Stakeholder preference mapping : the case for built heritage of Georgetown, Malaysia

Purpose While there is an established body of literature that discusses the importance of stakeholder management, and also the need for involvement of all stakeholders so that all values of a heritage site can be captured in a heritage management plan, the concepts are not generally developed in ways that make them useful in practice. This research seeks to bring greater clarity to the practice of stakeholder engagement in built heritage, so that organisations can manage their stakeholders in ways that meet their strategic goals. This study proposes a novel method to identify stakeholders, a stakeholder preference mapping approach, which will depict their influence on decisions based on a of power-interest scale. Design/methodology/approach This research posits a stakeholder preference mapping approach. Virtual Stakeholder Groups (VSG) were identified and stakeholder’s significance impacts were measured using the RIBA Plan of Work 2013 to determine in-depth consideration of each stakeholder’s power and interest against differing stages of a heritage project. Participants were convened through a 5-day workshop, consisting of twenty Malaysian and nineteen international participants (80% academics and 20% Malaysian civil servants). The Multi-Attribute Decision Analysis (MADA) technique was then used to demonstrate how stakeholder identification and analysis can be used to help heritage teams meet their mandates. Findings The research identified 8 virtual VSG (Extremist, Expert, Economic, Social, Governance and Tourists) and their scale of power-interest influence at different stages of the heritage management process. The findings reveal varying levels of engagement from each of the different groups of stakeholders at each work stage – with Stage 5 (Construction) being the least engaged. Originality/value It is anticipated that through stakeholder preference mapping, heritage teams can increase the robustness of their strategies by identifying and effectively managing the important concepts; heritage teams can effectively manage the interface between the many (often competing) demands of differing stakeholders. Using Georgetown as a case study, the research team were able to delineate the interaction and interplay between the various stakeholders in the complex decision-making processes for a UNESCO heritage site. Applying the RIBA 2013 Plan of Work as a framework to the heritage management process enables a formalised mapping approach to the process

Modifying patterns of movement in people with low back pain -does it help? A systematic review

Background: Physiotherapy for people with low back pain frequently includes assessment and modification of lumbo-pelvic movement. Interventions commonly aim to restore normal movement and thereby reduce pain and improve activity limitation. The objective of this systematic review was to investigate: (i) the effect of movement-based interventions on movement patterns (muscle activation, lumbo-pelvic kinematics or postural patterns) of people with low back pain (LBP), and (ii) the relationship between changes in movement patterns and subsequent changes in pain and activity limitation. Methods. MEDLINE, Cochrane Central, EMBASE, AMI, CINAHL, Scopus, AMED, ISI Web of Science were searched from inception until January 2012. Randomised controlled trials or controlled clinical trials of people with LBP were eligible for inclusion. The intervention must have been designed to influence (i) muscle activity patterns, (ii) lumbo-pelvic kinematic patterns or (iii) postural patterns, and included measurement of such deficits before and after treatment, to allow determination of the success of the intervention on the lumbo-pelvic movement. Twelve trials (25% of retrieved studies) met the inclusion criteria. Two reviewers independently identified, assessed and extracted data. The PEDro scale was used to assess method quality. Intervention effects were described using standardised differences between group means and 95% confidence intervals. Results: The included trials showed inconsistent, mostly small to moderate intervention effects on targeted movement patterns. There was considerable heterogeneity in trial design, intervention type and outcome measures. A relationship between changes to movement patterns and improvements in pain or activity limitation was observed in one of six studies on muscle activation patterns, one of four studies that examined the flexion relaxation response pattern and in two of three studies that assessed lumbo-pelvic kinematics or postural characteristics. Conclusions: Movement-based interventions were infrequently effec tive for changing observable movement patterns. A relationship between changes in movement patterns and improvement in pain or activity limitation was also infrequently observed. No independent studies confirm any observed relationships. Challenges for future research include defining best methods for measuring (i) movement aberrations, (ii) improvements in movements, and (iii) the relationship between changes in how people move and associated changes in other health indicators such as activity limitation

Sensory and motor deficits exist on the non-injured side of patients with unilateral tendon pain and disability - Implications for central nervous system involvement: A systematic review with meta-analysis

Introduction: Tendinopathy manifests as activityrelated tendon pain with associated motor and sensory impairments. Tendon tissue changes in animals present in injured as well as contralateral non-injured tendon. This review investigated evidence for bilateral sensory and motor system involvement in unilateral tendinopathy in humans.Methods: A comprehensive search of electronic databases, and reference lists using keywords relating to bilateral outcomes in unilateral tendinopathy was undertaken. Study quality was rated with the Epidemiological Appraisal Instrument and meta-analyses carried out where appropriate. Analysis focused on comparison of measures in the non-symptomatic side of patients against pain-free controls.Results: The search revealed 5791 studies, of which 20 were included (117 detailed reviews, 25 met criteria). There were 17 studies of lateral epicondylalgia (LE) and one each for patellar, Achilles and rotator cuff tendinopathy. Studies of LE were available for metaanalysis revealing the following weighted pooled mean deficits: pressure pain thresholds (-144.3 kPa; 95% CI -169.2 to -119.2 p>0.001), heat pain thresholds (-1.2°C; 95% CI -2.1 to -0.2, p>0.001), cold pain thresholds (3.1°C; 95% CI 1.8 to 4.4, p>0.001) and reaction time (37.8 ms; 95% CI 24.8 to 50.7, p>0.001).Discussion: Deficits in sensory and motor systems present bilaterally in unilateral tendinopathy. This implies potential central nervous system involvement. This indicates that rehabilitation should consider the contralateral side of patients. Research of unilateral tendinopathy needs to consider comparison against painfree controls in addition to the contralateral side to gain a complete understanding of sensory and motor features

Identifying SARS-CoV Membrane Protein Amino Acid Residues Linked to Virus-Like Particle Assembly

Severe acute respiratory syndrome coronavirus (SARS-CoV) membrane (M) proteins are capable of self-assembly and release in the form of membrane-enveloped vesicles, and of forming virus-like particles (VLPs) when coexpressed with SARS-CoV nucleocapsid (N) protein. According to previous deletion analyses, M self-assembly involves multiple M sequence regions. To identify important M amino acid residues for VLP assembly, we coexpressed N with multiple M mutants containing substitution mutations at the amino-terminal ectodomain, carboxyl-terminal endodomain, or transmembrane segments. Our results indicate that a dileucine motif in the endodomain tail (218LL219) is required for efficient N packaging into VLPs. Results from cross-linking VLP analyses suggest that the cysteine residues 63, 85 and 158 are not in close proximity to the M dimer interface. We noted a significant reduction in M secretion due to serine replacement for C158, but not for C63 or C85. Further analysis suggests that C158 is involved in M-N interaction. In addition to mutations of the highly conserved 107-SWWSFNPE-114 motif, substitutions at codons W19, W57, P58, W91, Y94 or F95 all resulted in significantly reduced VLP yields, largely due to defective M secretion. VLP production was not significantly affected by a tryptophan replacement of Y94 or F95 or a phenylalanine replacement of W19, W57 or W91. Combined, these results indicate the involvement of specific M amino acids during SARS-CoV virus assembly, and suggest that aromatic residue retention at specific positions is critical for M function in terms of directing virus assembly