Study design, rationale and methods of the Revitalising Informal Settlements and their Environments (RISE) study: a cluster randomised controlled trial to evaluate environmental and human health impacts of a water-sensitive intervention in informal settlements in Indonesia and Fiji

Introduction: Increasing urban populations have led to the growth of informal settlements, with contaminated environments linked to poor human health through a range of interlinked pathways. Here, we describe the design and methods for the Revitalising Informal Settlements and their Environments (RISE) study, a transdisciplinary randomised trial evaluating impacts of an intervention to upgrade urban informal settlements in two Asia-Pacific countries. Methods and analysis: RISE is a cluster randomised controlled trial among 12 settlements in Makassar, Indonesia, and 12 in Suva, Fiji. Six settlements in each country have been randomised to receive the intervention at the outset; the remainder will serve as controls and be offered intervention delivery after trial completion. The intervention involves a water-sensitive approach, delivering site-specific, modular, decentralised infrastructure primarily aimed at improving health by decreasing exposure to environmental faecal contamination. Consenting households within each informal settlement site have been enrolled, with longitudinal assessment to involve health and well-being surveys, and human and environmental sampling. Primary outcomes will be evaluated in children under 5 years of age and include prevalence and diversity of gastrointestinal pathogens, abundance and diversity of antimicrobial resistance (AMR) genes in gastrointestinal microorganisms and markers of gastrointestinal inflammation. Diverse secondary outcomes include changes in microbial contamination; abundance and diversity of pathogens and AMR genes in environmental samples; impacts on ecological biodiversity and microclimates; mosquito vector abundance; anthropometric assessments, nutrition markers and systemic inflammation in children; caregiver-reported and self-reported health symptoms and healthcare utilisation; and measures of individual and community psychological, emotional and economic well-being. The study aims to provide proof-of-concept evidence to inform policies on upgrading of informal settlements to improve environments and human health and well-being. Ethics: Study protocols have been approved by ethics boards at Monash University, Fiji National University and Hasanuddin University. Trial registration number: ACTRN12618000633280; Pre-results

Why New Hybrid Organizations Are Formed: Historical Perspectives on Epistemic and Academic Drift

Abstract in Undetermined By comparing three types of hybrid organizations-18th-century scientific academies, 19th-century institutions of higher vocational education, and 20th-century industrial research institutes-it is the purpose here to answer the question of why new hybrid organizations are continuously formed. Traditionally, and often implicitly, it is often assumed that emerging groups of potential knowledge users have their own organizational preferences and demands influencing the setup of new hybrid organizations. By applying the concepts epistemic and academic drift, it will be argued here, however, that internal organizational dynamics are just as important as changing historical conjunctures in the uses of science when understanding why new hybrid organizations are formed. Only seldom have older hybrid organizations sought to make themselves relevant to new categories of knowledge users as the original ones have been marginalized. Instead, they have tended to accede to ideals supported by traditional academic organizations with higher status in terms of knowledge management, primarily universities. Through this process, demand has been generated for the founding of new hybrid organizations rather than the transformation of existing ones. Although this study focuses on Swedish cases, it is argued that since Sweden strove consistently to implement existing international policy trends during the periods in question, the observations may be generalized to apply to other national and transnational contexts