Evidence-based Planning Research Articles

Shortfalls in our understanding of the causes and consequences of functional and phylogenetic variation of freshwater communities across continents

Freshwater ecosystems harbour a disproportionately high biodiversity relative to their area, being also one of the most threatened ecosystem types worldwide. However, our capacity to design evidence-based conservation plans for this realm is restricted by all biodiversity shortfalls that have been recognized so far. In this context, the paucity of comparable field data and information on traits and phylogenies of freshwater organisms should be emphasized. Here, we highlight how increased knowledge could be gained and where we should aim at in research on the functional and phylogenetic features of freshwater communities. First, attempts to combine datasets from different sources should pay careful attention to data harmonization. Second, more effort should be focused on natural history observations on species habitats and life histories, providing the backbone of information for multi-trait databases. Third, fully resolved phylogenies would be required for deciphering the evolutionary relationships of freshwater organisms. Provided that these three hurdles can be overcome, conducting studies of local freshwater communities across continental spatial extents would pave the way for mapping functionally important ecosystems and evolutionarily valuable areas for the conservation of freshwater organisms and their habitats.

Applying the syndemic framework to cancer research for effective cancer control in low- and middle-income countries.

Cancer burden is increasing rapidly globally, especially in low- and middle-income countries (LMICs), which already face a double burden of infectious diseases and other non-communicable diseases (NCDs). LMICs also struggle with poor social determinants of health, leading to cancer health disparities, such as delayed diagnoses and increased death rates due to cancer. Contextually, relevant research needs to be prioritised in these regions to ensure feasible, evidence-based healthcare planning and delivery for cancer prevention and control. A syndemic framework has been used to study the disease clustering of infectious diseases and NCDs across varied social contexts to understand how diseases interact adversely and how the wider environmental context and other socioeconomic factors contribute to poor health outcomes within specific populations. We propose using this model to study the 'syndemic of cancers' in the disadvantaged population of LMICs and suggest ways for the clear operationalisation of the syndemic framework through multidisciplinary evidence-generation models for the delivery of integrated, socially conscious interventions for effective cancer control.

The influencing factors of elder-friendly public open spaces promoting older adults’ health in deprived urban neighborhoods: Partial Least Square Structural Equation Modeling approach

Public open spaces (POSs) is considered a feature of the built environment that is important for physical, mental, and social health during life and contributes to active aging. Hence, policymakers, practitioners, and academics have recently focused on indicators of elder-friendly environments, particularly in developing countries. This study aimed to examine the attributes of POSs and socio-demographic status that positively influence older people's health in Tehran's deprived neighborhoods using a pathway model. We employed a pathway model to explore the relationships between place function, place preferences, and process in the environment as the perceived (subjective) positive features of POSs associated with older adults' health, compared to the objective attributes of POSs. We also included personal characteristics, including physical, mental, and social dimensions, to explore how these factors are related to the health of older adults. To assess the subjective perception of POSs attributes, 420 older adults were asked to complete Elder-Friendly Urban Spaces Questionnaire (EFUSQ) from April 2018 to September 2018 in the 10th District of Tehran. We used the SF-12 questionnaire and "The self-Rated Social Health of Iranians Questionnaire to measure older people's physical and mental health and elder social health." Geographical Information System (GIS) measures (Street connectivity, Residential density, Land use mix, Housing quality) were derived as objective measures of neighborhood features. According to our findings, the personal aspect, socio-demographic status (such as Gender, Marital status, Education, Occupation as well as Frequency of being present in POSs), place preferences (Security, Fear of Falling, Way Finding and Perceived Aesthetics), and process in the environment's latent (Social Environment, Cultural Environment, Place Attachment, and Life Satisfaction)constructs collectively influenced the elders' health. We found positive associations between Place preference, Process-in-environment, and personal health-related factors to elders' health (social, mental, and physical). The path model presented in the study could be guided in future research in this area and inform the development of evidence-based urban planning and design interventions for improve older adults health and social functioning and quality of life.

Impact of a regional community of practice for academic developers engaged in institution-level support for SoTL

ABSTRACT Academic developers play a key role in advancing instructor engagement in the Scholarship of Teaching and Learning (SoTL) at their higher education institutions, but face structural and epistemological isolation. To leverage the knowledge and experience of developers leading SoTL efforts at their respective institutions, a group of academic developers co-created a regional community of practice (CoP) centered on developing evidence-based strategic plans and programming models to advance SoTL at their. We describe the development and outcomes of this regional CoP. Future directions for the use of such a regional CoP model to collaboratively develop cross-institutional offerings are also discussed.

Automatic Mapping of Physical Urban Problems Using Remotely Sensed Imagery

While big cities are expected to exercise cost-effective, evidence-based planning, many are under reactive management, facing simultaneous problems and limited resources. This project develops a proof-of-concept workflow for the automatic monitoring of physical urban problems by combining remote sensing for detection and cartography for visualization. The example problem treated was the obstructive parking of vehicles on pavements as proxy for restricted urban mobility. Nine aerial images of UK urban areas were processed by a deep learning object detector of standard cars, achieving an F-score of 70.72%. Two large scale map reports of 200m wide areas were produced, featuring car detections and overlaps with topographic mapping features. Complementary analysis included the calculation of total detection window overlap per roadside pavement and its change with time. The proposed method combines uniform city-wide coverage with fast interpretation and can inspire the development of professional urban planning tools.

Harnessing biodiversity data to inform policy: Rapid regional audits should underpin Local Nature Recovery Strategies

Nature recovery actions within anthropogenic landscapes typically target small and unrepresentative species sub-sets, or generic habitat features that are assumed to benefit wider suites of species, despite incomplete understanding of what these species are, or of their autecological needs. These limitations in the evidence underpinning conservation contribute to continuing biodiversity losses.Experimental evidence shows improved outcomes follow the use of spatially-targeted audits of multi-taxa biodiversity information, allowing actions to be tailored towards the ecological requirements of complete local species pools. We illustrate how this approach could be integrated into environmental policy, with particular reference to the European Union's 2030 Biodiversity Strategy and the UK Environment Act 2021's Local Nature Recovery Strategies (LNRS).Biodiversity auditing uses existing repositories of species occurrence and functional trait data to group priority species into cross-taxa ‘management guilds’ that share similar responses to conservation interventions, allowing practitioners to identify and implement regionally-optimized, evidence-based action plans. Where previously implemented, this approach has successfully transformed conservation practices at bioregional scales, increasing the richness and abundance of priority species relative to pre-existing management.We provide methods for incorporating rapid low-cost biodiversity auditing into local conservation strategies, to ensure these support the widest complement of priority biodiversity. Failure to adopt a data-driven approach risks reproducing previously ineffective paradigms, and thus failing to seize vital chances to reverse declines in biodiversity. We further argue that researchers should prioritize the development of accessible tools to support authorities to incorporate species data into strategic landscape-scale conservation design.

District-based Baseline Resilience Indicators for Communities (DBRIC) for assessment of a Global South city

Assessing resilience at the community level is essential for evidence-based planning and policymaking. However, issues such as data availability and accessibility make community resilience assessment a challenging task. Development and implementation of resilience assessment models are particularly challenging in Global South cities that lack access to skilled personnel and updated databases. Using the Baseline Resilience Indicators for Communities (BRIC) model, developed for county-level resilience assessment in the United States, this article aims to create an urban district-level resilience index called District-based Baseline Resilience Indicators for Communities (DBRIC). We utilized DBRIC to measure the resilience of Tehran districts and examine how it has changed from 2006 to 2016. The selection of these years was primarily influenced by the data availability. The results show that 45.5% of the districts of Tehran experienced a decrease in the DBRIC index by up to -300%. The decline was particularly noteworthy in terms of social and community capital. Further, the results highlight relatively less resilient districts that require specific attention from planners and policy makers. The findings of the study can inform local planners and policymakers in their efforts towards enhancing resilience. They can also be of interest to policymakers in other Global South cities with similar conditions.

Management of Stable Angina: A Treatment Strategy Mnemonic

Nurse practitioners are well-positioned to diagnose and manage stable angina pectoris by implementing guideline-driven medical interventions. This report presents a mnemonic based on current guidelines to support the nurse practitioner by effectively recalling and using evidence-based treatment plans in clinical practice.

Elder Abuse Prevalence in Iran: A Systematic Review and Meta-Analysis

Background & Objective: With the increase in the population of the aged, one of the most crucial issues that can result in serious health consequences is elder abuse. This study aimed to estimate the prevalence of elder abuse and its subtypes in Iran.
 Materials & Methods: This is a systematic review and meta-analysis based on PRISMA guidelines. Relevant keywords were used for database search in Scopus, PubMed, Web of Science. All of the search and data extraction process was conducted independently by two researchers. JBI checklist was used for risk of bias assessment. The data were cleaned and analyzed using Biostat, (Comprehensive Meta-Analysis). The meta-analysis was performed using Random Effects Model, and I2 index was calculated for assessing heterogeneity.
 Results: Twenty-three articles were finally analyzed. The data of 6,298 individuals were analyzed, which were significantly heterogeneous (I2= 99.38). The prevalence of elder abuse was 55% (95% CI: 0.42-0.68). The subtype with the highest prevalence was emotional neglect (39%, 95% CI: 0.29-0.50), while the lowest prevalence was related to social rejection (15%, 95% CI: 0.11-0.19).
 Conclusion: All types of elder abuse are highly prevalent in Iran. Therefore, it is crucial to develop evidence-based comprehensive plans to better identify, intervene, and prevent this issue.

Computed tomography derived cervical fat-free muscle fraction as an imaging-based outcome marker in patients with acute ischemic stroke: a pilot study

BackgroundOutcome assessment in stroke patients is essential for evidence-based stroke care planning. Computed tomography (CT) is the mainstay of diagnosis in acute stroke. This study aimed to investigate whether CT-derived cervical fat-free muscle fraction (FFMF) as a biomarker of muscle quality is associated with outcome parameters after acute ischemic stroke.MethodsIn this retrospective study, 66 patients (mean age: 76 ± 13 years, 30 female) with acute ischemic stroke in the anterior circulation who underwent CT, including CT-angiography, and endovascular mechanical thrombectomy of the middle cerebral artery between August 2016 and January 2020 were identified. Based on densitometric thresholds, cervical paraspinal muscles covered on CT-angiography were separated into areas of fatty and lean muscle and FFMF was calculated. The study cohort was binarized based on median FFMF (cutoff value: < 71.6%) to compare clinical variables and outcome data between two groups. Unpaired t test and Mann-Whitney U test were used for statistical analysis.ResultsNational Institute of Health Stroke Scale (NIHSS) (12.2 ± 4.4 vs. 13.6 ± 4.5, P = 0.297) and modified Rankin scale (mRS) (4.3 ± 0.9 vs. 4.4 ± 0.9, P = 0.475) at admission, and pre-stroke mRS (1 ± 1.3 vs. 0.9 ± 1.4, P = 0.489) were similar between groups with high and low FFMF. NIHSS and mRS at discharge were significantly better in patients with high FFMF compared to patients with low FFMF (NIHSS: 4.5 ± 4.4 vs. 9.5 ± 6.7; P = 0.004 and mRS: 2.9 ± 2.1 vs.3.9 ± 1.8; P = 0.049). 90-day mRS was significantly better in patients with high FFMF compared to patients with low FFMF (3.3 ± 2.2 vs. 4.3 ± 1.9, P = 0.045).ConclusionCervical FFMF obtained from routine clinical CT might be a new imaging-based muscle quality biomarker for outcome prediction in stroke patients.

Using a Learning System Approach to Improve Safety for Prone-Position Ventilation Patients.

This study aimed to describe how a Patient Safety Organization, to which healthcare organizations submit patient safety event data for both protections and analysis, used a learning system approach to analyze and interpret trends in member data. The data analysis informed evidence-based practice recommendations for improvement of patient outcomes for patients receiving prone-position ventilation. Patient safety analysts with critical care nursing backgrounds identified a need for increased support of Patient Safety Organization members who were proning patients during the COVID-19 pandemic. Patient safety events from member organizations across the United States were analyzed and aggregated. Primary and secondary taxonomies for safety events experienced by patients receiving prone-position ventilation were created, which provided insight into harm trends in this patient population. Analysis of 392 patient safety events resulted in the identification of gaps in the care of these fragile patients, including but not limited to medical device-related pressure injuries, concerns with care delivery, staffing and acuity issues, and medical device dislodgement. Event themes in prone-position ventilation safety events informed a literature search from which an evidence-based action plan was developed and disseminated to Patient Safety Organization members for use in harm reduction efforts. Using a learning system approach, patient safety event data related to prone-position ventilation or any other type of patient safety event can be aggregated and analyzed to identify key areas of safety concerns and gaps in practice, allowing organizations to affect improvement efforts.

A Review of the Trade in Toucans (Ramphastidae): Levels of Trade in Species, Source and Sink Countries, Effects from Governance Actions and Conservation Concerns

Utilising wildlife as natural resources has a long history and wide appeal for many nations, while seeking international wildlife that is sustainably managed is the primary responsibility of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). However, data-driven trade reviews are required, utilising CITES data to increase our understanding of the trade and facilitate evidence-based conservation planning. This study presents the first trade review for Toucans utilising CITES import reported data. The total number of Toucans exported was over 22,000, which subsequently generated a retail ‘real price’ value of nearly US $72 million. The countries accounting for the majority of Toucan exports were Guyana (39%), Suriname (33%) and Nicaragua (14%), while the main importing country was The Netherlands (nearly 25%). Toucan species traded were Ramphastos vitellinus (accounting for 21.5%), Ramphastos toco (19%) and Ramphastos tucanus (17%), making the top three while trade was recorded in 10 species. However, successfully identifying economic values for 15 species highlights that trade exists within non-CITES listed Toucan species too. Therefore, the levels of trade in non-CITES-listed Toucan species need urgent attention, as do the non-detrimental findings that underpin the CITES quotas set for each species, given the species’ importance ecologically.

Towards the high-quality development of City Region Food Systems: Emerging approaches in China

The outbreak of COVID-19 has underscored the vulnerability of our current food systems. In China, following a series of strategies in guaranteeing food security in the past decades, the pandemic has further highlighted the necessity to strengthen urban-rural linkages and facilitate the sustainable development of local agri-food systems. The study for the first time introduced the City Region Food Systems (CRFS) approach to Chinese cities and attempted to holistically structure, analyze and promote the sustainability of local food systems in China. Taking Chengdu as an example, the study first took stock of existing concepts and policies in China and the city, and defined the high-quality development goals of CRFS for Chengdu. An indicator framework was then developed to serve as a CRFS assessment tool for identifying existing challenges and potentials of local food systems. Further, a rapid CRFS scan using the framework was conducted in Chengdu Metropolitan Area, providing concrete evidence for potential policy interventions and practice improvement in the area. The study has explored new paradigm of analysis for food related issues in China and provided supporting tools for evidence-based food planning in cities, which collectively contribute to the food system transformation in a post-pandemic scenario.

Perspectives on informal STEM teaching and learning during and beyond COVID-19

ABSTRACT This study explored STEM program quality prior to and during the COVID-19 pandemic, including differences based on learning setting. Program quality data was drawn from a national database consisting of 1259 program quality observations conducted between 2013 and 2021. Using the Dimensions of Success (DoS), an observation tool focused on informal STEM learning program quality, we analyzed 12 dimensions of quality obtained from 1212 observations gathered prior to the COVID-19 pandemic, a subsample of the national dataset (n = 616) including only states who submitted DoS observations before and during the pandemic, and 47 observations gathered throughout the pandemic. National trends in program strengths and challenges were replicated in the pandemic sample. Compared to observations conducted prior to the pandemic, the pandemic sample demonstrated significantly weaker evidence of quality in the dimension of Engagement with STEM, which considers the extent to which activities promote physical and cognitive learning. Findings revealed no significant differences across the 12 dimensions between in-person and virtual observations conducted during the pandemic. Common frameworks to support evidence-based planning relevant to dimensions that are challenging in the context of the pandemic are key to promoting high-quality teaching and learning practices that contribute to equitable, positive youth outcomes in STEM.

‘Harnessing the power of the law’: a qualitative analysis of the legal determinants of health in English urban planning and recommendations for fairer and healthier decision-making

BackgroundUrban environments impact negatively on the risks of non-communicable diseases and perpetuate health inequalities. Against this, law could play a critical role, notably through implementing and securing visions of health and well-being, and evidence-based interventions.MethodsSeven teams conducted 123 interviews with 132 actors in urban planning in England. Teams had expertise in urban planning, transport, real estate, public health, public policy, administration, and management. An additional team with expertise in law analysed data from all interviews to explore how the law is perceived and used to promote health in urban planning.ResultsSix issues were identified as preventing actors from using the law to improve health in urban planning: (i) density and complexity of the law; (ii) weak and outdated regulatory standards; (iii) absence of health from legal requirements in the decision-making process; (iv) inconsistent interpretations by actors with competing interests; (v) lack of strong health evidence-based local planning policies; and (vi) inertia of the law.ConclusionsThe legal determinants of health listed in the Lancet-O’Neill Commission’s report need to be strengthened at the local level to effectively deploy law in English urban development. The findings call for strong, evidence-based local planning policies and decision-making frameworks, placing health as (one of the) core value(s) of urban planning and showing what types of development benefit health, i.e., prevent NCDs risks and reduce health inequalities on the long term. The legal capacity of local government should be strengthened to empower decision-makers in shaping urban development that promotes health for everyone.

Health and economic benefits of achieving contraceptive and maternal health targets in Small Island Developing States in the Pacific and Caribbean

IntroductionReducing unmet need for modern contraception and expanding access to quality maternal health (MH) services are priorities for improving women’s health and economic empowerment. To support investment decisions, we estimated...

Sociodemographic predictors of flourishing among older adults in rural and urban Mongolia

Flourishing is an eudaimonic dimension of psychological well-being associated with positive social and health outcomes. Determining correlates of health and well-being is critical for the development of evidence-based best practices, policies, and action plans that target older adults, especially in low- and middle-income countries where research on ageing, health and well-being is still scarce. The study aimed to determine the level of flourishing among older adults in Mongolia and to explore demographic and social factors that contribute to their flourishing in urban and rural areas of Mongolia. We used proportional quota sampling to select a non-probability sample of 304 community-dwelling older adults that reflected the national distribution of older age groups and rural/urban residency. We adapted and administered a widely used standardized questionnaire on flourishing and used multiple regression to establish correlates of flourishing. Study participants reported “very high” levels of flourishing; differences in median scores 53 for urban and 50 for rural older adults were significant. Sex (beta =-,2.09, p=0.080), level of education(beta =0.98, p=0.009) and receive help with ADLs (beta =-,2.29, p=0.013) were associated with flourishing in rural areas, as were self-rated health (beta =1.14, p=0.028), number of social activities (beta =0.050, p=0.019),and friends network (beta =0.22, p=0.035) in urban areas. Despite facing many challenges to well-being, older adults in Mongolia reported high levels of flourishing. Those in urban areas had higher scores than those in rural areas and predictors of flourishing differed for these groups.

Prevalence and Disparities in the Detection of Autism Without Intellectual Disability.

Intellectual ability predicts functional outcomes for children with autism spectrum disorder (ASD). It is essential to classify ASD children with and without intellectual disability (ID) to aid etiological research, provide services, and inform evidence-based educational and health planning. Using a cross-sectional study design, data from 2000 to 2016 active ASD surveillance among 8-year-olds residing in the New York-New Jersey Metropolitan Area were analyzed to determine ASD prevalence with and without ID. Multivariable Poisson regression models were used to identify trends for ASD with ID (ASD-I) and without ID (ASD-N). Overall, 4661 8-year-olds were identified with ASD. Those that were ASI-I were 1505 (32.3%) and 2764 (59.3%) were ASD-N. Males were 3794 (81.4%), 946 (20.3%) were non-Hispanic Black (Black), 1230 (26.4%) were Hispanic, and 2114 (45.4%) were non-Hispanic white (white). We observed 2-fold and 5-fold increases in the prevalence of ASD-I and ASD-N, respectively, from 2000-2016. Black children were 30% less likely to be identified with ASD-N compared with white children. Children residing in affluent areas were 80% more likely to be identified with ASD-N compared with children in underserved areas. A greater proportion of children with ASD-I resided in vulnerable areas compared with children with ASD-N. Males had higher prevalence compared with females regardless of ID status; however, male-to-female ratios were slightly lower among ASD-I compared with ASD-N cases. One-in-3 children with ASD had ID. Disparities in the identification of ASD without ID were observed among Black and Hispanic children as well as among children residing in underserved areas.

Disease burden and attributable risk factors of neonatal disorders and their specific causes in China from 1990 to 2019 and its prediction to 2024

BackgroundNeonatal health is a cornerstone for the healthy development of the next generation and a driving force for the progress of population and society in the future. Updated information on the burden of neonatal disorders (NDs) are of great importance for evidence-based health care planning in China, whereas such an estimate has been lacking at national level. This study aims to estimate the temporal trends and the attributable burdens of selected risk factors of NDs and their specific causes in China from 1990 to 2019, and to predict the possible trends between 2020 and 2024.MethodsData was explored from the Global Burden of Disease study (GBD) 2019. Six measures were used: incidence, mortality, prevalence, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). Absolute numbers and age-standardized rates (with 95% uncertainty intervals) were calculated. The specific causes of NDs mainly included neonatal preterm birth (NPB), neonatal encephalopathy due to birth asphyxia and trauma (NE), neonatal sepsis and other neonatal infections (NS), and hemolytic disease and other neonatal jaundice (HD). An autoregressive integrated moving average (ARIMA) model was used to forecast disease burden from 2020 to 2024.ResultsThere were notable decreasing trends in the number of deaths (84.3%), incidence (30.3%), DALYs (73.5%) and YLLs (84.3%), while increasing trends in the number of prevalence (102.3%) and YLDs (172.7%) from 1990 to 2019, respectively. The corresponding age-standardized rates changed by -74.9%, 0.1%, -65.8%, -74.9%, 86.8% and 155.1%, respectively. Four specific causes of NDs followed some similar and different patterns. The prediction results of the ARIMA model shown that all measures still maintained the original trends in the next five years. Low birth weight, short gestation, ambient particulate matter pollution and household air pollution from solid fuels were the four leading risk factors.ConclusionThe health burden due to NDs is declining and is likely to continue to decline in the future in China. Delaying the increasing burden of disability may be the next target of concern. Targeted prevention and control strategies for specific causes of NDs are urgently needed to reduce the disease burden.

Occupational Therapy to Improve Activities of Daily Living of People With Parkinson's Disease.

Evidence Connection articles are offered by the American Occupational Therapy Association's Evidence-Based Practice Program to inform and assist occupational therapy practitioners in methods that translate findings from the literature into usable knowledge for daily practice. These articles can guide professional reasoning and help practitioners operationalize findings from systematic reviews into practical strategies that can improve patient outcomes and support evidence-based practice. This Evidence Connection article is based on findings from a systematic review of interventions within the scope of occupational therapy practice to improve performance with activities of daily living (ADLs) for adults with Parkinson's disease (Doucet etal., 2021). In this article, we present a case study of an older adult with Parkinson's disease. We discuss suggested evaluation tools and intervention strategies that might be used as part of occupational therapy to address limitations and meet his desired needs for improved participation in ADLs. A client-centered, evidence-based plan was constructed for this case.