Study protocol of the YOU CALL - WE CALL TRIAL: Impact of a multimodal support intervention after a "mild" stroke

Background More than 60% of new strokes each year are "mild" in severity and this proportion is expected to rise in the years to come. Within our current health care system those with "mild" stroke are typically discharged home within days, without further referral to health or rehabilitation services other than advice to see their family physician. Those with mild stroke often have limited access to support from health professionals with stroke-specific knowledge who would typically provide critical information on topics such as secondary stroke prevention, community reintegration, medication counselling and problem solving with regard to specific concerns that arise. Isolation and lack of knowledge may lead to a worsening of health problems including stroke recurrence and unnecessary and costly health care utilization. The purpose of this study is to assess the effectiveness, for individuals who experience a first "mild" stroke, of a sustainable, low cost, multimodal support intervention (comprising information, education and telephone support) - "WE CALL" compared to a passive intervention (providing the name and phone number of a resource person available if they feel the need to) - "YOU CALL", on two primary outcomes: unplanned-use of health services for negative events and quality of life. Method/Design We will recruit 384 adults who meet inclusion criteria for a first mild stroke across six Canadian sites. Baseline measures will be taken within the first month after stroke onset. Participants will be stratified according to comorbidity level and randomised to one of two groups: YOU CALL or WE CALL. Both interventions will be offered over a six months period. Primary outcomes include unplanned use of heath services for negative event (frequency calendar) and quality of life (EQ-5D and Quality of Life Index). Secondary outcomes include participation level (LIFE-H), depression (Beck Depression Inventory II) and use of health services for health promotion or prevention (frequency calendar). Blind assessors will gather data at mid-intervention, end of intervention and one year follow up. Discussion If effective, this multimodal intervention could be delivered in both urban and rural environments. For example, existing infrastructure such as regional stroke centers and existing secondary stroke prevention clinics, make this intervention, if effective, deliverable and sustainable.

On food security and alternative food networks: Understanding and performing food security in the context of urban bias

This paper offers one explanation for the institutional basis of food insecurity in Australia, and argues that while alternative food networks and the food sovereignty movement perform a valuable function in building forms of social solidarity between urban consumers and rural producers, they currently make only a minor contribution to Australia’s food and nutrition security. The paper begins by identifying two key drivers of food security: household incomes (on the demand side) and nutrition-sensitive, ‘fair food’ agriculture (on the supply side). We focus on this second driver and argue that healthy populations require an agricultural sector that delivers dietary diversity via a fair and sustainable food system. In order to understand why nutrition-sensitive, fair food agriculture is not flourishing in Australia we introduce the development economics theory of urban bias. According to this theory, governments support capital intensive rather than labour intensive agriculture in order to deliver cheap food alongside the transfer of public revenues gained from rural agriculture to urban infrastructure, where the majority of the voting public resides. We chart the unfolding of the Urban Bias across the twentieth century and its consolidation through neo-liberal orthodoxy, and argue that agricultural policies do little to sustain, let alone revitalize, rural and regional Australia. We conclude that by observing food system dynamics through a re-spatialized lens, Urban Bias Theory is valuable in highlighting rural–urban socio-economic and political economy tensions, particularly regarding food system sustainability. It also sheds light on the cultural economy tensions for alternative food networks as they move beyond niche markets to simultaneously support urban food security and sustainable rural livelihoods.

Provisioning a 3.3 MW PhotoVoltaic generation system onto a distribution authority’s 11 kV rural feeder

This paper describes part of an engineering study that was undertaken to demonstrate that a multi-megawatt Photovoltaic (PV) generation system could be connected to a rural 11 kV feeder without creating power quality issues for other consumers. The paper concentrates solely on the voltage regulation aspect of the study as this was the most innovative part of the study. The study was carried out using the time-domain software package, PSCAD/EMTDC. The software model included real time data input of actual measured load and scaled PV generation data, along with real-time substation voltage regulator and PV inverter reactive power control. The outputs from the model plot real-time voltage, current and power variations throughout the daily load and PV generation variations. Other aspects of the study not described in the paper include the analysis of harmonics, voltage flicker, power factor, voltage unbalance and system losses.

Defining green road infrastructure projects—A critical review

Green infrastructure is considered as a strategic approach to address the ecological and social impacts of urban sprawl. The main elements of green infrastructure have been well established and include a series of multifunctional ecological systems, such as green urban space, green road infrastructure and the links between these systems. However, it should be noted that the elements of green road infrastructure have only been briefly mentioned in isolated life cycle stages, e.g. design, procurement, construction, maintenance and operation. The definition of green road infrastructure and the elements in green road infrastructure projects remain largely unknown. To explore the elements in green road infrastructure, a critical review was adopted. As the development of green road infrastructure projects is guided by rating systems, a comparison of three major green roads rating systems, including GreenroadsTM, EnvisionTM and Infrastructure Sustainability Rating Tool—IS, was conducted. The comparison reveals that green roads can be defined as road projects that have superior performance in economic, social and environmental sustainability. The sustainability features in green roads mainly include environmental sustainability, social sustainability, economic sustainability, quality, pavement technology and innovation. The results will contribute to an increased understanding of green roads and will be useful to improve the performance of road projects on these sustainability features.

Formation of highly conductive composite coatings and their applications to broadband antennas and mechanical transducers

Tight networks of interwoven carbon nanotube bundles are formed in our highly conductive composite. The composite possesses propertiessuggesting a two-dimensional percolative network rather than other reported dispersions displaying three-dimensional networks. Binding nanotubes into large but tight bundles dramatically alters the morphology and electronic transport dynamics of the composite. This enables itto carry higher levels of charge in the macroscale leading to conductivities as high as 1600 S/cm. We now discuss in further detail, the electronic and physical properties of the nanotube composites through Raman spectroscopy and transmission electron microscopy analysis. When controlled and usedappropriately, the interesting properties of these composites reveal their potential for practical device applications. For instance, we used this composite to fabricate coatings, whic improve the properties of an electromagnetic antenna/amplifier transducer. The resulting transducer possesses a broadband range up to GHz frequencies. A strain gauge transducer was also fabricated using changes in conductivity to monitor structural deformations in the composite coatings.

IT pricing: Copyright law, consumer rights, and competition policy. A submission to the House of Representatives Standing Committee on Infrastructure and Communications Inquiry into IT Pricing

For a hundred years, since Federation, Australian consumers have suffered the indignity and the tragedy of price discrimination. From the time of imperial publishing networks, Australia has been suffered from cultural colonialism. In respect of pricing of copyright works, Australian consumers have been gouged; ripped-off; and exploited. Digital technologies have not necessarily brought an end to such price discrimination. Australian consumers have been locked out by technological protection measures; subject to surveillance, privacy intrusions and security breaches; locked into walled gardens by digital rights management systems; and geo-blocked.

Framework for assessing the influence of critical infrastructure interdependencies in post-disaster reconstruction management

Due to ever increasing climate instability, the number of natural disasters affecting society and communities is expected to increase globally in the future, which will result in a growing number of casualties and damage to property and infrastructure. Such damage poses crucial challenges for recovery of interdependent critical infrastructures. Post-disaster reconstruction is a complex undertaking as it is not only closely linked to the well-being and essential functioning of society, but also requires a large financial commitment. Management of critical infrastructure during post-disaster recovery needs to be underpinned by a holistic recognition that the recovery of each individual infrastructure system (e.g. energy, water, transport and information and communication technology) can be affected by the interdependencies that exist between these different systems. A fundamental characteristic of these interdependencies is that failure of one critical infrastructure system can result in the failure of other interdependent infrastructures, leading to a cascade of failures, which can impede post-disaster recovery and delay the subsequent reconstruction process. Consequently, there is a critical need for developing a holistic strategy to assess the influence of infrastructure interdependencies, and for incorporating these interdependencies into a post-disaster recovery strategy. This paper discusses four key dimensions of interdependencies that need to be considered in a post-disaster reconstruction planning. Using key concepts and sub-concepts derived from the notion of interdependency, the paper examines how critical infrastructure interdependencies affect the recovery processes of damaged infrastructures.

Infrastructure Disputes Shape Future of Streaming Media

In November 2010, tension between Internet infrastructure companies boiled over in a dispute between content distribution network (CDN) Level 3 and Internet service provider (ISP) Comcast. Level 3, a distribution partner of Netflix, accused Comcast of violating the principles of net neutrality when the ISP increased distribution fees for carrying high bandwidth services. Comcast justified its actions by stating that the price increase was standard practice and argued Level 3 was trying to avoid paying its fair share. The dispute exemplifies the growing concern over the rising costs of streaming media services. The companies facing these inflated infrastructure costs are CDNs (Level 3, Equinix, Limelight, Akamai, and Voxel), companies that host streaming media content on server farms and distribute the content to a variety of carriers, and ISPs (Comcast, Time Warner, Cox, and AT&T), the cable and phone companies that provide “last mile” service to paying customers. Both CDNs and ISPs are lobbying government regulators to keep their costs at a minimum. The outcome of these disputes will influence the cost, quality, and legal status of streaming media.

Client learning and the performance of collaborative infrastructure projects

Australia is a leading user of collaborative procurement methods, which are used to deliver large and complex infrastructure projects. Project alliances, Early Contractor Involvement (ECI), and partnering are typical examples of collaborative procurement models. In order to increase procurement effectiveness and value for money (VfM), clients have adopted various learning strategies for new contract development. However client learning strategies and behaviours have not been systematically analysed before. Therefore, the current paper undertakes a literature review addressing the research question “How can client learning capabilities be effectively understood?”. From the resource-based and dynamic capability perspectives, this paper proposes that the collaborative learning capability (CLC) of clients drives procurement model evolution. Learning routines underpinning CLC carry out exploratory, transformative and exploitative learning phases associated with collaborative project delivery. This learning improves operating routines, and ultimately performance. The conceptualization of CLC and the three sequential learning phases is used to analyse the evidence in the construction management literature. The main contribution of this study is the presentation of a theoretical foundation for future empirical studies to unveil effective learning strategies, which help clients to improve the performance of collaborative projects in the dynamic infrastructure market.

The opportunity for implementing Islamic project financing to the Indonesian infrastructure development

Purpose: This chapter discusses the opportunity of Islamic project financing implementation for public infrastructure development in Indonesia. Design/Methodology/Approach: This chapter, firstly, reviewed existing literature on Islamic finance to explore the applicability of Islamic financing in infrastructure development. Interviews were conducted as the first stage of Delphi method approach. This was then followed by reviewing Indonesia’s government policies and regulations in infrastructure industry and Islamic financing. Findings: This chapter enlightens the implementation of Islamic financing on infrastructure project financing in Indonesia. The findings indicate that the government policies and regulations on both infrastructure investment and Islamic financing support the implementation of Islamic project financing, whereas, an improvement is still needed in order to overarch infrastructure business and Islamic financing investment. Research: Financing framework development for Indonesia infrastructure projects. Limitations/Implications: The result reported comprises the preliminary study of Islamic project paper written based on published research papers and interviews. Furthermore, the data collected for the study are limited to the case of Indonesian infrastructure projects. Practical Implication: Islamic financing in Indonesia infrastructure projects development has not been optimally implemented. Therefore, this chapter serves as a catalyst to explore alternative financial scheme such as Islamic financing for infrastructure development. Originality/Value: This chapter highlights possibilities and obstacles in applying Islamic scheme to infrastructure project financing. This provides a framework to analyse the steps to implement Islamic financing successfully in infrastructure development.

The influence of critical infrastructure interdependencies on post-disaster reconstruction: Elements of infrastructure interdependency that impede the post-disaster recovery effort

The importance of developing effective disaster management strategies has significantly grown as the world continues to be confronted with unprecedented disastrous events. Factors such as climate instability, recent urbanization along with rapid population growth in many cities around the world have unwittingly exacerbated the risks of potential disasters, leaving a large number of people and infrastructure exposed to new forms of threats from natural disasters such as flooding, cyclones, and earthquakes. With disasters on the rise, effective recovery planning of the built environment is becoming imperative as it is not only closely related to the well-being and essential functioning of society, but it also requires significant financial commitment. In the built environment context, post-disaster reconstruction focuses essentially on the repair and reconstruction of physical infrastructures. The reconstruction and rehabilitation efforts are generally performed in the form of collaborative partnerships that involve multiple organisations, enabling the restoration of interdependencies that exist between infrastructure systems such as energy, water (including wastewater), transport, and telecommunication systems. These interdependencies are major determinants of vulnerabilities and risks encountered by critical infrastructures and therefore have significant implications for post-disaster recovery. When disrupted by natural disasters, such interdependencies have the potential to promote the propagation of failures between critical infrastructures at various levels, and thus can have dire consequences on reconstruction activities. This paper outlines the results of a pilot study on how elements of infrastructure interdependencies have the potential to impede the post-disaster recovery effort. Using a set of unstructured interview questionnaires, plausible arguments provided by seven respondents revealed that during post-disaster recovery, critical infrastructures are mutually dependent on each other’s uninterrupted availability, both physically and through a host of information and communication technologies. Major disruption to their physical and cyber interdependencies could lead to cascading failures, which could delay the recovery effort. Thus, the existing interrelationship between critical infrastructures requires that the entire interconnected network be considered when managing reconstruction activities during the post-disaster recovery period.

Associated schools of construction of southern Africa infrastructure design and delivery workshop - Report. CIB task group 91 infrastructure

This workshop comprised a diverse group of African construction experts, ranging far wider than RSA. Each of the attendees had attended the annual ASOCSA conference and was additionally provided with a short workshop pre-brief. The aim was to develop a view of their 15-20 year vision of construction improvement in RSA and the steps necessary to get there. These included sociological, structural, technical and process changes. Whilst some suggestions are significantly challenging, none are impossible, given sufficient collaboration between government, industry, academia and NGOs. The highest priority projects (more properly, programmes) were identified and further explored. These are: 1. Information Hub (‘Open Africa’). Aim – to utilise emerging trends in Open Data to provide a force for African unity. 2. Workforce Development. Aim – to rebuild a competent, skilled construction industry for RSA projects and for export. 3. Modular DIY Building. Aim – to accelerate the development of sustainable, cost-efficient and desirable housing for African economic immigrants and others living in makeshift and slum dwellings. Open Data is a maturing theme in different cities and governments around the world and the workshop attendees were very keen to seize such a possibility to assist in developing an environment where Africans can share information and foster collaboration. It is likely that NGOs might be keen to follow up such an initiative. There are significant developments taking place around the world in the construction sector currently, with comparatively large savings being made for taxpayers (20% plus in the UK). Not all of these changes would be easy to transplant to RSA (even more so to much of the rest of Africa). Workforce development was a keen plea amongst the attendees, who seemed concerned that expertise has leaked away and is not being replaced with sufficient intensity. It is possible today to develop modular buildings in such a way that even unskilled residents can assist in their construction, and even their appropriate design. These buildings can be sited nearly autonomously from infrastructures, thus relieving the tensions on cities and townships, whilst providing humane accommodation for the economically disadvantaged. Development of suitable solutions could either be conducted with other similarly stressed countries or developed in-country and the expertise exported. Finally, it should be pointed out that this was very much a first step. Any opportunity to collaborate from an Australian, QUT or CIB perspective would be welcomed, whilst acknowledging that the leading roles belong to RSA, CSIR, NRF, ASOCSA and the University of KwaZulu-Natal.

Associations between extreme precipitation and childhood hand, foot and mouth disease in urban and rural areas in Hefei, China

Background Understanding the relationship between extreme weather events and childhood hand, foot and mouth disease (HFMD) is important in the context of climate change. This study aimed to quantify the relationship between extreme precipitation and childhood HFMD in Hefei, China, and further, to explore whether the association varied across urban and rural areas. Methods Daily data on HFMD counts among children aged 0–14 years from 2010 January 1st to 2012 December 31st were retrieved from Hefei Center for Disease Control and Prevention. Daily data on mean temperature, relative humidity and precipitation during the same period were supplied by Hefei Bureau of Meteorology. We used a Poisson linear regression model combined with a distributed lag non-linear model to assess the association between extreme precipitation (≥ 90th precipitation) and childhood HFMD, controlling for mean temperature, humidity, day of week, and long-term trend. Results There was a statistically significant association between extreme precipitation and childhood HFMD. The effect of extreme precipitation on childhood HFMD was the greatest at six days lag, with a 5.12% (95% confident interval: 2.7–7.57%) increase of childhood HFMD for an extreme precipitation event versus no precipitation. Notably, urban children and children aged 0–4 years were particularly vulnerable to the effects of extreme precipitation. Conclusions Our findings indicate that extreme precipitation may increase the incidence of childhood HFMD in Hefei, highlighting the importance of protecting children from forthcoming extreme precipitation, particularly for those who are young and from urban areas.

Life-course determinants of bone mass in young adults from a transitional rural community in India: The Andhra Pradesh Children and Parents Study (APCAPS)

Background: Undernutrition and physical inactivity are both associated with lower bone mass. Objective: This study aimed to investigate the combined effects of early-life undernutrition and urbanized lifestyles in later life on bone mass accrual in young adults from a rural community in India that is undergoing rapid socioeconomic development. Design: This was a prospective cohort study of participants of the Hyderabad Nutrition Trial (1987–1990), which offered balanced protein-calorie supplementation to pregnant women and preschool children younger than 6 y in the intervention villages. The 2009–2010 follow-up study collected data on current anthropometric measures, bone mineral density (BMD) measured by dual-energy X-ray absorptiometry, blood samples, diet, physical activity, and living standards of the trial participants (n = 1446, aged 18–23 y). Results: Participants were generally lean and had low BMD [mean hip BMD: 0.83 (women), 0.95 (men) g/cm2; lumbar spine: 0.86 (women), 0.93 (men) g/cm2]. In models adjusted for current risk factors, no strong evidence of a positive association was found between BMD and early-life supplementation. On the other hand, current lean mass and weight-bearing physical activity were positively associated with BMD. No strong evidence of an association was found between BMD and current serum 25-hydroxyvitamin D or dietary intake of calcium, protein, or calories. Conclusions: Current lean mass and weight-bearing physical activity were more important determinants of bone mass than was early-life undernutrition in this population. In transitional rural communities from low-income countries, promotion of physical activity may help to mitigate any potential adverse effects of early nutritional disadvantage.

Profiles of illicit drug use during annual key holiday and control periods in Australia: Wastewater analysis in an urban, a semi-rural and a vacation area

AIMS: To examine changes in illicit drug consumption between peak holiday season (23 December-3 January) in Australia and a control period two months later in a coastal urban area, an inland semi-rural area and an island populated predominantly by vacationers during holidays. DESIGN: Analysis of representative daily composite wastewater samples collected from the inlet of the major wastewater treatment plant in each area. SETTING: Three wastewater treatment plants. PARTICIPANTS: Wastewater treatment plants serviced approximately 350, 000 persons in the urban area, 120,000 in the semi-rural area and 1100-2400 on the island. MEASUREMENTS: Drug residues were analysed using liquid chromatography coupled to a tandem mass spectrometer. Per capita drug consumption was estimated. Changes in drug use were quantified using Hedges' g. FINDINGS: During the holidays, cannabis consumption in the semi-rural area declined (g = -2.8) as did methamphetamine (-0.8), whereas cocaine (+1.5) and ecstasy (+1.6) use increased. In the urban area, consumption of all drugs increased during holidays (cannabis +1.6, cocaine +1.2, ecstasy +0.8 and methamphetamine +0.3). In the vacation area, methamphetamine (+0.7), ecstasy (+0.7) and cocaine (+1.1) use increased, but cannabis (-0.5) use decreased during holiday periods. CONCLUSIONS: While the peak holiday season in Australia is perceived as a period of increased drug use, this is not uniform across all drugs and areas. Substantial declines in drug use in the semi-rural area contrasted with substantial increases in urban and vacation areas. Per capita drug consumption in the vacation area was equivalent to that in the urban area, implying that these locations merit particular attention for drug use monitoring and harm minimisation measures.