Top-down Interventions Research Articles

Assessing biosocial vectors in water contamination, the incidence of water-borne illnesses, and insecurity in Kathmandu, Nepal

ABSTRACT In this study, we use water quality tests, epidemiological data, and ethnographic interviews gathered in Kathmandu in 2017 to provide an interdisciplinary analysis of water insecurity, illness, and targeted responses. Our findings fit the pattern of the past 20 years: the concentration of coliform bacteria across water sources remains unsafe. Our epidemiological data documents high rates of water-borne infectious diseases consistent with fecal contamination of water sources. Our ethnographic interviews suggest that social marginalization, poverty, and dislocation are major drivers in the incidence of illness. Evaluating some of the collective responses to water insecurity and contamination, we argue that effectively addressing water pollution, scarcity, and health outcomes in Kathmandu requires redirecting the focus of programs and the primary methods of implementation. Instead of large-scale top-down infrastructural interventions such as the Melamchi Water Supply Project, programs should target women's leadership in and subsidize funding for small-scale, community-managed interventions.

Megacity urban green space equity evaluation and its driving factors from supply and demand perspective: A case study of Tianjin

Urban green space (UGS) equity is crucial for sustainable urban development, social harmony, and stability. Given the escalating environmental justice crisis in megacity UGS, ensuring spatial justice and social equity in these areas is vital for sustainable development. This study analyzes the equity of UGS in megacity by assessing both spatial equity from the supply perspective and social equity from the demand perspective while exploring key factors driving this equity. This study found that: 1) The green Gini coefficient in Tianjin's central city, stands at 0.7787, indicating significant spatial inequity, with small UGS exhibiting the highest, followed by medium and large spaces. 2) There is a varying perception of UGS equity across different socioeconomic groups, most pronounced in the center urban area, then in the encircling urban area and remote urban area, indicating a gradual diffusion of green equity from the city center outward. 3) Key external factors influencing UGS equity include economic development, population density, traffic patterns, and local environmental quality, while internal factors like accessibility and size also play a role in spatial equity. Thus, enhancing UGS equity in megacities requires not only top-down supply interventions but also bottom-up demand feedback mechanisms.

Paradoxes in the coevolution of contagions and institutions.

Epidemic models study the spread of undesired agents through populations, be it infectious diseases through a country, misinformation in social media or pests infesting a region. In combating these epidemics, we rely neither on global top-down interventions, nor solely on individual adaptations. Instead, interventions commonly come from local institutions such as public health departments, moderation teams on social media platforms or other forms of group governance. Classic models, which are often individual or agent-based, are ill-suited to capture local adaptations. We leverage developments of institutional dynamics based on cultural group selection to study how groups attempt local control of an epidemic by taking inspiration from the successes and failures of other groups. Incorporating institutional changes into epidemic dynamics reveals paradoxes: a higher transmission rate can result in smaller outbreaks as does decreasing the speed of institutional adaptation. When groups perceive a contagion as more worrisome, they can invest in improved policies and, if they maintain these policies long enough to have impact, lead to a reduction in endemicity. By looking at the interplay between the speed of institutions and the transmission rate of the contagions, we find rich coevolutionary dynamics that reflect the complexity of known biological and social contagions.

Bottom-up versus Top-down designed rehabilitation sessions in chronic stroke survivors: a pilot randomized controlled trial

Purpose The present study aimed to compare the effectiveness of Top-down and Bottom-up approaches on levels of the International Classification of Functioning, Disability and Health Framework (ICF), including impairments, activities, and participation. Materials and methods Thirty-nine chronic stroke survivors were recruited for this single-blinded randomized clinical trial. Participants were assigned to Top-down, Bottom-up interventions, or control group, and received a 6-week intervention. They were assessed before/after treatments and at follow-up (6 weeks later). Impairments were measured through kinematic analysis, Trail Making Tests (TMT), and Fugl-Meyer Assessment (FMA). Activity and participation were evaluated via Box and Block Test, Motor Activity Log (MAL), and Canadian Occupational Performance Measure (COPM), respectively. Results We found significant improvements in impairment (FMA) and participation (COPM) in all groups, however, COPM scores improved beyond the MCID only in the Top-down, and FMA scores exceeded the MCID in Top-down and Bottom-up groups. Use of the upper limb in daily activities (MAL) enhanced in the Top-down group, although was not clinically significant. Conclusion In most of the outcome measures, no significant difference was observed between groups. It seems that Top-down, Bottom-up, and traditional interventions have relatively comparable effectiveness in chronic stroke survivors. Trial Registration IRCT20150721023277N2

Navigating process evaluation in co-creation: a Health CASCADE scoping review of used frameworks and assessed components

BackgroundCo-creation is seen as a way to ensure all relevant needs and perspectives are included and to increase its potential for beneficial effects and uptake process evaluation is crucial. However,...

Wellbeing Predictors in Animal Shelter Workers: Exploring the Roles of Job Demands, Job Resources, and Job Crafting

ABSTRACT Animal shelter workers are at risk of poor wellbeing resulting from their work, with this potentially impacting employee performance and attrition. Using the Job Demands-Resources (JD-R) model as a theoretical framework, the study explored relationships between job demands, job resources, workplace wellbeing (exhaustion and engagement), performance, and intentions to leave. Use of job-crafting behaviors, and the extent that these behaviors predict wellbeing after controlling for the impact of job demands and resources, were also explored. Among the 142 participants surveyed, a range of job-crafting behaviors were reported. Consistent with the JD-R model, hierarchical regressions revealed job demands and resources accounted for 36.4% of the variance in work engagement and 36.2% of the variance in exhaustion. Job crafting predicted wellbeing in animal shelter workers after controlling for demands and resources and explained an additional 7.8% of the variance in work engagement and 5.9% of the variance in exhaustion. Work engagement, but not exhaustion, was related to performance, while both engagement and exhaustion were related to intentions to leave. The results suggest that job demands and resources impact wellbeing in animal shelter workers, affecting their performance and contributing to intentions to leave. Broad workplace interventions that build resources and minimize demands may, therefore, be effective in promoting wellbeing and performance in animal-shelter environments, which could potentially increase retention rates. Animal shelter workers make active adjustments to their work environment through job crafting, and these are linked to workplace wellbeing. Interventions that offer flexibility and encourage job crafting, particularly those that involve finding opportunities for growth and seeking feedback on performance, offer a useful bottom-up approach to complement top-down interventions.

Understanding the role of regional cooperation in mitigating ecological footprint: An empirical analysis of the Guangdong-Hong Kong-Macao Greater Bay Area

Confronted with an escalating ecological crisis, regional cooperation has emerged as a recognized strategy for orchestrating collective actions among diverse stakeholders across territories. Nonetheless, the potential of regional cooperation in mitigating ecological footprints remains significantly underexplored. To address this gap, this study employs the case of the Guangdong-Hong Kong-Macao Greater Bay Area (GBA) to quantitatively scrutinize the impacts of regional cooperation on ecological footprints from 2010 to 2018, while also elucidating its underlying mechanisms. Our investigation into the GBA unveils four pivotal findings. First, the data paints an increasing ecological footprint picture across the GBA, with a discernible spatial pattern of decreasing intensity from coastal to hinterland cities over the past decade. Second, intergovernmental cooperation amplifies the ecological footprint, a phenomenon intricately tied to top-down interventions from upper-level governments. Such highly formalized spatial interventions often overlook local ecological repercussions, thereby intensifying discord. Third, the collaboration between government and market entities aids in reducing the ecological footprint, provided it is contingent on the symbiotic relationship between regional market competition policies provided by the upper-level government and the flexible, informal arrangements offered by local governments to support enterprises. Last, regional cooperation may intensify the ecological footprint in ordinary cities through the transfer of industries from core cities.

Distinguishing between Low- and High-Cost Pro-Environmental Behavior: Empirical Evidence from Two Complementary Studies

To reach sustainability goals, researchers and policymakers must focus on addressing changes toward more pro-environmental behavior (PEB). Therefore, this study shows evidence-based perceptions of low- and high-cost behaviors and deduces recommendations for PEB interventions. We applied a multi-step mixed-method approach: First, a representative online survey was conducted to collect a general quantitative overview and classify low- and high-cost behavior based on past behavior and behavioral intentions. Second, a gamification intervention that aimed to gain quantitative data about certain behaviors and perceived low- and high-costs was conducted with university students. The results of the two studies showed that PEB can easily be categorized into high-, rather-high-, rather-low-, and low-cost behavior. However, this classification is not based on emission sectors, e.g., mobility, but on the specific behavior. Interventions can be recommended according to subjective costs: For example, low-cost behavior does not need additional interventions in most cases but must be maintained as is. According to the empirical findings, high-cost behavior needs top-down interventions, while rather-high- and rather-low-cost behavior requires bottom-up interventions to achieve behavior changes. In summary, managing interventions using this classification and focusing on high-impact behavior can lead to successful behavior changes and emission reductions.

The racial biopolitics of humanitarianism in Africa: examining European resilience-building in the Sahel and lake Chad Basin

The racial biopolitics of humanitarianism in Africa: examining European resilience-building in the Sahel and lake Chad Basin

Gender and social class inequalities in higher education: intersectional reflections on a workshop experience.

Research about the experiences of underrepresented groups in higher education (HE) demonstrates the persistence of challenges, despite policies and institutional strategies to promote inclusion. Diversity and inclusion policies have been part of the HE agenda for several decades, yet most policies and interventions focus on (a) a given, isolated identity experience (e.g., based solely on gender, social class, or ethnicity) rather than more intersectional approaches to identity; and (b) top-down interventions that do not include participants insights in their design. In this paper, we report a case study of a workshop with students at an elite university that drew on an intersectional approach to social identities (IASI), specifically, looking at gender and social class. We explore three key themes: (a) the importance of group processes, (b) the use of visual techniques, and (c) the institutional tensions and the (de)politicisation of social psychology research. Reflecting on this case study we argue that approaches to identity and inclusion in HE can benefit from intersectionality beyond the use of multi and overlapping identity and social group categories. We argue that research in this space is not neutral and needs to acknowledge researchers' position about (a) inclusion and diversity, (b) perceptions of participants in research, and (c) the motivation and aims of institutions where the research is conducted. Finally, we discuss the theoretical and practical implications of integrating an intersectional approach within social identity research in HE when focusing on underrepresented groups.

From Barter to Market: an Agent-Based Model of Prehistoric Market Development

Despite interest in preindustrial markets, archaeological discussions have largely been limited to proposing methods to determine the presence or absence of market exchange in ancient societies. While these contributions are important, methodological limitations have prevented theoretical considerations of the emergence and evolution of marketplaces and market exchange in prehistory. We propose that agent-based modeling provides a window to explore physical conditions and agent behaviors that facilitate the emergence of customary exchange locations and how such locations may evolve into socially embedded institutions. The model we designed suggests that simple bartering rules among agents can generate concentrated locations of exchange and that spatial heterogeneity of resources is the most important factor in facilitating the emergence of such locales. Furthermore, partner-search behaviors and exchange of information play a key role in the institutionalization of the marketplace. The results of our simulation suggest that marketplaces can develop, even with the absence of formalized currency or central planning, as a consequence of collective strategies taken up by agents to reduce exchange partner-search costs and make transactions more frequent and predictable. The model also suggests that, once established as a social institution, marketplaces may become highly conservative and resistant to change. As such, it is inferred that bottom-up and/or top-down interventions may have often been required to establish new marketplaces or relocate marketplaces to incorporate new resources, resolve supply–demand imbalances, or minimize rising economic costs that arise as a result of social, political, and economic change.

Sensor platform for assessment of water usage patterns in informal settlements

Rapid urbanization has intensified pressures on global water systems, particularly impacting informal settlements. Understanding water usage patterns within these settlements is of importance for better addressing water scarcity issues. Current methods for gaining information about water within these settings tend to lack spatio-temporal granularity and miss complex patterns of behavior related to water usage. As a consequence, there is a shortage of the reliable quantitative measurements needed to improve water management processes and modeling. Here we introduce a low-cost sensing platform for water assessment in informal settlements. Households within these types of settlements, lacking water utility connections and piping, often use storage tanks and buckets to distribute, store, and consume water; hence, the platform consists of four distinct sensor modules that can be placed on these types of water infrastructure. Evaluated in controlled settings, the sensors prove to be reliable for measuring water quantity, quality, and usage. Field testing within an informal community in Mexico reveals that the system can comprehensively track multiple tank storage levels, assess water quality, and capture bucket usage patterns without disrupting a household’s common activities or infrastructure. Our validation shows the technique’s potential to improve water management in informal communities, while opening opportunities for enhancement of water-related research and policy making through combinations of top-down and bottom-up interventions.

Inclusive Approach of Türkiye on Access and Integration of Refugees to Higher Education

Türkiye stands at the forefront of countries that have embraced a considerable number of refugees and asylum-seekers, making it a prominent host for displaced populations worldwide. In recent years, Türkiye has developed a novel and inclusive approach designed to facilitate the access of refugees to higher education. This article endeavours to examine Türkiye’s policy framework and intricate challenges that arise during its implementation, with a keen focus on how top-down policy interventions interact with institutional bureaucracies and the socio-cultural context. The
 study postulates that while Türkiye boasts a national inclusive policy, the effectiveness and outcome of its implementation lie within the realm of decentralization. The success or failure of
 the policy hinges on the institutional capacity, willingness of the higher education institutions to accept refugee students and the sociological dynamics between locals and refugee students. For the
 policy to genuinely thrive, it necessitates addressing institutional disparities and variances among higher education institutions.

Do Sanitation Marketing Activities Increase Households' Likelihoods of Reaching Improved Sanitation or Involving Women in Decision Making?

Poor sanitation causes 30% of diarrheal deaths globally, and much of the world has struggled to finance top-down interventions. Sanitation marketing is a demand-led approach that uses a mixture of social and commercial marketing methods and direct sales to households. However, little is known about its impacts on household decision making. This mixed-methods study uses data from eight focus groups and 86,666 household surveys from participants in a five-year sanitation marketing program in Uganda. Logistic regression models identified 10 variables predicting attainment of improved (limited or basic) sanitation and four variables predicting female involvement in decision making. Triggering session attendance increased chances of reaching improved sanitation by 15-28%, depending on who attended, and by 19% if the household found the session motivational. Although women were engaged in decision-making conversations, they were not viewed as primary decision makers, even in female-headed households. Women were more likely to become involved in decision making if they had attended triggering sessions with men (+70%) or engaged with sales promoters alone (+74%) or with men (+78%). For both outcomes, joint activity engagement was more effective than male or female engagement alone. This work highlights two sanitation marketing activities as pathways to improving latrine coverage and women's decision-making agency.

Frontline healthcare workers' mental health and wellbeing during the first year of the COVID-19 pandemic: Analysis of interviews and social media data.

The COVID-19 pandemic has shed light on the fractures of healthcare systems around the world and continues to have a significant impact, particularly in relation to the healthcare workforce. Frontline staff have been exposed to unprecedented strain and delivering care during the pandemic has impacted their safety, mental health and wellbeing. The aim of this paper was to explore the experiences of Health Care Workers (HCWs) delivering care in the UK during the COVID-19 pandemic to understand their wellbeing needs, experiences and strategies used to maintain wellbeing (at individual and organizational levels). We analysed 94 telephone interviews with HCWs and 2000 tweets about HCWs mental health during the first year of the COVID-19 pandemic. Results were grouped under six themes: redeployment, clinical work, and sense of duty; wellbeing support and HCW's coping strategies; negative mental health effects; organisational support; social network and support; and public and government support. These findings demonstrate a need for open conversations, where staff wellbeing needs and the strategies they adopted can be shared and encouraged, rather than implementing solely top-down psychological interventions. At the macro level, findings also highlighted the impact on HCW's wellbeing of public and government support, as well as the need for ensuring protection through PPE, testing, and/or vaccines for frontline workers.

Bending the pipes: Regaining attention through reinvention and renewal

Organizations’ attention structures are traditionally perceived as stable “pipes and prisms” representing organizational communication and procedural channels. Changes in attention structures are typically attributed to top-down interventions. In this study, we extend the “dynamic Attention Based View” by demonstrating first that attention structures are plastic and second that they can be “bent” through bottom-up adaptations of communication channels previously designed from the top. Using a single case study of the large telecommunication corporation Ericsson, we show how mid-level organizational actors manifest distinct forms of agency in reacting to adverse changes in attention structures: projective agency and iterational agency. Organizational actors regain influence over the strategy-making process through two corresponding practices: reinvention (the projective agency of adding new channels) and renewal (the iterational agency of restoring old channels).

Rethinking urban utopianism: The fallacy of social mix in the 15-minute city

The concept of urban living is evolving, and there is a growing interest in creating smaller, more connected, and hyperlocal neighbourhoods, where everything people need is within a 15-minute walk or bike ride. This paper challenges the concept of the ‘15-minute city’ as a panacea for urban ills, by exploring the history of utopian urban planning and regeneration aimed at creating sustainable, inclusive and vibrant communities by desegregating disadvantaged groups. Specifically, we examine social mixing policies, which are recurring top-down interventions that pathologise concentrated urban disadvantage. We trace the evolution of these policies in Europe from the Garden City movement to post-war social housing redevelopment to the current 15-minute city, which we consider to be social mix by stealth. While such policies can reduce the degree of concentrated disadvantage in the short term, they tend to be ineffective in the long term, as deprived neighbourhoods often remain so despite attempts to make them more diverse. The paper argues that the 15-minute city would be implemented through de facto social mix actions at the neighbourhood level, which are insufficient to address the deeper structural issues that perpetuate spatial inequality and deprivation. We propose that longitudinal and comparative analyses, combined with ‘right to the city’ perspectives, should be considered in future research and policymaking to understand – and more importantly address – why urban renewal initiatives that aim for equitable outcomes at the neighbourhood scale ultimately fail to deliver.

From protests into pandemic: demographic change in Hong Kong, 2019–2021

ABSTRACT Compared to other settings, COVID-19 infection and death rates in Hong Kong were very low until 2022, due to top-down interventions (e.g. quarantines, ‘mask mandates’) and community activation. However, in addition to these epidemiological circumstances, Hong Kong has also undergone significant social and political change stemming from the social movement beginning in 2019 through the enacting, and aftermath, of the National Security Law. We draw on registered birth and marriage data from 2015 through 2021 to explore how fertility and nuptiality changed after the social movement followed by the first four waves of the COVID pandemic. We describe how fertility and marriage rates have changed in Hong Kong and to what extent the changes are associated with the social movement and the COVID pandemic. We further disaggregate the fertility and nuptiality trends by Hong Kong-born and non-Hong Kong-born population, with a specific focus on migrants from the Mainland.

Learning capacity and diversification, enabling and constraining factors, and external assistance: A cross-national comparative analysis of long-term livelihood recovery

Despite a wide recognition of the importance of learning capacity and diversification, enabling and constraining factors, and external assistance in facilitating long-term livelihood recovery (LTLR), there is a paucity of comparison for a nuanced understanding of interconnections among the three themes (learning capacity and diversification, enabling and constraining factors, and external assistance) in different societal and disaster scenarios. Accordingly, this article employs a cross-national comparative approach in examining the interplay of these three factors in LTLR, within rural communities, following the two international post-disaster case studies, the 2007 Cyclone Sidr, Barguna, Bangladesh and the 2008 Wenchuan earthquake, Sichuan, China. This cross-national comparison indicates that the affected communities in both cases experienced extreme challenges in LTLR while illustrating the differences. Learning capacity and diversification facilitated asset loss recovery and risk mitigation in the Sidr case, while the Wenchuan case demonstrated a limited learning opportunity for livelihood diversification. Enabling and constraining factors were identified in both case studies. Particularly, people-place connections positively shaped the LTLR in the Wenchuan case while producing negative results in the Sidr case. External assistance facilitated livelihood provisioning, protection, and promotion for the Sidr case; in contrast, giving little, if any, credence to the local traditional livelihood practice, the top-down external interventions in the Wenchuan case jeopardized the rural communities LTLR. This article defends that promoting grassroots participation in community reconstruction and recovery and strengthening grassroots livelihood learning and practice capacities would advance LTLR.

‘Lifestyle drift’ in disaster risk reduction practices magnifies inequities for high-risk populations

High-risk populations are at disproportionate risk when disasters occur because of the vulnerable social circumstances and settings in which they live. Emergency Managers (EMs) and Emergency Social Services Directors (ESSDs) work to support individual and community resilience in all phases of the disaster management cycle. The purpose of this qualitative study was to explore the current practices and challenges experienced by EMs and ESSDs in Canada, in supporting community resilience and high-risk populations in the context of disaster risk reduction (DRR). EMs and ESSDs (n ​= ​21) from six Canadian provinces were interviewed. Through thematic analysis, three themes were identified and a model was developed to show how the themes interconnect. The themes included: 1) Individual level interventions magnify inequities and lead to ‘lifestyle drift’, 2) Resilience can be supported upstream by addressing social vulnerabilities, and 3) Inclusive engagement empowers high-risk populations but is challenging to implement. ‘Lifestyle Drift’ permeates DRR practices and has unique implications for high-risk populations, whose basic needs are already challenged. Both top-down and bottom-up interventions can reduce the demands placed on emergency services in the hours after a disaster. However, bottom-up interventions, such as a ‘whole community’ approach are more likely to foster asset literacy, adaptive capacity, and social justice —and ultimately support resilience of high-risk populations.