Foundational guiding principles for a flourishing Earth System

In this perspectives article, we maintain that the current local to global sustainable development predicaments we face are the result of humanity's impact on the Earth System (ES)—that is to say, on the very systemic fabric of the ES (i.e., its functioning and configuration), combined with an insufficiently coherent application of sustainable development policy to address and resolve this systemic problem. In response to what is an urgent crisis, we propose four foundational guiding principles, which we contend provide an overarching framing that, if implemented, would offer an approach to steer global sustainable development policy in a manner that would be to the benefit of the ES and the securing of a flourishing future for all. Our principles are applicable at the levels from a local business ecosystem, national-regional networks, to global policy

The varieties of vitality: A cross-cultural lexical analysis

Vitality has been underappreciated and underexplored by academia at large. This oversight is potentially explained by the Western-centric nature of most fields, with vitality having been comparatively neglected in the West relative to elsewhere. One explanation for this lacuna is that vitality is not easily pigeonholed within the ontological categories dominant in the West, such as mind and body. This paper therefore aims to learn from cultures that have cultivated a greater understanding of vitality, doing so by engaging with relevant ‘untranslatable’ words (i.e., those without exact equivalent in English), thus enriching our conceptual map of this topic. Over 200 relevant terms were located and analyzed using an adapted form of grounded theory. Three themes were identified, each with four subthemes: spirit (life force, channels, soul, and transcendence); energy (fortitude, channeling, willpower, and recharging); and heart (desire, passion, affection, and satisfaction). The paper thus refines our understanding of this important topic and provides a foundation for future research.

Targeted interventions for patellofemoral pain syndrome (TIPPS): classification of clinical subgroups

Introduction Patellofemoral pain (PFP) can cause significant pain leading to limitations in societal participation and physical activity. An international expert group has highlighted the need for a classification system to allow targeted intervention for patients with PFP; we have developed a work programme systematically investigating this. We have proposed six potential subgroups: hip abductor weakness, quadriceps weakness, patellar hypermobility, patellar hypomobility, pronated foot posture and lower limb biarticular muscle tightness. We could not uncover any evidence of the relative frequency with which patients with PFP fell into these subgroups or whether these subgroups were mutually exclusive. The aim of this study is to provide information on the clinical utility of our classification system. Methods and analysis 150 participants will be recruited over 18 months in four National Health Services (NHS) physiotherapy departments in England. Inclusion criteria: adults 18–40 years with PFP for longer than 3 months, PFP in at least two predesignated functional activities and PFP elicited by clinical examination. Exclusion criteria: prior or forthcoming lower limb surgery; comorbid illness or health condition; and lower limb training or pregnancy. We will record medical history, demographic details, pain, quality of life, psychomotor movement awareness and knee temperature. We will assess hip abductor and quadriceps weakness, patellar hypermobility and hypomobility, foot posture and lower limb biarticular muscle tightness. The primary analytic approach will be descriptive. We shall present numbers and percentages of participants who meet the criteria for membership of (1) each of the subgroups, (2) none of the subgroups and (3) multiple subgroups. Exact (binomial) 95% CIs for these percentages will also be presented. Ethics and dissemination This study has been approved by National Research Ethics Service (NRES) Committee North West—Greater Manchester North (11/NW/0814) and University of Central Lancashire (UCLan) Built, Sport, Health (BuSH) Ethics Committee (BuSH 025). An abstract has been accepted for the third International Patellofemoral Pain Research Retreat, Vancouver, September 2013

Are there three main subgroups within the patellofemoral pain population? A detailed characterisation study of 127 patients to help develop targeted Intervention (TIPPs)

• Background Current multimodal approaches for the management of non-specific patellofemoral pain are not optimal, however, targeted intervention for subgroups could improve patient outcomes. This study explores whether subgrouping of non-specific patellofemoral pain patients, using a series of low cost simple clinical tests, is possible. • Method The exclusivity and clinical importance of potential subgroups was assessed by applying à priori test thresholds (1 SD) from seven clinical tests in a sample of adult patients with non-specific patellofemoral pain. Hierarchical clustering and latent profile analysis, were used to gain additional insights into subgroups using data from the same clinical tests. • Results One hundred and thirty participants were recruited, 127 had complete data: 84 (66%) female, mean age 26 years (SD 5.7) and mean BMI 25.4 (SD 5.83), median (IQR) time between onset of pain and assessment was 24 (7-60) months. Potential subgroups defined by the à priori test thresholds were not mutually exclusive and patients frequently fell into multiple subgroups. Using hierarchical clustering and latent profile analysis three subgroups were identified using 6 of the 7 clinical tests. These subgroups were given the following nomenclature: (i) ‘strong’, (ii) ‘weak and tighter’, and (iii) ‘weak and pronated foot’. • Conclusions We conclude that three subgroups of patellofemoral patients may exist based on the results of six clinical tests which are feasible to perform in routine clinical practice. Further research is needed to validate these findings in other datasets and, if supported by external validation, to see if targeted interventions for these subgroups improve patient outcomes

Seasonal Influenza Vaccine Effectiveness in the community (SIVE): protocol for a cohort study exploiting a unique national linked data set

Introduction Seasonal influenza vaccination is recommended for all individuals aged 65 years and over and in individuals younger than 65 years with comorbidities. There is good evidence of vaccine effectiveness (VE) in young healthy individuals but less robust evidence for effectiveness in the populations targeted for influenza vaccination. Undertaking a randomised controlled trial to assess VE is now impractical due to the presence of national vaccination programmes. Quasi-experimental designs offer the potential to advance the evidence base in such scenarios, and the authors have therefore been commissioned to undertake a naturalistic national evaluation of seasonal influenza VE by using data derived from linkage of a number of Scottish health databases. The aim of this study is to examine the effectiveness of the seasonal influenza vaccination in the Scottish population. Methods and analysis A cohort study design will be used pooling data over nine seasons. A primary care database covering 4% of the Scottish population for the period 2000–2009 has been linked to the national database of hospital admissions and the death register and is being linked to the Health Protection Scotland virology database. The primary outcome is VE measured in terms of rate of hospital admissions due to respiratory illness. Multivariable regression will be used to produce estimates of VE adjusted for confounders. The major challenge of this approach is addressing the strong effect of confounding due to vaccinated individuals being systematically different from unvaccinated individuals. Analyses using propensity scores and instrumental variables will be undertaken, and the effect of an unknown confounder will be modelled in a sensitivity analysis to assess the robustness of the estimates

Louisville / Jefferson County Hazardous Material Commodity Flow Analysis

This report presents the results of a Hazardous Material Commodity Flow Analysis for the Louisville Metro area and Jefferson County. Study components were conducted by Western Kentucky University in partnership with Louisville / Jefferson County Emergency Management Agency. The study area was focused in Louisville and Jefferson County, Louisville Metro area, and included monitoring in Bullet County and Oldham County, as shown in Figure 1.1. As part of the study, hazardous material transport was monitored at the following sites: Interstate-64 (I-64), East and West bound lanes at The Belvedere; I-64, East and West bound lanes at Blankenbaker exit location; Interstate-65 (I-65, North and South bound lanes at the Jewish Hospital; I-65, North and South bound lanes at Brooks, KY exit location; Interstate-71 (I-71), North and South bound lanes at Oldham County rest areas; Hwy 841, North and South bound Lanes at Westport Road. The purpose of this report is to present information on patterns of hazardous material commodity flow along I-64, I-65, I-71 and Highway 841, as observed from June 11, 2012 to August 2, 2012. This report also summarizes incidents involving hazardous materials over the previous 3 years, August 2008 to June 2011, in the Louisville Metro area. Finally, this report assesses survey information collected from fixed facilities that ship and receive hazardous materials in the Louisville Metro Area

Beyond a single story: The heterogeneity of human flourishing in 22 countries

Contemporary cross-cultural research on flourishing and development has been limited by a focus on Western populations and typically Western priorities, and by attention to only a few indicators of flourishing, such as life satisfaction, life expectancy, or GDP per capita. This paper highlights some significant challenges for robust cross-national and cross-cultural research on the domains and drivers of flourishing. Using data from the recently proposed Global Comparison Framework and the Gallup World Poll, we explore the within- and between-country heterogeneity of flourishing and its determinants across the 22 countries which are the subject of the Global Flourishing Study. Sources of heterogeneity considered include potential tradeoffs among domains of flourishing; the effects of cultural differences on the conceptualization and actualization of flourishing; and the cultural specificity of core analytical concepts, including “life evaluation” and “nation.