Comparison of intensity-based cut-points for the RT3 accelerometer in youth

OBJECTIVES: To compare the classification accuracy of previously published RT3 accelerometer cut-points for youth using energy expenditure, measured via portable indirect calorimetry, as a criterion measure. DESIGN: Cross-sectional cross-validation study. METHODS: 100 children (mean age 11.2±2.8 years, 61% male) completed 12 standardized activities trials (3 sedentary, 5 lifestyle and 4 ambulatory) while wearing an RT3 accelerometer. V˙O2 was measured concurrently using the Oxycon Mobile portable calorimeter. Cut-points by Vanhelst (VH), Rowlands (RW), Chu (CH), Kavouras (KV) and the RT3 manufacturer (RT3M) were used to classify PA intensity as sedentary (SED), light (LPA), moderate (MPA) or vigorous (VPA). Classification accuracy was evaluated using the area under the Receiver Operating Characteristic curve (ROC-AUC) and weighted Kappa (κ). RESULTS: For moderate-to-vigorous PA (MVPA), VH, KV and RW exhibited excellent accuracy classification (ROC-AUC≥0.90), while the CH and RT3M exhibited good classification accuracy (ROC-AUC>0.80). Classification accuracy for LPA was fair to poor (ROC-AUC<0.76). For SED, VH exhibited excellent classification accuracy (ROC-AUC>0.90), while RW, CH, and RT3M exhibited good classification accuracy (ROC-AUC>0.80). Kappa statistics ranged from 0.67 (VH) to 0.55 (CH). CONCLUSIONS: All cut-points provided acceptable classification accuracy for SED and MVPA, but limited accuracy for LPA. On the basis of classification accuracy over all four levels of intensity, the use of the VH cut-points is recommended.

Narratives of possession : reading for saga authorship

The aim of this thesis is to show how character analysis can be used to approach conceptions of saga authorship in medieval Iceland. The idea of possession is a metaphor that is adopted early in the thesis, and is used to describe Icelandic sagas as works in which traditional material is subtly interpreted by medieval authors. For example, we can say that if authors claim greater possession of the sagas, they interpret, and not merely record, the sagas' historical information. On the other hand, tradition holds onto its possession of the narrative whenever it is not possible for an author to develop his own creative and historical interests. The metaphor of possession also underpins the character analysis in the thesis, which is based on the idea that saga authors used characters as a vehicle by which to possess saga narratives and so develop their own historical interests. The idea of possession signals the kinds of problems of authorship study which are addressed here, in particular, the question of the authors' sense of saga writing as an act either of preservation or of creation. While, in that sense, the thesis represents an additional voice in a long-standing debate about the saga writers' relation to their source materials, I argue against a clear-cut distinction between creative and non-creative authors, and focus instead on the wide variation in authorial control over saga materials. This variation suggests that saga authorship is a multi-functional activity, or one which co-exists with tradition. Further, by emphasising characterisation as a method, I am adding to the weight of scholarship that seeks to understand the sagas in terms of their literary effects. The Introduction and chapter one lay out the theoretical scope of this thesis. My aim in these first two sections is to inform the reader of the type of critical questions that arise when authorship is approached in relation to characterisation, and to suggest an interpretive framework with which to approach these questions. In the Introduction this aim manifests as a brief discussion of the application of the term "authorship" to the medieval Icelandic corpus, a definition of the scope of this study, and an introduction to the connections, made throughout this thesis, between saga authors, the sagas' narrative style, and the style of characterisation in the sagas. Chapter one is a far more detailed discussion of our ability to make these connections. In particular, the chapter develops the definition of the analytical term "secondary authorship" that I introduce in order to delineate the type of characterisation that is of most interest in this thesis. "Secondary authorship" is a literary term that aims to sharpen our approach to saga authors' relationship to their characters by focusing on characters who make representations about the events of the saga. The term refers to any instance in which characters behave in a manner that resembles the creativity, interpretation, and understanding associated with authorship more generally. Character analysis cannot, however, be divorced from socio-historical approaches to the saga corpus. Most importantly, the sagas themselves are socio-historical representations that claim some degree of truth value. This claim that the sagas make by implication about their historicity is the starting point of a discussion of authorship in medieval Iceland. Therefore, at the beginning of chapter one I discuss some of the approaches to the social context of saga writing. This discussion serves as an introduction to both the culture of saga writing in medieval Iceland and to the nature of the sagas' historical perspective, and reflects my sense that literary interpretations of the sagas cannot be isolated from the historical discourses that frame them. The chapter also discusses possession, which, as I note above, is used alongside the concept of secondary authorship to describe the saga authors' relationship with the stories and characters of the past. At the close of chapter one, I offer a preliminary list the various functions of saga authorship, and give some examples of secondary authorship. From this point I am able to tie my argument about secondary authorship to specific examples from the sagas. Chapter two examines the effect of family obligations and domestic points of view in the depiction of characters' choices and conception of themselves. The examples that are given in that chapter - from Gisla saga Súrssonar and Íslendinga saga - are the first of a number of textual analyses that demonstrate the application of the concepts of secondary authorship and possession of saga narratives. The relationship between narratives about national and domestic matters shows how authorial creativity in the area of kinship obligation provides the basis for the saga's development of historical themes. Thus, the two major case studies given in chapter two tie authorial engagement with characters to the most influential social institution in early and medieval Iceland, the family. The remaining chapters represent similar attempts to relate authorial possession of saga characters to central socio-historical themes in the sagas, such as the settlement process in early Iceland and its influence on the development of regional political life (chapter three). Likewise, the strong authorial interest in an Icelander's journey to Norway in Heimskringla is presented as evidence of the author's use of a saga character to express an Icelandic interpretation of Norwegian history and to promote a sense that Iceland shared the ownership of regal history with Norway (chapter four). In that authorial engagement with the Icelander abroad, we witness saga characterisation being used as a basis for historical interpretation and the means by which foreign traditions and influence, not least the narratives of royal lives and of the Christianisation, are claimed as part of medieval Icelanders' self-conception. While saga authors observe the conventions of saga narration, characters are often subtly positioned as the authors' interpretive mirrors, especially clear than when they act as secondary authors. Nowhere is this more apparent than in Brennu- Njáls saga, which contains many characters who voice the author's claim to interpret the past. Even Hrútr Herjólfsson, through his remarkable perception of events and his conspicuous comments about them, acts as a secondary author by enabling the author to emphasise the importance of the disposition of characters. In Laxdœla saga and Þorgils saga ok Hafliða, authorial interest in characters' perception is matched by the thematising of learning, from the inception of knowledge as prophecy or advice to complete understanding by saga characters (chapter six). In Þorgils saga skarða, a character's inner development from an excessively ambitious and politically ruthless youth to a Christian leader killed by his kinsman allows the author to shape a political life into a lesson about leadership and the community's ability to moderate and contain the behaviour of extraordinary individuals. The portrayal draws on methods of characterisation that we can identify in Grettis saga Ásmundarson, Fóstbrœðra saga, and Orkneyinga saga. A comparison of the characterisation of figures with intense political or military ambitions suggests that saga authors were interested in the community's ability to balance their strength and ability with a degree of social moderation. The discussion of these sagas shows that character study can be used to analyse how the saga authors added their own voice to the voices passed down to medieval Icelanders in traditional narratives. Authorial engagement with characters allowed inherited traditions about early Norway and Iceland and records of thirteenth century events to be transformed into sophisticated historical works with highly creative elements. Through secondary authorship, saga authors took joint-possession of narratives and contested the power of tradition in setting the interpretive framework of a saga.

Identification and Validity of Accelerometer Cut-Points for Toddlers

The purpose of this study was to derive ActiGraph cut-points for sedentary (SED), light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) in toddlers and evaluate their validity in an independent sample. The predictive validity of established preschool cut-points were also evaluated and compared. Twenty-two toddlers (mean age = 2.1 years ± 0.4 years) wore an ActiGraph accelerometer during a videotaped 20-min play period. Videos were subsequently coded for physical activity (PA) intensity using the modified Children's Activity Rating Scale (CARS). Receiver operating characteristic (ROC) curve analyses were conducted to determine cut-points. Predictive validity was assessed in an independent sample of 18 toddlers (mean age = 2.3 ± 0.4 years). From the ROC curve analyses, the 15-s count ranges corresponding to SED, LPA, and MVPA were 0–48, 49–418, and >418 counts/15 s, respectively. Classification accuracy was fair for the SED threshold (ROC-AUC = 0.74, 95% confidence interval = 0.71–0.76) and excellent for MVPA threshold (ROC-AUC = 0.90, 95% confidence interval = 0.88–0.92). In the cross-validation sample, the toddler cut-point and established preschool cut-points significantly overestimated time spent in SED and underestimated time in spent in LPA. For MVPA, mean differences between observed and predicted values for the toddler and Pate cut-points were not significantly different from zero. In summary, the ActiGraph accelerometer can provide useful group-level estimates of MVPA in toddlers. The results support the use of the Pate cut-point of 420 counts/15 s for MVPA.

Comparison of accelerometer cut points for predicting activity intensity in youth

The absence of comparative validity studies has prevented researchers from reaching consensus regarding the application of intensity-related accelerometer cut points for children and adolescents. PURPOSE This study aimed to evaluate the classification accuracy of five sets of independently developed ActiGraph cut points using energy expenditure, measured by indirect calorimetry, as a criterion reference standard. METHODS A total of 206 participants between the ages of 5 and 15 yr completed 12 standardized activity trials. Trials consisted of sedentary activities (lying down, writing, computer game), lifestyle activities (sweeping, laundry, throw and catch, aerobics, basketball), and ambulatory activities (comfortable walk, brisk walk, brisk treadmill walk, running). During each trial, participants wore an ActiGraph GT1M, and VO 2 was measured breath-by-breath using the Oxycon Mobile portable metabolic system. Physical activity intensity was estimated using five independently developed cut points: Freedson/Trost (FT), Puyau (PU), Treuth (TR), Mattocks (MT), and Evenson (EV). Classification accuracy was evaluated via weighted κ statistics and area under the receiver operating characteristic curve (ROC-AUC). RESULTS Across all four intensity levels, the EV (κ = 0.68) and FT (κ = 0.66) cut points exhibited significantly better agreement than TR (κ = 0.62), MT (κ = 0.54), and PU (κ = 0.36). The EV and FT cut points exhibited significantly better classification accuracy for moderate-to vigorous-intensity physical activity (ROC-AUC = 0.90) than TR, PU, or MT cut points (ROC-AUC = 0.77-0.85). Only the EV cut points provided acceptable classification accuracy for all four levels of physical activity intensity and performed well among children of all ages. The widely applied sedentary cut point of 100 counts per minute exhibited excellent classification accuracy (ROC-AUC = 0.90). CONCLUSIONS On the basis of these findings, we recommend that researchers use the EV ActiGraph cut points to estimate time spent in sedentary, light-, moderate-, and vigorous-intensity activity in children and adolescents. Copyright © 2011 by the American College of Sports Medicine.

Neurological consequences of diabetic ketoacidosis at initial presentation of type 1 diabetes in a prospective cohort study of children

OBJECTIVE To investigate the impact of new-onset diabetic ketoacidosis (DKA) during child- hood on brain morphology and function. RESEARCH DESIGN AND METHODS Patients aged 6–18 years with and without DKA at diagnosis were studied at four time points: <48 h, 5 days, 28 days, and 6 months postdiagnosis. Patients under- went magnetic resonance imaging (MRI) and spectroscopy with cognitive assess- ment at each time point. Relationships between clinical characteristics at presentation and MRI and neurologic outcomes were examined using multiple linear regression, repeated-measures, and ANCOVA analyses. RESULTS Thirty-six DKA and 59 non-DKA patients were recruited between 2004 and 2009. With DKA, cerebral white matter showed the greatest alterations with increased total white matter volume and higher mean diffusivity in the frontal, temporal, and parietal white matter. Total white matter volume decreased over the first 6 months. For gray matter in DKA patients, total volume was lower at baseline and increased over 6 months. Lower levels of N-acetylaspartate were noted at base- line in the frontal gray matter and basal ganglia. Mental state scores were lower at baseline and at 5 days. Of note, although changes in total and regional brain volumes over the first 5 days resolved, they were associated with poorer delayed memory recall and poorer sustained and divided attention at 6 months. Age at time of presentation and pH level were predictors of neuroimaging and functional outcomes. CONCLUSIONS DKA at type 1 diabetes diagnosis results in morphologic and functional brain changes. These changes are associated with adverse neurocognitive outcomes in the medium term.

Calibration and comparison of accelerometer cut points in preschool children

Objective The present study aimed to develop accelerometer cut points to classify physical activities (PA) by intensity in preschoolers and to investigate discrepancies in PA levels when applying various accelerometer cut points. Methods To calibrate the accelerometer, 18 preschoolers (5.8 +/- 0.4 years) performed eleven structured activities and one free play session while wearing a GT1M ActiGraph accelerometer using 15 s epochs. The structured activities were chosen based on the direct observation system Children's Activity Rating Scale (CARS) while the criterion measure of PA intensity during free play was provided using a second-by-second observation protocol (modified CARS). Receiver Operating Characteristic (ROC) curve analyses were used to determine the accelerometer cut points. To examine the classification differences, accelerometer data of four consecutive days from 114 preschoolers (5.5 +/- 0.3 years) were classified by intensity according to previously published and the newly developed accelerometer cut points. Differences in predicted PA levels were evaluated using repeated measures ANOVA and Chi Square test. Results Cut points were identified at 373 counts/15 s for light (sensitivity: 86%; specificity: 91%; Area under ROC curve: 0.95), 585 counts/15 s for moderate (87%; 82%; 0.91) and 881 counts/15 s for vigorous PA (88%; 91%; 0.94). Further, applying various accelerometer cut points to the same data resulted in statistically and biologically significant differences in PA. Conclusions Accelerometer cut points were developed with good discriminatory power for differentiating between PA levels in preschoolers and the choice of accelerometer cut points can result in large discrepancies.

Estimating present day extreme total water level exceedance probabilities around the Australian coastline

The occurrence of extreme water level events along low-lying, highly populated and/or developed coastlines can lead to devastating impacts on coastal infrastructure. Therefore it is very important that the probabilities of extreme water levels are accurately evaluated to inform flood and coastal management and for future planning. The aim of this study was to provide estimates of present day extreme total water level exceedance probabilities around the whole coastline of Australia, arising from combinations of mean sea level, astronomical tide and storm surges generated by both extra-tropical and tropical storms, but exclusive of surface gravity waves. The study has been undertaken in two main stages. In the first stage, a high-resolution (~10 km along the coast) hydrodynamic depth averaged model has been configured for the whole coastline of Australia using the Danish Hydraulics Institute’s Mike21 modelling suite of tools. The model has been forced with astronomical tidal levels, derived from the TPX07.2 global tidal model, and meteorological fields, from the US National Center for Environmental Prediction’s global reanalysis, to generate a 61-year (1949 to 2009) hindcast of water levels. This model output has been validated against measurements from 30 tide gauge sites around Australia with long records. At each of the model grid points located around the coast, time series of annual maxima and the several highest water levels for each year were derived from the multi-decadal water level hindcast and have been fitted to extreme value distributions to estimate exceedance probabilities. Stage 1 provided a reliable estimate of the present day total water level exceedance probabilities around southern Australia, which is mainly impacted by extra-tropical storms. However, as the meteorological fields used to force the hydrodynamic model only weakly include the effects of tropical cyclones the resultant water levels exceedance probabilities were underestimated around western, northern and north-eastern Australia at higher return periods. Even if the resolution of the meteorological forcing was adequate to represent tropical cyclone-induced surges, multi-decadal periods yielded insufficient instances of tropical cyclones to enable the use of traditional extreme value extrapolation techniques. Therefore, in the second stage of the study, a statistical model of tropical cyclone tracks and central pressures was developed using histroic observations. This model was then used to generate synthetic events that represented 10,000 years of cyclone activity for the Australia region, with characteristics based on the observed tropical cyclones over the last ~40 years. Wind and pressure fields, derived from these synthetic events using analytical profile models, were used to drive the hydrodynamic model to predict the associated storm surge response. A random time period was chosen, during the tropical cyclone season, and astronomical tidal forcing for this period was included to account for non-linear interactions between the tidal and surge components. For each model grid point around the coast, annual maximum total levels for these synthetic events were calculated and these were used to estimate exceedance probabilities. The exceedance probabilities from stages 1 and 2 were then combined to provide a single estimate of present day extreme water level probabilities around the whole coastline of Australia.

Turning points, power transfer, and frequency response of mode transitions in RF plasmas

Turning points for transitions between the electrostatic and electromagnetic discharge modes in low-frequency (∼ 500 kHz) inductively coupled plasmas have been identified and cross-referenced using time-resolved measurements of the plasma optical emission intensities, RF coil current, and ion saturation current collected by a single RF-compensated Langmuir probe. This enables one to monitor the variation of the plasma parameters, power transfer efficiency, which accompany the discharge hysteresis. The excitation conditions for the pure and hybrid modes in the plasma are considered, and the possibility of the TMmnl → TEm'n'l' transitions at higher frequencies are discussed.

Reliability of a wellness inventory for use among adolescent females aged 12-14 years

Background The wellness construct has application in a number of fields including education, healthcare and counseling, particularly with regard to female adolescents. The effective measurement of wellness in adolescents can assist researchers and practitioners in determining lifestyle behaviors in which they are lacking. Behavior change interventions can then be designed which directly aid in the promotion of these areas. Methods The 5-Factor Wellness Inventory (designed to measure the Indivisible Self model of wellness) is a popular instrument for measuring the broad aspects of wellness amongst adolescents. The instrument comprises 97 items contributing to 17 subscales, five dimension scores, four context scores, total wellness score, and a life satisfaction index. This investigation evaluated the test-retest (intra-rater) reliability of the 5 F-Wel instrument in repeated assessments (seven days apart) among adolescent females aged 12-14 years. Percentages of exact agreement for individual items, and the number of respondents who scored within +/-5, +/-7.5 and +/-10 points for total wellness and the five summary dimension scores were calculated. Results Overall, 46 (95.8%) participants responded with complete data and were included in the analysis. Item agreement ranged from 47.8% to 100% across the 97 items (median 69.9%, interquartile range 60.9%-73.9%). The percentage of respondents who scored within +/-5, +/-7.5 and +/-10 points for total wellness at the re-assessment was 87.0%, 97.8% and 97.8% respectively. The percentage of respondents who scored within +/-5, +/-7.5 and +/-10 for the domain scores at the reassessment ranged between 54.3-76.1%, 78.3-95.7% and 89.1-95.7% respectively across the five dimensions. Conclusions These findings suggest there was considerable variation in agreement between the two assessments on some individual items. However, the total wellness score and the five dimension summary scores remained comparatively stable between assessments.

Testing the effectiveness of a self-efficacy based exercise intervention for adults with venous leg ulcers : protocol of a randomised controlled trial

Background: Exercise and adequate self-management capacity may be important strategies in the management of venous leg ulcers. However, it remains unclear if exercise improves the healing rates of venous leg ulcers and if a self-management exercise program based on self-efficacy theory is well adhered to. Method/Design: This is a randomised controlled in adults with venous leg ulcers to determine the effectiveness of a self-efficacy based exercise intervention. Participants with venous leg ulcers are recruited from 3 clinical sites in Australia. After collection of baseline data, participants are randomised to either an intervention group or control group. The control group receive usual care, as recommended by evidence based guidelines. The intervention group receive an individualised program of calf muscle exercises and walking. The twelve week exercise program integrates multiple elements, including up to six telephone delivered behavioural coaching and goal setting sessions, supported by written materials, a pedometer and two follow-up booster calls if required. Participants are encouraged to seek social support among their friends, self-monitor their weekly steps and lower limb exercises. The control group are supported by a generic information sheet that the intervention group also receive encouraging lower limb exercises, a pedometer for self-management and phone calls at the same time points as the intervention group. The primary outcome is the healing rates of venous leg ulcers which are assessed at fortnightly clinic appointments. Secondary outcomes, assessed at baseline and 12 weeks: functional ability (range of ankle motion and Tinetti gait and balance score), quality of life and self-management scores. Discussion: This study seeks to address a significant gap in current wound management practice by providing evidence for the effectiveness of a home-based exercise program for adults with venous leg ulcers. Theory-driven, evidence-based strategies that can improve an individual’s exercise self-efficacy and self-management capacity could have a significant impact in improving the management of people with venous leg ulcers. Information gained from this study will provide much needed information on management of this chronic disease to promote health and independence in this population. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12612000475842 Trial status: Current follow up

Peripheral, central and coercive routes for promoting Enterprise Social Networks

Organisations employ Enterprise Social Networks (ESNs) (such as Yammer) expecting better intra-organisational communication and collaboration. However, ESNs are struggling to gain momentum and wide adoption among users. Promoting user participation is a challenge, particularly in relation to lurkers – the silent ESN members who do not contribute any content. Building on behaviour change research, we propose a three-route model consisting of the central, peripheral and coercive routes of influence that depict users’ cognitive strategies, and we examine how management interventions (e.g. sending promotional emails) impact users’ beliefs and (consequent) posting and lurking behaviours in ESNs. Furthermore, we identify users’ salient motivations to lurk or post. We employ a multi-method research design to conceptualise, operationalise and validate the research model. This study has implications for academics and practitioners regarding the nature, patterns and outcomes of management interventions in prompting ESN.

Can a text message a week improve breastfeeding?

Background Breastfeeding is recognised as the optimal method for feeding infants with health gains made by reducing infectious diseases in infancy; and chronic diseases, including obesity, in childhood, adolescence and adulthood. Despite this, exclusivity and duration in developed countries remains resistant to improvement. The objectives of this research were to test if an automated mobile phone text messaging intervention, delivering one text message a week, could increase “any” breastfeeding rates and improve breastfeeding self-efficacy and coping. Methods Women were eligible to participate if they were: over eighteen years; had an infant less than three months old; were currently breastfeeding; no diagnosed mental illness; and used a mobile phone . Women in the intervention group received MumBubConnect, a text messaging service with automated responses delivered once a week for 8 weeks. Women in the comparison group received their usual care and were sampled two years after the intervention group. Data collection included online surveys at two time points, week zero and week nine, to measure breastfeeding exclusivity and duration, coping, emotions, accountability and self-efficacy. A range of statistical analyses were used to test for differences between groups. Hierarchical regression was used to investigate change in breastfeeding outcome, between groups, adjusting for co-variates. Results The intervention group had 120 participants at commencement and 114 at completion, the comparison group had 114 participants at commencement and 86 at completion. MumBubConnect had a positive impact on the primary outcome of breastfeeding behaviors with women receiving the intervention more likely to continue exclusive breastfeeding; with a 6% decrease in exclusive breastfeeding in the intervention group, compared to a 14% decrease in the comparison group (p < 0.001). This remained significant after controlling for infant age, mother’s income, education and delivery type (p = 0.04). Women in the intervention group demonstrated active coping and were less likely to display emotions-focussed coping (p < .001). There was no discernible statistical effect on self-efficacy or accountability. Conclusions A fully automated text messaging services appears to improve exclusive breastfeeding duration. The service provides a well-accepted, personalised support service that empowers women to actively resolve breastfeeding issues. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12614001091695.

Public space for street-scape theatrics : guerrilla spatial tactics and methods of urban hacking in Brisbane, Australia

It could be argued that architecture has an inherent social responsibility to enrich the urban and spatial environments for the city’s occupants. However how we define quality, and how ‘places’ can be designed to be fair and equitable, catering for individuals on a humanistic and psychological level, is often not clearly addressed. Lefebvre discusses the idea of the ‘right to the city’; the belief that public space design should facilitate freedom of expression and incite a sense of spatial ownership for its occupants in public/commercial precincts. Lefebvre also points out the importance of sensory experience in the urban environment. “Street-scape theatrics” are performative activities that summarise these two concepts, advocating the ‘right to the city’ by way of art as well as providing sensual engagement for city users. Literature discusses the importance of Street-scape Theatrics however few sources attempt to discuss this topic in terms of how to design these spaces/places to enhance the city on both a sensory and political level. This research, grounded in political theory, investigates the case of street music, in particular busking, in the city of Brisbane, Australia. Street culture is a notion that already exists in Brisbane, but it is heavily controlled especially in central locations. The study discusses how sensory experience of the urban environment in Brisbane can be enriched through the design for busking; multiple case studies, interviews, observations and thematic mappings provide data to gather an understanding of how street performers see and understand the built form. Results are sometime surprisingly incongruous with general assumptions in regards to street artist as well as the established political and ideological framework, supporting the idea that the best and most effective way of urban hacking is working within the system. Ultimately, it was found that the Central Business District in Brisbane, Australia, could adopt certain political and design tactics which attempt to reconcile systematic quality control with freedom of expression into the public/commercial sphere, realism upheld. This can bridge the gap between the micro scale of the body and the macro of the political economy through freedom of expression, thus celebrating the idiosyncratic nature of the city.