Taking the High Road to Canalside: How Community Activism Has Shaped Buffalo’s Waterfront

This policy brief was drafted by Michelle Zhao, the 2017 Cornell High Road Fellow at Partnership for the Public Good. It documents the efforts of local advocates to bring “High Road” economic development to Canalside, to advance community benefits over corporate control. After setting out the historical context of Canalside and the fight that won its preservation, the brief focuses on the period of 2004 to 2015. It details the proposal to bring a Bass Pro Shop to the Inner Harbor, the leadership and governance of the Erie Canal Harbor Development Corporation (ECHDC), and the campaign for a Community Benefits Agreement for the waterfront. This campaign led to three years of negotiations with the ECHDC, leading to the formal adoption of a consensus document, “A Public Statement of Principles for High Road Development of Buffalo’s Waterfront,” to guide development practices in the future. The community activists who took the High Road to Canalside succeeded in changing the way that economic development is understood and practiced in Buffalo. The author extends her thanks to the organizers, advocates, and officials who shared their stories and insights for this brief

Our Vulnerable Teenagers: Their Victimization, Its Consequences, and Directions for Prevention and Intervention

Teenagers are twice as likely as any other age group to be victims of violent crime, and one in five teenagers report being the victim of a violent crime, according to a new report. The single greatest factor in predicting criminal behavior on the part of teenagers, the report also found, was not teenage pregnancy, drug use, or truancy, but whether they had been a victim of crime. This publication provides a new and comprehensive analysis of existing -- but largely unnoticed -- research and data on the crime experiences of American teenagers ages 12-19, who make up about 14 percent of the general population, but represent 25 percent of victims of violent crime

Lessons learned: structuring knowledge codification and abstraction to provide meaningful information for learning

Purpose – To increase the spread and reuse of lessons learned (LLs), the purpose of this paper is to develop a standardised information structure to facilitate concise capture of the critical elements needed to engage secondary learners and help them apply lessons to their contexts. Design/methodology/approach – Three workshops with industry practitioners, an analysis of over 60 actual lessons from private and public sector organisations and seven practitioner interviews provided evidence of actual practice. Design science was used to develop a repeatable/consistent information model of LL content/structure. Workshop analysis and theory provided the coding template. Situation theory and normative analysis were used to define the knowledge and rule logic to standardise fields. Findings – Comparing evidence from practice against theoretical prescriptions in the literature highlighted important enhancements to the standard LL model. These were a consistent/concise rule and context structure, appropriate emotional language, reuse and control criteria to ensure lessons were transferrable and reusable in new situations. Research limitations/implications – Findings are based on a limited sample. Long-term benefits of standardisation and use need further research. A larger sample/longitudinal usage study is planned. Practical implications – The implementation of the LL structure was well-received in one government user site and other industry user sites are pending. Practitioners validated the design logic for improving capture and reuse of lessons to render themeasily translatable to a new learner’s context. Originality/value – The new LL structure is uniquely grounded in user needs, developed from existing best practice and is an original application of normative and situation theory to provide consistent rule logic for context/content structure

Intravenous magnesium sulfate for treating adults with acute asthma in the emergency department.

BACKGROUND: Asthma is a chronic respiratory condition characterised by airways inflammation, constriction of airway smooth muscle and structural alteration of the airways that is at least partially reversible. Exacerbations of asthma can be life threatening and place a significant burden on healthcare services. Various guidelines have been published to inform management personnel in the acute setting; several include the use of a single bolus of intravenous magnesium sulfate (IV MgSO4) in cases that do not respond to first-line treatment. However, the effectiveness of this approach remains unclear, particularly in less severe cases. OBJECTIVES: To assess the safety and efficacy of IV MgSO4 in adults treated for acute asthma in the emergency department. SEARCH METHODS: We identified trials from the Cochrane Airways Review Group Specialised Register (CAGR) up to 2 May 2014. We also searched www.ClinicalTrials.gov and reference lists of other reviews, and we contacted trial authors to ask for additional information. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of adults treated in the emergency department (ED) for exacerbations of asthma if they compared any dose of IV MgSO4 with placebo. DATA COLLECTION AND ANALYSIS: All review authors screened titles and abstracts for inclusion, and at least two review authors independently extracted study characteristics, risk of bias and numerical data. Disagreements were resolved by consensus, and we contacted trial investigators to obtain missing information.We analysed dichotomous data as odds ratios using study participants as the unit of analysis, and we analysed continuous data as mean differences or standardised mean differences using fixed-effect models. We rated all outcomes using GRADE and presented results in Summary of findings table 1.We carried out subgroup analyses on the primary outcome for baseline severity of exacerbations and whether or not ipratropium bromide was given as a co-medication. Unpublished data and studies at high risk of bias for blinding were removed from the main analysis in sensitivity analyses. MAIN RESULTS: Fourteen studies met the inclusion criteria, randomly assigning 2313 people with acute asthma to the comparisons of interest in this review.Most studies were double-blinded trials comparing a single infusion of 1.2 g or 2 g IV MgSO4 over 15 to 30 minutes versus a matching placebo. Eleven were conducted at a single centre, and three were multi-centre trials. Participants in almost all of the studies had already been given at least oxygen, nebulised short-acting beta2-agonists and IV corticosteroids in the ED; in some studies, investigators also administered ipratropium bromide. Ten studies included only adults, and four included both adults and children; these were included because the mean age of participants was over 18 years.Intravenous MgSO4 reduced hospital admissions compared with placebo (odds ratio (OR) 0.75, 95% confidence interval (CI) 0.60 to 0.92; I(2) = 28%, P value 0.18; n = 972; high-quality evidence). In absolute terms, this odds ratio translates into a reduction of seven hospital admissions for every 100 adults treated with IV MgSO4 (95% CI two to 13 fewer). The test for subgroup differences revealed no statistical heterogeneity between the three severity subgroups (I(2) = 0%, P value 0.73) or between the four studies that administered nebulised ipratropium bromide as a co-medication and those that did not (I(2) = 0%, P value 0.82). Sensitivity analyses in which unpublished data and studies at high risk for blinding were removed from the primary analysis did not change conclusions.Within the secondary outcomes, high- and moderate-quality evidence across three spirometric indices suggests some improvement in lung function with IV MgSO4. No difference was found between IV MgSO4and placebo for most of the non-spirometric secondary outcomes, all of which were rated as low or moderate quality (intensive care admissions, ED treatment duration, length of hospital stay, readmission, respiration rate, systolic blood pressure).Adverse events were inconsistently reported and were not meta-analysed. The most commonly cited adverse events in the IV MgSO4 groups were flushing, fatigue, nausea and headache and hypotension (low blood pressure). AUTHORS' CONCLUSIONS: This review provides evidence that a single infusion of 1.2 g or 2 g IV MgSO4 over 15 to 30 minutes reduces hospital admissions and improves lung function in adults with acute asthma who have not responded sufficiently to oxygen, nebulised short-acting beta2-agonists and IV corticosteroids. Differences in the ways the trials were conducted made it difficult for the review authors to assess whether severity of the exacerbation or additional co-medications altered the treatment effect of IV MgSO4. Limited evidence was found for other measures of benefit and safety.Studies conducted in these populations should clearly define baseline severity parameters and systematically record adverse events. Studies recruiting participants with exacerbations of varying severity should consider subgrouping results on the basis of accepted severity classifications