Tools for adaptive governance for complex social-ecological systems: A review of role-playing-games as serious games at the community-policy interface

The management of natural resources—from forests to fisheries to freshwater—is becoming increasingly complex and requires new tools and processes for engaging with individuals, communities, and decision-makers. Policy makers and practitioners have begun using serious games (SGs) (those used for purposes other than entertainment) to overcome some of the complex challenges of governing resources in social-ecological systems. This paper uses a systematic literature review methodology to assess role-playing SGs for natural resource management. Fifty-two articles from the role-playing game (RPG) subset of SGs are identified, synthesised and analysed using a multi-criteria evaluation framework. First, we explore three theoretical and conceptual elements of games: principles of RPGs, functions of games, and (practical) game characteristics. We evaluate game elements, including game design, adherence to reality and the degree to which games integrate elements of participatory—and action research. These dimensions of RPGs are then analysed and discussed. Particular attention is paid to the value and application of RPGs to address complex problems with interacting environmental, social, cultural and economic challenges, and the extent to which they can inform adaptive governance solutions. Results show that RPGs can be a valuable tool at different levels; however, we also identify important gaps in the current state of knowledge, in particular, related to bridging community—and higher-level decision-making scales through RPGs

Identifying Sources of Children’s Consumption of Junk Food in Boston After-School Programs, April–May 2011

Introduction: Little is known about how the nutrition environment in after-school settings may affect children’s dietary intake. We measured the nutritional quality of after-school snacks provided by programs participating in the National School Lunch Program or the Child and Adult Care Food Program and compared them with snacks brought from home or purchased elsewhere (nonprogram snacks). We quantified the effect of nonprogram snacks on the dietary intake of children who also received program-provided snacks during after-school time. Our study objective was to determine how different sources of snacks affect children’s snack consumption in after-school settings. Methods: We recorded snacks served to and brought in by 298 children in 18 after-school programs in Boston, Massachusetts, on 5 program days in April and May 2011. We measured children’s snack consumption on 2 program days using a validated observation protocol. We then calculated within-child change-in-change models to estimate the effect of nonprogram snacks on children’s dietary intake after school. Results: Nonprogram snacks contained more sugary beverages and candy than program-provided snacks. Having a nonprogram snack was associated with significantly higher consumption of total calories (+114.7 kcal, P < .001), sugar-sweetened beverages (+0.5 oz, P = .01), desserts (+0.3 servings, P < .001), and foods with added sugars (+0.5 servings; P < .001) during the snack period. Conclusion: On days when children brought their own after-school snack, they consumed more salty and sugary foods and nearly twice as many calories than on days when they consumed only program-provided snacks. Policy strategies limiting nonprogram snacks or setting nutritional standards for them in after-school settings should be explored further as a way to promote child health

Adaptation knowledge for New Zealand’s primary industries: Known, not known and needed

Climate sensitive primary industries including pastoral farming, high-value horticulture and viticulture are central to Aotearoa-New Zealand’s economy. While advances have been made in understanding the impacts and implications of climate change critical knowledge gaps remain, particularly for adaptation. This study develops and applies a novel methodology to identify and characterise adaptation knowledge for primary industries. The basis for the review is ten years’ of research and action under the Sustainable Land Management and Climate Change (SLMACC) program, supplemented with a systematic review of the published literature. Reports (n = 32) and literature (n = 22) are reviewed and assessed using the Adaptation Knowledge Cycle to characterise analytical and empirical foci. The detailed assessment of knowledge for Impacts, Implications, Decisions or Actions enables a robust and rigorous assessment of existing knowledge, identifies critical research gaps and emerging needs. Results show research to date has focused almost exclusively on understanding the impact of climate variability and extremes on land management. There are significant empirical (e.g. location and sector) and methodological (e.g. integrated assessments, scenarios, and vulnerability assessment) gaps, for at risk regions and sectors, and limited understanding of the decisions and actions necessary to enable successful adaptation. To inform future adaptation planning, additional work is required to better understand the implications, decision-making processes and obstacles to action. More detailed understanding of location-, season-, time- and sector-specific responses to climate change is also necessary. Findings advance our understanding of adaptation knowledge and reflect on diversity of information necessary to enable and sustain resilient rural futures and provide a conceptual and methodological basis for similar assessments elsewhere

State and Regional Variation in Regulations Related to Feeding Infants in Child Care

The purpose of this study was to compare state and regional variation in infant feeding regulations for child care facilities and to compare these regulations to national standards

Impact of mental health problems on case fatality in male cancer patients

Background: Although mortality rates are elevated in psychiatric patients relative to their healthy counterparts, little is known about the impact of mental health on survival in people with cancer. / Methods and results: Among 16 498 Swedish men with cancer, survival was worse in those with a history of psychiatric hospital admissions: multiply-adjusted hazard ratio (95% confidence interval) comparing cancer mortality in men with and without psychiatric admissions: 1.59 (1.39, 1.83). / Conclusion: Survival in cancer patients is worse among those with a history of psychiatric disease. The mechanisms underlying this association should be further explored

Assessment of a Districtwide Policy on Availability of Competitive Beverages in Boston Public Schools, Massachusetts, 2013

Introduction: Competitive beverages are drinks sold outside of the federally reimbursable school meals program and include beverages sold in vending machines, a la carte lines, school stores, and snack bars. Competitive beverages include sugar-sweetened beverages, which are associated with overweight and obesity. We described competitive beverage availability 9 years after the introduction in 2004 of district-wide nutrition standards for competitive beverages sold in Boston Public Schools. Methods: In 2013, we documented types of competitive beverages sold in 115 schools. We collected nutrient data to determine compliance with the standards. We evaluated the extent to which schools met the competitive-beverage standards and calculated the percentage of students who had access to beverages that met or did not meet the standards. Results: Of 115 schools, 89.6% met the competitive beverage nutrition standards; 88.5% of elementary schools and 61.5% of middle schools did not sell competitive beverages. Nutrition standards were met in 79.2% of high schools; 37.5% did not sell any competitive beverages, and 41.7% sold only beverages meeting the standards. Overall, 85.5% of students attended schools meeting the standards. Only 4.0% of students had access to sugar-sweetened beverages. Conclusion: A comprehensive, district-wide competitive beverage policy with implementation support can translate into a sustained healthful environment in public schools

The face of equipoise - delivering a structured education programme within a randomized controlled trial: qualitative study

Background: In trials of behavioural interventions, the individuals who deliver the intervention are in a position of key influence on the success of the trial. Their fidelity to the intervention is crucial. Yet little is understood about the experiences of this group of trial personnel. This study aimed to investigate the views and experiences of educators who delivered a structured education intervention to people with type 2 diabetes, which incorporated training in self-monitoring of either blood glucose (SMBG) or urine glucose (SMUG) as part of a randomized controlled trial (RCT). Methods: Educators’ views were explored through focus groups before and after training (N = 18) and approximately 1 year into the trial (N = 14), and semi-structured telephone interviews at approximately 2 years (N = 7). Analysis was based on the constant comparative method. Results: Educators held preferences regarding the intervention variants; thus, they were not in individual equipoise. Training raised awareness of preferences and their potential to impact on delivery. Educators were confident in their unbiased delivery, but acknowledged the challenges involved. Concealing their preferences was helped by a sense of professionalism, the patient-centred nature of the intervention, and concessions in the trial protocol (enabling participants to swap monitoring methods if needed). Commitment to unbiased delivery was explained through a desire for evidence-based knowledge in the contentious area of SMBG. Conclusions: The findings provide insight into a previously unexplored group of trial personnel - intervention deliverers in trials of behavioural interventions - which will be useful to those designing and running similar trials. Rather than individual equipoise, it is intervention deliverers’ awareness of personal preferences and their potential impact on the trial outcome that facilitates unbiased delivery. Further, awareness of community equipoise, the need for evidence, and relevance to the individual enhance commitment to the RCT