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Spatiotemporal patterns of asthma in Bhutan:a Bayesian analysis
No full textINTRODUCTION: Asthma is a chronic respiratory disorder requiring ongoing medical management. This ecological study investigated the spatial and temporal patterns of notification rates for asthma from clinic visits and hospital discharges and identified demographic, meteorological and environmental factors that drive asthma in Bhutan.METHODS: Monthly numbers of asthma notifications from 2016 to 2022 were obtained from the Bhutan Ministry of Health. Climatic variables (rainfall, relative humidity, minimum and maximum temperature) were obtained from the National Centre for Hydrology and Meteorology, Bhutan. The Normalised Difference Vegetation Index (NDVI) and surface particulate matter (PM2.5) were extracted from open sources. A multivariable zero-inflated Poisson regression (ZIP) model was developed in a Bayesian framework to quantify the relationship between risk of asthma and sociodemographic and environmental correlates, while also identifying the underlying spatial structure of the data.RESULTS: There were 12 696 asthma notifications, with an annual average prevalence of 244/100 000 population between 2016 and 2022. In ZIP analysis, asthma notifications were 3.4 times (relative risk (RR)=3.39; 95% credible interval (CrI) 3.047 to 3.773) more likely in individuals aged >14 years than those aged ≤14 years, and 43% (RR=1.43; 95% CrI 36.5% to 49.2%) more likely for females than males. Asthma notification increased by 0.8% (RR=1.008, 95% CrI 0.2% to 1.5%) for every 10 cm increase in rainfall, and 1.7% (RR=1.017; 95% CrI 1.2% to 2.3%) for a 1°C increase in maximum temperature. An increase in one unit of NDVI and 10 µg/m 3 PM2.5 was associated with 27.3% (RR=1.273; 95% CrI 8.7% to 49.2%), and 2.0% (RR=1.02; 95% CrI 1.0% to 4.0%) increase in asthma notification, respectively. The high-risk spatial clusters were identified in the south and southeastern regions of Bhutan, after accounting for covariates. CONCLUSION: Environmental risk factors and spatial clusters of asthma notifications were identified. Identification of spatial clusters and environmental risk factors can help develop targeted interventions that maximise impact of limited public health resources for controlling asthma in Bhutan.</p
Co-design workshops to inform an at-home rehabilitation intervention for people with dementia: a qualitative analysis
No full textBACKGROUND: At-home rehabilitation programs for people with dementia require essential components that are both person-centred and goal-directed. While several interventions have been evaluated in Australia, they often require significant resources and time to deliver. This research investigates end-user priorities for developing a cost-effective and accessible home-based dementia rehabilitation program, for people unable to participate in group settings in the Australian Capital Territory. METHOD: A co-design working group was established to ensure the views of all stakeholders contributed to the intervention design, which has funding allocated for six home visits per participant. An occupational therapist and physiotherapist will design and monitor the intervention which will be delivered by an allied health assistant. Four two-hour co-design workshops were held over a period of six months. Sixteen experts were recruited, comprising three dyads, and ten healthcare professionals with a minimum of three years cumulative experience working with people with dementia. Workshops were recorded and transcribed, and iterative thematic analysis was applied. RESULT: Four overarching themes and seven subthemes were identified. Themes: 1) Awareness, acceptance and access; 2) Person-centred care: Understanding unique needs, preferences, and goals, with two subthemes: a) Respect and dignity, b) Flexibility and adaptability; 3) Empowerment through community engagement & continuous support, with three subthemes: a) Building confidence & self-efficacy. b) A gateway to engaging with other services c) Preventing information overload & overwhelm; and 4) Multidisciplinary coordinated care, with two subthemes: a) creating a raft and b) ensuring robust handover processes. CONCLUSION: Engaging relevant stakeholders in the co-design process helped to identify key components deemed feasible and valuable for an at-home intervention for people with dementia. Findings demonstrate confidence from participants that the program would be feasible and valuable to people with dementia living at home. Assessing the feasibility and effectiveness of the at-home rehabilitation program is necessary to determine whether it should be implemented in the public health system in the Australian Capital Territory.</p
Lighting the Way: Quiet Quitting, Leader Humility, and Citizenship Behavior
No full textQuiet quitting is often seen as disengagement with negative organizational outcomes, yet quiet quitters are not necessarily untalented; they disengage for various reasons. This study investigates how they can be re-engaged in extra role behaviors, such as Organizational Citizenship Behavior (OCB). Drawing on Conservation of Resources (COR) theory, we propose that quiet quitters may develop public self-consciousness, especially under humble leaders, which fosters greater OCB. Results generally support the hypotheses: when leader humility is high, quiet quitting positively relates to OCB through public self-consciousness. Mediating and moderating mechanisms are identified, offering both theoretical and practical insights
Beyond ‘Eat-Pray-Love’: Designing transformative CX for self-discovery in extended service encounters
Get PDFTransformative experiences are considered to be the most impactful of all customer experience (CX) types. Many consumers seek service experiences that facilitate extraordinary personal revelations, like those depicted in the ‘Eat-Pray-Love’ self-discovery pilgrimage. However, there has been limited research on the design of transformative CX in more accessible, long-term services. Using a service co-design method of three workshops (n = 36), we develop an empirically-based framework for the design of transformative CX in extended service contexts (e.g. fitness, tertiary education, aged care, employee onboarding). Three stages were identified: the Foundation stage, Fortification stage and Fruition stage. This study makes a theoretical contribution presenting the criticality of designing discomfort into the service for transformative CX, and evidences the importance of ordinary, frequent moments (rather than peak-end intense moments) to support self-discovery over time. Managers involved in the design of extended services must highlight the relationship between involvement and expected degree of transformation
Digitalization in Hong Kong building surveying: advancements in building plan scrutiny process
No full textPurposeThis study seeks to unpack the digitalization of building surveying practices, focusing on the contribution of building information modelling (BIM) to the building plan scrutiny process (BPSP). It aims to evaluate and propose enhancements to the existing BIM-enabled building plan scrutiny practices in Hong Kong by comparing current practices with global standards and identifying actionable improvements.Design/methodology/approachA mixed-method approach, incorporating a case study and professional interviews, is employed to examine BPSP practices in Hong Kong and compare them with international counterparts. The case study provides in-depth insights into implementation barriers and opportunities, while the interviews offer complementary perspectives, analyzed thematically to identify key themes.FindingsThe results reveal that BIM implementation in Hong Kong’s BPSP is still in its early stages, yet it holds substantial potential to enhance efficiency, compliance and innovation in building surveying practices. The study also identifies key barriers to adoption, such as industry reluctance and systemic inertia, and provides strategic recommendations to overcome these challenges.Research limitations/implicationsWhile focused on Hong Kong, the findings may have broader implications for other regions seeking to adopt BIM-based digitalization in construction.Originality/valueThis study offers novel insights into the role of BIM in transforming BPSP, filling a research gap in the application of digital technologies within surveying practices. It emphasizes the importance of modernizing building surveying practices to foster a more efficient and innovative construction industry
Reimagining Innovation in Health Equity: Making a Case for a Community-embedded Participatory Learning Site for Adivasi Health Research
Get PDFIntroduction: This paper explores the development of the Realist Implementation Action Research Lab (RIAL), a participatory learning site aimed at addressing health disparities among Adivasi communities in India. Despite national health improvements, Adivasis face significant health inequities. RIAL employs a realist-inspired, theory-driven design to co-create solutions with communities, fostering collaboration among diverse stakeholders. The paper discusses insights from the establishment of RIAL, focusing on strategies implemented, opportunities identified, challenges encountered, and lessons learned to inform public health research and practice for Adivasi populations.Methods: We utilized processual analysis to examine the evolving dynamics of RIAL, combining historical and current documentation with collaborative team reflections. Context-Mechanism-Outcome (CMO) configurations were developed to tailor interventions to community needs and foster stakeholder engagement. These methods emphasized the contextual nature of health interventions, aligning with a systems-oriented, participatory approach. The establishment of RIAL involved consultations with community-based organizations, capacity-building workshops, and collaborative platforms to engage community leaders, healthcare providers, and policymakers, ensuring a participatory and contextually relevant foundation.Results: RIAL’s implementation highlighted the importance of reconfiguring power dynamics and fostering participatory processes. Strategies included co-design workshops, town hall assemblies, and capacity-building sessions, which enhanced community ownership and engagement. Challenges such as gender norms, logistical barriers, and resistance from non-Adivasi stakeholders were encountered, but iterative adaptation allowed for overcoming these barriers. Key findings included improved intervention receptivity, such as the successful relocation of a deaddiction clinic to a community-trusted NGO hospital and the implementation of sports-based psychosocial interventions for Adivasi youth, which demonstrated increased mental health awareness and reduced stigma.Conclusion: RIAL exemplifies the potential of participatory and context-aware methodologies in addressing health inequities among marginalized populations. Although scalability and resource availability pose limitations, this paper advocates for a shift from techno-centric solutions to those that are participatory, emphasizing sustained community engagement and co-creation of health interventions. The insights from RIAL's implementation offer potential implications for adapting similar models in other contexts, aiming to reduce health disparities through inclusive research practices
Greens announce dumbest policy ever: ‘renters’ right to solar’
Get PDFOwning a rental property in Australia is becoming a complete farce. Why would you bother owning a rental property when renters can do whatever they want with your property? Adam Bandt’s latest socialist brainchild, the ‘Renters [sic] right to solar’, is the dumbest policy in Australian history
The Relationship Between CSF1R Signaling, Monocyte-Macrophage Differentiation, and Susceptibility to Inflammatory Bowel Disease
No full textMore than 300 genomic loci have been associated with increased susceptibility to inflammatory bowel disease (IBD) through genome-wide association studies. A major challenge in the translation of genome-wide association studies to mechanistic insights lies in connecting noncoding variants to function. For example, single-nucleotide variants (SNVs) in the vicinity of the gene encoding the transcription factor ETS2 on human chromosome 21 are associated with the risk of developing IBD in Europeans. The peak of SNV association lies within a distal enhancer that may regulate ETS2 transcription. The interpretation of this and many other SNV associations with IBD depends on a model linking variation in transcriptional regulation to the likelihood of developing chronic intestinal inflammation. One model for the ETS2 locus is that overexpression in monocytes is causally associated with the risk allele, which in turn leads to a hyperinflammatory state. Here we summarize evidence for an alternative mechanism focused on negative regulators of monocyte-macrophage activation. We argue that IBD susceptibility arises from dysregulation of monocyte adaptation in the intestinal milieu to form resident intestinal macrophages that are anergic to inflammatory stimuli. This process depends on signals initiated by macrophage colony–stimulating factor (CSF1) binding to its receptor (CSF1R). Within this framework, ETS2 is a myeloid-specific transcription factor, expressed in pluripotent and committed progenitors and monocytes, and is down-regulated by CSF1, in common with many genes associated with IBD susceptibility, including NOD2. ETS2 is also both a downstream target and a mediator of the CSF1/CSF1R signaling pathway. Therapeutic targeting of ETS2 and its upstream regulators has the potential to prevent CSF1-dependent monocyte differentiation toward a prorepair resident macrophage phenotype and consequently exacerbate intestinal inflammation.</p
The sea and the here and:Translation of a poem by Kyongmi Park
No full textIn Kyongmi Park’s dreamlike narrative poem, the sea and the body shape each other in mysterious ways and raise questions about community and selfhood
Game changers: An objective assessment of players’ contribution to team success in women’s rugby league
No full textThis study introduces new performance metrics to address the lack of objective player evaluations in women’s rugby league. Using data from six seasons (2018–2023) of the Women’s National Rugby League (NRLW), five machine learning algorithms generated two key metrics: “Wins Created” for offensive performance and “Losses Created” for defensive performance. These were adjusted by a situational importance modifier based on player positions and combined into a final metric called “Net Wins Added”. An Elo rating variant modified to suit a rugby league context was also created to provide a strength of opponent multiplier for player performance. The validity of these metrics against traditional objective and subjective performance measures in rugby league were evaluated. The metrics predicted seasonal team wins with a Root Mean Squared Error (RMSE) of 0.9 and Player of the Year top 10 leaderboard points with an RMSE of 8.2. The metrics displayed substantial agreement (Gwet AC1 = 0.82) when predicting experts’ Team of the Year award recipients and substantial agreement (Gwet AC1 = 0.75) when predicting players’ Team of the Year awards. Developing and validating these objective player performance metrics provide women’s rugby league with a unique system to enhance talent evaluation and player recruitment