Improving the health of Australians by applying evidence from behavioural epidemiology to urban design projects

Rapid urban population growth in Australia requires an expansion of supporting hard and soft infrastructure. In the State of Victoria, directing this growth are a number of urban design and planning mechanisms that provide a ‘blueprint for development and investment’. Although topics revolving around physical health are present in these and other planning related documents, largely absent from this literature are ‘tools’ to assist decision makers in determining whether or not an urban setting supports physical health and provides opportunities for physical activity. Insufficient physical activity is a risk factor contributing to Australia’s growing and significant burden of chronic disease including cardiovascular disease, Type 2 diabetes and overweight/obesity. The potential of the built environment to influence population-level physical activity is well recognised. A key element in Victoria’s planning framework that can help address these health concerns is the provision and redevelopment of open space(s) in urban areas that provide opportunities for people of all ages and abilities to engage in physical activity. However, in the realisation of these settings, evidence informing the design of urban open space(s) that promote opportunities for physical activity is needed to produce evidence based decision making. Using the three geo-spatial visioning layers embedded in Victoria’s planning framework (i.e. Growth Area Framework Plans, Precinct Structure Plans and Planning Permits) as positioning instruments, this paper merges the fields of behavioural epidemiology and urban design to: i) provide a brief overview of current research relating to design of open space to optimise usage and physical activity, ii) consider what type of evidence relating to features of open space is needed to help inform decision makers, iii) consider the methods and procedures practitioners may use to incorporate evidence in to their planning, and iv) discuss the geo-spatial development level that the respective data can best assist decision making to achieve positive gains in physical health.

Early recognition of ipilimumab-related autoimmune hypophysitis in patients with metastatic melanoma: case studies and recommendations for management

Ipilimumab is a human anti-CTLA-4 monoclonal antibody recently approved for the treatment of advanced melanoma. Stimulation of T-cell activity unmasks antitumor activity, but can cause immune-related adverse events. Autoimmune hypophysitis is of particular importance because its presentation can be subtle but life threatening. We present two cases where early recognition of ipilimumab-related autoimmune hypophysitis led to timely intervention and low subsequent morbidity, without compromise of antitumor effects. We provide recommendations for detection and management of this potentially life-threatening complication of ipilimumab.

Bellwether procedures for monitoring and planning essential surgical care in low- and middle-income countries: caesarean delivery, laparotomy and treatment of open fractures

BACKGROUND: Surgical conditions represent a significant proportion of the global burden of disease, and therefore, surgery is an essential component of health systems. Achieving universal health coverage requires effective monitoring of access to surgery. However, there is no widely accepted standard for the required capabilities of a first-level hospital. We aimed to determine whether a group of operations could be used to describe the delivery of essential surgical care.

METHODS: We convened an expert panel to identify procedures that might indicate the presence of resources needed to treat an appropriate range of surgical conditions at first-level hospitals. Using data from the World Health Organization Emergency and Essential Surgical Care Global database, collected using the WHO Situational Analysis Tool (SAT), we analysed whether the ability to perform each of these procedures-which we term "bellwether procedures"-was associated with performing a full range of essential surgical procedures.

FINDINGS: The ability to perform caesarean delivery, laparotomy, and treatment of open fracture was closely associated with performing all obstetric, general, basic, emergency, and orthopaedic procedures (p < 0.001) in the population that responded to the WHO SAT Survey. Procedures including cleft lip, cataract, and neonatal surgery did not correlate with performing the bellwether procedures.

INTERPRETATION: Caesarean delivery, laparotomy, and treatment of open fractures should be standard procedures performed at first-level hospitals. With further validation in other populations, local managers and health ministries may find this useful as a benchmark for what first-level hospitals can and should be able to perform on a 24/7 basis in order to ensure delivery of emergency and essential surgical care to their population. Those procedures which did not correlate with the bellwether procedures can be referred to a specialized centre or collected for treatment by a visiting specialist team.

What I ‘know’: Literary studies and the teaching of English

This essay unfolds through a series of juxtapositions, involving storytelling and writing of a more analytical nature. In thinking about what I ‘know’ as an English teacher, my aim has been to present my ideas in a form that might do justice to the contradictions and complexities of my professional life, including my continuing efforts to negotiate a pathway between the rich particularities of the educational settings in which I have worked and my knowledge and values as an English teacher. My primary focus is on how my literary education has shaped and been shaped by my work as an English teacher vis-à-vis a devaluing of teachers’ disciplinary knowledge that has occurred through standards-based reforms. I attempt to make the standpoint from which I am writing an object of scrutiny, thus producing an account of what I ‘know’ that arises out of my work as an English teacher and returns to it as a necessary dimension of a politically committed praxis.

Indigenous cultural studies: intersections between cultural studies and Indigenous studies

History, Power, Text collects together selected contributions on Indigenous themes published between 1996 and 2013 in the journal first known as UTS Review and now known as Cultural Studies Review. Since the journal’s inception, successive editors have sought to open up a space for new kinds of politics, new styles of writing and new modes of interdisciplinary engagement. Like the journal it draws its material from, this collection has been conceived and assembled as an exercise in institution building beyond ‘the Institution’. We call this institution, tentatively, ‘Indigenous cultural studies’ and see it as a disciplinary space that is built iteratively through events, single articles and books. We do not seek to prescribe or delimit this project but rather to give it density and energise those working in the overlapping fields represented here.

Educating for designing in and planning for country: Empowering built environment students with Indigenous protocols and knowledge

Increasingly, built environment professionals in Australia, including architect, landscape architect and planner practitioners, are becoming involved in planning and design of projects for, and in direct consultation with Indigenous communities and their proponents. Critically, built environment professionals must be able to plan and design, and demonstrate respect for Indigenous protocols, cultural issues and their community values. Yet many students graduate with little or no comprehension of Indigenous knowledge systems or the protocols for engagement with Australian or international Indigenous communities in which they are required to work. This paper reports on a recently completed Office of Learning & Teaching funded project that was designed to improve the knowledge and skills of tertiary students in the built environment professions including proposing strategies and processes to expose students in the built environment professions to Australian Indigenous knowledge systems. This is a positive beginning in a long-term decolonising project.

Virtual ampang Jaya

Virtual Ampang Jaya is an interactive visualization environment for modeling urban growth and spatio-temporal transformation to expose and evaluate the different layers of Ampang Jaya, consisting of social, economic, built and natural environments. The research will investigate the techniques of data acquisition, data reconstruction from physical to digital, urban analysis and visualization in constructing a digital model which may include low geometric content such as 2D digital maps and digital orthographics to high geometric content such as full volumetric parametric modeling. The process will integrate the state of the art GIS system to explore GIS powerful analytical and querying capabilities with interactive visualization environment as well as test the model as a predictive tool. The model will set as an experimental test pad in providing a new platform to support decision making about the spatial growth of Ampang Jaya by the various stakeholders in the planning processes. Such an environment will improve the subsequent digital models and research in the area of urban design and planning where visual communication is central.

Urbanheart surgery - a logic of design alternatives

In 1972 Sir Leslie Martin in his essay “The Grid as Generator”, advocated “a strong theoretical basis for [planning and] urban design” (Carolin P, 2000, p4) by methodically shifting design parameters regarding the way “in which buildings [could be] placed on the land” Martin was able to demonstrate how the generation of alternatives could “allow wider scope for decisions and objectives” to be considered and discussed (Carmona M, & Tiesdell S 2007, p81). Operating within a conventional design studio yet drawing of Sir Leslie Martin’s logic, ie developing an informed understanding of a problem by identifying a finite world of design ‘alternatives’, the following paper outlines a studio based program at the School of Architecture and Building, Deakin University, referred to as the ‘UrbanHeart Surgery’. While most atelier-based courses operate largely on an ad-hoc basis where students often work within self imposed competitive isolation, Urbanheart adopts a more open yet structured approach where students work in design collaboratives to generate a matrix of alternative design scenarios. The program actively integrates postgraduate students from Architecture, Urban Design and Planning into a design research culture and allows them to engage in critical discourse by working on strategic design projects in three areas significant to the future development of the state of Victoria: Metropolitan Urbanism, Urbanism on the Periphery and Regional Urbanism.

Temporary use 2.0, a tool for planning and developing the new urban context

Temporary urban spaces are gaining even more footing and acceptance on the political agenda as a result of their potential for creating eventful, cultural and creative urban environments. This political focus on temporary urban space is an indication of general urban regulations and development tendencies characterized by cultural planning, leisure, economy, collaborative planning and an increased focus on everyday life. Particularly economic parameters related to leisure such as creativity, culture, urban life and experiences are highly prioritized on the urban municipal agenda, with temporary uses as a concrete development tool. An interesting dichotomy has also arisen between the use of temporary space as a tool for social planning by urban designers as opposed to the use of temporary spaces by politicians as a vehicle for economic gain through leisure spaces. This paper focuses on the phenomenon of Temporary Use as a city-political focus area now and in the future as well as the use of the temporary as a planning tool. Several case studies are used to illustrate these topics.

Advancing community engagement practice for strategic urban planning : learning from allied and remote disciplines

Urban planning has the potential to draw on allied and remote disciplines to improve community consultation processes for strategic planning projects. Urban design and landscape architecture have quantitative and qualitative methods which can be utilised to visualise different options of urban intensification which may fit within communities’ expectations of change. Furthermore political science has long used scientifically established psychometric techniques to collect data from broad sections of the population, analysing demographic profiles of communities and understanding their perceptions and attitudes. By appropriating quantitative and qualitative methods from other disciplines, urban planning policies can be developed which may reflect communities’ aspirations of amenity and neighbourhood character. The aim of this paper is to assist local government urban planners with their community engagement practice in order to form policies which are acceptable to the affected communities. The paper draws on Victoria as a case study of community engagement practice, examines research methods from allied and remote disciplines and proposes a community engagement framework which introduces rigour within the community engagement process.

Access to social insurance in urban China: a comparative study of rural-urban and urban-urban migrants in Beijing

 Since 1958 the hukou (household registration) system has assigned Chinese citizens either a rural or urban status. Some studies argue that the rural-to-urban migrants in China who do not have urban hukou are not entitled to urban social insurance schemes, due to institutional discrimination, which applies differing treatment to urban and rural hukou (chengxiang fenge). Although rural-urban migrants participate less in the social insurance system than their counterparts with urban hukou, a closer examination of recent policy developments shows that migrants actually do have the legal right to access the system. This implies that discrimination between rural and urban workers has been declining, and distinctions based on household registration status are less able to explain China's current urban transition. This paper provides a new way of examining Chinese migrants' social insurance participation, by adopting a framework that includes both rural-to-urban migrants and urban-to-urban migrants, which are an important, but less studied, migrant group. Among our key findings are that urban migrants are more likely to sign a labour contract than rural migrants; urban migrants have higher participation rates in social insurance than rural migrants; having a labour contract has a greater impact than hukou status in determining whether Beijing's floating population accesses social insurance; and urban migrants who have signed a labour contract have higher participation rates in social insurance than either rural migrants or urban migrants without a labour contract. © 2013 Elsevier Ltd.

Approaches to urban heritage, development and sustainability

More than half of the world’s population now live in urban areas, and cities provide the setting for contemporary challenges such as population growth, mass tourism and unequal access to socio-economic opportunities. Urban Heritage, Development and Sustainability examines the impact of these issues on urban heritage, considering innovative approaches to managing developmental pressures and focusing on how taking an ethical, inclusive and holistic approach to urban planning and heritage conservation may create a stronger basis for the sustainable growth of cities in the future.This volume is a timely analysis of current theories and practises in urban heritage, with particular reference to the conflict between, and potential reconciliation of, conservation and development goals.

Animals and urban informality in sacred spaces: bull-calf trafficking in Simhachalam Temple, Vishakapatnam

Religion and Urbanism contributes to an expanded understanding of 'sustainable cities' in South Asia by demonstrating the multiple, and often conflicting ways in which religion enables or challenges socially equitable and ecologically sustainable urbanisation in the region. In particular, this collection focuses on two aspects that must inform the sustainable cities discourse in South Asia: the intersections of religion and urban heritage, and religion and various aspects of informality.

This book makes a much-needed contribution to the nexus between religion and urban planning for researchers, postgraduate students and policy makers in Sustainable Development, Development Studies, Urban Studies, Religious Studies, Asian Studies, Heritage Studies and Urban and Religious Geography.

Religion and urban policy for South Asia: where next?

Religion and Urbanism contributes to an expanded understanding of 'sustainable cities' in South Asia by demonstrating the multiple, and often conflicting ways in which religion enables or challenges socially equitable and ecologically sustainable urbanisation in the region. In particular, this collection focuses on two aspects that must inform the sustainable cities discourse in South Asia: the intersections of religion and urban heritage, and religion and various aspects of informality.

This book makes a much-needed contribution to the nexus between religion and urban planning for researchers, postgraduate students and policy makers in Sustainable Development, Development Studies, Urban Studies, Religious Studies, Asian Studies, Heritage Studies and Urban and Religious Geography.