Reinhabiting, Reimagining, and Recreating Ableist Spaces: Embodied Criticality In Art

In this chapter, we bring critical disability studies into dialogue with disability artworks that resituate critiques of inaccessibility and exclusion as complicated encounters with space, lived experience, and embodiment. Drawing on Irit Rogoff's notions of embodied criticality, and the pioneering work of performance studies scholar Petra Kuppers, we argue for an embodied, embedded, and creative form of critical disability studies - enacted through art. We examine recent performance and installation works in hotels, including Welcome Inn by British artist Christopher Samuel, and Intimate Space by Australian performance company Restless Dance Theatre. Concentrating on hotels as part-public/part-private spaces where lived experiences of power are written across human bodies and relationships. Invoking critical disability studies, we argue that Welcome Inn and Intimate Space deepen engagement with criticality as a means of exploring new possibilities for embodiment, identity, and agency. These contemporary works engage disabled and non-disabled audiences in lived, embodied, interactive, and durational critique of the inaccessibility of spaces constantly overwritten by ableist worldviews. In the process, both artworks reveal how embodied critical experiences with art may lead to new ways of inhabiting spaces - theoretical, lived, and imagined - and different ways of relating to ourselves and each other.</p

Global, regional, and national burden of upper respiratory infections and otitis media, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021

Background: Upper respiratory infections (URIs) are the leading cause of acute disease incidence worldwide and contribute to a substantial health-care burden. Although acute otitis media is a common complication of URIs, the combined global burden of URIs and otitis media has not been studied comprehensively. We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to explore the fatal and non-fatal burden of the two diseases across all age groups, including a granular analysis of children younger than 5 years, in 204 countries and territories from 1990 to 2021. Methods: Mortality due to URIs and otitis media was estimated with use of vital registration and sample-based vital registration data, which are used as inputs to the Cause of Death Ensemble model to separately model URIs and otitis media mortality by age and sex. Morbidity was modelled with a Bayesian meta-regression tool using data from published studies identified via systematic reviews, population-based survey data, and cause-specific URI and otitis media mortality estimates. Additionally, we assessed and compared the burden of otitis media as it relates to URIs and examined the collective burden and contributing risk factors of both diseases. Findings: The global number of new episodes of URIs was 12·8 billion (95% uncertainty interval 11·4 to 14·5) for all ages across males and females in 2021. The global all-age incidence rate of URIs decreased by 10·1% (–12·0 to –8·1) from 1990 to 2019. From 2019 to 2021, the global all-age incidence rate fell by 0·5% (–0·8 to –0·1). Globally, the incidence rate of URIs was 162 484·8 per 100 000 population (144 834·0 to 183 289·4) in 2021, a decrease of 10·5% (–12·4 to –8·4) from 1990, when the incidence rate was 181 552·5 per 100 000 population (160 827·4 to 206 214·7). The highest incidence rates of URIs were seen in children younger than 2 years in 2021, and the largest number of episodes was in children aged 5–9 years. The number of new episodes of otitis media globally for all ages was 391 million (292 to 525) in 2021. The global incidence rate of otitis media was 4958·9 per 100 000 (3705·4 to 6658·6) in 2021, a decrease of 16·3% (–18·1 to –14·0) from 1990, when the incidence rate was 5925·5 per 100 000 (4371·8 to 8097·9). The incidence rate of otitis media in 2021 was highest in children younger than 2 years, and the largest number of episodes was in children aged 2–4 years. The mortality rate of URIs in 2021 was 0·2 per 100 000 (0·1 to 0·5), a decrease of 64·2% (–84·6 to –43·4) from 1990, when the mortality rate was 0·7 per 100 000 (0·2 to 1·1). In both 1990 and 2021, the mortality rate of otitis media was less than 0·1 per 100 000. Together, the combined burden accounted for by URIs and otitis media in 2021 was 6·86 million (4·24 to 10·4) years lived with disability and 8·16 million (4·99 to 12·0) disability-adjusted life-years (DALYs) for all ages across males and females. Globally, the all-age DALY rate of URIs and otitis media combined in 2021 was 103 per 100 000 (63 to 152). Infants aged 1–5 months had the highest combined DALY rate in 2021 (647 per 100 000 [189 to 1412]), followed by early neonates (aged 0–6 days; 582 per 100 000 [176 to 1297]) and late neonates (aged 7–24 days; 482 per 100 000 [161 to 1052]). Interpretation: The findings of this study highlight the widespread burden posed by URIs and otitis media across all age groups and both sexes. There is a continued need for surveillance, prevention, and management to better understand and reduce the burden associated with URIs and otitis media, and research is needed to assess their impacts on individuals, communities, economies, and health-care systems worldwide. Funding: Bill &amp; Melinda Gates Foundation.</p

Living with Pediatric Coeliac Disease: Lessons for Health Service Delivery

Background: Coeliac Disease (CD) affects up to 1.4% of children worldwide, with a rising global incidence. A less typical clinical presentation and the need for a life-long gluten exclusion diet raise challenges for diagnosis, management, and healthcare delivery with considerable impacts for CD patients and families as well as clinical services. Aims: To explore the lived experiences of caregivers of children with CD to identify barriers and enablers to diagnosis, referral, and treatment to inform a more streamlined service delivery model. Methods: Semi-structured interviews with caregivers of children with CD diagnosed for at least one month with no significant co-morbidities. Interviews were thematically analyzed. Results: Sixteen participants representing 12 family units were interviewed. Children with CD ranged in age from 3 to 18 years. Time from symptom onset to diagnosis varied from one month to > 10 years and symptoms were mainly atypical and non-specific. Six key themes were identified: the iterative diagnosis journey, restricted choices, child responsibility and autonomy, mental load (encompassing foodwork, emotional rollercoaster, and lack of trust), Google™ reigns for information, and where to from here? Conclusion: There is a need to decentralize CD diagnosis and management to meet the increasing demand created by rising incidence. Participants highlighted the need for a more streamlined diagnosis pathway, increased training of health professionals, and access to age-appropriate resources. Efforts need to be made to advocate for increased community awareness. These insights will be used to reimagine and co-design a decentralized model of care for pediatric CD diagnosis and management in Queensland, Australia.</p

Submission into the Victorian Government's Inquiry into Women's Pain

As Media and Communication researchers from Swinburne University of Technology and Queensland University of Technology investigating the intersection of sexual health and technology, we welcome the opportunity to make a submission to the Victorian Government’s Inquiry into Women’s Pain. Our submission is informed by two ongoing projects:Digital sexual health: Designing for safety, pleasure and wellbeing in LGBTQ+ communities, a collaboration with Professor Jenny Sundén (Södertörn University) funded by FORTE Sweden.Digital and data capabilities for sexual health policy and practice, funded by the Australian Research Council via the Future Fellowship scheme (FT2100085)

Challenges and Opportunities for Promoting Sustainability in Public Buildings

The building and construction sector remains largely climate-unfriendly as a significant global greenhouse gas emitter. Public buildings can play a significant role in promoting sustainability practices. Unlike developed countries that have successfully promoted sustainable building practices, developing countries have experienced slow progress in implementing sustainable practices in public buildings. This research study investigated the challenges and opportunities for improving sustainability practices in public buildings from a multi-stakeholder perspective within the context of developing countries. Using Indonesian public buildings as a case study, a wide range of stakeholders directly involved in the public building sector such as policy-makers, building owners, building professionals, and building users were interviewed over two time periods of 2019 and 2023. The interview results show consistent findings on challenges and possible opportunities with respect to regulation, occupant behavior, and the primacy of technical intervention in the practice of sustainable buildings. Despite the importance of strong policy and the role of technology in sustainability practices in public buildings, this study advocates the need for greater intervention in occupant behavior so that sustainable practices in public buildings can be continuously promoted

Association between axial elongation and corneal topography in children undergoing orthokeratology with different back optic zone diameters

Purpose: To explore the associations between myopia defocus dosage (MDD), aberration coefficients (primary spherical aberration and coma), and axial elongation in children undergoing orthokeratology (ortho-k) with back optic zone diameters (BOZD) of 5 mm and 6 mm over 2 years. Methods: Data from 80 participants from two ortho-k studies were analyzed: 22 and 58 children wore lenses with 5-mm and 6-mm BOZD, respectively. Four MDD metrics were calculated from corneal topography data over a 5-mm pupil for the 1-month and 24-month visits: the circumferential, flat, steep, and volumetric MDD. Corneal primary spherical aberration and comatic aberrations were also extracted from topography data over a 5-mm pupil. Linear mixed modelling was performed to explore the associations between the MDD, corneal aberrations, and axial elongation over 2 years, while controlling for confounding factors (e.g., baseline age and sex). Results: Participants in the 5-mm BOZD group displayed less axial elongation than the 6-mm BOZD group over 2 years (0.15 ± 0.21 mm vs. 0.35 ± 0.21 mm, P 0.05). Less axial elongation was associated with a greater volumetric MDD at the 1- and 24-month visits (both β = –0.01, P 0.05). Conclusions: The volumetric MDD over a 5-mm pupil after 1 month of ortho-k lens wear was associated with axial elongation after 24 months, and may be a useful predictor of future axial elongation in children undergoing ortho-k.</p

Assessing Water Requirements of Groundwater Dependent Ecosystems Using a Water Balance Approach and Streamflow Separation

Groundwater supports approximately one -third of global water consumption. With increasing pressures on this resource from both anthropogenic users and climatic influences, sustainable management of groundwater has become crucial. This article identifies groundwater requirements by Groundwater Dependent Ecosystems (GDEs) as groundwater evapotranspiration and groundwater discharge to surface water features (baseflow). These requirements are investigated using a soil moisture model combined with a water balance approach, baseflow separation techniques and groundwater level monitoring. The results are compared to groundwater evapotranspiration estimates based on diurnal water level fluctuations. For the period 2000 to 2019, the combined GDE requirements, including groundwater evapotranspiration and environmental baseflow requirements, ranged from 130 to 420 mm/year for the highest ecological indicator level within the study area of approximately 20 km2. These estimates provide valuable information on the short-term (daily to monthly) to long-term (yearly to multi yearly) responses to climate variations and can be integrated into water stress assessments. These findings can be used to enhance our understanding of the role of GDEs water requirements and contribute to managing GDEs as part of sustainable management of groundwater resources

Health Services Costs of Clinical Heart Failure With Reduced Ejection Fraction in Singapore

Objectives: This study aimed to estimate the annual healthcare burden of heart failure (HF) with reduced ejection fraction (<40%) in Singapore. Methods: Retrospective longitudinal descriptive cohort study was conducted using a linked national administrative data set (Singapore Cardiovascular Longitudinal Outcomes Database). In Singapore, during 2011, there were a total of 3267 HF-related hospital admissions. Among these, 1631 patients (49.9%), who had an ejection fraction of less than 40%, were followed up for 9 years. The primary outcomes were annual healthcare costs related to hospital admissions and outpatient visits. Results: There was a consistent decline in HF-related hospital admissions over the years, and the average per-hospital admission cost and average cost per day for HF varied over the 9 years. The average all-cause per-patient admission cost remained stable annually, ranging between S$16 000 and S$18 800. In the final year of life, there was a significant increase in both all-cause and HF-related hospital admission costs (by 24% and 54% from the previous year, respectively), and this rise in costs reflected increased frequency of admissions and longer hospital stays. There was an upward trend in the cost of outpatient visits as the patients neared death. Conclusions: Hospital-based HF care imposes a significant financial impact on Singapore's healthcare system. This suggests a need for cost-efficient management strategies to reduce the reliance on hospital-based treatment, thus mitigating economic pressures on the healthcare system.</p

Salivary cortisol measures across the clinical stages of psychosis: An individual participant data (IPD) meta-analysis

BACKGROUND: Studies of salivary cortisol levels in psychosis have yielded inconsistent findings, which may be attributable to heterogeneity in cortisol measurement, illness stage, and approaches to dealing with sampling factors and potential confounders. To address these issues, we performed an individual participant data (IPD) meta-analysis comparing individuals at different stages of psychosis to controls using five different salivary cortisol measures and explored potential effect modifiers.METHODS: Salivary cortisol data from five London-based cohorts were used to derive the cortisol awakening response, total daytime cortisol output, basal cortisol, and diurnal slope measures (wake-to-evening and peak-to-evening). Linear regression models were first performed to obtain standardised beta coefficients (β), representing the difference in each cortisol metric between each clinical stage group (cases) and healthy individuals (controls) after accounting for relevant sampling factors; we then used random-effects meta-analyses and meta-regression models to investigate the effect of psychosis stage and sample characteristics on effect sizes.RESULTS: Data were available for 352 individuals distributed across psychosis clinical stages (1a - distress disorder: N = 35; 1b - clinical high-risk for psychosis: N = 90; 2a - first-episode psychosis: N = 197; 2b - single episode remitted: N = 5; 3 - relapsing/remitting illness: N = 18; 4 - severe and persistent illness: N = 7) and 292 controls. A significant overall main effect of clinical stage on peak-to-evening diurnal slope was observed (χ 2=12.83, p = 0.025), with both the clinical high-risk (β=0.21, 95 % CI: 0.06, 0.36) and first-episode psychosis (β=0.20, 95 % CI: 0.10, 0.31) groups characterised by flatter slopes than controls. The clinical stage groups and controls did not differ on any other cortisol measure. Several sample characteristics were significantly associated with diurnal slope effect sizes, but after accounting for clinical stage, only the association between mean age in cases and wake-to-evening diurnal slope retained significance. CONCLUSION: Clinical high-risk and first-episode psychosis participants differed from healthy controls in the peak-to-evening diurnal cortisol slope. This measure has not been examined in these populations before, and its potential predictive and prognostic utility for psychotic disorders merits further investigation.</p

How best to regulate voluntary assisted dying: a qualitative study of perceptions of Australian doctors and regulators

It is widely accepted that voluntary assisted dying (VAD) should be regulated but little is known about the most effective way to regulate doctors in this setting. This article reports on empirical research conducted in two Australian states where VAD is lawful (Victoria and Western Australia). Interviews were conducted with 92 participants: one group comprised doctors providing VAD and the other group was regulators in this field. Participants were asked about how best to regulate doctors providing this service. Strikingly, both regulator and doctor participant groups were consistent with each other in their views on what constituted effective regulation. The nature of VAD was perceived by participants to require special regulation, although some felt this was overdone in these states. Reported features of effective regulation included regulators taking an educative approach, regulation being perceived as acceptable by doctors, and it being responsive and nimble to provide the guidance that doctors need. Participants also considered a range of regulatory tools were required to regulate VAD effectively, and some identified a need for these tools to be employed together in a holistic way. This article concludes with a set of principles for effective regulation of VAD, discerned from the views of participants