Pathways from research to sustainable development: insights from ten research projects in sustainability and resilience

Drawing on collective experience from ten collaborative research projects focused on the Global South, we identify three major challenges that impede the translation of research on sustainability and resilience into better-informed choices by individuals and policy-makers that in turn can support transformation to a sustainable future. The three challenges comprise: (i) converting knowledge produced during research projects into successful knowledge application; (ii) scaling up knowledge in time when research projects are short-term and potential impacts are long-term; and (iii) scaling up knowledge across space, from local research sites to larger-scale or even global impact. Some potential pathways for funding agencies to overcome these challenges include providing targeted prolonged funding for dissemination and outreach, and facilitating collaboration and coordination across different sites, research teams, and partner organizations. By systematically documenting these challenges, we hope to pave the way for further innovations in the research cycle

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

The Satisfaction of Tourists on Community-based Tourism in My Hoa Hung, Vietnam

The research was conducted to assess the satisfaction of tourists with local community-based tourism services in the My Hoa Hung (MHH) commune in Long Xuyen, An Giang, Vietnam. The research findings will be the scientific and practical basis for effective and sustainable tourism development in MHH. A mixed-method of qualitative and quantitative is used in this study. Tourist local officers and tourist providers were interviewed as key informants. Such samples of domestic and foreign tourists were interviewed using a questionnaire survey to collect and analyze the tourists' satisfaction with tourism services. The result shows that tourists visiting MHH come from different regions and countries, from different age groups, and occupations, so their needs and satisfaction with MHH's community-based tourism services are also very diverse. The study uncovers that tourists are most satisfied with the human factor, especially the enthusiasm attitude of the tourist service provider (reaching 4.07 points), and then environmental landscape (3.90 points), infrastructure (3.90 points), price (3.80 points), and the lowest security- safety factor (3.73 points). However, in each factor, there are still a number of criteria that tourists are not satisfied with, which should be paid attention to for sustainable tourism development, such as environmental sanitation, traffic safety, and English communication ability of tourists' service providers

The Satisfaction of Tourists on Community-based Tourism in My Hoa Hung, Vietnam

The research was conducted to assess the satisfaction of tourists with local community-based tourism services in the My Hoa Hung (MHH) commune in Long Xuyen, An Giang, Vietnam. The research findings will be the scientific and practical basis for effective and sustainable tourism development in MHH. A mixed-method of qualitative and quantitative is used in this study. Tourist local officers and tourist providers were interviewed as key informants. Such samples of domestic and foreign tourists were interviewed using a questionnaire survey to collect and analyze the tourists' satisfaction with tourism services. The result shows that tourists visiting MHH come from different regions and countries, from different age groups, and occupations, so their needs and satisfaction with MHH's community-based tourism services are also very diverse. The study uncovers that tourists are most satisfied with the human factor, especially the enthusiasm attitude of the tourist service provider (reaching 4.07 points), and then environmental landscape (3.90 points), infrastructure (3.90 points), price (3.80 points), and the lowest security- safety factor (3.73 points). However, in each factor, there are still a number of criteria that tourists are not satisfied with, which should be paid attention to for sustainable tourism development, such as environmental sanitation, traffic safety, and English communication ability of tourists' service providers

Floods, soil and food – Interactions between water management and rice production within An Giang province, Vietnam

Rapid intensification of Vietnamese rice production has had a positive effect on the nation's food production and economy. However, the sustainability of intensive rice production is increasingly being questioned within Vietnam, particularly in major agricultural provinces such as An Giang. The construction of high dykes within this province, which allow for complete regulation of water onto rice fields, has enabled farmers to grow up to three rice crops per year. However, the profitability of producing three crops is rapidly decreasing as farmers increase their use of chemical fertilizer inputs and pesticides. Increased fertilizer inputs are partly used to replace natural flood-borne, nutrient-rich sediment inputs that have been inhibited by the dykes, but farmers believe that despite this, soil health within the dyke system is degrading. However, the effects of the dykes on soil properties have not been tested. Therefore, a sampling campaign was conducted to assess differences in soil properties caused by the construction of dykes. The results show that, under present fertilization practices, although dykes may inhibit flood-borne sediments, this does not lead to a systematic reduction in nutrients that typically limit rice growth within areas producing three crops per year. Concentrations of total nitrogen, available phosphorous, and both total and available potassium, and pH were higher in the surface layer of soils of three crop areas when compared to two crop areas. This suggests that yield declines may be caused by other factors related to the construction of dykes and the use of chemical inputs, and that care should be taken when attempting to maintain crop yields. Attempting to compensate for yield declines by increasing fertilizer inputs may ultimately have negative effects on yields

Pathways from research to sustainable development: Insights from ten research projects in sustainability and resilience.

Acknowledgements: The authors would like to thank the editorial team and anonymous referees. Stockholm University supports open access publishing by covering article-processing charges.Funder: Stockholm UniversityDrawing on collective experience from ten collaborative research projects focused on the Global South, we identify three major challenges that impede the translation of research on sustainability and resilience into better-informed choices by individuals and policy-makers that in turn can support transformation to a sustainable future. The three challenges comprise: (i) converting knowledge produced during research projects into successful knowledge application; (ii) scaling up knowledge in time when research projects are short-term and potential impacts are long-term; and (iii) scaling up knowledge across space, from local research sites to larger-scale or even global impact. Some potential pathways for funding agencies to overcome these challenges include providing targeted prolonged funding for dissemination and outreach, and facilitating collaboration and coordination across different sites, research teams, and partner organizations. By systematically documenting these challenges, we hope to pave the way for further innovations in the research cycle

Twelve-Month Outcomes of the AFFINITY Trial of Fluoxetine for Functional Recovery After Acute Stroke: AFFINITY Trial Steering Committee on Behalf of the AFFINITY Trial Collaboration

Background and Purpose: The AFFINITY trial (Assessment of Fluoxetine in Stroke Recovery) reported that oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and seizures. After trial medication was ceased at 6 months, survivors were followed to 12 months post-randomization. This preplanned secondary analysis aimed to determine any sustained or delayed effects of fluoxetine at 12 months post-randomization. Methods: AFFINITY was a randomized, parallel-group, double-blind, placebo-controlled trial in adults (n=1280) with a clinical diagnosis of stroke in the previous 2 to 15 days and persisting neurological deficit who were recruited at 43 hospital stroke units in Australia (n=29), New Zealand (4), and Vietnam (10) between 2013 and 2019. Participants were randomized to oral fluoxetine 20 mg once daily (n=642) or matching placebo (n=638) for 6 months and followed until 12 months after randomization. The primary outcome was function, measured by the modified Rankin Scale, at 6 months. Secondary outcomes for these analyses included measures of the modified Rankin Scale, mood, cognition, overall health status, fatigue, health-related quality of life, and safety at 12 months. Results: Adherence to trial medication was for a mean 167 (SD 48) days and similar between randomized groups. At 12 months, the distribution of modified Rankin Scale categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio, 0.93 [95% CI, 0.76–1.14]; P =0.46). Compared with placebo, patients allocated fluoxetine had fewer recurrent ischemic strokes (14 [2.18%] versus 29 [4.55%]; P =0.02), and no longer had significantly more falls (27 [4.21%] versus 15 [2.35%]; P =0.08), bone fractures (23 [3.58%] versus 11 [1.72%]; P =0.05), or seizures (11 [1.71%] versus 8 [1.25%]; P =0.64) at 12 months. Conclusions: Fluoxetine 20 mg daily for 6 months after acute stroke had no delayed or sustained effect on functional outcome, falls, bone fractures, or seizures at 12 months poststroke. The lower rate of recurrent ischemic stroke in the fluoxetine group is most likely a chance finding. REGISTRATION: URL: http://www.anzctr.org.au/ ; Unique identifier: ACTRN12611000774921