Not surprisingly, these students often experience culture shock with deleterious effects on their mental health and academic functioning. Thus, it is critical to understand the experiences of international students with the hope that such knowledge will keep the field of psychology from promulgating Eurocentric ideals and values and prevent the training of these students as good-enough White therapists. Using a critical narrative inquiry framework, this study elicits stories about the challenges encountered by international students as they navigate their clinical training in the presence of acculturative stress and potentially different worldviews. With its emphasis on story-telling as meaning making, narrative research design is hinged on the assumption that people are interpretive beings who make meaning of themselves and their world through the language of stories. Also, dominant socially-constructed narratives play a central role in creating and maintaining hegemonic structures that privilege certain individuals and ideologies at the expense of others. On this premise, narrative inquiry begins with an exploration of the experiences of participants in their lived stories. Bounded narrative segments were read, interpreted, and analyzed using a critical events approach. Throughout the process, issues of reliability and researcher bias were addressed by keeping a reflective analytic memo, as well as triangulating the data using peer-reviewers and check-ins with participants. The findings situate culture at the epicenter of international students’ acculturation challenges as well as their resiliency in psychology doctoral programs. It was not uncommon for these international students to experience ethical dilemmas inherent in learning content that conflicted with their cultural beliefs and values. Issues of cultural incongruence appear to be further exacerbated by visible markers for differences like speech accent and clothing attire. These stories also link the acculturative stress reported by international students to the experiences of perceived racial discrimination and lack of support from the faculty, administration, peers, and the society at large. Beyond the impact on the international students themselves, there are implications for internationalization in psychology with the goal of equipping doctoral programs to be better prepared to meet the needs of their international students. More than ever before, programs need to liaise with international students’ services and work in tandem to meet the unique needs of this population of students. Also, there exists a need for multiculturally competent supervisors working with international students with varying degrees of acculturation. In addition to making social justice and advocacy salient in students’ multicultural training, it may be helpful for psychology doctoral programs to be more intentional about infusing cross-cultural theories, indigenous psychotherapies, and/or when practical, the possibility for geographically cross-cultural practicum experiences in the home countries of international students while taking into consideration the ethical issues for virtual supervision.

Keywords: decolonizing pedagogies, international students, multiculturalism, psychology doctoral programs

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Authors: N. Reza Pour, S. Chuah, T. Vo

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Background: Vertebral artery dissection (VAD) is a rare complication of pregnancy. It can occur spontaneously or following a traumatic event. The pathogenesis is unclear. Predisposing factors include chronic hypertension, Marfan’s syndrome, fibromuscular dysplasia, vasculitis and cystic medial necrosis. Physiological changes of pregnancy have also been proposed as potential mechanisms of injury to the vessel wall. The clinical presentation varies and it can present as a headache, neck pain, diplopia, transient ischaemic attack, or an ischemic stroke. Isolated cases of VAD in pregnancy and puerperium have been reported in the literature. One case was found to have posterior circulation stroke as a result of bilateral VAD and labour was induced at 37 weeks gestation for preeclampsia. Another patient at 38 weeks with severe neck pain that persisted after induction for elevated blood pressure and arteriography showed right VAD postpartum. A single case of lethal VAD in pregnancy with subsequent massive subarachnoid haemorrhage has been reported which was confirmed by the autopsy. Case Presentation: We report two cases of vertebral artery dissection in pregnancy. The first patient was a 32-year-old primigravida presented at the 38th week of pregnancy with the onset of early labour and blood pressure (BP) of 130/70 on arrival. After 2 hours, the patient developed a severe headache with blurry vision and BP was 238/120. Despite treatment with an intravenous antihypertensive, she had eclamptic fit. Magnesium solfate was started and Emergency Caesarean Section was performed under the general anaesthesia. On the second day after the operation, she developed left-sided neck pain. Magnetic Resonance Imaging (MRI) angiography confirmed a short segment left vertebral artery dissection at the level of C3. The patient was treated with aspirin and remained stable without any neurological deficit. The second patient was a 33-year-old primigavida who was admitted to the hospital at 36 weeks gestation with BP of 155/105, constant headache and visual disturbances. She was medicated with an oral antihypertensive agent. On day 4, she complained of right-sided neck pain. MRI angiogram revealed a short segment dissection of the right vertebral artery at the C2-3 level. Pregnancy was terminated on the same day with emergency Caesarean Section and anticoagulation was started subsequently. Post-operative recovery was complicated by rectus sheath haematoma requiring evacuation. She was discharged home on Aspirin without any neurological sequelae. Conclusion: Because of collateral circulation, unilateral vertebral artery dissections may go unrecognized and may be more common than suspected. The outcome for most patients is benign, reflecting the adequacy of the collateral circulation in young patients. Spontaneous VAD is usually treated with anticoagulation or antiplatelet therapy for a minimum of 3-6 months to prevent future ischaemic events, allowing the dissection to heal on its own. We had two cases of VAD in the context of hypertensive disorders of pregnancy with an acceptable outcome. A high level of vigilance is required particularly with preeclamptic patients presenting with head/neck pain to allow an early diagnosis. This is as we hypothesize, early and aggressive management of vertebral artery dissection may potentially prevent further complications.

Keywords: eclampsia, preeclampsia, pregnancy, Vertebral Artery Dissection

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Authors: Swati Gautam, Salman Akhtar, S. P. Jaiswar, Amita Jain

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Background: FGTB is now a major global health problem mostly in developing countries including India. In humans, Mycobacterium Tuberculosis (M.tb) is a causating agent of infection. High index of suspicion is required for early diagnosis due to asymptomatic presentation of FGTB disease. In macrophages Toll Like Receptor-2 (TLR-2) is one which mediated host’s immune response to M.tb. The expression of TLR-2 on macrophages is important to determine the fate of innate immune responses to M.tb. TLR-2 have two work. First its high expression on macrophages worsen the outer of infection and another side, it maintains M.tb to its dormant stage avoids activation of M.tb from latent phase. Single Nucleotide Polymorphism (SNP) of TLR-2 gene plays an important role in susceptibility to TB among different populations and subsequently, in the development of infertility. Methodology: This Case-Control study was done in the Department of Obs and Gynae and Department of Microbiology at King George’s Medical University, U.P, Lucknow, India. Total 300 subjects (150 Cases and 150 Controls) were enrolled in the study. All subjects were enrolled only after fulfilling the given inclusion and exclusion criteria. Inclusion criteria: Age 20-35 years, menstrual-irregularities, positive on Acid-Fast Bacilli (AFB), TB-PCR, (LJ/MGIT) culture in Endometrial Aspiration (EA). Exclusion criteria: Koch’s active, on ATT, PCOS, and Endometriosis fibroid women, positive on Gonococal and Chlamydia. Blood samples were collected in EDTA tubes from cases and healthy control women (HCW) and genomic DNA extraction was carried out by salting-out method. Genotyping of TLR2 genetic variants (Arg753Gln and Arg677Trp) were performed by using single amplification refractory mutation system (ARMS) PCR technique. PCR products were analyzed by electrophoresis on 1.2% agarose gel and visualized by gel-doc. Statistical analysis of the data was performed using the SPSS 16.3 software and computing odds ratio (OR) with 95% CI. Linkage Disequiliribium (LD) analysis was done by SNP stats online software. Results: In TLR-2 (Arg753Gln) polymorphism significant risk of FGTB observed with GG homozygous mutant genotype (OR=13, CI=0.71-237.7, p=0.05), AG heterozygous mutant genotype (OR=13.7, CI=0.76-248.06, p=0.03) however, G allele (OR=1.09, CI=0.78-1.52, p=0.67) individually was not associated with FGTB. In TLR-2 (Arg677Trp) polymorphism a significant risk of FGTB observed with TT homozygous mutant genotype (OR= 0.020, CI=0.001-0.341, p < 0.001), CT heterozygous mutant genotype (OR=0.53, CI=0.33-0.86, p=0.014) and T allele (OR=0.463, CI=0.32-0.66, p < 0.001). TT mutant genotype was only found in FGTB cases and frequency of CT heterozygous more in control group as compared to FGTB group. So, CT genotype worked as protective mutation for FGTB susceptibility group. In haplotype analysis of TLR-2 genetic variants, four possible combinations, i.e. (G-T, A-C, G-C, and A-T) were obtained. The frequency of haplotype A-C was significantly higher in FGTB cases (0.32). Control group did not show A-C haplotype and only found in FGTB cases. Conclusion: In conclusion, study showed a significant association with both genetic variants of TLR-2 of FGTB disease. Moreover, the presence of specific associated genotype/alleles suggest the possibility of disease severity and clinical approach aimed to prevent extensive damage by disease and also helpful for early detection of disease.

Keywords: ARMS, EDTA, FGTB, TLR

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Authors: Priya Nangia, Sanchita Bansal

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As fashion cycles become more rapid, some segments of the fashion industry have adopted increasingly unsustainable production processes to keep up with demand and enhance profit margins. The growing threat to environmental and social wellbeing posed by unethical fast fashion practices and the need to integrate the targets of SDGs into this industry necessitates a shift in the fashion industry's unsustainable nature, which can only be accomplished in the long run if consumers support sustainable fashion by purchasing it. Fast fashion is defined as low-cost, trendy apparel that takes inspiration from the catwalk or celebrity culture and rapidly transforms it into garments at high-street stores to meet consumer demand. Given the importance of identity formation to many consumers, the desire to be “fashionable” often outweighs the desire to be ethical or sustainable. This paradox exemplifies the tension between the human drive to consume and the will to do so in moderation. Previous research suggests that there is an attitude-behavior gap when it comes to determining consumer purchasing behavior, but to the best of our knowledge, no study has analysed how to encourage customers to shift from fast to slow fashion. Against this backdrop, the aim of this study is twofold: first, to identify and examine the factors that impact consumers' decisions to engage in sustainable fashion, and second, the authors develop a comprehensive framework for conceptualizing and encouraging researchers and practitioners to foster sustainable consumer behavior. This study used a systematic approach to collect data and analyse literature. The approach included three key steps: review planning, review execution, and findings reporting. Authors identified the keywords “sustainable consumption” and “sustainable fashion” and retrieved studies from the Web of Science (WoS) (126 records) and Scopus database (449 records). To make the study more specific, the authors refined the subject area to management, business, and economics in the second step, retrieving 265 records. In the third step, the authors removed the duplicate records and manually reviewed the articles to examine their relevance to the research issue. The final 96 research articles were used to develop this study's systematic scheme. The findings indicate that societal norms, demographics, positive emotions, self-efficacy, and awareness all have an effect on customers' decisions to purchase sustainable apparel. The authors propose a framework, denoted by the acronym SHIFT, in which consumers are more likely to engage in sustainable behaviors when the message or context leverages the following factors: (s)social influence, (h)habit formation, (i)individual self, (f)feelings, emotions, and cognition, and (t)tangibility. Furthermore, the authors identify five broad challenges that encourage sustainable consumer behavior and use them to develop novel propositions. Finally, the authors discuss how the SHIFT framework can be used in practice to drive sustainable consumer behaviors. This research sought to define the boundaries of existing research while also providing new perspectives on future research, with the goal of being useful for the development and discovery of new fields of study, thereby expanding knowledge.

Keywords: consumer behavior, fast fashion, sustainable consumption, sustainable fashion, systematic literature review

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Authors: James Semmens, James Boyd, Anna Ferrante, Katrina Spilsbury, Sean Randall, Adrian Brown

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‘Big data’ is a relatively new concept that describes data so large and complex that it exceeds the storage or computing capacity of most systems to perform timely and accurate analyses. Health services generate large amounts of data from a wide variety of sources such as administrative records, electronic health records, health insurance claims, and even smart phone health applications. Health data is viewed in Australia and internationally as highly sensitive. Strict ethical requirements must be met for the use of health data to support health research. These requirements differ markedly from those imposed on data use from industry or other government sectors and may have the impact of reducing the capacity of health data to be incorporated into the real time demands of the Big Data environment. This ‘big data revolution’ is increasingly supported by national governments, who have invested significant funds into initiatives designed to develop and capitalize on big data and methods for data integration using record linkage. The benefits to health following research using linked administrative data are recognised internationally and by the Australian Government through the National Collaborative Research Infrastructure Strategy Roadmap, which outlined a multi-million dollar investment strategy to develop national record linkage capabilities. This led to the establishment of the Population Health Research Network (PHRN) to coordinate and champion this initiative. The purpose of the PHRN was to establish record linkage units in all Australian states, to support the implementation of secure data delivery and remote access laboratories for researchers, and to develop the Centre for Data Linkage for the linkage of national and cross-jurisdictional data. The Centre for Data Linkage has been established within Curtin University in Western Australia; it provides essential record linkage infrastructure necessary for large-scale, cross-jurisdictional linkage of health related data in Australia and uses a best practice ‘separation principle’ to support data privacy and security. Privacy preserving record linkage technology is also being developed to link records without the use of names to overcome important legal and privacy constraint. This paper will present the findings of the first ‘Proof of Concept’ project selected to demonstrate the effectiveness of increased record linkage capacity in supporting nationally significant health research. This project explored how cross-jurisdictional linkage can inform the nature and extent of cross-border hospital use and hospital-related deaths. The technical challenges associated with national record linkage, and the extent of cross-border population movements, were explored as part of this pioneering research project. Access to person-level data linked across jurisdictions identified geographical hot spots of cross border hospital use and hospital-related deaths in Australia. This has implications for planning of health service delivery and for longitudinal follow-up studies, particularly those involving mobile populations.

Keywords: data integration, data linkage, health planning, health services research

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Authors: Ruth Shapira

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Introduction: The rapid urbanization of the last century confronts planners, regulatory bodies, developers and most of all – the public with seemingly unsolved conflicts regarding values, capital, and wellbeing of the built and un-built urban space. This is reflected in the quality of the urban form and life which has known no significant progress in the last 2-3 decades despite the on-growing urban population. It is the objective of this paper to analyze some of these fundamental issues through the case study of a relatively small town in the center of Israel (Kiryat-Ono, 100,000 inhabitants), unfold the deep structure of qualities versus disruptors, present some cure that we have developed to bridge over and humbly suggest a practice that may be generic for similar cases. Basic Methodologies: The OBJECT, the town of Kiryat Ono, shall be experimented upon in a series of four action processes: De-composition, Re-composition, the Centering process and, finally, Controlled Structural Disintegration. Each stage will be based on facts, analysis of previous multidisciplinary interventions on various layers – and the inevitable reaction of the OBJECT, leading to the conclusion based on innovative theoretical and practical methods that we have developed and that we believe are proper for the open ended network, setting the rules for the contemporary urban society to cluster by. The Study: Kiryat Ono, was founded 70 years ago as an agricultural settlement and rapidly turned into an urban entity. In spite the massive intensification, the original DNA of the old small town was still deeply embedded, mostly in the quality of the public space and in the sense of clustered communities. In the past 20 years, the recent demand for housing has been addressed to on the national level with recent master plans and urban regeneration policies mostly encouraging individual economic initiatives. Unfortunately, due to the obsolete existing planning platform the present urban renewal is characterized by pressure of developers, a dramatic change in building scale and widespread disintegration of the existing urban and social tissue. Our office was commissioned to conceptualize two master plans for the two contradictory processes of Kiryat Ono’s future: intensification and conservation. Following a comprehensive investigation into the deep structures and qualities of the existing town, we developed a new vocabulary of conservation terms thus redefying the sense of PLACE. The main challenge was to create master plans that should offer a regulatory basis to the accelerated and sporadic development providing for the public good and preserving the characteristics of the PLACE consisting of a tool box of design guidelines that will have the ability to reorganize space along the time axis in a coherent way. In Conclusion: The system of rules that we have developed can generate endless possible patterns making sure that at each implementation fragment an event is created, and a better place is revealed. It takes time and perseverance but it seems to be the way to provide a healthy framework for the accelerated urbanization of our chaotic present.

Keywords: housing, architecture, urban qualities, urban regeneration, conservation, intensification

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Authors: Manjula Kola, K. Chandralekha

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Anaemia is one of the world’s most widespread health problems. Prevalence of anemia in south Asia is among the highest in the world. Iron deficiency anemia accounts for almost 85 percent of all types of anemia in India and affects more than half of the total population. Women of childbearing age particularly pregnant women, infants, preschool children and adolescents are at greatest risk of developing iron deficiency anemia. In India, 74 percent children between 6-35 months of age are anemic. Children between 1-6 years in major cities are found with a high prevalence rate of 64.8 percent. Iron deficiency anemia is not only a public health problem, but also a development problem. Its prevention and reduction must be viewed as investment in human capital that will enhance development and reduce poverty. Ending this hidden hunger in the form of iron deficiency is the most important achievable international health goal. Eliminating the underlying problem is essential to the sustained elimination of the iron deficiency anemia. The intervention programmes toward the sustained elimination need to be broadly based so that interventions become accepted community practices. Hence, intervention strategies need to go well beyond traditional health and nutrition systems and based upon empowering people and communities so that they will be capable of arranging for and sustaining an adequate intake of foods with respect to iron, independent of external support. Such strategies must necessarily be multisectoral and integrate interventions with social communications, evaluation and surveillance. The main objective of the study was to design a community based Nutrition intervention using theoretical framework of social marketing to sustain improvement of iron nutriture among preschool children. In order to carryout the study eight rural communities In Chittoor district of Andhra Pradesh, India were selected. A formative research was carryout for situational analysis and baseline data was generated with regard to demographic and socioeconomic status, dietary intakes, Knowledge, Attitude and Practices of the mothers of preschool children, clinical and hemoglobin status of the target group. Based on the formative research results, the research area was divides into four groups as experimental area I,II,III and control area. A community based, integrated and comprehensive social marketing intervention was designed based on various theories and models of nutrition education/ communication. In Experimental area I, Nutrition intervention using social marketing and a weekly iron folic acid supplementation was given to improve iron nutriture of preschool children. In experimental area II, Social marketing alone was implemented and in experimental area III Iron supplementation alone was given. No intervention was given in control area. The Impact evaluation revealed that among different interventions tested, the integrated social marketing intervention resulted best outcomes. The overall observations of the study state that social marketing, an integrated and functional strategy for nutrition communication to prevent and control iron deficiency. Various theoretical frame works / models for nutrition communication facilitate to design culturally appropriate interventions thus achieved improvements in the knowledge, attitude and practices there by resulting successful impact on nutritional status of the target groups.

Keywords: anemia, iron deficiency, social marketing, theoretical framework

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Authors: Mukul Sharma, Madhusmita Das, Sundeep Chaitanya Vedithi

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Leprosy is a chronic human disease caused by Mycobacterium leprae, that cannot be cultured in vitro. Though treatable with multidrug therapy (MDT), recently, bacteria reported resistance to multiple antibiotics. Targeting DNA replication and repair pathways can serve as the foundation of developing new anti-leprosy drugs. Due to the absence of an axenic culture medium for the propagation of M. leprae, studying cellular processes, especially those belonging to DNA repair pathways, is challenging. Genomic understanding of M. Leprae harbors several protein-coding genes with no previously assigned function known as 'hypothetical proteins'. Here, we report identification and expression of known and hypothetical DNA repair genes from a human skin biopsy and mouse footpads that are involved in base excision repair, direct reversal repair, and SOS response. Initially, a bioinformatics approach was employed based on sequence similarity, identification of known protein domains to screen the hypothetical proteins in the genome of M. leprae, that are potentially related to DNA repair mechanisms. Before testing on clinical samples, pure stocks of bacterial reference DNA of M. leprae (NHDP63 strain) was used to construct standard graphs to validate and identify lower detection limit in the qPCR experiments. Primers were designed to amplify the respective transcripts, and PCR products of the predicted size were obtained. Later, excisional skin biopsies of newly diagnosed untreated, treated, and drug resistance leprosy cases from SIHR & LC hospital, Vellore, India were taken for the extraction of RNA. To determine the presence of the predicted transcripts, cDNA was generated from M. leprae mRNA isolated from clinically confirmed leprosy skin biopsy specimen across all the study groups. Melting curve analysis was performed to determine the integrity of the amplification and to rule out primer‑dimer formation. The Ct values obtained from qPCR were fitted to standard curve to determine transcript copy number. Same procedure was applied for M. leprae extracted after processing a footpad of nude mice of drug sensitive and drug resistant strains. 16S rRNA was used as positive control. Of all the 16 genes involved in BER, DR, and SOS, differential expression pattern of the genes was observed in terms of Ct values when compared to human samples; this was because of the different host and its immune response. However, no drastic variation in gene expression levels was observed in human samples except the nth gene. The higher expression of nth gene could be because of the mutations that may be associated with sequence diversity and drug resistance which suggests an important role in the repair mechanism and remains to be explored. In both human and mouse samples, SOS system – lexA and RecA, and BER genes AlkB and Ogt were expressing efficiently to deal with possible DNA damage. Together, the results of the present study suggest that DNA repair genes are constitutively expressed and may provide a reference for molecular diagnosis, therapeutic target selection, determination of treatment and prognostic judgment in M. leprae pathogenesis.

Keywords: DNA repair, human biopsy, hypothetical proteins, mouse footpads, Mycobacterium leprae, qPCR

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Authors: M. Velana, G. Rinkenauer

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Nowadays, nurses are facing unprecedented amounts of pressure due to the ongoing global health demands. Work-related stress can cause a high physical and psychological workload, which can lead, in turn, to burnout. On the physiological level, stress triggers an initial activation of the sympathetic nervous and adrenomedullary systems resulting in increases in cardiac activity. Furthermore, activation of the hypothalamus-pituitary-adrenal axis provokes endocrine and immune changes leading to the release of cortisol and cytokines in an effort to re-establish body balance. Based on the current state of the literature, it has been identified that resilience and mindfulness exercises among nurses can effectively decrease stress and improve mood. However, it is still unknown what relaxation techniques would be suitable for and to what extent would be effective to decrease psychophysiological arousal deriving from either a physiological or a psychological stressor. Moreover, although cardiac activity and cortisol are promising candidates to examine the effectiveness of relaxation to reduce stress, it still remains to shed light on the role of cytokines in this process so as to thoroughly understand the body’s response to stress and to relaxation. Therefore, the main aim of the present study is to develop a comprehensive experimental paradigm and assess different relaxation techniques, namely progressive muscle relaxation and a mindfulness exercise originating from cognitive therapy by means of biofeedback, under highly controlled laboratory conditions. An experimental between-subject design will be employed, where 120 participants will be randomized either to a physiological or a psychological stress-related experiment. Particularly, the cold pressor test refers to a procedure in which the participants have to immerse their non-dominant hands into ice water (2-3 °C) for 3 min. The participants are requested to keep their hands in the water throughout the whole duration. However, they can immediately terminate the test in case it would be barely tolerable. A pre-test anticipation phase and a post-stress period of 3 min, respectively, are planned. The Trier Social Stress Test will be employed to induce psychological stress. During this laboratory stressor, the participants are instructed to give a 5-min speech in front of a committee of communication specialists. Before the main task, there is a 10-min anticipation period. Subsequently, participants are requested to perform an unexpected arithmetic task. After stress exposure, the participants will perform one of the relaxation exercises (treatment condition) or watch a neutral video (control condition). Electrocardiography, salivary samples, and self-report will be collected at different time points. The preliminary results deriving from the pilot study showed that the aforementioned paradigm could effectively induce stress reactions and that relaxation might decrease the impact of stress exposure. It is of utmost importance to assess how the human body responds under different stressors and relaxation exercises so that an evidence-based intervention could be transferred in a clinical setting to improve nurses’ general health. Based on suggestive future laboratory findings, the research group plans to conduct a pilot-level randomized study to decrease stress and promote well-being among nurses who work in the stress-riddled environment of a hospital located in Northern Germany.

Keywords: nurses, psychophysiology, relaxation, stress

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Authors: Arti Singh, Carolyn Jenkins, Oyedunni S. Arulogun, Mayowa O. Owolabi, Fred S. Sarfo, Bruce Ovbiagele, Enzinne Sylvia

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Background: Stroke, the leading cause of adult-onset disability and the second leading cause of death, is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur. The Stroke Investigative Research and Education Network (SIREN) seeks to comprehensively characterize the genomic, sociocultural, economic, and behavioral risk factors for stroke and to build effective teams for research to address and decrease the burden of stroke and other non communicable diseases in SSA. One of the first steps to address this goal was to effectively engage the communities that suffer the high burden of disease in SSA. This study describes how the SIREN project engaged six sites in Ghana and Nigeria over the past three years, describing the community engagement activities that have arisen since inception. Aim: The aim of community engagement (CE) within SIREN is to elucidate information about knowledge, attitudes, beliefs, and practices (KABP) about stroke and its risk factors from individuals of African ancestry in SSA, and to educate the community about stroke and ways to decrease disabilities and deaths from stroke using socioculturally appropriate messaging and messengers. Methods: Community Advisory Board (CABs), Focus Group Discussions (FGDs) and community outreach programs. Results: 27 FGDs with 168 participants including community heads, religious leaders, health professionals and individuals with stroke among others, were conducted, and over 60 CE outreaches have been conducted within the SIREN performance sites. Over 5,900 individuals have received education on cardiovascular risk factors and about 5,000 have been screened for cardiovascular risk factors during the outreaches. FGDs and outreach programs indicate that knowledge of stroke, as well as risk factors and follow-up evidence-based care is limited and often late. Other findings include: 1) Most recognize hypertension as a major risk factor for stroke. 2) About 50% report that stroke is hereditary and about 20% do not know organs affected by stroke. 3) More than 95% willing to participate in genetic testing research and about 85% willing to pay for testing and recommend the test to others. 4) Almost all indicated that genetic testing could help health providers better treat stroke and help scientists better understand the causes of stroke. The CABs provided stakeholder input into SIREN activities and facilitated collaborations among investigators, community members and stakeholders. Conclusion: The CE core within SIREN is a first-of-its kind public outreach engagement initiative to evaluate and address perceptions about stroke and genomics by patients, caregivers, and local leaders in SSA and has implications as a model for assessment in other high-stroke risk populations. SIREN’s CE program uses best practices to build capacity for community-engaged research, accelerate integration of research findings into practice and strengthen dynamic community-academic partnerships within our communities. CE has had several major successes over the past three years including our multi-site collaboration examining the KABP about stroke (symptoms, risk factors, burden) and genetic testing across SSA.

Keywords: community advisory board, community engagement, focus groups, outreach, SSA, stroke

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Authors: Tamar Lin, Nufar Buchshtab, Yifat Elharar, Julian Nicenboim, Rotem Edgar, Iddo Weiner, Lior Zelcbuch, Ariel Cohen, Sharon Kredo-Russo, Inbar Gahali-Sass, Naomi Zak, Sailaja Puttagunta, Merav Bassan

Abstract:

Background: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder that is characterized by dry skin and flares of eczematous lesions and intense pruritus. Multiple lines of evidence suggest that AD is associated with increased colonization by Staphylococcus aureus, which contributes to disease pathogenesis through the release of virulence factors that affect both keratinocytes and immune cells, leading to disruption of the skin barrier and immune cell dysfunction. The aim of the current study is to develop a bacteriophage-based product that specifically targets S. aureus. Methods: For the discovery of phage, environmental samples were screened on 118 S. aureus strains isolated from skin samples, followed by multiple enrichment steps. Natural phages were isolated, subjected to Next-generation Sequencing (NGS), and analyzed using proprietary bioinformatics tools for undesirable genes (toxins, antibiotic resistance genes, lysogeny potential), taxonomic classification, and purity. Phage host range was determined by an efficiency of plating (EOP) value above 0.1 and the ability of the cocktail to completely lyse liquid bacterial culture under different growth conditions (e.g., temperature, bacterial stage). Results: Sequencing analysis demonstrated that the 118 S. aureus clinical strains were distributed across the phylogenetic tree of all available Refseq S. aureus (~10,750 strains). Screening environmental samples on the S. aureus isolates resulted in the isolation of 50 lytic phages from different genera, including Silviavirus, Kayvirus, Podoviridae, and a novel unidentified phage. NGS sequencing confirmed the absence of toxic elements in the phages’ genomes. The host range of the individual phages, as measured by the efficiency of plating (EOP), ranged between 41% (48/118) to 79% (93/118). Host range studies in liquid culture revealed that a subset of the phages can infect a broad range of S. aureus strains in different metabolic states, including stationary state. Combining the single-phage EOP results of selected phages resulted in a broad host range cocktail which infected 92% (109/118) of the strains. When tested in vitro in a liquid infection assay, clearance was achieved in 87% (103/118) of the strains, with no evidence of phage resistance throughout the study (24 hours). A S. aureus host was identified that can be used for the production of all the phages in the cocktail at high titers suitable for large-scale manufacturing. This host was validated for the absence of contaminating prophages using advanced NGS methods combined with multiple production cycles. The phages are produced under optimized scale-up conditions and are being used for the development of a topical formulation (BX005) that may be administered to subjects with atopic dermatitis. Conclusions: A cocktail of natural phages targeting S. aureus was effective in reducing bacterial burden across multiple assays. Phage products may offer safe and effective steroid-sparing options for atopic dermatitis.

Keywords: atopic dermatitis, bacteriophage cocktail, host range, Staphylococcus aureus

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Authors: Ciaran Friel, Jerry Suls, Patrick Robles, Frank Vicari, Joan Duer-Hefele, Karina W. Davidson

Abstract:

Physical activity guidelines focus on increasing moderate intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence supports that any increase in physical activity is positively correlated with health benefits. Behavior change techniques (BCTs) have demonstrated effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a Personalized Trials (N-of-1) design to evaluate the efficacy of using four BCTs to promote an increase in low-intensity physical activity (2,000 steps of walking per day) in adults aged 45-75 years old. The 4 BCTs tested were goal setting, action planning, feedback, and self-monitoring. BCTs were tested in random order and delivered by text message prompts requiring participant response. The study recruited health system employees in the target age range, without mobility restrictions and demonstrating interest in increasing their daily activity by a minimum of 2,000 steps per day for a minimum of five days per week. Participants were sent a Fitbit Charge 4 fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7, but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by the Fitbit for two weeks. Participants then engaged with a clinical research coordinator to review comprehension of the text message content and required actions for each of the BCTs to be tested. Participants then selected a consistent daily time in which they would receive their text message prompt. In the 8 week intervention phase of the study, participants received each of the four BCTs, in random order, for a two week period. Text message prompts were delivered daily at a time selected by the participant. All prompts required an interactive response from participants and may have included recording their detailed plan for walking or daily step goal (action planning, goal setting). Additionally, participants may have been directed to a study dashboard to view their step counts or compare themselves with peers (self-monitoring, feedback). At the end of each two week testing interval, participants were asked to complete the Self-Efficacy for Walking Scale (SEW_Dur), a validated measure that assesses the participant’s confidence in walking incremental distances and a survey measuring their satisfaction with the individual BCT that they tested. At the end of their trial, participants received a personalized summary of their step data in response to each individual BCT. Analysis will examine the novel individual-level heterogeneity of treatment effect made possible by N-of-1 design, and pool results across participants to efficiently estimate the overall efficacy of the selected behavioral change techniques in increasing low-intensity walking by 2,000 steps, 5 days per week. Self-efficacy will be explored as the likely mechanism of action prompting behavior change. This study will inform the providers and demonstrate the feasibility of N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

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Authors: Jennifer Kehinde, Claire O’Donnell, Annmarie Grealish

Abstract:

Introduction: Breastfeeding has been shown to provide numerous health benefits for both infants and mothers. The decision to breastfeed is influenced by physiological, psychological, and emotional factors. However, the importance of equipping mothers with the necessary knowledge for successful breastfeeding practice cannot be ruled out. The decline in global breastfeeding rate can be linked to a lack of adequate breastfeeding education during the prenatal stage. This systematic review examined the effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum. Method: This review was undertaken and reported in conformity with the Preferred Reporting Items for Systemic Reviews and Meta-Analysis statement (PRISMA) and was registered on the international prospective register for systematic reviews (PROSPERO: CRD42020213853). A PICO analysis (population, intervention, comparison, outcome) was undertaken to inform the choice of keywords in the search strategy to formulate the review question, which was aimed at determining the effectiveness of prenatal breastfeeding educational programs in improving breastfeeding uptake following birth. A systematic search of five databases (Cumulative Index to Nursing and Allied Health Literature, Medline, Psych INFO, and Applied Social Sciences Index and Abstracts) was searched between January 2014 until July 2021 to identify eligible studies. Quality assessment and narrative synthesis were subsequently undertaken. Results: Fourteen studies were included. All 14 studies used different types of breastfeeding programs; eight used a combination of curriculum-based breastfeeding education programs, group prenatal breastfeeding counselling, and one-to-one breastfeeding educational programs, which were all delivered in person; four studies used web-based learning platforms to deliver breastfeeding education prenatally which were both delivered online and face to face over a period of 3 weeks to 2 months with follow-up periods ranging from 3 weeks to 6 months; one study delivered breastfeeding educational intervention using mother-to-mother breastfeeding support groups in promoting exclusive breastfeeding, and one study disseminated breastfeeding education to participants based on the theory of planned behaviour. The most effective interventions were those that included both theory and hands-on demonstrations. Results showed an increase in breastfeeding uptake, breastfeeding knowledge, an increase in a positive attitude to breastfeeding, and an increase in maternal breastfeeding self-efficacy among mothers who participated in breastfeeding educational programs during prenatal care. Conclusion: Prenatal breastfeeding education increases women’s knowledge of breastfeeding. Mothers who are knowledgeable about breastfeeding and hold a positive approach towards breastfeeding have the tendency to initiate breastfeeding and continue for a lengthened period. Findings demonstrate a general correlation between prenatal breastfeeding education and increased breastfeeding uptake postpartum. The high level of positive breastfeeding outcomes inherent in all the studies can be attributed to prenatal breastfeeding education. This review provides rigorous contemporary evidence that healthcare professionals and policymakers can apply when developing effective strategies to improve breastfeeding rates and ultimately improve the health outcomes of mothers and infants.

Keywords: breastfeeding, breastfeeding programs, breastfeeding self-efficacy, prenatal breastfeeding education

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Authors: Hamid Reza Tabatabaiefar, Bita Mansoury, Mohammad Javad Khadivi Zand

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The current energy and climate change impacts of the residential building sector in Australia are significant. Thus, the Australian Government has introduced more stringent regulations to improve building energy efficiency. In 2006, the Australian residential building sector consumed about 11% (around 440 Petajoule) of the total primary energy, resulting in total greenhouse gas emissions of 9.65 million tonnes CO2-eq. The gas and electricity consumption of residential dwellings contributed to 30% and 52% respectively, of the total primary energy utilised by this sector. Around 40 percent of total energy consumption of Australian buildings goes to heating and cooling due to the low thermal performance of the buildings. Thermal performance of buildings determines the amount of energy used for heating and cooling of the buildings which profoundly influences energy efficiency. Employing sustainable design principles and effective use of construction materials can play a crucial role in improving thermal performance of new and existing buildings. Even though awareness has been raised, the design phase of refurbishment projects is often problematic. One of the issues concerning the refurbishment of residential buildings is mostly the consumer market, where most work consists of moderate refurbishment jobs, often without assistance of an architect and partly without a building permit. There is an individual and often fragmental approach that results in lack of efficiency. Most importantly, the decisions taken in the early stages of the design determine the final result; however, the assessment of the environmental performance only happens at the end of the design process, as a reflection of the design outcome. Finally, studies have identified the lack of knowledge, experience and best-practice examples as barriers in refurbishment projects. In the context of sustainable development and the need to reduce energy demand, refurbishing the ageing residential building constitutes a necessary action. Not only it does provide huge potential for energy savings, but it is also economically and socially relevant. Although the advantages have been identified, the guidelines come in the form of general suggestions that fail to address the diversity of each project. As a result, it has been recognised that there is a strong need to develop guidelines for optimised retrofitting of existing residential buildings in order to improve their energy performance. The current study investigates the effectiveness of different energy retrofitting techniques and examines the impact of employing those methods on energy consumption of residential brick veneer buildings in Victoria (Australia). Proposing different remedial solutions for improving the energy performance of residential brick veneer buildings, in the simulation stage, annual energy usage analyses have been carried out to determine heating and cooling energy consumptions of the buildings for different proposed retrofitting techniques. Then, the results of employing different retrofitting methods have been examined and compared in order to identify the most efficient and cost-effective remedial solution for improving the energy performance of those buildings with respect to the climate condition in Victoria and construction materials of the studied benchmark building.

Keywords: brick veneer residential buildings, building energy efficiency, climate change impacts, cost effective remedial solution, energy performance, sustainable design principles

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Authors: Wen Liu, Errol Haarhoff, Lee Beattie

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In 2010, New Zealand’s central government re-organise the local governments arrangements in Auckland, New Zealand by amalgamating its previous regional council and seven supporting local government units into a single unitary council, the Auckland Council. The Auckland Council is charged with providing local government services to approximately 1.5 million people (a third of New Zealand’s total population). This includes addressing Auckland’s strategic urban growth management and setting its urban planning policy directions for the next 40 years. This is expressed in the first ever spatial plan in the region – the Auckland Plan (2012). The Auckland plan supports implementing a compact city model by concentrating the larger part of future urban growth and development in, and around, existing and proposed transit centres, with the intention of Auckland to become globally competitive city and achieving ‘the most liveable city in the world’. Turning that vision into reality is operatized through the statutory land use plan, the Auckland Unitary Plan. The Unitary plan replaced the previous regional and local statutory plans when it became operative in 2016, becoming the ‘rule book’ on how to manage and develop the natural and built environment, using land use zones and zone standards. Common to the broad range of literature on urban growth management, one significant issue stands out about intensification. The ‘gap’ between strategic planning and what has been achieved is evident in the argument for the ‘compact’ urban form. Although the compact city model may have a wide range of merits, the extent to which these are actualized largely rely on how intensification actually is delivered. The transformation of the rhetoric of the residential intensification model into reality is of profound influence, yet has enjoyed limited empirical analysis. In Auckland, the establishment of the Auckland Plan set up the strategies to deliver intensification into diversified arenas. Nonetheless, planning policy itself does not necessarily achieve the envisaged objectives, delivering the planning system and high capacity to enhance and sustain plan implementation is another demanding agenda. Though the Auckland Plan provides a wide ranging strategic context, its actual delivery is beholden on the Unitary Plan. However, questions have been asked if the Unitary Plan has the necessary statutory tools to deliver the Auckland Plan’s policy outcomes. In Auckland, there is likely to be continuing tension between the strategies for intensification and their envisaged objectives, and made it doubtful whether the main principles of the intensification strategies could be realized. This raises questions over whether the Auckland Plan’s policy goals can be achieved in practice, including delivering ‘quality compact city’ and residential intensification. Taking Auckland as an example of traditionally sprawl cities, this article intends to investigate the efficacy plan making and implementation directed towards higher density development. This article explores the process of plan development, plan making and implementation frameworks of the first ever spatial plan in Auckland, so as to explicate the objectives and processes involved, and consider whether this will facilitate decision making processes to realize the anticipated intensive urban development.

Keywords: urban intensification, sustainable development, plan making, governance and implementation

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