Doctor’s knowledge and practices of traumatic brain injury management in Chinese prehospital settings

Objectives: The incidence and mortality of traumatic brain injury (TBI) has increased rapidly in the last decade in China. Appropriate ambulance service can reduce case-fatality rates of TBI significantly. This study aimed to explore the factors (age, gender, education level, clinical experience, professional title, organization, specialty before prehospital care, and training frequency) that could influence prehospital doctors’ knowledge level and practices in TBI management in China, Hubei Province. Methods: A cross-sectional questionnaire survey was conducted in two cities in Hubei Province. The self-administered questionnaire consisted of demographic information and questions about prehospital TBI management. Independent samples t-test and one-way ANOVA were used to analyze group differences in the average scores in terms of demographic character. General linear regression was used to explore associated factors in prehospital TBI management. Results: A total of 56 questionnaires were handed out and 52 (93%) were returned. Participants received the lowest scores in TBI treatment (0.64; SD=0.08) and the highest scores in TBI assessment (0.80; SD=0.14). According to the regression model, the education level was associated positively with the score of TBI identification (P=.019); participants who worked in the emergency department (ED; P=.011) or formerly practiced internal medicine (P=.009) tended to get lower scores in TBI assessment; participants’ scores in TBI treatment were associated positively with the training frequency (P=.011); and no statistically significant associated factor was found in the overall TBI management. Conclusion: This study described the current situation of prehospital TBI management. The prehospital doctors’ knowledge level and practices in TBI management were quantified and the influential factors hidden underneath were explored. The results indicated that an appropriate continuing medical education (CME) program enables improvement of the quality of ambulance service in China.

Urban Revitalization: Remaking Cities in a Changing World

Following decades of neglect and decline, many US cities have undergone a dramatic renaissance. From New York to Nashville and Pittsburgh to Portland governments have implemented innovative redevelopment strategies to adapt to a globally integrated, post-industrial economy and cope with declining industries, tax bases, and populations - but the urban comeback has been highly uneven. Urban Revitalization integrates academic and policy research with professional knowledge and techniques. Written in an accessible style and with a thoughtful structure, it will provide graduate and upper-level undergraduate students with a comprehensive resource while also serving as a reference for professionals.

Knowledge Exchange, Spatial Analysis & Healthy Urban Environments (KESUE): Project Report

The Knowledge Exchange, Spatial Analysis and Healthy Urban Environments (KESUE) project has extended work previously undertaken by a QUB team of inter-disciplinary researchers engaged with the Physical Activity in the Regeneration of Connswater (PARC) project (Tully et al, 2013). The PARC project focussed on parts of East Belfast to assess the health impact of the Connswater Community Greenway. The KESUE project has aimed to extend some of the tools used initially in East Belfast so that they have data coverage of all of Belfast and Derry-Londonderry. The purpose of this has been to enable the development of evidence and policy tools that link features of the built environment with physical activity in these two cities. The project has used this data to help shape policy decisions in areas such as physical activity, park management, public transport and planning.

Working with a range of local partners who part-funded the project (City Councils in Belfast and Derry-Londonderry, Public Health Agency, Belfast Healthy Cities and Department of Regional Development), this project has mapped all the footpaths in the two cities (covering 37% of the NI population) and employed this to develop evidence used in strategies related to healthy urban planning. Using Geographic Information Systems (GIS), the footpath network has been used as a basis for a wide range of policy-relevant analyses including pedestrian accessibility to public facilities, site options for new infrastructure and assessing how vulnerable groups can access services such as pharmacies. Key outputs have been Accessibility Atlases and maps showing how walkability of the built environment varies across the two cities.

In addition to generating this useful data, the project included intense engagement with potential users of the research, which has led to its continued uptake in a number of policies and strategies, creating a virtuous circle of research, implementation and feedback. The project has proved so valuable to Belfast City Council that they have now taken on one of the researchers to continue the work in-house.

Renaturing cities using a regionally-focused biodiversity-led multifunctional benefits approach to urban green infrastructure

If a ‘Renaturing of Cities’ strategy is to maximise the ecosystem service provision of urban green infrastructure (UGI), then detailed consideration of a habitat services, biodiversity-led approach and multifunctionality are necessary rather than relying on the assumed benefits of UGI per se. The paper presents preliminary data from three case studies, two in England and one in Germany, that explore how multifunctionality can be achieved, the stakeholders required, the usefulness of an experimental approach for demonstrating transformation, and how this can be fed back into policy. We argue that incorporating locally contextualised biodiversity-led UGI design into the planning and policy spheres contributes to the functioning and resilience of the city and provides the adaptability to respond to locally contextualised challenges, such as overheating, flooding, air pollution, health and wellbeing as well as biodiversity loss. Framing our research to encompass both the science of biodiversity-led UGI and co-developing methods for incorporating a strategic approach to implementation of biodiversity-led UGI by planners and developers addresses a gap in current knowledge and begins to address barriers to UGI implementation. By combining scientific with policy learning and defined urban environmental targets with community needs, our research to date has begun to demonstrate how nature-based solutions to building resilience and adaptive governance can be strategically incorporated within cities through UGI.

Eco-cities: technological showcases or public spaces?

A growing body of critical literature seeks to identify conceptual and practical problems accompanying the realisation of mainstream ‘eco-city’ initiatives around the world. However, little attention has been paid to the status of the ‘city’ itself within the broader discourse. If eco-cities are to be more than experimental ‘technological showcases’, and aim to transform urban life more generally, the question of what types of ‘cityness’ will ensue is of considerable importance. To effect a more significant sustainability transition, eco-city plans and policies may need somehow to encompass a more nuanced conceptualisation of cities as complex, unpredictable, and emergent spaces. The incompatibility of such a conceptualisation with liberal-modernist modes of planning means that radically innovative new approaches to eco-city development may need to be found. This thesis considers whether the eco-city, theorised as a multiple process of real-world experimentation, may shed some light on how ‘cityness’ might better be planned for in future. To do so, it conceptualises cityness through the lens of ‘publicness’. It makes an original contribution to knowledge by developing a new theoretical model of publicness as an ‘assemblage’ of space and behaviour, with an ‘emergent’ and ‘civic’ modality. It thereby extends recent debates over the idea of ‘urban assemblage’, and makes innovative links between theories of planning and of the public. This model informs the analysis of original empirical research, investigating the conceptualisation of the public in an international sample of official eco-city documents, and exploring the publicness of two implemented initiatives, in Portland, Oregon (US) and newly built Sejong City (South Korea). The research finds that publicness tends to be poorly articulated in mainstream eco-city plans and policies, with potentially negative implications for sustainability in the ‘urban age’. However, it also argues that state institution-led planning – even when experimental ‘governance’ approaches are adopted – may inevitably be limited in its ability to encompass the emergent public life of the city. The thesis concludes by considering the prospects for overcoming or more productively acknowledging these limits in future.

Growth of entrepreneurial software firms in cities

Despite the prediction of the demise of cities with the advance of new information and communication technologies in the New Economy, the software industry has emerged from cities in the USA, Europe and Asia in the past two decades. This article explores the reasons why cities are centers of software clusters, with reference to Boston, London and Dublin. It is suggested that cities' roles as centres of knowledge flows and creativity are the key determinants of their competitiveness in the knowledge-intensive software industry.

The missing pillar: the creativity theory of knowledge spillover entrepreneurship

Knowledge spillover theory of entrepreneurship and the prevailing theory of economic growth treat opportunities as endogenous and generally focus on opportunity recognition by entrepreneurs. New knowledge created endogenously results in knowledge spillovers enabling inventors and entrepreneurs to commercialize it. This article discusses that knowledge spillover entrepreneurship depends not only on ordinary human capital, but more importantly also on creativity embodied in creative individuals and diverse urban environments that attract creative classes. This might result in self-selection of creative individuals into entrepreneurship or enable entrepreneurs to recognize creativity and commercialize it. This creativity theory of knowledge spillover entrepreneurship is tested utilizing data on European cities.

Entrepreneurship and cities: evidence from the post-communist world

While attributing urban success to more abundant supply of entrepreneurship, more recent studies on entrepreneurship have shifted their focus to examining cross-city variation in entrepreneurial activity. Despite a growing number of spatial-oriented studies of entrepreneurship worldwide to our best knowledge no empirical evidence exists on the determinants of cross-city variation in entrepreneurship in the context of the Former Soviet Union (FSU) states. Estrin and Mickiewicz (2010) show that transition economies generally exhibit lower rates of entrepreneurship than observed in most developed and developing market economies. This difference is even more pronounced for the FSU compared to Central and Eastern Europe. This paper investigates variation in entrepreneurial activity across FSU cities, attempting to bridge the city-level gap in spatial-oriented empirical research.

Entrepreneurial activity across European cities

The importance of entrepreneurship as a driving force in the economic development has been widely recognised. Respectively, a growing number of empirical studies have focused on explaining variation in entrepreneurial activity at various spatial levels with the majority of them taking either a cross-country perspective or looking at the inter-regional differences. More recent studies on entrepreneurship have shifted their focus to examining cross-city variation in entrepreneurship. However, overall, given limited city-level data availability, scarce work has been undertaken so far on cross-city entrepreneurship within the spatially oriented entrepreneurship research. Furthermore, to our best knowledge, no empirical studies exist on entrepreneurship in European cities and our paper aims to fill this gap

Intersections of Jane Jacobs’ conditions for diversity and low-carbon urban systems: a look at four global cities

Countless cities are rapidly developing across the globe, pressing the need for clear urban planning and design recommendations geared towards sustainability. This article examines the intersections of Jane Jacobs’ four conditions for diversity with low-carbon and low-energy use urban systems in four cities around the world: Lyon (France), Chicago (United-States), Kolkata (India), and Singapore (Singapore). After reviewing Jacobs’ four conditions for diversity, we introduce the four cities and describe their historical development context. We then present a framework to study the cities along three dimensions: population and density, infrastructure development/use, and climate and landscape. These cities differ in many respects and their analysis is instructive for many other cities around the globe. Jacobs’ conditions are present in all of them, manifested in different ways and to varying degrees. Overall we find that the adoption of Jacobs' conditions seems to align well with concepts of low-carbon urban systems, with their focus on walkability, transit-oriented design, and more efficient land use (i.e., smaller unit sizes). Transportation sector emissions seems to demonstrate a stronger influence from the presence of Jacobs' conditions, while the link was less pronounced in the building sector. Kolkata, a low-income, developing world city, seems to possess many of Jacobs' conditions, while exhibiting low per capita emissions - maintaining both of these during its economic expansion will take careful consideration. Greenhouse gas mitigation, however, is inherently an in situ problem and the first task must therefore be to gain local knowledge of an area before developing strategies to lower its carbon footprint.