Planning for knowledge-based urban development : global perspectives

Purpose: The purpose of this article is to investigate the engineering of creative urban regions through knowledge-based urban development. In recent years city administrators realised the importance of engineering and orchestrating knowledge city formation through visioning and planning for economic, socio-cultural and physical development. For that purpose a new development paradigm of ‘‘knowledge-based urban development’’ is formed, and quickly finds implementation ground in many parts of the globe.----- Design/methodology/approach: The paper reviews the literature and examines global best practice experiences in order to determine how cities are engineering their creative urban regions so as to establish a base for knowledge city formation.----- Findings: The paper sheds light on the different development approaches for creative urban regions, and concludes with recommendations for urban administrations planning for knowledge-based development of creative urban regions.----- Originality/value: The paper provides invaluable insights and discussion on the vital role of planning for knowledge-based urban development of creative urban regions.

Inequalities in cardiovascular disease mortality : the role of behavioural, physiological and social risk factors

Background: While the relationship between socioeconomic disadvantage and cardiovascular disease (CVD) is well established, the role that traditional cardiovascular risk factors play in this association remains unclear. We examined the association between education attainment and CVD mortality and the extent to which behavioural, social and physiological factors explained this relationship. Methods: Adults (n=38 355) aged 40-69 years living in Melbourne, Australia were recruited in 1990-1994. Subjects with baseline CVD risk factor data ascertained through questionnaire and physical measurement were followed for an average of 9.4 years with CVD deaths verified by review of medical records and autopsy reports. Results: CVD mortality was higher for those with primary education only compared to those who had completed tertiary education, with a hazard ratio (HR) of 1.66 (95% confidence interval [CI] 1.11-2.49) after adjustment for age, country of birth and gender. Those from the lowest educated group had a more adverse cardiovascular risk factor profile compared to the highest educated group, and adjustment for these risk factors reduced the HR to 1.18 (95% CI 0.78-1.77). In analysis of individual risk factors, smoking and waist circumference explained most of the difference in CVD mortality between the highest and lowest education groups. Conclusions: Most of the excess CVD mortality in lower socioeconomic groups can be explained by known risk factors, particularly smoking and overweight. While targeting cardiovascular risk factors should not divert efforts from addressing the underlying determinants of health inequalities, it is essential that known risk factors are addressed effectively among lower socioeconomic groups.

New insights into appetite, inflammation and the use of fish oil in hemodialysis patients

Protein-energy wasting (PEW) is commonly seen in patients with chronic kidney disease (CKD). The condition is characterised by chronic, systemic low-grade inflammation which affects nutritional status by a variety of mechanisms including reducing appetite and food intake and increasing muscle catabolism. PEW is linked with co-morbidities such as cardiovascular disease, and is associated with lower quality of life, increased hospitalisations and a 6-fold increase in risk of death1. Significant gender differences have been found in the severity and effects of several markers of PEW. There have been limited studies testing the ability of anti-inflammatory agents or nutritional interventions to reduce the effects of PEW in dialysis patients. This thesis makes a significant contribution to the understanding of PEW in dialysis patients. It advances understanding of measurement techniques for two of the key components, appetite and inflammation, and explores the effect of fish oil, an anti-inflammatory agent, on markers of PEW in dialysis patients. The first part of the thesis consists of two methodological studies conducted using baseline data. The first study aims to validate retrospective ratings of hunger, desire to eat and fullness on visual analog scales (VAS) (paper and pen and electronic) as a new method of measuring appetite in dialysis patients. The second methodological study aims to assess the ability of a variety of methods available in routine practice to detect the presence of inflammation. The second part of the thesis aims to explore the effect of 12 weeks supplementation with 2g per day of Eicosapentaenoic Acid (EPA), a longchain fatty acid found in fish oil, on markers of PEW. A combination of biomarkers and psychomarkers of appetite and inflammation are the main outcomes being explored, with nutritional status, dietary intake and quality of life included as secondary outcomes. A lead in phase of 3 months prior to baseline was used so that each person acts as their own historical control. The study also examines whether there are gender differences in response to the treatment. Being an exploratory study, an important part of the work is to test the feasibility of the intervention, thus the level of adherence and factors associated with adherence are also presented. The studies were conducted at the hemodialysis unit of the Wesley Hospital. Participants met the following criteria: adult, stage 5 CKD on hemodialysis for at least 3 months, not expected to receive a transplant or switch to another dialysis modality during the study, absence of intellectual impairment or mental illness impairing ability to follow instructions or complete the intervention. A range of intermediate, clinical and patient-centred outcome measures were collected at baseline and 12 weeks. Inflammation was measured using five biomarkers: c-reactive protein (CRP), interleukin-6 (IL6), intercellular adhesion molecule (sICAM-1), vascular cell adhesion molecule (sVCAM-1) and white cell count (WCC). Subjective appetite was measured using the first question from the Appetite and Dietary Assessment (ADAT) tool and VAS for measurements of hunger, desire to eat and fullness. A novel feature of the study was the assessment of the appetite peptides leptin, ghrelin and peptide YY as biomarkers of appetite. Nutritional status/inflammation was assessed using the Malnutrition-Inflammation Score (MIS) and the Patient-Generated Subjective Global Assessment (PG-SGA). Dietary intake was measured using 3-day records. Quality of life was measured using the Kidney Disease Quality of Life Short Form version 1.3 (KDQOL-SF™ v1.3 © RAND University), which combines the Short-Form 36 (SF36) with a kidney-disease specific module2. A smaller range of these variables was available for analysis during the control phase (CRP, ADAT, dietary intake and nutritional status). Statistical analysis was carried out using SPSS version 14 (SPSS Inc, Chicago IL, USA). Analysis of the first part of the thesis involved descriptive and bivariate statistics, as well as Bland-Altman plots to assess agreement between methods, and sensitivity analysis/ROC curves to test the ability of methods to predict the presence of inflammation. The unadjusted (paired ttests) and adjusted (linear mixed model) change over time is presented for the main outcome variables of inflammation and appetite. Results are shown for the whole group followed by analyses according to gender and adherence to treatment. Due to the exploratory nature of the study, trends and clinical significance were considered as important as statistical significance. Twenty-eight patients (mean age 61±17y, 50% male, dialysis vintage 19.5 (4- 101) months) underwent baseline assessment. Seven out of 28 patients (25%) reported sub-optimal appetite (self-reported as fair, poor or very poor) despite all being well nourished (100% SGA A). Using the VAS, ratings of hunger, but not desire to eat or fullness, were significantly (p<0.05) associated with a range of relevant clinical variables including age (r=-0.376), comorbidities (r=-0.380) nutritional status (PG-SGA score, r=-0.451), inflammatory markers (CRP r=-0.383; sICAM-1 r=-0.387) and seven domains of quality of life. Patients expressed a preference for the paper and pen method of administering VAS. None of the tools (appetite, MIS, PG-SGA, albumin or iron) showed an acceptable ability to detect patients who are inflamed. It is recommended that CRP should be tested more frequently as a matter of course rather than seeking alternative methods of measuring inflammation. 27 patients completed the 12 week intervention. 20 patients were considered adherent based on changes in % plasma EPA, which rose from 1.3 (0.94)% to 5.2 (1.1)%, p<0.001, in this group. The major barriers to adherence were forgetting to take the tablets as well as their size. At 12 weeks, inflammatory markers remained steady apart from the white cell count which decreased (7.6(2.5) vs 7.0(2.2) x109/L, p=0.058) and sVCAM-1 which increased (1685(654) vs 2249(925) ng/mL, p=0.001). Subjective appetite using VAS increased (51mm to 57mm, +12%) and there was a trend towards reduction in peptide YY (660(31) vs 600(30) pg/mL, p=0.078). There were some gender differences apparent, with the following adjusted change between baseline and week 12: CRP (males -3% vs females +17%, p=0.19), IL6 (males +17% vs females +48%, p=0.77), sICAM-1 (males -5% vs females +11%, p=0.07), sVCAM-1 (males +54% vs females +19%, p=0.08) and hunger ratings (males 20% vs females -5%, p=0.18). On balance, males experienced a maintainence or reduction in three inflammatory markers and an improvement in hunger ratings, and therefore appeared to have responded better to the intervention. Compared to those who didn’t adhere, adherent patients maintained weight (mean(SE) change: +0.5(1.6) vs - 0.8(1.2) kg, p=0.052) and fat-free mass (-0.1 (1.6) vs -1.8 (1.8) kg, p=0.045). There was no difference in change between the intervention and control phase for CRP, appetite, nutritional status or dietary intake. The thesis makes a significant contribution to the evidence base for understanding of PEW in dialysis patients. It has advanced knowledge of methods of assessing inflammation and appetite. Retrospective ratings of hunger on a VAS appear to be a valid method of assessing appetite although samples which include patients with very poor appetite are required to confirm this. Supplementation with fish oil appeared to improve subjective appetite and dampen the inflammatory response. The effectiveness of the intervention is influenced by gender and adherence. Males appear to be more responsive to the primary outcome variables than females, and the quality of response is improved with better adherence. These results provide evidence to support future interventions aimed at reducing the effects of PEW in dialysis patients.

Building partnerships as a key strategy in developing an event management model for an international dance event : a case study of the 2008 WDA (World Dance Alliance) Global Summit, Brisbane, Australia

With the increasing growth of cultural events both in Australia and internationally, there has also been an increase in event management studies; in theory and in practice. Although a series of related knowledge and skills required specifically by event managers has already been identified by many researchers (Perry et al., 1996; Getz, 2002 & Silvers et al., 2006) and generic event management models proposed, including ‘project management’ strategies in an event context (Getz, 2007), knowledge gaps still exist in relation to identifying specific types of events, especially for not-for-profit arts events. For events of a largely voluntary nature, insufficient resources are recognised as the most challenging; including finance, human resources and infrastructure. Therefore, the concepts and principles which are adopted by large scale commercial events may not be suitable for not-for-profit arts events aiming at providing professional network opportunities for artists. Building partnerships are identified as a key strategy in developing an effective event management model for this type of event. Using the 2008 World Dance Alliance Global Summit (WDAGS) in Brisbane 13-18 July, as a case study, the level, nature and relationship of key partners are investigated. Data is triangulated from interviews with organisers of the 2008 WDAGS, on-line and email surveys of delegates, participant observation and analysis of formal and informal documents, to produce a management model suited to this kind of event.

Recruiting local public relations professionals for global relations practice : a comparative analysis between Australian and Indian public relations recruitment advertisements

The aim of this exploratory study was to gain an insight into Asian and Western public relations practices by investigating them through job advertisements and thus reflecting on what organisations expect from the public relations professionals. Grunig's (1984) four models of public relations and the concept of relationships management were used as the foundation for this study. Australia was used to represent the Western region and India was used to represent the Asian region. Sample sets of public relations recruitment advertisements from both countries were examined against Grunig's one-way communication, two-way communication and relationship management attributes.

Implication of global warming on air-conditioned office buildings in Australia

As climate change will entail new conditions for the built environment, the thermal behaviour of air-conditioned office buildings may also change. Using building computer simulations, the impact of warmer weather is evaluated on the design and performance of air-conditioned office buildings in Australia, including the increased cooling loads and probable indoor temperature increases due to a possibly undersized air-conditioning system, as well as the possible change in energy use. It is found that existing office buildings would generally be able to adapt to the increasing warmth of year 2030 Low and High scenarios projections and the year 2070 Low scenario projection. However, for the 2070 High scenario, the study indicates that the existing office buildings in all capital cities of Australia would suffer from overheating problems. For existing buildings designed for current climate conditions, it is shown that there is a nearly linear correlation between the increase of average external air temperature and the increase of building cooling load. For the new buildings designed for warmer scenarios, a 28-59% increase of cooling capacity under the 2070 High scenario would be required.

Adaptation to global warming by changing internal loads of buildings

Global warming can have a significant impact on the building thermal environment and energy performance. Because greenhouse gas concentrations are still continuing to increase, this warming process will continue and may accelerate. Adaptation to global warming is therefore emerging as one of the key requirements for buildings. This requires all the existing and new buildings not only to perform and operate satisfactorily in the new environment but also to satisfy the environmental performance criteria of sustainability. Through a parametric study using the building simulation technique, this paper investigates the adaptation potential of changing the building internal load densities to the future global warming. Case studies for office buildings in major Australian capital cities are presented. Based on the results of parametric study, possible adaptation strategies are also proposed and evaluated.

Is the world their oyster? The global imagination of pre-service teachers

This paper reports on a qualitative interview study with eleven pre-service primary teachers in Queensland about their career plans exploring whether and how a global imagination motivates this next generation of teachers. The study is framed within sociological theory of globalisation, with regard to the growing possibilities for international mobility for work purposes, and the new life circumstances which make this imaginable. Teaching as a profession has changed and teachers are no longer as entangled with specific systems or geographical locations anymore. International recruitment campaigns are shown to pursue these pre-service teachers during their university preparation. The analysis of the interview data reveals the kind of impact these possibilities make on how pre-service teachers imagine their career, and what other considerations enhance or limit their global imagination. The findings are used to reflect on the highly localised governance of pre-service teacher preparation and the limited state-bound imaginaries to which these pre-service teachers are unnecessarily confined in their preparation.

A pilot randomised control trial of general practitioner and exercise physiologist interventions to reduce primary cardiovascular risk in overweight patients [Abstract]

Aims & Rationale/Objectives: With the knowledge that overweight is a major public health concern in Australia, that a multidisciplinary team approach to the management of lifestyle-related conditions is supported, and that the Australian Government recently recognised the role of the exercise physiologist (EP) in reducing the health burden of disease by their inclusion for reimbursement under the Medicare Plus scheme, this study sought to undertake a pilot RCT to compare GP and EP interventions to reduce primary cardiovascular risk in the overweight general practice population. Methods and Measures: Overweight patients recruited by a convenience sample of GPs were randomised into one of three arms: the control group, or the GP or EP intervention group (in which patients received either five GP or five EP consultations over 24 weeks). Patients had baseline, 12- and 24-week measures of body composition and cardio-respiratory fitness, and completed baseline and end-of-study surveys, fasting lipids and glucose. GPs and EPs completed an end-of-study survey. Results:Sixty-seven patients attended the baseline assessment. Overall retention rate was 67%. Patients were generally satisfied with the effectiveness of the interventions and their weight reduction. Favourable trends in BMI, weight, glucose and exercise levels for GP and EP intervention groups and in physical activity levels for all groups Conclusions: This study supports the feasibility of a RCT of GP and EP interventions for decreasing primary cardiovascular risk in the overweight general practice population.

Simulation and enhancement of a cardiovascular device test rig

Cardiovascular assist devices are tested in mock circulation loops (MCLs) prior to animal and clinical testing. These MCLs rely on characteristics such as pneumatic parameters to create pressure and flow, and pipe dimensions to replicate the resistance, compliance and fluid inertia of the natural cardiovascular system. A mathematical simulation was developed in SIMULINK to simulate an existing MCL. Model validation was achieved by applying the physical MCL characteristics to the simulation and comparing the resulting pressure traces. These characteristics were subsequently altered to improve and thus predict the performance of a more accurate physical system. The simulation was successful in simulating the physical mock circulation loop, and proved to be a useful tool in the development of improved cardiovascular device test rigs.