Journal articles: 'American Academy of Natural Family Planning' – Grafiati (2025)

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Background: Knowledge concerning value of menstrual cycle observation and its use to monitor procreative health is underestimated and limited in women's health promotion, education and health care. Academy of Pediatrics, Committee on Adolescence and , American College of Obstetricians and Gynecologists recommends starting to observe the forming cycle as early as puberty in order to pre-screen girls , from groups at risk of fertility disorders such as polycystic ovary syndrome. In view of the numerous reports on the increase in fertility problems, such a simple tool as self-observation of the menstrual cycle becomes particularly useful to learn about the natural rhythm of fertility and in the case of abnormalities, i.e. deviation from the typical course shortens the time to the first medical consultation. In Poland there are several non-governmental non-profit organizations, which through certified teachers of fertility awareness methods can professionally support the teaching of adolescents, adults and interested people working in the health service in the field of fertility awareness, health education and natural family planning. Aim of the presented study was to analyze 105 menstrual cycle observation charts among polish women not using contraception according to the principles of the symptom-thermal double-check method. Method: The study was performed using the method of documentation analysis, 105 menstrual cycle observation charts using the statistical package SPSS Statistica version 25. The level of p < 0.05 was considered statistically significant. Results: The average age of the women studied was 29 years. The majority of the women , i.e. more than 58%, were unmarried and childless (79.1%). The average length of the menstrual cycle was: 28.6 days. The average duration of the luteal phase was almost 13 days. The average length of days of highly fertile mucus was nearly 4 days. The average length of cycles of women over 35 years of age was: 28.88 days, while for women under 35 years of age. 28.48 days. The age of onset of the first menstrual period of the women studied varied between 10 and 17 years of age. Conclusions: The studied group of women was homogeneous in terms of the adopted eligibility criteria, i.e. they had typical cycles and did not use contraceptive methods. The examined parameters of the menstrual cycle, i.e.: the average length of the cycle , the course of the luteal phase and the average length of the occurrence of highly fertile mucus met the criteria for a normal cycle according to the symptom-thermal double-check method.

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The need for strategic planning to ensure future leaders led to the development of the American Association of Family & Consumer Sciences (AAFCS) Leadership Academy. Leaders envisioned an approach to identify and strengthen future leaders from within the organization. Based on transformational and servant leadership precepts, the Academy includes a proven curriculum, mentorship, and projects at the affiliate and national levels to develop leadership skills of participants. The skills learned in the Academy are applicable in all family and consumer sciences (FCS) settings and beyond including, but not limited to, secondary and higher education, business, research, and Cooperative Extension. The development process of the AAFCS Leadership Academy serves as a best practice model for professional leadership development.

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This letter is in strong support of the principles outlined in the American Academy of Pediatrics (AAP) statement on parental leave for pediatric residents and pediatric training programs.1 While family illness, paternity, and other personal leave issues must be appropriately handled, maternity leave situations are by far the most common reason for schedule adjustments for our residency each year. Although these adjustments can take much effort (especially by the resident involved and the chiefs) to ensure fairness to all, they can be successful with careful planning of call schedules and rotation changes.

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The literature on China's social stratification and mobility has discussed the roles of family background and an individual's education attainment. This article aims to extend the existing literature by examining the interplay of these two aspects in fostering a homogeneous group of scientists, the members (yuanshi) of the Chinese Academy of Sciences (CAS, Zhongguo kexueyuan). Since its establishment in 1955, honorific CAS membership has been awarded to outstanding Chinese scientists in their respective fields. As of the end of 1997, a total of 859 Chinese natural scientists, including 40 women, had been elected to the five Academic Divisions of the CAS – Mathematics and Physics, Chemistry, Biological Sciences, Earth Sciences, and Technological Sciences (Table 1) – of whom 610 were alive. They have been renowned, nationally if not internationally, for their academic achievements and contributions, and they have a reputation and prestige similar to those enjoyed by their counterparts in other countries, such as members of the National Academy of Sciences in the United States and fellows of the Royal Society in Britain. Because the occupational prestige of scientists is very high in China, as it is in other countries, and following similar research on the scientific elite, it is reasonable to define CAS members as the Chinese scientific elite.

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Objective. To examine the frequency with which pediatricians provide care coordination services to children, particularly those with special health care needs, in their practices and the barriers to providing these services. Methods. An 8-page questionnaire was mailed to 1632 randomly selected US members of the American Academy of Pediatrics. Results. The response rate was 56.7%. Most pediatricians (71.2%) reported that they or someone in their practice serves as the primary care coordinator for their children with special needs, but fewer than one fourth (23.3%) always contact the school about the child’s health and educational needs as part of care coordination, only 18.7% always schedule time with the child’s family to discuss the findings of a specialist, and only 23.2% meet with the discharge planning team to facilitate transition from hospital to home. The respondents identified the 2 top barriers that impede this activity: limited time and lack of medical staff in their offices. Conclusions. Although most pediatricians believe that they are providing care coordination services, when asked about specific care coordination activities, such as contacting the school or scheduling time with the family to discuss the findings of a specialist, many do not provide these services.

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Abstract Children with advanced cancer, including those with hematologic malignancies, can benefit from interdisciplinary palliative care services. Palliative care includes management of distressing symptoms, attention to psychosocial and spiritual needs, and assistance with navigating complex medical decisions with the ultimate goal of maximizing the quality-of-life of the child and family. Palliative care is distinct from hospice care and can assist with the care of patients throughout the cancer continuum, irrespective of prognosis. While key healthcare organizations, including the Institute of Medicine, the American Academy of Pediatrics and the American Society of Clinical Oncology among many others endorse palliative care for children with advanced illness, barriers to integration of palliative care into cancer care still exist. Providing assistance with advance care planning, guiding patients and families through prognostic uncertainty, and managing transitions of care are also included in goals of palliative care involvement. For patients with advanced malignancy, legislation, included in the Patient Protection and Affordable Health Care Act allows patients and families more options as they make the difficult transition from disease directed therapy to care focused on comfort and quality-of-life.

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: Community stakeholders can be valuable allies to city officials engaged in downtown regeneration and community planning. This project highlights the force of engaging such allies in planning initiatives. It focuses on a long-neglected community that was once a thriving African American cultural and commercial hub. Organized as a city-university collaborative, the project brought together a cadre of community stakeholders: a planning studio professor and graduate students; a professional planner; architects; preservationists; and area residents, business owners and community leaders. Stakeholders held several meetings to evaluate the overall needs of the area, discuss options that would allow the concurrency of neighborhood revitalization, historic preservation and commercial economic interests while adhering to existing design guidelines. The group’s work culminated in a proposed land use plan that is sensitive to the needs of families, businesses and the city’s revitalization efforts. The plan calls for creating built spaces that complement the natural environment and encourages integrating green initiatives with regenerative efforts. It proposes creating active parks; cultural, arts and entertainment districts; and zoning that allows for single and multifamily housing. It transforms the district into one that is mixed-use, economically viable, family-oriented and preserves the area’s authentically historic and cultural assets.

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ObjectivesTo identify patient-reported paediatric advance care planning (pACP) needs of adolescents living with HIV and to examine the congruence with their family’s perception of their needs.MethodsA cross-sectional survey among six paediatric hospital-based outpatient HIV specialty clinics. Participants included 48 adolescent/family dyads (n=96 participants) within a larger study facilitating pACP. The main outcome measure was the Lyon Advance Care Planning Survey – Adolescent and Surrogate Versions-Revised.ResultsAdolescents’ mean age was 18 years (range ≥14–<21); 54% male; 92% African-American; 27% with prior AIDS diagnosis. If dying, 92% believed in completing an advance directive; 85% preferred to die at home;88% knowing how to say good bye; 71% being off machines that extend life and 77% dying a natural death. Best timing for end-of-life (EOL) decisions was while healthy (38%), when first diagnosed (17%), when first sick from a life-threatening illness (4%), when first hospitalised (8%), if dying (4%) and all of the above (19%). Prevalence-adjusted bias-adjusted Kappa (PABAK) measured congruence in pACP needs within adolescent/family dyads. There was substantial congruence in that being free from pain (PABAK=0.83), and understanding your treatment choices (PABAK=0.92) were very important or important. There was discordance about being off machines that extend life (PABAK=0.08) and when is the best time to bring up EOL decisions (PABAK=0.32).ConclusionsAreas of discordance were associated with life-sustaining choices and when to have the EOL conversation. Targeted, adolescent/family-centred, evidence-based pACP interventions are needed to improve family understanding of youth’s EOL wishes.Trial registration numberNCT01289444; Results.

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Abstract Background: The growing proportion of older adults in the U.S. population tends to be most vulnerable to the effects of natural disasters such as pandemics. To date, little has been done to counteract the impacts of public health emergencies and disasters on the aging populations, particularly in African American and Latinx communities. Methods: We administered a survey to community-dwelling minority older adults, 55+, in the Houston metroplex, between 11/2020 and 01/2021. The survey assessed how the COVID-19 pandemic has impacted minority older adults. This thematic analysis focused on open-ended questions regarding daily health management, biggest health concerns, and personal experiences with COVID-19. Results: A total of 575 older adults completed the survey. The mean age was 69 years, 74% were female, 71% reported English as their primary language and 27% were college educated. Three main themes of COVID-19 related concerns emerged from the thematic data analysis: 1) Fear of contracting COVID-19 from family members and fear of passing COVID-19 on to family members. 2) Social needs, including prolonged isolation from family/friends to stay safe, obtaining basic necessitates such as food, medications, and transportation . (3) Personal experiences focused on COVID-19 cases, hospitalizations, and deaths of family/community members. Conclusions: These older minority adults framed their experiences and concerns regarding the COVID-19 pandemic through the lens of family and their community. Their personal relationships permeated their responses and demonstrate the importance of integrating a family lens into future disaster planning, response and recovery efforts for minority older adults.

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Objective: “Pediatrics in Disasters” (PEDS) is a course designed by the American Academy of Pediatrics to provide disaster preparedness and response training to pediatricians worldwide. China has managed to sustain the course and adapt its content for local needs. China has also experienced several natural disasters since the course’s inception, providing an opportunity to evaluate the impact of courses that took place in Beijing and Sichuan, in 2008-2010.Methods: We used pretesting/post-testing, participant surveys, and in-depth interviews to evaluate whether the course imparted cognitive knowledge, was perceived as useful, and fostered participation in relief efforts and disaster preparedness planning.Results: In Beijing and Sichuan, post-test scores were 16 percent higher than pretest scores. On immediate postcourse surveys, 86 percent of Beijing and Sichuan respondents rated the course as very good or excellent. On 6-month surveys, participants identified emotional impact of disasters, planning/triage, and nutrition as the three most useful course modules. Twelve of 75 (16 percent) of Beijing respondents reported direct involvement in disaster response activities following the course; eight of 12 were first-time responders. Participant interviews revealed a need for more training in providing nutritional and psychological support to disaster victims and to train a more diverse group of individuals in disaster response.Conclusions: PEDS imparts cognitive knowledge and is highly valued by course participants. Emotional impact of disasters, planning/triage, and nutrition modules were perceived as the most relevant modules. Future versions of the course should include additional emphasis on emotional care for disaster victims and should be extended to a broader audience.

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ObjectiveTo update the 1995 American Academy of Neurology (AAN) practice parameter on persistent vegetative state and the 2002 case definition on minimally conscious state (MCS) and provide care recommendations for patients with prolonged disorders of consciousness (DoC).MethodsRecommendations were based on systematic review evidence, related evidence, care principles, and inferences using a modified Delphi consensus process according to the AAN 2011 process manual, as amended.RecommendationsClinicians should identify and treat confounding conditions, optimize arousal, and perform serial standardized assessments to improve diagnostic accuracy in adults and children with prolonged DoC (Level B). Clinicians should counsel families that for adults, MCS (vs vegetative state [VS]/unresponsive wakefulness syndrome [UWS]) and traumatic (vs nontraumatic) etiology are associated with more favorable outcomes (Level B). When prognosis is poor, long-term care must be discussed (Level A), acknowledging that prognosis is not universally poor (Level B). Structural MRI, SPECT, and the Coma Recovery Scale–Revised can assist prognostication in adults (Level B); no tests are shown to improve prognostic accuracy in children. Pain always should be assessed and treated (Level B) and evidence supporting treatment approaches discussed (Level B). Clinicians should prescribe amantadine (100–200 mg bid) for adults with traumatic VS/UWS or MCS (4–16 weeks post injury) to hasten functional recovery and reduce disability early in recovery (Level B). Family counseling concerning children should acknowledge that natural history of recovery, prognosis, and treatment are not established (Level B). Recent evidence indicates that the term chronic VS/UWS should replace permanent VS, with duration specified (Level B). Additional recommendations are included.

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This op-ed article is a metaphor, bemoaning life without the cruelty, brutality, and murder of minorities by police. It indicates the similarities in not needing milk nor police when it is intolerant to survival. Milk is an important nutrient, staple, and a source of calcium for the purpose of supplementing the health in children’s development and for adults in need of additional, calcium-rich foods. Milk is known to build bone development and density. Milk has a long history in the “western diet” (Dalsgaard, Bertram 2015) (standard American diet), as an important nutrient, representative as a valuable source for the human body. In validating food “intake biomarkers (a measurable substance in an organism whose presence is indicative of some phenomenon, such as disease, infection, or environmental exposure), milk becomes part of the human biofluid (a generic term for bio-organic fluid produced by an organism such as, serum, plasma, urine, saliva, and so on” (Dalsgaard, Bertram 2015). We are taught by our parents and advised by natal-conscious doctors, that children cannot grow or maintain a healthy life as babies, pre-k, young adults or grown-ups, if we don’t drink milk or have a diet of milk by-products. But in 1972, early research found; “Negroes” (Paige, Bayless, Graham 1972), Asians, American Indians, Hispanic, South Americans and Black Heritage (American Family Physician, 2006), had trouble digesting an enzyme that breaks down the natural sugar in milk and the same intestinal intolerance arrives in significant numbers when this same group of people within the greater population are in the presence of police.

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Background Bangladesh is a South Asian developing country trying to achieve the Sustainable Development Goals (SDG)-3 and the objective of the Rural Electrification Board (REB) regarding child mortality. Infectious diseases are leading causes of child mortality, and lack of exclusive breastfeeding (EBF) among infants aged 0–6 months increases child morbidity and mortality from various infectious diseases in developing countries. However, as per existing literature, no study has been conducted yet to determine the lack of EBF practice effect on child mortality in Bangladesh. With this backdrop, the authors intend to measure the likelihood of infectious diseases due to the lack of EBF of infants aged 0–6 months in Bangladesh. Materials and methods This study used Bangladesh Demographic and Health Survey (BDHS) data over 1996–97 to 2017–18. The mothers of infants aged 0–6 months who were willingly participated in the BDHSs were considered to include in our analysis. Initially, there were 9,133 cases in the combined dataset. After filtering, there were 5,724 cases in the final dataset. We have considered diarrhea (D), acute respiratory infection (ARI) separately as well as the presence of either D or ARI or both and named as CoDARI as outcome variables. This study used both graphical and statistical techniques (Chi-square test, Wald test, and logistic regression) to analyze the data. The odds ratio (OR) and 95% confidence interval (CI) were used to quantify the likelihood of infectious diseases due to lack of EBF practice and its elasticity, respectively. Results The EBF practice got a conspicuous increasing trend, but the prevalence of infectious diseases was declined from 0 to 3 months of age of infants, whereas an inverse scenario is observed between 4–6 months. The significance of that inverse relationship was confirmed by p-value corresponding to the chi-square test and the Wald test of the adjusted regression coefficients after adjusting the associated factor’s effect on infectious diseases. The adjusted ORs also concluded that the lack of EBF practice up to six months of age could enhance the risk of D, ARI, and CoDARI by 2.11 [95% CI: 1.56–2.85], 1.43 [95% CI: 1.28–1.60], and 1.48 [95% CI: 1.32–1.66] times higher, respectively. Conclusion Findings of this study emphasize the importance of EBF up to six months of age of infants against diarrhea and ARI specific morbidity and mortality. Our results also agreed to the recommendation of the World Health Organization (WHO), United Nations International Children’s Emergency Fund (UNICEF), American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), and National Nutrition Programme of Ethiopia (NNPE) that the EBF practice for the first six months of age could be a best, cost-effective, long-lasting natural preventive way to reduce the child morbidity and mortality due to infectious diseases in developing countries. Therefore, findings would help policymakers ensuring the achievement target of REB and SDG-3 associated with the health sector in Bangladesh.

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Levels of fertility among Indochinese refugees in the United States are explored in the context of a highly compressed demographic transition implicit in the move from high-fertility Southeast Asian societies to a low-fertility resettlement region. A theoretical model is developed to explain the effect on refugee fertility of social background characteristics, migration history and patterns of adaptation to a different economic and cultural environment controlling for marital history and length of residence in the U.S. Multiple regression techniques are used to test the model which was found to account for nearly half of the variation in refugee fertility levels in the United States. Fertility is much higher for all Indochinese ethnic groups than it is for American women; the number of children in refugee families is in turn a major determinant of welfare dependency. Adjustments for rates of natural increase indicate a total 1985 Indochinese population of over one million, making it one of the largest Asian-origin populations in the United States. This remarkable phenomenon has occurred in less than a decade. Implications of these findings for public policy are discussed, focusing on family planning, maternal and child health needs, and the attainment of refugee economic self-sufficiency.

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Purpose The following paper details a “Q&A interview” conducted by Joanne Pransky, Associate Editor of Industrial Robot Journal, to impart the combined technological, business and personal experience of a prominent, robotic industry engineer-turned successful business leader, regarding the commercialization and challenges of bringing technological inventions to the market while overseeing a company. The paper aims to discuss these issues. Design/methodology/approach The interviewee is Dr William “Red” Whittaker, Fredkin Research Professor of Robotics, Robotics Institute, Carnegie Mellon University (CMU); CEO of Astrobotic Technology; and President of Workhorse Technologies. Dr Whittaker provides answers to questions regarding the pioneering experiences of some of his technological wonders in land, sea, air, underwater, underground and space. Findings As a child, Dr Whittaker built things and made them work and dreamed about space and robots. He has since then turned his dreams, and those of the world, into realities. Dr Whittaker’s formal education includes a BS degree in civil engineering from Princeton and MS and PhD degrees in civil engineering from CMU. In response to designing a robot to cleanup radioactive material at the Three Mile Island nuclear plant, Dr Whittaker established the Field Robotics Center (FRC) in 1983. He is also the founder of the National Robotics Engineering Center, an operating unit within CMU’s Robotics Institute (RI), the world’s largest robotics research and development organization. Dr Whittaker has developed more than 60 robots, breaking new ground in autonomous vehicles, field robotics, space exploration, mining and agriculture. Dr Whittaker’s research addresses computer architectures for robots, modeling and planning for non-repetitive tasks, complex problems of objective sensing in random and dynamic environments and integration of complete robot systems. His current focus is Astrobotic Technology, a CMU spin-off firm that is developing space robotics technology to support planetary missions. Dr Whittaker is competing for the US$20m Google Lunar XPRIZE for privately landing a robot on the Moon. Originality/value Dr Whittaker coined the term “field robotics” to describe his research that centers on robots in unconstrained, uncontrived settings, typically outdoors and in the full range of operational and environmental conditions: robotics in the “natural” world. The Field Robotics Center has been one of the most successful initiatives within the entire robotics industry. As the Father of Field Robotics, Dr Whittaker has pioneered locomotion technologies, navigation and route-planning methods and advanced sensing systems. He has directed over US$100m worth of research programs and spearheaded several world-class robotic explorations and operations with significant outreach, education and technology commercializations. His ground vehicles have driven thousands of autonomous miles. Dr Whittaker won DARPA’s US$2m Urban Challenge. His Humvees finished second and third in the 2005 DARPA’s Grand race Challenge desert race. Other robot projects have included: Dante II, a walking robot that explored an active volcano; Nomad, which searched for meteorites in Antarctica; and Tugbot, which surveyed a 1,800-acre area of Nevada for buried hazards. Dr Whittaker is a member of the National Academy of Engineering. He is a fellow of the American Association for Artificial Intelligence and served on the National Academy of Sciences Space Studies Board. Dr Whittaker received the Alan Newell Medal for Research Excellence. He received Carnegie Mellon’s Teare Award for Teaching Excellence. He received the Joseph Engelberger Award for Outstanding Achievement in Robotics, the Advancement of Artificial Intelligence’s inaugural Feigenbaum Prize for his contributions to machine intelligence, the Institute of Electrical and Electronics Engineers Simon Ramo Medal, the American Society of Civil Engineers Columbia Medal, the Antarctic Service Medal and the American Spirit Honor Medal. Science Digest named Dr Whittaker one of the top 100 US innovators for his work in robotics. He has been recognized by Aviation Week & Space Technology and Design News magazines for outstanding achievement. Fortune named him a “Hero of US Manufacturing”. Dr Whittaker has advised 26 PhD students, has 16 patents and has authored over 200 publications. Dr Whittaker’s vision is to drive nanobiologics technology to fulfillment and create nanorobotic agents for enterprise on Earth and beyond (Figure 1).

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Abstract STUDY QUESTION Are any novel mutations and corresponding new phenotypes, other than recurrent hydatidiform moles, seen in patients with MEI1 mutations? SUMMARY ANSWER We identified several novel mutations in MEI1 causing new phenotypes of early embryonic arrest and recurrent implantation failure. WHAT IS KNOWN ALREADY It has been reported that biallelic mutations in MEI1, encoding meiotic double-stranded break formation protein 1, cause azoospermia in men and recurrent hydatidiform moles in women. STUDY DESIGN, SIZE, DURATION We first focused on a pedigree in which two sisters were diagnosed with recurrent hydatidiform moles in December 2018. After genetic analysis, two novel mutations in MEI1 were identified. We then expanded the mutational screening to patients with the phenotype of embryonic arrest, recurrent implantation failure, and recurrent pregnancy loss, and found another three novel MEI1 mutations in seven new patients from six families recruited from December 2018 to May 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS Nine primary infertility patients were recruited from the reproduction centers in local hospitals. Genomic DNA from the affected individuals, their family members, and healthy controls was extracted from peripheral blood. The MEI1 mutations were screened using whole-exome sequencing and were confirmed by the Sanger sequencing. In silico analysis of mutations was performed with Sorting Intolerant From Tolerant (SIFT) and Protein Variation Effect Analyzer (PROVEAN). The influence of the MEI1 mutations was determined by western blotting and minigene analysis in vitro. MAIN RESULTS AND THE ROLE OF CHANCE In this study, we identified five novel mutations in MEI1 in nine patients from seven independent families. Apart from recurrent hydatidiform moles, biallelic mutations in MEI1 were also associated with early embryonic arrest and recurrent implantation failure. In addition, we demonstrated that protein-truncating and missense mutations reduced the protein level of MEI1, while the splicing mutations caused abnormal alternative splicing of MEI1. LIMITATIONS, REASONS FOR CAUTION Owing to the lack of in vivo data from the oocytes of the patients, the exact molecular mechanism(s) involved in the phenotypes remains unknown and should be further investigated using knock-out or knock-in mice. WIDER IMPLICATIONS OF THE FINDINGS Our results not only reveal the important role of MEI1 in human oocyte meiosis and early embryonic development, but also extend the phenotypic and mutational spectrum of MEI1 and provide new diagnostic markers for genetic counseling of clinical patients. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the National Key Research and Development Program of China (2018YFC1003800, 2017YFC1001500, and 2016YFC1000600), the National Natural Science Foundation of China (81725006, 81822019, 81771581, 81971450, and 81971382), the project supported by the Shanghai Municipal Science and Technology Major Project (2017SHZDZX01), the Project of the Shanghai Municipal Science and Technology Commission (19JC1411001), the Natural Science Foundation of Shanghai (19ZR1444500), the Shuguang Program of the Shanghai Education Development Foundation and the Shanghai Municipal Education Commission (18SG03), the Shanghai Health and Family Planning Commission Foundation (20154Y0162), the Strategic Collaborative Research Program of the Ferring Institute of Reproductive Medicine, Ferring Pharmaceuticals and the Chinese Academy of Sciences (FIRMC200507) and the Chongqing Key Laboratory of Human Embryo Engineering (2020KFKT008). No competing interests are declared. TRIAL REGISTRATION NUMBER N/A.

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Fossil-bearing sites containing predominantly mastodon, Mammut americanum, remains were discovered west of the Mississippi River on the Osage River in Upper Louisiana only a few decades after the discovery by Longueuil of similar remains at Big Bone Lick in Kentucky. The first excavations were conducted in the 1790s by Pierre Chouteau, a fur trader and member of the founding family of St Louis. Chouteau's work was documented by several early travelers, including Georges-Henri-Victor Collot and later by Meriwether Lewis and William Clark, among others. It was from Chouteau's excavation that the first mastodon molar from west of the Mississippi River reached Baron Georges Cuvier in Paris, having been sent from Philadelphia by Benjamin Smith Barton. Early nineteenth-century travelers continued to mention the Osage River locality and, by 1816, William Clark displayed fossil specimens in his St Louis Museum. By 1840 the indefatigable fossil collector and museum entrepreneur, Albert C. Koch, began extensive digging in the Osage River basin along with sites in the Bourbeuse River valley and at Kimmswick along the Mississippi River in Missouri. Koch's extensive collection of mastodon bones enabled him to assemble a mounted specimen that he named the Missourium, an exaggerated and poorly reconstructed skeleton that was later identified and properly reassembled by Richard Owen at the British Museum. The specimen was later purchased by the trustees of that museum. The publicity surrounding Koch's work stimulated a veritable ‘bone rush’ to the Osage River in the years preceding the Civil War, with some of the fossils making their way into the collections of the American Philosophical Society and the Academy of Natural Sciences in Philadelphia. Following the Civil War, interest shifted to the Mississippi valley and the Kimmswick site just south of St Louis, where ongoing excavations became an attraction during the 1904 Louisiana Purchase Exposition in St Louis. C. W. Beehler, a St Louis resident, was responsible for the work, a venture that attracted scientists from the Smithsonian as well as other institutions. While none of the principals in the early exploration of fossil sites in Missouri had scientific training, the fact that their collections were passed on to scientific practitioners in Philadelphia, Washington, Paris, and London contributed to the expanding body of information that aided in the development of the field of vertebrate paleontology.

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Abstract STUDY QUESTION What is the clinical validity and utility of preconception Expanded Carrier Screening (ECS) application on the management of prospective parents? SUMMARY ANSWER The high detection rate of at-risk couples (ARCs) and the high proportion opting for IVF/preimplantation genetic testing (PGT) treatment demonstrate the clinical utility of ECS in the preconception space in IVF and general population. WHAT IS KNOWN ALREADY About 2–4% of couples are at risk of conceiving a child with an autosomal recessive or X-linked genetic disorder. In recent years, the increasing cost-effectiveness of genetic diagnostic techniques has allowed the creation of ECS panels for the simultaneous detection of multiple recessive disorders. Comprehensive preconception genetic screening holds the potential to significantly improve couple’s genetic risk assessment and reproductive planning to avoid detectable inheritable genetic offspring. STUDY DESIGN, SIZE, DURATION A total of 3877 individuals without a family history of genetic conditions were analyzed between January 2017 and January 2020. Of the enrolled individuals, 1212 were gamete donors and 2665 were patients planning on conceiving from both the IVF and the natural conception group. From the non-donor cohort, 1133 were analyzed as individual patients, while the remaining ones were analyzed as couples, for a total of 766 couples. PARTICIPANTS/MATERIALS, SETTING, METHODS A focused ECS panel was developed following American College of Obstetrics and Gynecology ACOG-recommended criteria (prevalence, carrier rate, severity), including highly penetrant severe childhood conditions. Couples were defined at-risk when both partners carried an autosomal recessive pathogenic/likely pathogenic variant (PLP) on the same gene or when the woman was a carrier of an X-linked PLP variant. ARC detection rate defined the clinical validity of the ECS approach. Clinical utility was evaluated by monitoring ARCs reproductive decision making. MAIN RESULTS AND THE ROLE OF CHANCE A total of 402 individuals (10.4%) showed PLP for at least one of the genes tested. Among the 766 couples tested, 173 showed one carrier partner (22.6%), whereas 20 couples (2.6%) were found to be at increased risk. Interestingly, one ARC was identified as a result of cascade testing in the extended family of an individual carrying a pathogenic variant on the Survival Of Motor Neuron 1SMN1 gene. Of the identified ARCs, 5 (0.7%) were at risk for cystic fibrosis, 5 (0.7%) for fragile X syndrome, 4 (0.5%) for spinal muscular atrophy, 4 (0.5%) for Beta-Thalassemia/Sickle Cell Anemia, 1 (0.1%) for Smith-Lemli-Opitz Syndrome and 1 (0.1%) for Duchenne/Becker Dystrophy. Fifteen ARCs were successfully followed up from both the IVF and the natural conception groups. All of these (15/15) modified their reproductive planning by undergoing ART with Preimplantation Genetic Testing for Monogenic disease and Aneuploidies (PGT-M and PGT-A). To date, 6/15 (40%) couples completed their PGT cycle with euploid/unaffected embryos achieving a pregnancy after embryo transfer and three of them have already had an unaffected baby. LIMITATIONS, REASONS FOR CAUTION The use of a limited panel of core gene-disease pairs represents a limitation on the research perspective as it can underestimate the rate of detectable carriers and ARCs in this cohort of prospective parents. Expanding the scope of ECS to a larger panel of conditions is becoming increasingly feasible, thanks to a persistent technological evolution and progressive cataloging of gene–disease associations. WIDER IMPLICATIONS OF THE FINDINGS These results highlight the potential clinical validity and utility of ECS in reducing the risk of a pregnancy affected by a detectable inheritable genetic condition. The steady reduction in the costs of genetic analyses enables the expansion of monogenic testing/screening applications at the preimplantation stage, thus, providing valid decisional support and reproductive autonomy to patients, particularly in the context of IVF. STUDY FUNDING/COMPETING INTEREST(S) No external funding was used for this study. A.C., M.F., S.C., M.P., L.G., and C.P. are employees of Igenomix Italy. C.S. is the head of the scientific board of Igenomix. TRIAL REGISTRATION NUMBER N/A.

Abstract:

In Ruang we address issues of form and urban space, leaving the economists to ponder the larger issues of democracy and equality in a rapidly fracturing social environment. This raises the problematic of urban form, its representations, symbolism and practices. The conservation of traditional values and norms imply the conservation of those environments that support them. Since conservation means retaining building form without its prior content, the actual fabric and processes of urban conservation are also thrown into the market place. Conservation on any scale also threatens the urban land market since large areas are then removed from trading (or is all history up for sale?) So do we proceed with adaptation, regulated change, conservation or sterilisation (preservation)? Today the identity of a place is not merely about localities, but is, in many occasions, more about image making to support the creation of a modern urban living environment. Over the last forty years, the use of iconic buildings to generate capital has become more and more frequent, from Sydney Opera House and the Pompidou Centre, to the new Guggenheim Bilbao. These are iconic structures whose prime function is not to give identity to neighbourhoods, but to source capital through tourism and to boost local industry. Here there is a crossover from high technology to local icons. For example Frank Gehry used technology from the American space program to design shapes and forms, as well as technology focussed on the properties of materials. But such buildings fall again into the arena of capital rather than community development. So what is happening on the other side of the coin? There is no doubt that social change is also accelerating in many countries and it is also clear that where we cannot hold capital accumulation and globalisation accountable for many adaptations from gender equality, new housing forms based on the disintegration of the nuclear family, the idea of a universal wage to counter automation, the generation of new communities that wish to live ‘off the grid’, and a phenomenon we might call ‘micro-communities of resistance’ to state neo-corporatism and the abuse of technology. At the level of design and urban form, the Charter of the New Urbanism, now sweeping Europe, and North America, with intrusions in Malaysia, China and other countries appears to have merit. Its agenda is community based planning and design, using a process of natural selection to generate urban density, with urban and architectural forms that reflect history and proven value in use. While the New Urbanism is theoretically weak, it sources two major thinkers namely Patrick Geddes and Ian McHarg, who were both concerned with the relationship between the natural environment and human habitation. Importantly, the New Urbanism deals with the tricky problem of transformation that links past formal languages with new uses. Something that we can all learn from.

Abstract:

Physical activity is very important for early childhood, especially outdoor activities that add a lot of new experiences. This study aims to check the relationship of children's outdoor activities and parenting styles and children's social skills. The participants are 125 parents of early childhood who attend kindergarten. The research method is a descriptive study using the relational screening model. The results showed that there was a relationship between outside play and parenting style on the social skills of children in their childhood. Democratic parenting styles are found to promote children's social skills, while authoritative parenting styles have a negative correlation with interpersonal skills, the ability to express verbally, self-control, listening skills, emotional management and adaptation to change. In the sub-dimensions of anger management and adaptation to changing skills is a significant difference between authoritative parenting styles and not permissive parenting with children's social skills. Keywords: Early Childhood Social skills, Outdoor Activities, Parenting Styles Reference: Azlina, W., & S., Z. A. (2012). A Pilot Study: The Impact of Outdoor Play Spaces on Kindergarten Children. Procedia - Social and Behavioral Sciences, 38(December 2010), 275–283. https://doi.org/10.1016/j.sbspro.2012.03.349 Bento, G., & Dias, G. (2017). The importance of outdoor play for young childrenʼs healthy development. Porto Biomedical Journal, 2(5), 157–160. https://doi.org/10.1016/j.pbj.2017.03.003 Beyer, K., Bizub, J., Szabo, A., Heller, B., Kistner, A., Shawgo, E., & Zetts, C. (2015). Development and validation of the attitudes toward outdoor play scales for children. Social Science and Medicine, 133, 253–260. https://doi.org/10.1016/j.socscimed.2014.10.033 Boxberger, K., & Reimers, A. K. (2019). Parental correlates of outdoor play in boys and girls aged 0 to 12—A systematic review. International Journal of Environmental Research and Public Health, 16(2). https://doi.org/10.3390/ijerph16020190 Coleman, W. L., & Lindsay, R. L. (1992). Interpersonal disabilities: Social skill deficits in older children and adolescents: Their description, assessment, and management. Pediatric Clinics of North America, 39(3), 551–567. https://doi.org/10.1016/S0031-3955(16)38344-4 Cui, M., Janhonen-Abruquah, H., Darling, C. A., Carlos Chavez, F. L., & Palojoki, P. (2019). Helicopter Parenting and Young Adults’ Well-Being: A Comparison Between United States and Finland. Cross-Cultural Research, 53(4), 410–427. https://doi.org/10.1177/1069397118802253 Fjørtoft, I., & Sageie, J. (2000). The natural environment as a playground for children. Landscape description and analyses of a natural playscape. Landscape and Urban Planning, 48(1–2), 83–97. https://doi.org/10.1016/S0169-2046(00)00045-1 Ghanbari-Azarneir, S., Anbari, S., Hosseini, S.-B., & Yazdanfar, S.-A. (2015). Identification of Child-friendly Environments in Poor Neighborhoods. Procedia - Social and Behavioral Sciences, 201(February), 19–29. https://doi.org/10.1016/j.sbspro.2015.08.114 Giedd, J. N. (2012). The Digital Revolution and Adolescent Brain Evolution. Journal of Adolescent Health, 51(2), 101–105. https://doi.org/10.1016/j.jadohealth.2012.06.002 Hinkley, T., Brown, H., Carson, V., & Teychenne, M. (2018). Cross sectional associations of screen time and outdoor play with social skills in preschool children. PLoS ONE, 13(4), 1–15. https://doi.org/10.1371 Johnson, J. E., & Christie, J. F. (2009). Play and digital media. Computers in the Schools, 26(4), 284–289. https://doi.org/10.1080/07380560903360202 Junot, A., Paquet, Y., & Martin-Krumm, C. (2017). Passion for outdoor activities and environmental behaviors: A look at emotions related to passionate activities. Journal of Environmental Psychology, 53, 177–184. https://doi.org/10.1016/j.jenvp.2017.07.011 Kemple, K. M., Oh, J. H., Kenney, E., & Smith-Bonahue, T. (2016). The Power of Outdoor Play and Play in Natural Environments. Childhood Education, 92(6), 446–454. https://doi.org/10.1080/00094056.2016.1251793 Kol, S. (2016). The Effects of the Parenting Styles on Social Skills of Children Aged 5-6. Malaysian Online Journal of Educational Sciences, 4(2), 49–58. Kozina, Z., Repko, O., Kozin, S., Kostyrko, A., Yermakova, T., & Goncharenko, V. (2016). Motor skills formation technique in 6 to 7-year-old children based on their psychological and physical features (Rock climbing as an example). Journal of Physical Education and Sport, 16(3), 866–874. https://doi.org/10.7752/jpes.2016.03137 Larson, L. R., Szczytko, R., Bowers, E. P., Stephens, L. E., Stevenson, K. T., & Floyd, M. F. (2019). Outdoor Time, Screen Time, and Connection to Nature: Troubling Trends Among Rural Youth? Environment and Behavior, 51(8), 966–991. https://doi.org/10.1177/0013916518806686 Lindsey, G., Maraj, M., & Kuan, S. C. (2001). Access, Equity, and Urban Greenways: An Exploratory Investigation. Professional Geographer, 53(3), 332–346. https://doi.org/10.1111/0033-0124.00288 Louv, R. (2008). Last child in the woods: Saving our children from nature-deficit disorder. Chapel Hill, NC: Algonquin Books. Maynard, T., & Waters, J. (2007). Learning in the outdoor environment: A missed opportunity? Early Years, 27(3), 255–265. https://doi.org/10.1080/09575140701594400 Moreland, A. D., & McRae-Clark, A. (2018). Parenting outcomes of parenting interventions in integrated substance-use treatment programs: A systematic review. Journal of Substance Abuse Treatment, 89(August 2017), 52–59. https://doi.org/10.1016/j.jsat.2018.03.005 Moriguchi, Y., Zelazo, P. D., & Chevalier, N. (2016). Development of Executive Function During Childhood. https://doi.org/10.3389/978-2-88919-800-9 Mullenbach, L. E., Andrejewski, R. G., & Mowen, A. J. (2019). Connecting children to nature through residential outdoor environmental education. Environmental Education Research, 25(3), 365–374. https://doi.org/10.1080/13504622.2018.1458215 Norðdahl, K., & Einarsdóttir, J. (2015). Children’s views and preferences regarding their outdoor environment. Journal of Adventure Education and Outdoor Learning, 15(2), 152–167. https://doi.org/10.1080/14729679.2014.896746 Pinquart, M. (2016). Associations of Parenting Styles and Dimensions with Academic Achievement in Children and Adolescents: A Meta-analysis. Educational Psychology Review, 28(3), 475–493. https://doi.org/10.1007/s10648-015-9338-y Riany, Y. E., Cuskelly, M., & Meredith, P. (2016). Cultural Beliefs about Autism in Indonesia. International Journal of Disability, Development and Education, 63(6), 623–640. https://doi.org/10.1080/1034912X.2016.1142069 Riany, Y. E., Meredith, P., & Cuskelly, M. (2017). Understanding the Influence of Traditional Cultural Values on Indonesian Parenting. Marriage and Family Review, 53(3), 207–226. https://doi.org/10.1080/01494929.2016.1157561 Saltali, N. D., & Arslan, E. (2012). Parent ’ s Attitudes as a Predictor of Preschoolers ’ Social Competence and Introverted Behavior. Elementary Education Online, 11(3), 729–737. Schoeppe, S., Vandelanotte, C., Bere, E., Lien, N., Verloigne, M., Kovács, É., … Van Lippevelde, W. (2017). The influence of parental modelling on children’s physical activity and screen time: Does it differ by gender? European Journal of Public Health, 27(1), 152–157. https://doi.org/10.1093/eurpub/ckw182 Shi, Y. (2017). Explore Children’s Outdoor Play Spaces of Community Areas in High-density Cities in China: Wuhan as an Example. Procedia Engineering, 198(September 2016), 654–682. https://doi.org/10.1016/j.proeng.2017.07.118 Strasburger, V. C., Jordan, A. B., & Donnerstein, E. (2012). Children, Adolescents, and the Media:. Health Effects. Pediatric Clinics of North America, 59(3), 533–587. https://doi.org/10.1016/j.pcl.2012.03.025 Victoria J. Rideout, Foehr, M. A. U. G., & Roberts, D. F. (2010). GENERATION M2 Media in the Lives of 8- to 18-Year-Olds. In Theresa Boston (Ed.), Henry J. Kaiser Family Foundation. Boston: Henry J. Kaiser Family Foundation. Wang, S. hua, Zhang, Y., & Baillargeon, R. (2016). Young infants view physically possible support events as unexpected: New evidence for rule learning. Cognition, 157, 100–105. https://doi.org/10.1016/j.cognition.2016.08.021 Waters, J., & Rekers, A. (2019). Young Children ’ s Outdoor Play-Based Learning. 1–7. Webster-Stratton, C., Reid, J., & Hammond, M. (2001). Social skills and problem-solving training for children with early-onset conduct problems: Who benefits? Journal of Child Psychology and Psychiatry and Allied Disciplines, 42(7), 943–952. Retrieved from http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed5&NEWS=N&AN=2001380196 Wilkie, H. J., Standage, M., Gillison, F. B., Cumming, S. P., & Katzmarzyk, P. T. (2018). The home electronic media environment and parental safety concerns: relationships with outdoor time after school and over the weekend among 9-11 year old children. BMC Public Health, 18(1), 456. https://doi.org/10.1186/s12889-018-5382-0 Zajenkowska, A., Jankowski, K. S., Lawrence, C., & Zajenkowski, M. (2013). Personality and individual differences in responses to aggression triggering events among prisoners and non-prisoners. Personality and Individual Differences, 55(8), 947–951. https://doi.org/10.1016/j.paid.2013.07.467

Abstract:

Objective This update of a 2011 guideline developed by the American Academy of Otolaryngology–Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Tonsillectomy is one of the most common surgical procedures in the United States, with 289,000 ambulatory procedures performed annually in children <15 years of age based on the most recent published data. This guideline is intended for all clinicians in any setting who interact with children who may be candidates for tonsillectomy. Purpose The purpose of this multidisciplinary guideline is to identify quality improvement opportunities in managing children under consideration for tonsillectomy and to create explicit and actionable recommendations to implement these opportunities in clinical practice. Specifically, the goals are to educate clinicians, patients, and/or caregivers regarding the indications for tonsillectomy and the natural history of recurrent throat infections. Additional goals include the following: optimizing the perioperative management of children undergoing tonsillectomy, emphasizing the need for evaluation and intervention in special populations, improving the counseling and education of families who are considering tonsillectomy for their children, highlighting the management options for patients with modifying factors, and reducing inappropriate or unnecessary variations in care. Children aged 1 to 18 years under consideration for tonsillectomy are the target patient for the guideline. For this guideline update, the American Academy of Otolaryngology–Head and Neck Surgery Foundation selected a panel representing the fields of nursing, anesthesiology, consumers, family medicine, infectious disease, otolaryngology–head and neck surgery, pediatrics, and sleep medicine. Key Action Statements The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should recommend watchful waiting for recurrent throat infection if there have been <7 episodes in the past year, <5 episodes per year in the past 2 years, or <3 episodes per year in the past 3 years. (2) Clinicians should administer a single intraoperative dose of intravenous dexamethasone to children undergoing tonsillectomy. (3) Clinicians should recommend ibuprofen, acetaminophen, or both for pain control after tonsillectomy. The guideline update group made recommendations for the following KASs: (1) Clinicians should assess the child with recurrent throat infection who does not meet criteria in KAS 2 for modifying factors that may nonetheless favor tonsillectomy, which may include but are not limited to multiple antibiotic allergies/intolerance, PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and adenitis), or history of >1 peritonsillar abscess. (2) Clinicians should ask caregivers of children with obstructive sleep-disordered breathing and tonsillar hypertrophy about comorbid conditions that may improve after tonsillectomy, including growth retardation, poor school performance, enuresis, asthma, and behavioral problems. (3) Before performing tonsillectomy, the clinician should refer children with obstructive sleep-disordered breathing for polysomnography if they are <2 years of age or if they exhibit any of the following: obesity, Down syndrome, craniofacial abnormalities, neuromuscular disorders, sickle cell disease, or mucopolysaccharidoses. (4) The clinician should advocate for polysomnography prior to tonsillectomy for obstructive sleep-disordered breathing in children without any of the comorbidities listed in KAS 5 for whom the need for tonsillectomy is uncertain or when there is discordance between the physical examination and the reported severity of oSDB. (5) Clinicians should recommend tonsillectomy for children with obstructive sleep apnea documented by overnight polysomnography. (6) Clinicians should counsel patients and caregivers and explain that obstructive sleep-disordered breathing may persist or recur after tonsillectomy and may require further management. (7) The clinician should counsel patients and caregivers regarding the importance of managing posttonsillectomy pain as part of the perioperative education process and should reinforce this counseling at the time of surgery with reminders about the need to anticipate, reassess, and adequately treat pain after surgery. (8) Clinicians should arrange for overnight, inpatient monitoring of children after tonsillectomy if they are <3 years old or have severe obstructive sleep apnea (apnea-hypopnea index ≥10 obstructive events/hour, oxygen saturation nadir <80%, or both). (9) Clinicians should follow up with patients and/or caregivers after tonsillectomy and document in the medical record the presence or absence of bleeding within 24 hours of surgery (primary bleeding) and bleeding occurring later than 24 hours after surgery (secondary bleeding). (10) Clinicians should determine their rate of primary and secondary posttonsillectomy bleeding at least annually. The guideline update group made a strong recommendation against 2 actions: (1) Clinicians should not administer or prescribe perioperative antibiotics to children undergoing tonsillectomy. (2) Clinicians must not administer or prescribe codeine, or any medication containing codeine, after tonsillectomy in children younger than 12 years. The policy level for the recommendation about documenting recurrent throat infection was an option: (1) Clinicians may recommend tonsillectomy for recurrent throat infection with a frequency of at least 7 episodes in the past year, at least 5 episodes per year for 2 years, or at least 3 episodes per year for 3 years with documentation in the medical record for each episode of sore throat and ≥1 of the following: temperature >38.3°C (101°F), cervical adenopathy, tonsillar exudate, or positive test for group A beta-hemolytic streptococcus. Differences from Prior Guideline (1) Incorporating new evidence profiles to include the role of patient preferences, confidence in the evidence, differences of opinion, quality improvement opportunities, and any exclusion to which the action statement does not apply. (2) There were 1 new clinical practice guideline, 26 new systematic reviews, and 13 new randomized controlled trials included in the current guideline update. (3) Inclusion of 2 consumer advocates on the guideline update group. (4) Changes to 5 KASs from the original guideline: KAS 1 (Watchful waiting for recurrent throat infection), KAS 3 (Tonsillectomy for recurrent infection with modifying factors), KAS 4 (Tonsillectomy for obstructive sleep-disordered breathing), KAS 9 (Perioperative pain counseling), and KAS 10 (Perioperative antibiotics). (5) Seven new KASs: KAS 5 (Indications for polysomnography), KAS 6 (Additional recommendations for polysomnography), KAS 7 (Tonsillectomy for obstructive sleep apnea), KAS 12 (Inpatient monitoring for children after tonsillectomy), KAS 13 (Postoperative ibuprofen and acetaminophen), KAS 14 (Postoperative codeine), and KAS 15a (Outcome assessment for bleeding). (6) Addition of an algorithm outlining KASs. (7) Enhanced emphasis on patient and/or caregiver education and shared decision making.

Abstract:

Objective This update of a 2011 guideline developed by the American Academy of Otolaryngology–Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Tonsillectomy is one of the most common surgical procedures in the United States, with 289,000 ambulatory procedures performed annually in children <15 years of age, based on the most recent published data. This guideline is intended for all clinicians in any setting who interact with children who may be candidates for tonsillectomy. Purpose The purpose of this multidisciplinary guideline is to identify quality improvement opportunities in managing children under consideration for tonsillectomy and to create explicit and actionable recommendations to implement these opportunities in clinical practice. Specifically, the goals are to educate clinicians, patients, and/or caregivers regarding the indications for tonsillectomy and the natural history of recurrent throat infections. Additional goals include the following: optimizing the perioperative management of children undergoing tonsillectomy, emphasizing the need for evaluation and intervention in special populations, improving the counseling and education of families who are considering tonsillectomy for their children, highlighting the management options for patients with modifying factors, and reducing inappropriate or unnecessary variations in care. Children aged 1 to 18 years under consideration for tonsillectomy are the target patient for the guideline. For this guideline update, the American Academy of Otolaryngology–Head and Neck Surgery Foundation selected a panel representing the fields of nursing, anesthesiology, consumers, family medicine, infectious disease, otolaryngology–head and neck surgery, pediatrics, and sleep medicine. Key Action Statements The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should recommend watchful waiting for recurrent throat infection if there have been <7 episodes in the past year, <5 episodes per year in the past 2 years, or <3 episodes per year in the past 3 years. (2) Clinicians should administer a single intraoperative dose of intravenous dexamethasone to children undergoing tonsillectomy. (3) Clinicians should recommend ibuprofen, acetaminophen, or both for pain control after tonsillectomy. The guideline update group made recommendations for the following KASs: (1) Clinicians should assess the child with recurrent throat infection who does not meet criteria in KAS 2 for modifying factors that may nonetheless favor tonsillectomy, which may include but are not limited to multiple antibiotic allergies/intolerance, PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and adenitis), or history of >1 peritonsillar abscess. (2) Clinicians should ask caregivers of children with obstructive sleep-disordered breathing and tonsillar hypertrophy about comorbid conditions that may improve after tonsillectomy, including growth retardation, poor school performance, enuresis, asthma, and behavioral problems. (3) Before performing tonsillectomy, the clinician should refer children with obstructive sleep-disordered breathing for polysomnography if they are <2 years of age or if they exhibit any of the following: obesity, Down syndrome, craniofacial abnormalities, neuromuscular disorders, sickle cell disease, or mucopolysaccharidoses. (4) The clinician should advocate for polysomnography prior to tonsillectomy for obstructive sleep-disordered breathing in children without any of the comorbidities listed in KAS 5 for whom the need for tonsillectomy is uncertain or when there is discordance between the physical examination and the reported severity of obstructive sleep-disordered breathing. (5) Clinicians should recommend tonsillectomy for children with obstructive sleep apnea documented by overnight polysomnography. (6) Clinicians should counsel patients and caregivers and explain that obstructive sleep-disordered breathing may persist or recur after tonsillectomy and may require further management. (7) The clinician should counsel patients and caregivers regarding the importance of managing posttonsillectomy pain as part of the perioperative education process and should reinforce this counseling at the time of surgery with reminders about the need to anticipate, reassess, and adequately treat pain after surgery. (8) Clinicians should arrange for overnight, inpatient monitoring of children after tonsillectomy if they are <3 years old or have severe obstructive sleep apnea (apnea-hypopnea index ≥10 obstructive events/hour, oxygen saturation nadir <80%, or both). (9) Clinicians should follow up with patients and/or caregivers after tonsillectomy and document in the medical record the presence or absence of bleeding within 24 hours of surgery (primary bleeding) and bleeding occurring later than 24 hours after surgery (secondary bleeding). (10) Clinicians should determine their rate of primary and secondary posttonsillectomy bleeding at least annually. The guideline update group made a strong recommendation against 2 actions: (1) Clinicians should not administer or prescribe perioperative antibiotics to children undergoing tonsillectomy. (2) Clinicians must not administer or prescribe codeine, or any medication containing codeine, after tonsillectomy in children younger than 12 years. The policy level for the recommendation about documenting recurrent throat infection was an option: (1) Clinicians may recommend tonsillectomy for recurrent throat infection with a frequency of at least 7 episodes in the past year, at least 5 episodes per year for 2 years, or at least 3 episodes per year for 3 years with documentation in the medical record for each episode of sore throat and ≥1 of the following: temperature >38.3°C (101°F), cervical adenopathy, tonsillar exudate, or positive test for group A beta-hemolytic streptococcus. Differences from Prior Guideline Incorporating new evidence profiles to include the role of patient preferences, confidence in the evidence, differences of opinion, quality improvement opportunities, and any exclusion to which the action statement does not apply. There were 1 new clinical practice guideline, 26 new systematic reviews, and 13 new randomized controlled trials included in the current guideline update. Inclusion of 2 consumer advocates on the guideline update group. Changes to 5 KASs from the original guideline: KAS 1 (Watchful waiting for recurrent throat infection), KAS 3 (Tonsillectomy for recurrent infection with modifying factors), KAS 4 (Tonsillectomy for obstructive sleep-disordered breathing), KAS 9 (Perioperative pain counseling), and KAS 10 (Perioperative antibiotics). Seven new KASs: KAS 5 (Indications for polysomnography), KAS 6 (Additional recommendations for polysomnography), KAS 7 (Tonsillectomy for obstructive sleep apnea), KAS 12 (Inpatient monitoring for children after tonsillectomy), KAS 13 (Postoperative ibuprofen and acetaminophen), KAS 14 (Postoperative codeine), and KAS 15a (Outcome assessment for bleeding). Addition of an algorithm outlining KASs. Enhanced emphasis on patient and/or caregiver education and shared decision making.

Abstract:

The paper shows the state of the art of identification, formation and development of the clusters in Colombia, collecting topics from the decentralization process in Colombia, the fiscal decentralization and the economic growth; a period of economic changes in the country begins from these two topics, the productive apparatus is prepared to compete with the most demanding markets of Europe, Asia and North America. For carrying out this, it was necessary to change the culture of production, it is not a matter of doing what the entrepreneur wants but to propose new goods and services to the global market, generating a brand value and differentiating them from international competitors; Colombia in the twentieth century opened its doors to foreign trade, and started working on the proposal of economic opening, it was necessary to work on the new Political Constitution of Colombia, from that time there is a change, a work of the National Planning Department, in conjunction with the National Council for Competitiveness, the work is based on proposing new productive bets, this as a strategy to face the competition that was seen coming to the country, with the risk of losing national entries in the market by national companies and on the contrary the international companies would arrive at the national market with new products, innovated and of low price, the national industry would not be able to produce and compete at the prices of the imported goods. One of the initiatives is to form associativity, by means of which productive processes could be improved, more advanced technology would be handled, joint research would be carried out, and work would be done to transfer knowledge, strengthen the productive chain and within the organizations would improve the value chain as a strategic tool, through which the company’s activities and sources of competitive advantage are analyzed; from this, the clusters are being worked on another proposal, which began to revolutionize Colombia’s economic change by moving from an economy based on extractive and mining activity to offering differentiated products with added value, quality was considered an integral part of the good and with a specialized human resource, in this way the regions have made a great social leap, since from this new chain the regions begin to strengthen their economy, to improve their human talent, to manage the supply chain, and above all to export non-mining energy products that in short only leave shortages of products from the family basket, depletes and impoverishes the productivity of their soils, contributing a negative GDP, because in the long time, the land where the mineral exploitation as oil and coal become sterile for that, although at one point they can represent an important sector for the economic activity of the country and reflects in its GDP an important percentage to the economy, this type of economic activity destroys the country’s competitiveness in the long term, so in the medium term can be seen as a lever for economic and social development. The clusters represent a new production alternative for the country as a strategy for local growth, for the Colombian economy in global scenarios means diversification in the exportable supply; for this, it is necessary to define strategies that enable productive transformation in the country, this will provide tools and sophisticated knowledge allowing the productive sector to obtain greater profitability and sustainability over time, to offer products, bines and high quality services [28]. The aim that the cluster network has been working for is the generation and exchange of knowledge among the different actors that are part of the productive alliance formation and cluster dynamization. This objective is evidenced by the success it has had in the Valle del Cauca with the cluster of sugarcane, medical excellence, macrosnacks, care and beauty, white protein, among others.It is for all the above that this work wants to show the importance of the diversification of goods and services of an economy from the synergetic and pooled work that the clusters provide, it is well known that the economies that diversify are those that can compete in the global market since its economic component is not only based on sometimes non-renewable natural resources such as hydrocarbons, but they work with the most important resource that an economy has its human talent, this resource is renewable and it is not exhausted, on the contrary it is transformed, updated, qualified, transferred and it is a know-how for international trade, this term can be understood as preexisting knowledge not always academic, which includes techniques, secret information that is known and handled efficiently and with experience, which has become a valuable intangible asset, this includes the most appropriate way to mix components, equipment used, this personnel that knows how to perform the tasks; all this is mixed in a cluster.

Abstract:

Children's school readiness is important to discuss because learning loss is an obstacle in preparing early childhood to enter elementary school. This study aims to look at parents' perceptions of their children's readiness for school during and after the COVID-19 pandemic. This study uses a quantitative descriptive survey research design to collect measurable data for statistical analysis from a population sample. The results show that preparing children for school during and after the COVID-19 pandemic is very different from the usual practice. Parents are required to provide appropriate stimulation to children at home to replace the role of teachers at school and restore the motivation and willingness of children to enter elementary school. The perception of parents is certainly very influential on the stimulation that will be given to children. Keywords: early childhood education, parents’ perceptions, school readiness References: Alexander, K. L., Entwisle, D. R., & Olson, L. S. (2007). Lasting Consequences of the Summer Learning Gap. American Sociological Review, 72(2), 167–180. https://doi.org/10.1177/000312240707200202 Araújo, L. A. de, Veloso, C. F., Souza, M. de C., Azevedo, J. M. C. de, & Tarro, G. (2021). The potential impact of the COVID-19 pandemic on child growth and development: A systematic review. Jornal de Pediatria, 97(4), 369–377. https://doi.org/10.1016/j.jped.2020.08.008 Atkinsonová, R. L., Atkinson, R. C., SMITH, E. E., Herman, E., Bem, D. J., & Petržela, M. (1995). Psychologies. Victoria Publishing. https://books.google.co.id/books?id=Tj9OAAAACAAJ Bao, X., Qu, H., Zhang, R., & Hogan, T. P. (2020). Modeling Reading Ability Gain in Kindergarten Children during COVID-19 School Closures. International Journal of Environmental Research and Public Health, 17(17). https://doi.org/10.3390/ijerph17176371 Benner, A. D., & Mistry, R. S. (2020). Child Development During the COVID-19 Pandemic Through a Life Course Theory Lens. Child Development Perspectives, 14(4), 236–243. https://doi.org/10.1111/cdep.12387 Brown, S. M., Doom, J. R., Lechuga-Peña, S., Watamura, S. E., & Koppels, T. (2020). Stress and parenting during the global COVID-19 pandemic. Child Abuse & Neglect, 110, 104699. https://doi.org/10.1016/j.chiabu.2020.104699 Colizzi, M., Sironi, E., Antonini, F., Ciceri, M. L., Bovo, C., & Zoccante, L. (2020). Psychosocial and Behavioral Impact of COVID-19 in autism spectrum disorder: An Online Parent Survey. Brain Sciences, 10(6). https://doi.org/10.3390/brainsci10060341 Creswell, J. W. (2015). Educational research: Planning, conducting, and evaluating quantitative and qualitative research (Fifth edition). Pearson. Cushon, J. A., Vu, L. T. H., Janzen, B. L., & Muhajarine, N. (2011). Neighborhood Poverty Impacts Children’s Physical Health and Well-Being Over Time: Evidence from the Early Development Instrument. Early Education and Development, 22(2), 183–205. https://doi.org/10.1080/10409280902915861 Duncan, R. J., Duncan, G. J., Stanley, L., Aguilar, E., & Halfon, N. (2020). The kindergarten Early Development Instrument predicts third grade academic proficiency. Early Childhood Research Quarterly, 53, 287–300. https://doi.org/10.1016/j.ecresq.2020.05.009 Engzell, P., Frey, A., & Verhagen, M. D. (2021). Learning loss due to school closures during the COVID-19 pandemic. Proceedings of the National Academy of Sciences, 118(17), e2022376118. https://doi.org/10.1073/pnas.2022376118 Friedman, M. M., Bowden, V. R., & Jones, E. (2003). Family Nursing: Research, Theory & Practice. Prentice Hall. https://books.google.co.id/books?id=mkBtAAAAMAAJ Gobbi, E., Maltagliati, S., Sarrazin, P., di Fronso, S., Colangelo, A., Cheval, B., Escriva-Boulley, G., Tessier, D., Demirhan, G., Erturan, G., Yüksel, Y., Papaioannou, A., Bertollo, M., & Carraro, A. (2020). Promoting Physical Activity during School Closures Imposed by the First Wave of the COVID-19 Pandemic: Physical Education Teachers’ Behaviors in France, Italy and Turkey. International Journal of Environmental Research and Public Health, 17(24). https://doi.org/10.3390/ijerph17249431 Griffith, A. K. (2020). Parental Burnout and Child Maltreatment During the COVID-19 Pandemic. Journal of Family Violence. https://doi.org/10.1007/s10896-020-00172-2 Hevia, F. J., Vergara-Lope, S., Velásquez-Durán, A., & Calderón, D. (2022). Estimation of the fundamental learning loss and learning poverty related to COVID-19 pandemic in Mexico. International Journal of Educational Development, 88, 102515. https://doi.org/10.1016/j.ijedudev.2021.102515 Jandrić, P. (2020). Postdigital Research in the Time of Covid-19. Postdigital Science and Education, 2(2), 233–238. https://doi.org/10.1007/s42438-020-00113-8 Kuhfeld, M., Tarasawa, B., Johnson, A., Ruzek, E., & Lewis, K. (2020). Initial findings on students’ reading and math achievement and growth. 12. Maldonado, J. E., & De Witte, K. (2022). The effect of school closures on standardised student test outcomes. British Educational Research Journal, 48(1), 49–94. https://doi.org/10.1002/berj.3754 McDowell, K., Jack, A., & Compton, M. (2018). Parent Involvement in Pre-Kindergarten and the Effects on Student Achievement. The Advocate, 23(6). https://doi.org/10.4148/2637-4552.1004 Nevid, J. S. (2012). Psychology: Concepts and Applications. Wadsworth Cengage Learning. https://books.google.co.id/books?id=TpxZXwAACAAJ Skulmowski, A., & Rey, G. D. (2020). COVID-19 as an accelerator for digitalization at a German university: Establishing hybrid campuses in times of crisis. Human Behavior and Emerging Technologies, 2(3), 212–216. https://doi.org/10.1002/hbe2.201 Spinelli, M., Lionetti, F., Pastore, M., & Fasolo, M. (2020). Parents’ Stress and Children’s Psychological Problems in Families Facing the COVID-19 Outbreak in Italy. Frontiers in Psychology, 11, 1713. https://doi.org/10.3389/fpsyg.2020.01713 Yoshikawa, H., Wuermli, A. J., Britto, P. R., Dreyer, B., Leckman, J. F., Lye, S. J., Ponguta, L. A., Richter, L. M., & Stein, A. (2020). Effects of the Global Coronavirus Disease-2019 Pandemic on Early Childhood Development: Short- and Long-Term Risks and Mitigating Program and Policy Actions. The Journal of Pediatrics, 223, 188–193. https://doi.org/10.1016/j.jpeds.2020.05.020

Abstract:

Objective Insertion of tympanostomy tubes is the most common ambulatory surgery performed on children in the United States. Tympanostomy tubes are most often inserted because of persistent middle ear fluid, frequent ear infections, or ear infections that persist after antibiotic therapy. All these conditions are encompassed by the term otitis media (middle ear inflammation). This guideline update provides evidence-based recommendations for patient selection and surgical indications for managing tympanostomy tubes in children. The guideline is intended for any clinician involved in managing children aged 6 months to 12 years with tympanostomy tubes or children being considered for tympanostomy tubes in any care setting as an intervention for otitis media of any type. The target audience includes specialists, primary care clinicians, and allied health professionals. Purpose The purpose of this clinical practice guideline update is to reassess and update recommendations in the prior guideline from 2013 and to provide clinicians with trustworthy, evidence-based recommendations on patient selection and surgical indications for managing tympanostomy tubes in children. In planning the content of the updated guideline, the guideline update group (GUG) affirmed and included all the original key action statements (KASs), based on external review and GUG assessment of the original recommendations. The guideline update was supplemented with new research evidence and expanded profiles that addressed quality improvement and implementation issues. The group also discussed and prioritized the need for new recommendations based on gaps in the initial guideline or new evidence that would warrant and support KASs. The GUG further sought to bring greater coherence to the guideline recommendations by displaying relationships in a new flowchart to facilitate clinical decision making. Last, knowledge gaps were identified to guide future research. Methods In developing this update, the methods outlined in the American Academy of Otolaryngology–Head and Neck Surgery Foundation’s “Clinical Practice Guideline Development Manual, Third Edition: A Quality-Driven Approach for Translating Evidence Into Action” were followed explicitly. The GUG was convened with representation from the disciplines of otolaryngology–head and neck surgery, otology, pediatrics, audiology, anesthesiology, family medicine, advanced practice nursing, speech-language pathology, and consumer advocacy. Action Statements The GUG made strong recommendations for the following KASs: (14) clinicians should prescribe topical antibiotic ear drops only, without oral antibiotics, for children with uncomplicated acute tympanostomy tube otorrhea; (16) the surgeon or designee should examine the ears of a child within 3 months of tympanostomy tube insertion AND should educate families regarding the need for routine, periodic follow-up to examine the ears until the tubes extrude. The GUG made recommendations for the following KASs: (1) clinicians should not perform tympanostomy tube insertion in children with a single episode of otitis media with effusion (OME) of less than 3 months’ duration, from the date of onset (if known) or from the date of diagnosis (if onset is unknown); (2) clinicians should obtain a hearing evaluation if OME persists for 3 months or longer OR prior to surgery when a child becomes a candidate for tympanostomy tube insertion; (3) clinicians should offer bilateral tympanostomy tube insertion to children with bilateral OME for 3 months or longer AND documented hearing difficulties; (5) clinicians should reevaluate, at 3- to 6-month intervals, children with chronic OME who do not receive tympanostomy tubes, until the effusion is no longer present, significant hearing loss is detected, or structural abnormalities of the tympanic membrane or middle ear are suspected; (6) clinicians should not perform tympanostomy tube insertion in children with recurrent acute otitis media who do not have middle ear effusion in either ear at the time of assessment for tube candidacy; (7) clinicians should offer bilateral tympanostomy tube insertion in children with recurrent acute otitis media who have unilateral or bilateral middle ear effusion at the time of assessment for tube candidacy; (8) clinicians should determine if a child with recurrent acute otitis media or with OME of any duration is at increased risk for speech, language, or learning problems from otitis media because of baseline sensory, physical, cognitive, or behavioral factors; (10) the clinician should not place long-term tubes as initial surgery for children who meet criteria for tube insertion unless there is a specific reason based on an anticipated need for prolonged middle ear ventilation beyond that of a short-term tube; (12) in the perioperative period, clinicians should educate caregivers of children with tympanostomy tubes regarding the expected duration of tube function, recommended follow-up schedule, and detection of complications; (13) clinicians should not routinely prescribe postoperative antibiotic ear drops after tympanostomy tube placement; (15) clinicians should not encourage routine, prophylactic water precautions (use of earplugs or headbands, avoidance of swimming or water sports) for children with tympanostomy tubes. The GUG offered the following KASs as options: (4) clinicians may perform tympanostomy tube insertion in children with unilateral or bilateral OME for 3 months or longer (chronic OME) AND symptoms that are likely attributable, all or in part, to OME that include, but are not limited to, balance (vestibular) problems, poor school performance, behavioral problems, ear discomfort, or reduced quality of life; (9) clinicians may perform tympanostomy tube insertion in at-risk children with unilateral or bilateral OME that is likely to persist as reflected by a type B (flat) tympanogram or a documented effusion for 3 months or longer; (11) clinicians may perform adenoidectomy as an adjunct to tympanostomy tube insertion for children with symptoms directly related to the adenoids (adenoid infection or nasal obstruction) OR in children aged 4 years or older to potentially reduce future incidence of recurrent otitis media or the need for repeat tube insertion.

Abstract:

In recent years, STEAM (Science, Technology, Engineering, Art, and Mathematics) has received wide attention. STEAM complements early childhood learning needs in honing 2nd century skills. This study aims to introduce a loose section in early childhood learning to pre-service teachers and then to explore their perceptions of how to use loose parts in supporting STEAM. The study design uses qualitative phenomenological methods. FGDs (Focus Group Discussions) are used as data collection instruments. The findings point to two main themes that emerged from the discussion: a loose section that supports freedom of creation and problem solving. Freedom clearly supports science, mathematics and arts education while problem solving significantly supports engineering and technology education. Keywords: Early Childhood Educators, Loose-part, STEAM References: Allen, A. (2016). Don’t Fear STEM: You Already Teach It! Exchange, (231), 56–59. Ansberry, B. K., & Morgan, E. (2019). Seven Myths of STEM. 56(6), 64–67. Bagiati, A., & Evangelou, D. (2015). Engineering curriculum in the preschool classroom: the teacher’s experience. European Early Childhood Education Research Journal, 23(1), 112–128. https://doi.org/10.1080/1350293X.2014.991099 Becker, K., & Park, K. (2011). Effects of integrative approaches among science , technology , engineering , and mathematics ( STEM ) subjects on students ’ learning : A preliminary meta-analysis. 12(5), 23–38. Berk, L. E. (2009). Child Development (8th ed.). Boston: Pearson Education. Can, B., Yildiz-Demirtas, V., & Altun, E. (2017). The Effect of Project-based Science Education Programme on Scientific Process Skills and Conception of Kindergargen Students. 16(3), 395–413. Casey, T., Robertson, J., Abel, J., Cairns, M., Caldwell, L., Campbell, K., … Robertson, T. (2016). Loose Parts Play. Edinburgh. Cheung, R. H. P. (2017). Teacher-directed versus child-centred : the challenge of promoting creativity in Chinese preschool classrooms. Pedagogy, Culture & Society, 1366(January), 1–14. https://doi.org/10.1080/14681366.2016.1217253 Clements, D. H., & Sarama, J. (2016). Math, Science, and Technology in the Early Grades. The Future of Children, 26(2), 75–94. Cloward Drown, K. (2014). Dramatic lay affordances of natural and manufactured outdoor settings for preschoolaged children. Dejarnette, N. K. (2018). Early Childhood Steam: Reflections From a Year of Steam Initiatives Implemented in a High-Needs Primary School. Education, 139(2), 96–112. DiGironimo, N. (2011). What is technology? Investigating student conceptions about the nature of technology. International Journal of Science Education, 33(10), 1337–1352. https://doi.org/10.1080/09500693.2010.495400 Dugger, W. E., & Naik, N. (2001). Clarifying Misconceptions between Technology Education and Educational Technology. The Technology Teacher, 61(1), 31–35. Eeuwijk, P. Van, & Zuzana, A. (2017). How to Conduct a Focus Group Discussion ( FGD ) Methodological Manual. Flannigan, C., & Dietze, B. (2018). Children, Outdoor Play, and Loose Parts. Journal of Childhood Studies, 42(4), 53–60. https://doi.org/10.18357/jcs.v42i4.18103 Fleer, M. (1998). The Preparation of Australian Teachers in Technology Education : Developing The Preparation of Australian Teachers in Technology Education : Developing Professionals Not Technicians. Asia-Pacific Journal of Teacher Education & Development, 1(2), 25–31. Freitas, H., Oliveira, M., Jenkins, M., & Popjoy, O. (1998). The focus group, a qualitative research method: Reviewing the theory, and providing guidelines to its planning. In ISRC, Merrick School of Business, University of Baltimore (MD, EUA)(Vol. 1). Gomes, J., & Fleer, M. (2019). The Development of a Scientific Motive : How Preschool Science and Home Play Reciprocally Contribute to Science Learning. Research in Science Education, 49(2), 613–634. https://doi.org/10.1007/s11165-017-9631-5 Goris, T., & Dyrenfurth, M. (n.d.). Students ’ Misconceptions in Science , Technology , and Engineering . Gull, C., Bogunovich, J., Goldstein, S. L., & Rosengarten, T. (2019). Definitions of Loose Parts in Early Childhood Outdoor Classrooms: A Scoping Review. The International Journal of Early Childhood Environmental Education, 6(3), 37. Hui, A. N. N., He, M. W. J., & Ye, S. S. (2015). Arts education and creativity enhancement in young children in Hong Kong. Educational Psychology, 35(3), 315–327. https://doi.org/10.1080/01443410.2013.875518 Jarvis, T., & Rennie, L. J. (1996). Perceptions about Technology Held by Primary Teachers in England. Research in Science & Technological Education, 14(1), 43–54. https://doi.org/10.1080/0263514960140104 Jeffers, O. (2004). How to Catch a Star. New York: Philomel Books. Kiewra, C., & Veselack, E. (2016). Playing with nature: Supporting preschoolers’ creativity in natural outdoor classrooms. International Journal of Early Childhood Environmental Education, 4(1), 70–95. Kuh, L., Ponte, I., & Chau, C. (2013). The impact of a natural playscape installation on young children’s play behaviors. Children, Youth and Environments, 23(2), 49–77. Lachapelle, C. P., Cunningham, C. M., & Oh, Y. (2019). What is technology? Development and evaluation of a simple instrument for measuring children’s conceptions of technology. International Journal of Science Education, 41(2), 188–209. https://doi.org/10.1080/09500693.2018.1545101 Liamputtong. (2010). Focus Group Methodology : Introduction and History. In Focus Group MethodoloGy (pp. 1–14). Liao, C. (2016). From Interdisciplinary to Transdisciplinary: An Arts-Integrated Approach to STEAM Education. 69(6), 44–49. https://doi.org/10.1080/00043125.2016.1224873 Lindeman, K. W., & Anderson, E. M. (2015). Using Blocks to Develop 21st Century Skills. Young Children, 70(1), 36–43. Maxwell, L., Mitchell, M., and Evans, G. (2008). Effects of play equipment and loose parts on preschool children’s outdoor play behavior: An observational study and design intervention. Children, Youth and Environments, 18(2), 36–63. McClure, E., Guernsey, L., Clements, D., Bales, S., Nichols, J., Kendall-Taylor, N., & Levine, M. (2017). How to Integrate STEM Into Early Childhood Education. Science and Children, 055(02), 8–11. https://doi.org/10.2505/4/sc17_055_02_8 McClure, M., Tarr, P., Thompson, C. M., & Eckhoff, A. (2017). Defining quality in visual art education for young children: Building on the position statement of the early childhood art educators. Arts Education Policy Review, 118(3), 154–163. https://doi.org/10.1080/10632913.2016.1245167 Mishra, L. (2016). Focus Group Discussion in Qualitative Research. TechnoLearn: An International Journal of Educational Technology, 6(1), 1. https://doi.org/10.5958/2249-5223.2016.00001.2 Monhardt, L., & Monhardt, R. (2006). Creating a context for the learning of science process skills through picture books. Early Childhood Education Journal, 34(1), 67–71. https://doi.org/10.1007/s10643-006-0108-9 Monsalvatge, L., Long, K., & DiBello, L. (2013). Turning our world of learning inside out! Dimensions of Early Childhood, 41(3), 23–30. Moomaw, S. (2012). STEM begins in the early years. School Science & Mathematics, 112(2), 57–58. Moomaw, S. (2016). Move Back the Clock, Educators: STEM Begins at Birth. School Science & Mathematics, 116(5), 237–238. Moomaw, S., & Davis, J. A. (2010). STEM Comes to Preschool. Young Cihildren, 12–18(September), 12–18. Munawar, M., Roshayanti, F., & Sugiyanti. (2019). Implementation of STEAM (Science, Technology, Engineering, Art, Mathematics)-Based Early Childhood Education Learning in Semarang City. Jurnal CERIA, 2(5), 276–285. National Research Council. (1996). National Science Education Standards. Washington, DC: National Academy of Sciences. Nicholson, S. (1972). The Theory of Loose Parts: An important principle for design methodology. Studies in Design Education Craft & Technology, 4(2), 5–12. O.Nyumba, T., Wilson, K., Derrick, C. J., & Mukherjee, N. (2018). The use of focus group discussion methodology: Insights from two decades of application in conservation. Methods in Ecology and Evolution, 9(1), 20–32. https://doi.org/10.1111/2041-210X.12860 Padilla-Diaz, M. (2015). Phenomenology in Educational Qualitative Research : Philosophy as Science or Philosophical Science ? International Journal of Educational Excellence, 1(2), 101–110. Padilla, M. J. (1990). The Science Process Skills. Research Matters - to the Science Teacher, 1(March), 1–3. Park, D. Y., Park, M. H., & Bates, A. B. (2018). Exploring Young Children’s Understanding About the Concept of Volume Through Engineering Design in a STEM Activity: A Case Study. International Journal of Science and Mathematics Education, 16(2), 275–294. https://doi.org/10.1007/s10763-016-9776-0 Rahardjo, M. M. (2019). Implementasi Pendekatan Saintifik Sebagai Pembentuk Keterampilan Proses Sains Anak Usia Dini. Scholaria: Jurnal Pendidikan Dan Kebudayaan, 9(2), 148–159. https://doi.org/10.24246/j.js.2019.v9.i2.p148-159 Robison, T. (2016). Male Elementary General Music Teachers : A Phenomenological Study. Journal of Music Teacher Education, 26(2), 77–89. https://doi.org/10.1177/1057083715622019 Rocha Fernandes, G. W., Rodrigues, A. M., & Ferreira, C. A. (2018). Conceptions of the Nature of Science and Technology: a Study with Children and Youths in a Non-Formal Science and Technology Education Setting. Research in Science Education, 48(5), 1071–1106. https://doi.org/10.1007/s11165-016-9599-6 Sawyer, R. K. (2006). Educating for innovation. 1(2006), 41–48. https://doi.org/10.1016/j.tsc.2005.08.001 Sharapan, H. (2012). ERIC - From STEM to STEAM: How Early Childhood Educators Can Apply Fred Rogers’ Approach, Young Children, 2012-Jan. Young Children, 67(1), 36–40. Siantayani, Y. (2018). STEAM: Science-Technology-Engineering-Art-Mathematics. Semarang: SINAU Teachers Development Center. Sikder, S., & Fleer, M. (2015). Small Science : Infants and Toddlers Experiencing Science in Everyday Family Life. Research in Science Education, 45(3), 445–464. https://doi.org/10.1007/s11165-014-9431-0 Smith-gilman, S. (2018). The Arts, Loose Parts and Conversations. Journal of the Canadian Association for Curriculum Studies, 16(1), 90–103. Sohn, B. K., Thomas, S. P., Greenberg, K. H., & Pollio, H. R. (2017). Hearing the Voices of Students and Teachers : A Phenomenological Approach to Educational Research. Qualitative Research in Education, 6(2), 121–148. https://doi.org/10.17583/qre.2017.2374 Strong-wilson, T., & Ellis, J. (2002). Children and Place : Reggio Emilia’s Environment as Third Teacher. Theory into Practice, 46(1), 40–47. Sutton, M. J. (2011). In the hand and mind: The intersection of loose parts and imagination in evocative settings for young children. Children, Youth and Environments, 21(2), 408–424. Tippett, C. D., & Milford, T. M. (2017). Findings from a Pre-kindergarten Classroom: Making the Case for STEM in Early Childhood Education. International Journal of Science and Mathematics Education, 15, 67–86. https://doi.org/10.1007/s10763-017-9812-8 Tippett, C., & Milford, T. (2017). STEM Resources and Materials for Engaging Learning Experiences. International Journal of Science & Mathematics Education, 15(March), 67–86. https://doi.org/10.1007/s10763-017-9812-8 Veselack, E., Miller, D., & Cain-Chang, L. (2015). Raindrops on noses and toes in the dirt: infants and toddlers in the outdoor classroom. Dimensions Educational Research Foundation. Yuksel-Arslan, P., Yildirim, S., & Robin, B. R. (2016). A phenomenological study : teachers ’ experiences of using digital storytelling in early childhood education. Educational Studies, 42(5), 427–445. https://doi.org/10.1080/03055698.2016.1195717

Abstract:

Objective Sudden hearing loss is a frightening symptom that often prompts an urgent or emergent visit to a health care provider. It is frequently, but not universally, accompanied by tinnitus and/or vertigo. Sudden sensorineural hearing loss affects 5 to 27 per 100,000 people annually, with about 66,000 new cases per year in the United States. This guideline update provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with sudden hearing loss. It focuses on sudden sensorineural hearing loss in adult patients aged 18 and over and primarily on those with idiopathic sudden sensorineural hearing loss. Prompt recognition and management of sudden sensorineural hearing loss may improve hearing recovery and patient quality of life. The guideline update is intended for all clinicians who diagnose or manage adult patients who present with sudden hearing loss. Purpose The purpose of this guideline update is to provide clinicians with evidence-based recommendations in evaluating patients with sudden hearing loss and sudden sensorineural hearing loss, with particular emphasis on managing idiopathic sudden sensorineural hearing loss. The guideline update group recognized that patients enter the health care system with sudden hearing loss as a nonspecific primary complaint. Therefore, the initial recommendations of this guideline update address distinguishing sensorineural hearing loss from conductive hearing loss at the time of presentation with hearing loss. They also clarify the need to identify rare, nonidiopathic sudden sensorineural hearing loss to help separate those patients from those with idiopathic sudden sensorineural hearing loss, who are the target population for the therapeutic interventions that make up the bulk of the guideline update. By focusing on opportunities for quality improvement, this guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients. Methods Consistent with the American Academy of Otolaryngology–Head and Neck Surgery Foundation’s Clinical Practice Guideline Development Manual, Third Edition, the guideline update group was convened with representation from the disciplines of otolaryngology–head and neck surgery, otology, neurotology, family medicine, audiology, emergency medicine, neurology, radiology, advanced practice nursing, and consumer advocacy. A systematic review of the literature was performed, and the prior clinical practice guideline on sudden hearing loss was reviewed in detail. Key action statements (KASs) were updated with new literature, and evidence profiles were brought up to the current standard. Research needs identified in the original clinical practice guideline and data addressing them were reviewed. Current research needs were identified and delineated. Results The guideline update group made strong recommendations for the following: clinicians should distinguish sensorineural hearing loss from conductive hearing loss when a patient first presents with sudden hearing loss (KAS 1); clinicians should educate patients with sudden sensorineural hearing loss about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy (KAS 7); and clinicians should counsel patients with sudden sensorineural hearing loss who have residual hearing loss and/or tinnitus about the possible benefits of audiological rehabilitation and other supportive measures (KAS 13). These strong recommendations were modified from the initial clinical practice guideline for clarity and timing of intervention. The guideline update group made strong recommendation against the following: clinicians should not order routine computed tomography of the head in the initial evaluation of a patient with presumptive sudden sensorineural hearing loss (KAS 3); clinicians should not obtain routine laboratory tests in patients with sudden sensorineural hearing loss (KAS 5); and clinicians should not routinely prescribe antivirals, thrombolytics, vasodilators, or vasoactive substances to patients with sudden sensorineural hearing loss (KAS 11). The guideline update group made recommendations for the following: clinicians should assess patients with presumptive sudden sensorineural hearing loss through history and physical examination for bilateral sudden hearing loss, recurrent episodes of sudden hearing loss, and/or focal neurologic findings (KAS 2); in patients with sudden hearing loss, clinicians should obtain, or refer to a clinician who can obtain, audiometry as soon as possible (within 14 days of symptom onset) to confirm the diagnosis of sudden sensorineural hearing loss (KAS 4); clinicians should evaluate patients with sudden sensorineural hearing loss for retrocochlear pathology by obtaining a magnetic resonance imaging or auditory brainstem response (KAS 6); clinicians should offer, or refer to a clinician who can offer, intratympanic steroid therapy when patients have incomplete recovery from sudden sensorineural hearing loss 2 to 6 weeks after onset of symptoms (KAS 10); and clinicians should obtain follow-up audiometric evaluation for patients with sudden sensorineural hearing loss at the conclusion of treatment and within 6 months of completion of treatment (KAS 12). These recommendations were clarified in terms of timing of intervention and audiometry, as well as method of retrocochlear workup. The guideline update group offered the following KASs as options: clinicians may offer corticosteroids as initial therapy to patients with sudden sensorineural hearing loss within 2 weeks of symptom onset (KAS 8); clinicians may offer, or refer to a clinician who can offer, hyperbaric oxygen therapy combined with steroid therapy within 2 weeks of onset of sudden sensorineural hearing loss (KAS 9a); and clinicians may offer, or refer to a clinician who can offer, hyperbaric oxygen therapy combined with steroid therapy as salvage therapy within 1 month of onset of sudden sensorineural hearing loss (KAS 9b). Differences from Prior Guideline Incorporation of new evidence profiles to include quality improvement opportunities, confidence in the evidence, and differences of opinion Included 10 clinical practice guidelines, 29 new systematic reviews, and 36 new randomized controlled trials Highlights the urgency of evaluation and initiation of treatment, if treatment is offered, by emphasizing the time from symptom occurrence Clarification of terminology by changing potentially unclear statements; use of the term sudden sensorineural hearing loss to mean idiopathic sudden sensorineural hearing loss to emphasize that over 90% of sudden sensorineural hearing loss is idiopathic sudden sensorineural hearing loss and to avoid confusion in nomenclature for the reader Changes to the key action statements (KASs) from the original guideline: KAS 1: When a patient first presents with sudden hearing loss, conductive hearing loss should be distinguished from sensorineural. KAS 2: The utility of history and physical examination when assessing for modifying factors is emphasized. KAS 3: The word routine is added to clarify that this statement addresses a nontargeted head computed tomography scan that is often ordered in the emergency room setting for patients presenting with sudden hearing loss. It does not refer to targeted scans such as a temporal bone computed tomography scan to assess for temporal bone pathology. KAS 4: The importance of audiometric confirmation of hearing status as soon as possible and within 14 days of symptom onset is emphasized. KAS 5: New studies were added to confirm the lack of benefit of nontargeted laboratory testing in sudden sensorineural hearing loss. KAS 6: Audiometric follow-up is excluded as a reasonable workup for retrocochlear pathology. Magnetic resonance imaging, computed tomography scan if magnetic resonance imaging cannot be done, or, secondarily, auditory brainstem response evaluation are the modalities recommended. A time frame for such testing is not specified, nor is it specified which clinician should be ordering this workup; however, it is implied that it would be the general or subspecialty otolaryngologist. KAS 7: The importance of shared decision making is highlighted, and salient points are emphasized. KAS 8: The option for corticosteroid intervention within 2 weeks of symptom onset is emphasized. KAS 9: Changed to KAS 9a and 9b; hyperbaric oxygen therapy remains an option but only when combined with steroid therapy for either initial treatment (9a) or for salvage therapy (9b). The timing is within 2 weeks of onset for initial therapy and within 1 month of onset of sudden sensorineural hearing loss for salvage therapy. KAS 10: Intratympanic steroid therapy for salvage is recommended within 2 to 6 weeks following onset of sudden sensorineural hearing loss. The time to treatment is defined and emphasized. KAS 11: Antioxidants were removed from the list of interventions that the clinical practice guideline recommends against using. KAS 12: Follow-up audiometry at conclusion of treatment and also within 6 months posttreatment is added. KAS 13: This statement on audiologic rehabilitation includes patients who have residual hearing loss and/or tinnitus who may benefit from treatment. Addition of an algorithm outlining KASs Enhanced emphasis on patient education and shared decision making with tools provided to assist in the same

Abstract:

Objective Sudden hearing loss is a frightening symptom that often prompts an urgent or emergent visit to a health care provider. It is frequently but not universally accompanied by tinnitus and/or vertigo. Sudden sensorineural hearing loss affects 5 to 27 per 100,000 people annually, with about 66,000 new cases per year in the United States. This guideline update provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with sudden hearing loss. It focuses on sudden sensorineural hearing loss in adult patients aged ≥18 years and primarily on those with idiopathic sudden sensorineural hearing loss. Prompt recognition and management of sudden sensorineural hearing loss may improve hearing recovery and patient quality of life. The guideline update is intended for all clinicians who diagnose or manage adult patients who present with sudden hearing loss. Purpose The purpose of this guideline update is to provide clinicians with evidence-based recommendations in evaluating patients with sudden hearing loss and sudden sensorineural hearing loss, with particular emphasis on managing idiopathic sudden sensorineural hearing loss. The guideline update group recognized that patients enter the health care system with sudden hearing loss as a nonspecific primary complaint. Therefore, the initial recommendations of this guideline update address distinguishing sensorineural hearing loss from conductive hearing loss at the time of presentation with hearing loss. They also clarify the need to identify rare, nonidiopathic sudden sensorineural hearing loss to help separate those patients from those with idiopathic sudden sensorineural hearing loss, who are the target population for the therapeutic interventions that make up the bulk of the guideline update. By focusing on opportunities for quality improvement, this guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients. Methods Consistent with the American Academy of Otolaryngology–Head and Neck Surgery Foundation’s “Clinical Practice Guideline Development Manual, Third Edition” (Rosenfeld et al. Otolaryngol Head Neck Surg. 2013;148[1]:S1-S55), the guideline update group was convened with representation from the disciplines of otolaryngology–head and neck surgery, otology, neurotology, family medicine, audiology, emergency medicine, neurology, radiology, advanced practice nursing, and consumer advocacy. A systematic review of the literature was performed, and the prior clinical practice guideline on sudden hearing loss was reviewed in detail. Key Action Statements (KASs) were updated with new literature, and evidence profiles were brought up to the current standard. Research needs identified in the original clinical practice guideline and data addressing them were reviewed. Current research needs were identified and delineated. Results The guideline update group made strong recommendations for the following: (KAS 1) Clinicians should distinguish sensorineural hearing loss from conductive hearing loss when a patient first presents with sudden hearing loss. (KAS 7) Clinicians should educate patients with sudden sensorineural hearing loss about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy. (KAS 13) Clinicians should counsel patients with sudden sensorineural hearing loss who have residual hearing loss and/or tinnitus about the possible benefits of audiologic rehabilitation and other supportive measures. These strong recommendations were modified from the initial clinical practice guideline for clarity and timing of intervention. The guideline update group made strong recommendations against the following: (KAS 3) Clinicians should not order routine computed tomography of the head in the initial evaluation of a patient with presumptive sudden sensorineural hearing loss. (KAS 5) Clinicians should not obtain routine laboratory tests in patients with sudden sensorineural hearing loss. (KAS 11) Clinicians should not routinely prescribe antivirals, thrombolytics, vasodilators, or vasoactive substances to patients with sudden sensorineural hearing loss. The guideline update group made recommendations for the following: (KAS 2) Clinicians should assess patients with presumptive sudden sensorineural hearing loss through history and physical examination for bilateral sudden hearing loss, recurrent episodes of sudden hearing loss, and/or focal neurologic findings. (KAS 4) In patients with sudden hearing loss, clinicians should obtain, or refer to a clinician who can obtain, audiometry as soon as possible (within 14 days of symptom onset) to confirm the diagnosis of sudden sensorineural hearing loss. (KAS 6) Clinicians should evaluate patients with sudden sensorineural hearing loss for retrocochlear pathology by obtaining magnetic resonance imaging or auditory brainstem response. (KAS 10) Clinicians should offer, or refer to a clinician who can offer, intratympanic steroid therapy when patients have incomplete recovery from sudden sensorineural hearing loss 2 to 6 weeks after onset of symptoms. (KAS 12) Clinicians should obtain follow-up audiometric evaluation for patients with sudden sensorineural hearing loss at the conclusion of treatment and within 6 months of completion of treatment. These recommendations were clarified in terms of timing of intervention and audiometry and method of retrocochlear workup. The guideline update group offered the following KASs as options: (KAS 8) Clinicians may offer corticosteroids as initial therapy to patients with sudden sensorineural hearing loss within 2 weeks of symptom onset. (KAS 9a) Clinicians may offer, or refer to a clinician who can offer, hyperbaric oxygen therapy combined with steroid therapy within 2 weeks of onset of sudden sensorineural hearing loss. (KAS 9b) Clinicians may offer, or refer to a clinician who can offer, hyperbaric oxygen therapy combined with steroid therapy as salvage therapy within 1 month of onset of sudden sensorineural hearing loss. Differences from Prior Guideline Incorporation of new evidence profiles to include quality improvement opportunities, confidence in the evidence, and differences of opinion Included 10 clinical practice guidelines, 29 new systematic reviews, and 36 new randomized controlled trials Highlights the urgency of evaluation and initiation of treatment, if treatment is offered, by emphasizing the time from symptom occurrence Clarification of terminology by changing potentially unclear statements; use of the term sudden sensorineural hearing loss to mean idiopathic sudden sensorineural hearing loss to emphasize that >90% of sudden sensorineural hearing loss is idiopathic sudden sensorineural hearing loss and to avoid confusion in nomenclature for the reader Changes to the KASs from the original guideline: KAS 1—When a patient first presents with sudden hearing loss, conductive hearing loss should be distinguished from sensorineural. KAS 2—The utility of history and physical examination when assessing for modifying factors is emphasized. KAS 3—The word “routine” is added to clarify that this statement addresses nontargeted head computerized tomography scan that is often ordered in the emergency room setting for patients presenting with sudden hearing loss. It does not refer to targeted scans, such as temporal bone computerized tomography scan, to assess for temporal bone pathology. KAS 4—The importance of audiometric confirmation of hearing status as soon as possible and within 14 days of symptom onset is emphasized. KAS 5—New studies were added to confirm the lack of benefit of nontargeted laboratory testing in sudden sensorineural hearing loss. KAS 6—Audiometric follow-up is excluded as a reasonable workup for retrocochlear pathology. Magnetic resonance imaging, computerized tomography scan if magnetic resonance imaging cannot be done, and, secondarily, auditory brainstem response evaluation are the modalities recommended. A time frame for such testing is not specified, nor is it specified which clinician should be ordering this workup; however, it is implied that it would be the general or subspecialty otolaryngologist. KAS 7—The importance of shared decision making is highlighted, and salient points are emphasized. KAS 8—The option for corticosteroid intervention within 2 weeks of symptom onset is emphasized. KAS 9—Changed to KAS 9A and 9B. Hyperbaric oxygen therapy remains an option but only when combined with steroid therapy for either initial treatment (9A) or salvage therapy (9B). The timing of initial therapy is within 2 weeks of onset, and that of salvage therapy is within 1 month of onset of sudden sensorineural hearing loss. KAS 10—Intratympanic steroid therapy for salvage is recommended within 2 to 6 weeks following onset of sudden sensorineural hearing loss. The time to treatment is defined and emphasized. KAS 11—Antioxidants were removed from the list of interventions that the clinical practice guideline recommends against using. KAS 12—Follow-up audiometry at conclusion of treatment and also within 6 months posttreatment is added. KAS 13—This statement on audiologic rehabilitation includes patients who have residual hearing loss and/or tinnitus who may benefit from treatment. Addition of an algorithm outlining KASs Enhanced emphasis on patient education and shared decision making with tools provided to assist in same

Abstract:

Can Gio mangrove forest (CGM) is located downstream of Ho Chi Minh City (HCMC), situated between an estuarine system of Dong Nai - Sai Gon river and a part of Vam Co river. The CGM is the largest restored mangrove forest in Vietnam and the UNESCO’s Mangrove Biosphere Reserve. The CGM has been gradually facing to numeric challenges of global climate change, environmental degradation and socio-economic development for the last decades. To evaluate sediment quality in the CGM, we collected 13 cores to analyze for sediment grain size, organic matter content, and trace element concentration of Cd, Cr, Cu, Ni, Pb, Zn. Results showed that trace element concentrations ranged from uncontaminated (Cd, Cu, and Zn) to very minor contaminated (Cr, Ni, and Pb). The concentrations were gradually influenced by suspended particle size and the mangrove plants.ReferencesAnh M.T., Chi D.H., Vinh N.N., Loan T.T., Triet L.M., Slootenb K.B.-V., Tarradellas J., 2003. Micropollutants in the sediment of Sai Gon – Dong Nai rivers: Situation and ecological risks. Chimia International Journal for Chemistry, 57, 09(0009–4293), 537–541.Baruddin N.A., Shazili N.A., Pradit S., 2017. Sequential extraction analysis of heavy metals in relation to bioaccumulation in mangroves, Rhizophora mucronata from Kelantan delta, Malaysia. AACL Bioflux, 10(2), 172-181. Retrieved from www.bioflux.com/aacl.Bravard J.-P., Goichot M., Tronchere H., 2014. An assessment of sediment transport processes in the lower Mekong river based on deposit grain size, the CM technique and flow energy data. Geomorphology, 207, 174-189.Cang L.T., Thanh N.C. 2008. Importing and exporting sediment to and from mangrove forest at Dong Trang estuary, Can Gio district, Ho Chi Minh city. Science & Technology Development, 11(04), 12-18.Carignan J., Hild P., Mevelle G., Morel J., Yeghicheyan D., 2001. Routine analyses of trace elements in geological samples using flow injection and low-pressure on-line liquid chromatography coupled to ICP-MS: A study of geochemical reference materials BR, DR-N, UB-N, AN-G and GH. The Journal of Geo standard and Geoanalysis, 187-198.Carlson P.R., Yarbro L.A., Zimmermann C.F., Montgomery J.R., 1983. Pore water chemistry of an overwash mangrove island. Academy Symposium: Future of the Indian River System, 46(3/4), 239-249. https://www.jstor.org/stable/24320336.Chatterjee M., Canário J., Sarkar S.K., Branco V., Godhantaraman N., Bhattacharya B.D., Bhattacharya A., 2012. Biogeochemistry of mercury and methylmercury in sediment cores from Sundarban mangrove wetland, India—a UNESCO World Heritage Site. Environ Monit Assess, 184, 5239–5254.Claudia R., Huy N.V., 2004. Water allocation policies for the Dong Nai river basin in Viet Nam: An integrated perspective. EPTD Discussion Paper, 127, 01-52.Folk R.L., Ward W.C., 1957. Brazos River bar: A study in the significance of grain size parameters. Journal of Sedimentary Petrology, 27(1), 3-26.Furukawaa K., Wolanski E., Mueller H., 1997. Currents and sediment transport in mangrove forests. Estuarine, Coastal and Shelf Science, 44, 301-310.Hai H.Q., Tuyen N.N., 2011. Coastal Erosion of Can Gio district Ho Chi Minh City due to the global climate change. The journal of development of technology and science, 14, 17-28.HCM SO S.O., 2015. Annual statistic data in 2015 for HCM city. Ho Chi Minh city: Statistic office of HCM city.HCMC, 2017. Decision No. 3901 on approving the areas of forest and land in HCM city in 2016. Ho Chi Minh: The people's committee of HCM city.Herut B., Sandler A., 2006. Normalization methods for pollutants in marine sediments: review and recommendations for the Mediterranean. Haifa 31080: Israel Oceanographic & Limnological Research: IOLR Report H18/2006.Hong P.N., San H.T., 1993. Mangroves of Vietnam: Chapter VI Human impacts on the mangrove ecosystem. Bangkok 10501: IUCN - The International Union for Conservation of Nature, ISBN: 2-8317-0166-x.Hubner R., Astin K.B., Herbert R.J., 2009. Comparison of sediment quality guidelines (SQGs) for the assessment of metal contamination in marine and estuarine environments. Journal of Environmental Monitoring, 11, 713–722.IAEA, 2003. Collection and preparation of bottom sediment samples for analysis of radionuclides and trace elements. Vienna, Austria: International Atomic Energy Agency, IAEA-TECDOC-1360, ISBN 92–0–109003–X.Jingchun L., Chongling Y., Ruifeng Z., Haoliang L., Guangqiu Q., 2008. Speciation changes of Cd in mangrove (Kandelia Candel L.) rhizosphere sediments. Bull Environ Contam Toxicol, 231-236. Doi:10.1007/s00128-007-9351-z.Kalaivanan R., Jayaprakash M., Nethaji S., Arya V., Giridharan L., 2017. Geochemistry of Core Sediments from Tropical Mangrove Region of Tamil Nadu: Implications on Trace Metals. Journal of Earth Science & Climatic Change, ISSN: 2157-7617., 8(1.1000385), 1-10. Doi:10.4172/2157-7617.1000385.Kathiresan K., Saravanakumar K., Mullai P., 2014. Bioaccumulation of trace elements by Avicennia marina. Journal of Coastal Life Medicine, 2(11), 888-894.Kitazawa T., Nakagawa T., Hashimoto T., Tateishi M., 2006. Stratigraphy and optically stimulated luminescence (OSL) dating of a Quaternary sequence along the Dong Nai River, southern Vietnam. Journal of Asian Earth Sciences, 27, 788–804.Lacerda L.D., 1998. Trace metals of biogeochemistry and diffuse pollution in mangrove (M. Vannucci, Ed.) Mangrove ecosystem occassional papers (ISSN: 0919-1348), 2, 1-72.Laura H., Probsta A., Probsta J.L., Ulrich E., 2003. Heavy metal distribution in some French forest soils: evidence for atmospheric contamination. The Science of Total Environment, 195-210.Li R., Li R., Chai M., Shen X., Xu H., Qiu G., 2015. Heavy metal contamination and ecological risk in Futian mangrove forest sediment in Shenzhen Bay, South China. Marine Pollution Bulletin, 101, 448–456.Long E., Morgan L.G., 1990. The potential for biological effects of sediment-sorted contaminants tested in the national status and trends program. Seattle, Washington: NOAA Technical Memorandum NOS OMA 52.Long E.R., Field L.J., MacDonald D.D., 1998. Predicting toxicity in marine sediments with numerical sediment quality guidelines. Environmental Toxicology and Chemistry, 17, 714–727. http://onlinelibrary.wiley.com/doi/10.1002/etc.5620170428/abstract;jsessionid=C5264A1AD0.7ACCA9B4EF9A088BE2EDE9.f04t04Long E.R., MacDonald D.D., Smith S.L., Calder F.D., 1995. Incidence of adverse biological effects within ranges of chemical concentration in marine and estuarine sediments. Environmental management, 19, 81-97.Maiti S.K., Chowdhury A., 2013. Effects of Anthropogenic Pollution on Mangrove Biodiversity: A Review. Journal of Environmental Protection, 4, 1428-1434.Marchand C., Allenbach M., Lallier-Verges E., 2011. Relation between heavy metal distribution and organic matter cycling in mangrove sediments (Conception Bay, New Caledonia). Geoderma, Elsevier, 160 (3-4), 444-456.Mohd F.N., Nor R.H., 2010. Heavy metal concentrations in an important mangrove species, Sonneratia caseolaris, in Peninsular Malaysia. Environment Asia, 3, 50-53.Muller G., 1979. Schwermetalle in den Sedimenten des Rheins - Veränderungen seit 1971. Umschau, 778-783.Nam V.N., 2007. Restoration of Can Gio mangrove forest: Its structure and function in comparison between the ecosytems of plantion and nature mangrove forest. Workshop on the thesis between Germany and Vietnam.Nickerson N.H., Thibodeau F.R., 1985. Association between pore water sulfide concentrations and the distribution of mangroves. Biogeochemistry, 1, 183-192.Ong Che R.G., 1999. Concentration of 7 Heavy Metals in Sediments and Mangrove Root Samples from Mai Po, Hong Kong. Marine Pollution Bulletin, 39, 269-279.Passega R., 1957. Texture as characteristics of clastic deposition. Publisher: American Association of Petroleum Geologists.Passega R., 1964. Grain size representation by CM patterns as a geological tool. J Sediment Petrol, 34, 830–847.Phuoc V.L., An D.T., Cang L.T., Chung B.N., Tien N.V., 2010. Study the sediment dynamics in Can Gio mangrove forest (Nang Hai site, Ho Chi Minh city). Ho Chi Minh city: The final report of National University Ho Chi Minh city, No. B2009-18-36.Pumijumnong N., Danpradit S., 2016. Heavy metal accumulation in sediments and mangrove forest stems from Surat Thani province, Thailand. The Malaysian forester, 79(1&2), 212-228.QCVN43:2012/BTNMT, 2012. QCVN43:2012/BTNMT: National technical regulation on the sediment quality, Ha Noi: Ministry of natural resources and environment of Vietnam.Qiao S., Shi X., Fang X., Liu S., Kornkanitnan N., Gao J., Yu Y., 2015. Heavy metal and clay mineral analyses in the sediments of Upper Gulf of Thailand and their implications on sedimentary provenance and dispersion pattern. Journal of Asian Earth Sciences, 114, 488–496.Rollinson H. R., 1993. Using geochemical data for evaluation, presentation and interpretation. UK: Longman Group UK Limited ISBN-0-582-06701-4.Spalding M., Blasco F., Field C., 2010. World atlas of mangrove. Cambridge: Earthscan in UK and US, ISBN: 978-1-84407-657-4.Strady E., Dang V.B., Némery J., Guédron S., Dinh Q.T., Denis H., Nguyen P.D., 2016. Baseline seasonal investigation of nutrients and trace metals in surface waters and sediments along the Saigon River basin impacted by the megacity of HCM, Viet Nam. Environ Sci Pollut Res, 1-18. doi:10.1007/s11356-016-7660-7.Tam N.F., Wong Y.S., 1996. Retention and distribution of heavy metals in mangrove soils receiving wastewater. Environment pollution, 94(5), 283-291.Thomas N., Lucas R., Bunting P., Hardy A., Rosenqvist A., Simard M., 2017. Distribution and drivers of global mangrove forest change, 1996– 2010. PLoS ONE, 12(6): e0179302, 1-14. Doi:10.1371/journal.pone.0179302.Thuy H.T., Loan T.T., Vy N.N., 2007. Study on environmental geochemistry of heavy metals in urban canal sediments of Ho Chi Minh city. Science and Technology Development, 10(01), 1-9.Toan T.T., Bay N.T., 2006. A study on the tendency of accretion and erosion in Can Gio coastal zone. Vietnam-Japan estuary workshop, 184-194.Tri N.H., Hong P.N., Cuc L.T., 2000. Can Gio Mangrove Biosphere Reserve Ho Chi Minh city, Ha Noi, Viet Nam. Ha Noi: Hanoi University Publisher.Truong T.V., 2007. Planning for water source of Dong Nai river basin. Retrieved from Water Resources Planning: http://siwrp.org.vn/tin-tuc/quy-hoach-tai-nguyen-nuoc-luu-vuc-song-dong-nai_143.html.Tuan L.D., Oanh T.T., Thanh C.V., Quy N.D., 2002. Can Gio mangrove biosphere reserve. HCM city, Vietnam: Agriculture Publisher.Tue N.T., Quy T.D., Amono A., 2012. Historical profiles of trace element concentrations in Mangrove sediments from the Ba Lat estuary, Red river, Vietnam. Water, Air & Soil Pollution, ISSN 0049-6979, 223(3), 1315-1330.Twilley R., Chen R., Hargis T., 1992. Carbon sinks in mangroves and their implications to carbon budget of tropical coastal ecosystems. Water, Air & Soil pollution, Netherland, 64, 265-288.UN Environment Program, 2006. Methods for sediment sampling and analysis. Palermo (Sicily), Italy: United Nation Environment Program.UNESCO, 2000. List of Biosphere reserves approved by MAB committee belonging to UNESCO. Retrieved from United Nations, Educational, Scientific, Cultural Organization (UNESCO): http://www.unesco.org/new/en/natural-sciences/environment/ecological-sciences/biosphere-reserves/asia-and-the-pacific.Vandenberghe N., 1975. An evaluation of CM patterns for grain size studies of fine grained sediments. Sedimentology, 22, 615-622.Vinh B.T., Ichiro D., 2012. Erosion mechanism of cohesive river bank and bed of Soai Rap river (Ho Chi Minh city). J. Sci. of the Earth, 34(2), 153-161.Wang J., Du H., Xu Y., Chen K., Liang J., Ke H., Cai M., 2016. Environmental and Ecological Risk Assessment of Trace Metal Contamination in Mangrove Ecosystems. BioMed Research International, Article ID 2167053, 1-14. Doi:10.1155/2016/2167053.Wedepohl K.H., 1995. The composition of the continental crust. Geochimica et Cosmochimica Acta, 59(7), 1217-1232.Woodroffe C., Rogers K., McKee K., Lovelock C., Mendelssohn I., Saintilan N., 2016. Mangrove sedimentation and response to relative sea level rise. The Annual Review of Marine Science, 8, 243-266.Zhang J., Liu C.L., 2002. Riverine Composition and Estuarine Geochemistry of Particulate Metals in China-Weathering Features, Anthropogenic Impact and Chemical Fluxes. Estuarine, Coastal and Shelf Science, 54(6), 1051-1070.Zhang W., Feng H., Chang J., Qu J., Xie H., Yu L., 2009. Heavy metal contamination in surface sediments of Yangtze River intertidal zone: An assessment from different indexes. Environmental Pollution, 157, 1533-1543.Zheng W.-j., Xiao-yong C., Peng L., 1997. Accumulation and biological cycling of heavy metal elements in Rhizophora stylosa mangroves in Yingluo Bay, China. Marine ecology progress series, 159, 293-301.

Abstract:

Climate change induced sea-level rise (SLR) is on its increase globally. Regionally the lowlands of China, Vietnam, Bangladesh, and islands of the Malaysian, Indonesian and Philippine archipelagos are among the world’s most threatened regions. Sea-level rise has major impacts on the ecosystems and society. It threatens coastal populations, economic activities, and fragile ecosystems as mangroves, coastal salt-marches and wetlands. This paper provides a summary of the current state of knowledge of sea level-rise and its effects on both human and natural ecosystems. The focus is on coastal urban areas and low lying deltas in South-East Asia and Vietnam, as one of the most threatened areas in the world. About 3 mm per year reflects the growing consensus on the average SLR worldwide. The trend speeds up during recent decades. The figures are subject to local, temporal and methodological variation. In Vietnam the average values of 3.3 mm per year during the 1993-2014 period are above the worldwide average. Although a basic conceptual understanding exists that the increasing global frequency of the strongest tropical cyclones is related with the increasing temperature and SLR, this relationship is insufficiently understood. Moreover the precise, complex environmental, economic, social, and health impacts are currently unclear. SLR, storms and changing precipitation patterns increase flood risks, in particular in urban areas. Part of the current scientific debate is on how urban agglomeration can be made more resilient to flood risks. Where originally mainly technical interventions dominated this discussion, it becomes increasingly clear that proactive special planning, flood defense, flood risk mitigation, flood preparation, and flood recovery are important, but costly instruments. Next to the main focus on SLR and its effects on resilience, the paper reviews main SLR associated impacts: Floods and inundation, salinization, shoreline change, and effects on mangroves and wetlands. The hazards of SLR related floods increase fastest in urban areas. This is related with both the increasing surface major cities are expected to occupy during the decades to come and the increasing coastal population. In particular Asia and its megacities in the southern part of the continent are increasingly at risk. The discussion points to complexity, inter-disciplinarity, and the related uncertainty, as core characteristics. An integrated combination of mitigation, adaptation and resilience measures is currently considered as the most indicated way to resist SLR today and in the near future.References Aerts J.C.J.H., Hassan A., Savenije H.H.G., Khan M.F., 2000. Using GIS tools and rapid assessment techniques for determining salt intrusion: Stream a river basin management instrument. Physics and Chemistry of the Earth, Part B: Hydrology, Oceans and Atmosphere, 25, 265-273. Doi: 10.1016/S1464-1909(00)00014-9. Alongi D.M., 2002. Present state and future of the world’s mangrove forests. Environmental Conservation, 29, 331-349. Doi: 10.1017/S0376892902000231 Alongi D.M., 2015. The impact of climate change on mangrove forests. Curr. Clim. Change Rep., 1, 30-39. Doi: 10.1007/s404641-015-0002-x. Anderson F., Al-Thani N., 2016. Effect of sea level rise and groundwater withdrawal on seawater intrusion in the Gulf Coast aquifer: Implications for agriculture. Journal of Geoscience and Environment Protection, 4, 116-124. Doi: 10.4236/gep.2016.44015. Anguelovski I., Chu E., Carmin J., 2014. Variations in approaches to urban climate adaptation: Experiences and experimentation from the global South. Global Environmental Change, 27, 156-167. Doi: 10.1016/j.gloenvcha.2014.05.010. Arustienè J., Kriukaitè J., Satkunas J., Gregorauskas M., 2013. Climate change and groundwater - From modelling to some adaptation means in example of Klaipèda region, Lithuania. In: Climate change adaptation in practice. P. Schmidt-Thomé, J. Klein Eds. John Wiley and Sons Ltd., Chichester, UK., 157-169. Bamber J.L., Aspinall W.P., Cooke R.M., 2016. A commentary on “how to interpret expert judgement assessments of twenty-first century sea-level rise” by Hylke de Vries and Roderik S.W. Van de Wal. Climatic Change, 137, 321-328. Doi: 10.1007/s10584-016-1672-7. Barnes C., 2014. Coastal population vulnerability to sea level rise and tropical cyclone intensification under global warming. BSc-thesis. Department of Geography, University of Lethbridge, Alberta Canada. Be T.T., Sinh B.T., Miller F., 2007. Challenges to sustainable development in the Mekong Delta: Regional and national policy issues and research needs. The Sustainable Mekong Research Network, Bangkok, Thailand, 1-210. Bellard C., Leclerc C., Courchamp F., 2014. Impact of sea level rise on 10 insular biodiversity hotspots. Global Ecology and Biogeography, 23, 203-212. Doi: 10.1111/geb.12093. Berg H., Söderholm A.E., Sönderström A.S., Nguyen Thanh Tam, 2017. Recognizing wetland ecosystem services for sustainable rice farming in the Mekong delta, Vietnam. Sustainability Science, 12, 137-154. Doi: 10.1007/s11625-016-0409-x. Bilskie M.V., Hagen S.C., Medeiros S.C., Passeri D.L., 2014. Dynamics of sea level rise and coastal flooding on a changing landscape. Geophysical Research Letters, 41, 927-934. Doi: 10.1002/2013GL058759. Binh T.N.K.D., Vromant N., Hung N.T., Hens L., Boon E.K., 2005. Land cover changes between 1968 and 2003 in Cai Nuoc, Ca Mau penisula, Vietnam. Environment, Development and Sustainability, 7, 519-536. Doi: 10.1007/s10668-004-6001-z. Blankespoor B., Dasgupta S., Laplante B., 2014. Sea-level rise and coastal wetlands. Ambio, 43, 996- 005.Doi: 10.1007/s13280-014-0500-4. Brockway R., Bowers D., Hoguane A., Dove V., Vassele V., 2006. A note on salt intrusion in funnel shaped estuaries: Application to the Incomati estuary, Mozambique.Estuarine, Coastal and Shelf Science, 66, 1-5. Doi: 10.1016/j.ecss.2005.07.014. Cannaby H., Palmer M.D., Howard T., Bricheno L., Calvert D., Krijnen J., Wood R., Tinker J., Bunney C., Harle J., Saulter A., O’Neill C., Bellingham C., Lowe J., 2015. Projected sea level rise and changes in extreme storm surge and wave events during the 21st century in the region of Singapore. Ocean Sci. Discuss, 12, 2955-3001. Doi: 10.5194/osd-12-2955-2015. Carraro C., Favero A., Massetti E., 2012. Investment in public finance in a green, low carbon economy. Energy Economics, 34, S15-S18. Castan-Broto V., Bulkeley H., 2013. A survey ofurban climate change experiments in 100 cities. Global Environmental Change, 23, 92-102. Doi: 10.1016/j.gloenvcha.2012.07.005. Cazenave A., Le Cozannet G., 2014. Sea level rise and its coastal impacts. GeoHealth, 2, 15-34. Doi: 10.1002/2013EF000188. Chu M.L., Guzman J.A., Munoz-Carpena R., Kiker G.A., Linkov I., 2014. A simplified approach for simulating changes in beach habitat due to the combined effects of long-term sea level rise, storm erosion and nourishment. Environmental modelling and software, 52, 111-120. Doi.org/10.1016/j.envcsoft.2013.10.020. Church J.A. et al., 2013. Sea level change. In: Climate change 2013: The physical science basis. Contribution of working group I to the fifth assessment report of Intergovernmental Panel on Climate Change. Eds: Stocker T.F., Qin D., Plattner G.-K., Tignor M., Allen S.K., Boschung J., Nauels A., Xia Y., Bex V., Midgley P.M., Cambridge University Press, Cambridge, UK. Connell J., 2016. Last days of the Carteret Islands? Climate change, livelihoods and migration on coral atolls. Asia Pacific Viewpoint, 57, 3-15. Doi: 10.1111/apv.12118. Dasgupta S., Laplante B., Meisner C., Wheeler, Yan J., 2009. The impact of sea level rise on developing countries: A comparative analysis. Climatic Change, 93, 379-388. Doi: 10.1007/s 10584-008-9499-5. Delbeke J., Vis P., 2015. EU climate policy explained, 136p. Routledge, Oxon, UK. DiGeorgio M., 2015. Bargaining with disaster: Flooding, climate change, and urban growth ambitions in QuyNhon, Vietnam. Public Affairs, 88, 577-597. Doi: 10.5509/2015883577. Do Minh Duc, Yasuhara K., Nguyen Manh Hieu, 2015. Enhancement of coastal protection under the context of climate change: A case study of Hai Hau coast, Vietnam. Proceedings of the 10th Asian Regional Conference of IAEG, 1-8. Do Minh Duc, Yasuhara K., Nguyen Manh Hieu, Lan Nguyen Chau, 2017. Climate change impacts on a large-scale erosion coast of Hai Hau district, Vietnam and the adaptation. Journal of Coastal Conservation, 21, 47-62. Donner S.D., Webber S., 2014. Obstacles to climate change adaptation decisions: A case study of sea level rise; and coastal protection measures in Kiribati. Sustainability Science, 9, 331-345. Doi: 10.1007/s11625-014-0242-z. Driessen P.P.J., Hegger D.L.T., Bakker M.H.N., Van Renswick H.F.M.W., Kundzewicz Z.W., 2016. Toward more resilient flood risk governance. Ecology and Society, 21, 53-61. Doi: 10.5751/ES-08921-210453. Duangyiwa C., Yu D., Wilby R., Aobpaet A., 2015. Coastal flood risks in the Bangkok Metropolitan region, Thailand: Combined impacts on land subsidence, sea level rise and storm surge. American Geophysical Union, Fall meeting 2015, abstract#NH33C-1927. Duarte C.M., Losada I.J., Hendriks I.E., Mazarrasa I., Marba N., 2013. The role of coastal plant communities for climate change mitigation and adaptation. Nature Climate Change, 3, 961-968. Doi: 10.1038/nclimate1970. Erban L.E., Gorelick S.M., Zebker H.A., 2014. Groundwater extraction, land subsidence, and sea-level rise in the Mekong Delta, Vietnam. Environmental Research Letters, 9, 1-20. Doi: 10.1088/1748-9326/9/8/084010. FAO - Food and Agriculture Organisation, 2007.The world’s mangroves 1980-2005. FAO Forestry Paper, 153, Rome, Italy. Farbotko C., 2010. Wishful sinking: Disappearing islands, climate refugees and cosmopolitan experimentation. Asia Pacific Viewpoint, 51, 47-60. Doi: 10.1111/j.1467-8373.2010.001413.x. Goltermann D., Ujeyl G., Pasche E., 2008. Making coastal cities flood resilient in the era of climate change. Proceedings of the 4th International Symposium on flood defense: Managing flood risk, reliability and vulnerability, 148-1-148-11. Toronto, Canada. Gong W., Shen J., 2011. The response of salt intrusion to changes in river discharge and tidal mixing during the dry season in the Modaomen Estuary, China.Continental Shelf Research, 31, 769-788. Doi: 10.1016/j.csr.2011.01.011. Gosian L., 2014. Protect the world’s deltas. Nature, 516, 31-34. Graham S., Barnett J., Fincher R., Mortreux C., Hurlimann A., 2015. Towards fair outcomes in adaptation to sea-level rise. Climatic Change, 130, 411-424. Doi: 10.1007/s10584-014-1171-7. COASTRES-D-12-00175.1. Güneralp B., Güneralp I., Liu Y., 2015. Changing global patterns of urban expoàsure to flood and drought hazards. Global Environmental Change, 31, 217-225. Doi: 10.1016/j.gloenvcha.2015.01.002. Hallegatte S., Green C., Nicholls R.J., Corfee-Morlot J., 2013. Future flood losses in major coastal cities. Nature Climate Change, 3, 802-806. Doi: 10.1038/nclimate1979. Hamlington B.D., Strassburg M.W., Leben R.R., Han W., Nerem R.S., Kim K.-Y., 2014. Uncovering an anthropogenic sea-level rise signal in the Pacific Ocean. Nature Climate Change, 4, 782-785. Doi: 10.1038/nclimate2307. Hashimoto T.R., 2001. Environmental issues and recent infrastructure development in the Mekong Delta: Review, analysis and recommendations with particular reference to large-scale water control projects and the development of coastal areas. Working paper series (Working paper No. 4). Australian Mekong Resource Centre, University of Sydney, Australia, 1-70. Hibbert F.D., Rohling E.J., Dutton A., Williams F.H., Chutcharavan P.M., Zhao C., Tamisiea M.E., 2016. Coral indicators of past sea-level change: A global repository of U-series dated benchmarks. Quaternary Science Reviews, 145, 1-56. Doi: 10.1016/j.quascirev.2016.04.019. Hinkel J., Lincke D., Vafeidis A., Perrette M., Nicholls R.J., Tol R.S.J., Mazeion B., Fettweis X., Ionescu C., Levermann A., 2014. Coastal flood damage and adaptation costs under 21st century sea-level rise. Proceedings of the National Academy of Sciences, 111, 3292-3297. Doi: 10.1073/pnas.1222469111. Hinkel J., Nicholls R.J., Tol R.S.J., Wang Z.B., Hamilton J.M., Boot G., Vafeidis A.T., McFadden L., Ganapolski A., Klei R.J.Y., 2013. A global analysis of erosion of sandy beaches and sea level rise: An application of DIVA. Global and Planetary Change, 111, 150-158. Doi: 10.1016/j.gloplacha.2013.09.002. Huong H.T.L., Pathirana A., 2013. Urbanization and climate change impacts on future urban flooding in Can Tho city, Vietnam. Hydrol. Earth Syst. Sci., 17, 379-394. Doi: 10.5194/hess-17-379-2013. Hurlimann A., Barnett J., Fincher R., Osbaldiston N., Montreux C., Graham S., 2014. Urban planning and sustainable adaptation to sea-level rise. Landscape and Urban Planning, 126, 84-93. Doi: 10.1016/j.landurbplan.2013.12.013. IMHEN-Vietnam Institute of Meteorology, Hydrology and Environment, 2011. Climate change vulnerability and risk assessment study for Ca Mau and KienGiang provinces, Vietnam. Hanoi, Vietnam Institute of Meteorology, Hydrology and Environment (IMHEN), 250p. IMHEN-Vietnam Institute of Meteorology, Hydrology and Environment, Ca Mau PPC, 2011. Climate change impact and adaptation study in The Mekong Delta - Part A: Ca Mau Atlas. Hanoi, Vietnam: Institute of Meteorology, Hydrology and Environment (IMHEN), 48p. IPCC-Intergovernmental Panel on Climate Change, 2014. Fifth assessment report. Cambridge University Press, Cambridge, UK. Jevrejeva S., Jackson L.P., Riva R.E.M., Grinsted A., Moore J.C., 2016. Coastal sea level rise with warming above 2°C. Proceedings of the National Academy of Sciences, 113, 13342-13347. Doi: 10.1073/pnas.1605312113. Junk W.J., AN S., Finlayson C.M., Gopal B., Kvet J., Mitchell S.A., Mitsch W.J., Robarts R.D., 2013. Current state of knowledge regarding the world’s wetlands and their future under global climate change: A synthesis. Aquatic Science, 75, 151-167. Doi: 10.1007/s00027-012-0278-z. Jordan A., Rayner T., Schroeder H., Adger N., Anderson K., Bows A., Le Quéré C., Joshi M., Mander S., Vaughan N., Whitmarsh L., 2013. Going beyond two degrees? The risks and opportunities of alternative options. Climate Policy, 13, 751-769. Doi: 10.1080/14693062.2013.835705. Kelly P.M., Adger W.N., 2000. Theory and practice in assessing vulnerability to climate change and facilitating adaptation. Climatic Change, 47, 325-352. Doi: 10.1023/A:1005627828199. Kirwan M.L., Megonigal J.P., 2013. Tidal wetland stability in the face of human impacts and sea-level rice. Nature, 504, 53-60. Doi: 10.1038/nature12856. Koerth J., Vafeidis A.T., Hinkel J., Sterr H., 2013. What motivates coastal households to adapt pro actively to sea-level rise and increased flood risk? Regional Environmental Change, 13, 879-909. Doi: 10.1007/s10113-12-399-x. Kontgis K., Schneider A., Fox J;,Saksena S., Spencer J.H., Castrence M., 2014. Monitoring peri urbanization in the greater Ho Chi Minh City metropolitan area. Applied Geography, 53, 377-388. Doi: 10.1016/j.apgeogr.2014.06.029. Kopp R.E., Horton R.M., Little C.M., Mitrovica J.X., Oppenheimer M., Rasmussen D.J., Strauss B.H., Tebaldi C., 2014. Probabilistic 21st and 22nd century sea-level projections at a global network of tide-gauge sites. Earth’s Future, 2, 383-406. Doi: 10.1002/2014EF000239. Kuenzer C., Bluemel A., Gebhardt S., Quoc T., Dech S., 2011. Remote sensing of mangrove ecosystems: A review.Remote Sensing, 3, 878-928. Doi: 10.3390/rs3050878. Lacerda G.B.M., Silva C., Pimenteira C.A.P., Kopp Jr. R.V., Grumback R., Rosa L.P., de Freitas M.A.V., 2013. Guidelines for the strategic management of flood risks in industrial plant oil in the Brazilian coast: Adaptive measures to the impacts of sea level rise. Mitigation and Adaptation Strategies for Global Change, 19, 104-1062. Doi: 10.1007/s11027-013-09459-x. Lam Dao Nguyen, Pham Van Bach, Nguyen Thanh Minh, Pham Thi Mai Thy, Hoang Phi Hung, 2011. Change detection of land use and river bank in Mekong Delta, Vietnam using time series remotely sensed data. Journal of Resources and Ecology, 2, 370-374. Doi: 10.3969/j.issn.1674-764x.2011.04.011. Lang N.T., Ky B.X., Kobayashi H., Buu B.C., 2004. Development of salt tolerant varieties in the Mekong delta. JIRCAS Project, Can Tho University, Can Tho, Vietnam, 152. Le Cozannet G., Rohmer J., Cazenave A., Idier D., Van de Wal R., de Winter R., Pedreros R., Balouin Y., Vinchon C., Oliveros C., 2015. Evaluating uncertainties of future marine flooding occurrence as sea-level rises. Environmental Modelling and Software, 73, 44-56. Doi: 10.1016/j.envsoft.2015.07.021. Le Cozannet G., Manceau J.-C., Rohmer J., 2017. Bounding probabilistic sea-level projections with the framework of the possible theory. Environmental Letters Research, 12, 12-14. Doi.org/10.1088/1748-9326/aa5528.Chikamoto Y., 2014. Recent Walker circulation strengthening and Pacific cooling amplified by Atlantic warming. Nature Climate Change, 4, 888-892. Doi: 10.1038/nclimate2330. Lovelock C.E., Cahoon D.R., Friess D.A., Gutenspergen G.R., Krauss K.W., Reef R., Rogers K., Saunders M.L., Sidik F., Swales A., Saintilan N., Le Xuan Tuyen, Tran Triet, 2015. The vulnerability of Indo-Pacific mangrove forests to sea-level rise. Nature, 526, 559-563. Doi: 10.1038/nature15538. MA Millennium Ecosystem Assessment, 2005. Ecosystems and human well-being: Current state and trends. Island Press, Washington DC, 266p. Masterson J.P., Fienen M.N., Thieler E.R., Gesch D.B., Gutierrez B.T., Plant N.G., 2014. Effects of sea level rise on barrier island groundwater system dynamics - ecohydrological implications. Ecohydrology, 7, 1064-1071. Doi: 10.1002/eco.1442. McGanahan G., Balk D., Anderson B., 2007. The rising tide: Assessing the risks of climate changes and human settlements in low elevation coastal zones.Environment and urbanization, 19, 17-37. Doi: 10.1177/095624780707960. McIvor A., Möller I., Spencer T., Spalding M., 2012. Reduction of wind and swell waves by mangroves. The Nature Conservancy and Wetlands International, 1-27. Merryn T., Pidgeon N., Whitmarsh L., Ballenger R., 2016. Expert judgements of sea-level rise at the local scale. Journal of Risk Research, 19, 664-685. Doi.org/10.1080/13669877.2015.1043568. Monioudi I.N., Velegrakis A.F., Chatzipavlis A.E., Rigos A., Karambas T., Vousdoukas M.I., Hasiotis T., Koukourouvli N., Peduzzi P., Manoutsoglou E., Poulos S.E., Collins M.B., 2017. Assessment of island beach erosion due to sea level rise: The case of the Aegean archipelago (Eastern Mediterranean). Nat. Hazards Earth Syst. Sci., 17, 449-466. Doi: 10.5194/nhess-17-449-2017. MONRE - Ministry of Natural Resources and Environment, 2016. Scenarios of climate change and sea level rise for Vietnam. Publishing House of Environmental Resources and Maps Vietnam, Hanoi, 188p. Montz B.E., Tobin G.A., Hagelman III R.R., 2017. Natural hazards. Explanation and integration. The Guilford Press, NY, 445p. Morgan L.K., Werner A.D., 2014. Water intrusion vulnerability for freshwater lenses near islands. Journal of Hydrology, 508, 322-327. Doi: 10.1016/j.jhydrol.2013.11.002. Muis S., Güneralp B., Jongman B., Aerts J.C.H.J., Ward P.J., 2015. Science of the Total Environment, 538, 445-457. Doi: 10.1016/j.scitotenv.2015.08.068. Murray N.J., Clemens R.S., Phinn S.R., Possingham H.P., Fuller R.A., 2014. Tracking the rapid loss of tidal wetlands in the Yellow Sea. Frontiers in Ecology and Environment, 12, 267-272. Doi: 10.1890/130260. Neumann B., Vafeidis A.T., Zimmermann J., Nicholls R.J., 2015a. Future coastal population growth and exposure to sea-level rise and coastal flooding. A global assessment. Plos One, 10, 1-22. Doi: 10.1371/journal.pone.0118571. Nguyen A. Duoc, Savenije H. H., 2006. Salt intrusion in multi-channel estuaries: a case study in the Mekong Delta, Vietnam. Hydrology and Earth System Sciences Discussions, European Geosciences Union, 10, 743-754. Doi: 10.5194/hess-10-743-2006. Nguyen An Thinh, Nguyen Ngoc Thanh, Luong Thi Tuyen, Luc Hens, 2017. Tourism and beach erosion: Valuing the damage of beach erosion for tourism in the Hoi An, World Heritage site. Journal of Environment, Development and Sustainability. Nguyen An Thinh, Luc Hens (Eds.), 2018. Human ecology of climate change associated disasters in Vietnam: Risks for nature and humans in lowland and upland areas. Springer Verlag, Berlin.Nguyen An Thinh, Vu Anh Dung, Vu Van Phai, Nguyen Ngoc Thanh, Pham Minh Tam, Nguyen Thi Thuy Hang, Le Trinh Hai, Nguyen Viet Thanh, Hoang Khac Lich, Vu Duc Thanh, Nguyen Song Tung, Luong Thi Tuyen, Trinh Phuong Ngoc, Luc Hens, 2017. Human ecological effects of tropical storms in the coastal area of Ky Anh (Ha Tinh, Vietnam). Environ Dev Sustain, 19, 745-767. Doi: 10.1007/s/10668-016-9761-3. Nguyen Van Hoang, 2017. Potential for desalinization of brackish groundwater aquifer under a background of rising sea level via salt-intrusion prevention river gates in the coastal area of the Red River delta, Vietnam. Environment, Development and Sustainability. Nguyen Tho, Vromant N., Nguyen Thanh Hung, Hens L., 2008. Soil salinity and sodicity in a shrimp farming coastal area of the Mekong Delta, Vietnam. Environmental Geology, 54, 1739-1746. Doi: 10.1007/s00254-007-0951-z. Nguyen Thang T.X., Woodroffe C.D., 2016. Assessing relative vulnerability to sea-level rise in the western part of the Mekong River delta. Sustainability Science, 11, 645-659. Doi: 10.1007/s11625-015-0336-2. Nicholls N.N., Hoozemans F.M.J., Marchand M., Analyzing flood risk and wetland losses due to the global sea-level rise: Regional and global analyses.Global Environmental Change, 9, S69-S87. Doi: 10.1016/s0959-3780(99)00019-9. Phan Minh Thu, 2006. Application of remote sensing and GIS tools for recognizing changes of mangrove forests in Ca Mau province. In Proceedings of the International Symposium on Geoinformatics for Spatial Infrastructure Development in Earth and Allied Sciences, Ho Chi Minh City, Vietnam, 9-11 November, 1-17. Reise K., 2017. Facing the third dimension in coastal flatlands.Global sea level rise and the need for coastal transformations. Gaia, 26, 89-93. Renaud F.G., Le Thi Thu Huong, Lindener C., Vo Thi Guong, Sebesvari Z., 2015. Resilience and shifts in agro-ecosystems facing increasing sea-level rise and salinity intrusion in Ben Tre province, Mekong Delta. Climatic Change, 133, 69-84. Doi: 10.1007/s10584-014-1113-4. Serra P., Pons X., Sauri D., 2008. Land cover and land use in a Mediterranean landscape. Applied Geography, 28, 189-209. Shearman P., Bryan J., Walsh J.P., 2013.Trends in deltaic change over three decades in the Asia-Pacific Region. Journal of Coastal Research, 29, 1169-1183. Doi: 10.2112/JCOASTRES-D-12-00120.1. SIWRR-Southern Institute of Water Resources Research, 2016. Annual Report. Ministry of Agriculture and Rural Development, Ho Chi Minh City, 1-19. Slangen A.B.A., Katsman C.A., Van de Wal R.S.W., Vermeersen L.L.A., Riva R.E.M., 2012. Towards regional projections of twenty-first century sea-level change based on IPCC RES scenarios. Climate Dynamics, 38, 1191-1209. Doi: 10.1007/s00382-011-1057-6. Spencer T., Schuerch M., Nicholls R.J., Hinkel J., Lincke D., Vafeidis A.T., Reef R., McFadden L., Brown S., 2016. Global coastal wetland change under sea-level rise and related stresses: The DIVA wetland change model. Global and Planetary Change, 139, 15-30. Doi:10.1016/j.gloplacha.2015.12.018. Stammer D., Cazenave A., Ponte R.M., Tamisiea M.E., 2013. Causes of contemporary regional sea level changes. Annual Review of Marine Science, 5, 21-46. Doi: 10.1146/annurev-marine-121211-172406. Tett P., Mee L., 2015. Scenarios explored with Delphi. In: Coastal zones ecosystems services. Eds., Springer, Berlin, Germany, 127-144. Tran Hong Hanh, 2017. Land use dynamics, its drivers and consequences in the Ca Mau province, Mekong delta, Vietnam. PhD dissertation, 191p. VUBPRESS Brussels University Press, ISBN 9789057186226, Brussels, Belgium. Tran Thuc, Nguyen Van Thang, Huynh Thi Lan Huong, Mai Van Khiem, Nguyen Xuan Hien, Doan Ha Phong, 2016. Climate change and sea level rise scenarios for Vietnam. Ministry of Natural resources and Environment. Hanoi, Vietnam. Tran Hong Hanh, Tran Thuc, Kervyn M., 2015. Dynamics of land cover/land use changes in the Mekong Delta, 1973-2011: A remote sensing analysis of the Tran Van Thoi District, Ca Mau province, Vietnam. Remote Sensing, 7, 2899-2925. Doi: 10.1007/s00254-007-0951-z Van Lavieren H., Spalding M., Alongi D., Kainuma M., Clüsener-Godt M., Adeel Z., 2012. Securing the future of Mangroves. The United Nations University, Okinawa, Japan, 53, 1-56. Water Resources Directorate. Ministry of Agriculture and Rural Development, 2016. Available online: http://www.tongcucthuyloi.gov.vn/Tin-tuc-Su-kien/Tin-tuc-su-kien-tong-hop/catid/12/item/2670/xam-nhap-man-vung-dong-bang-song-cuu-long--2015---2016---han-han-o-mien-trung--tay-nguyen-va-giai-phap-khac-phuc. Last accessed on: 30/9/2016. Webster P.J., Holland G.J., Curry J.A., Chang H.-R., 2005. Changes in tropical cyclone number, duration, and intensity in a warming environment. Science, 309, 1844-1846. Doi: 10.1126/science.1116448. Were K.O., Dick O.B., Singh B.R., 2013. Remotely sensing the spatial and temporal land cover changes in Eastern Mau forest reserve and Lake Nakuru drainage Basin, Kenya. Applied Geography, 41, 75-86. Williams G.A., Helmuth B., Russel B.D., Dong W.-Y., Thiyagarajan V., Seuront L., 2016. Meeting the climate change challenge: Pressing issues in southern China an SE Asian coastal ecosystems. Regional Studies in Marine Science, 8, 373-381. Doi: 10.1016/j.rsma.2016.07.002. Woodroffe C.D., Rogers K., McKee K.L., Lovdelock C.E., Mendelssohn I.A., Saintilan N., 2016. Mangrove sedimentation and response to relative sea-level rise. Annual Review of Marine Science, 8, 243-266. Doi: 10.1146/annurev-marine-122414-034025.

Abstract:

Background Health care transition (HCT) is a period of high vulnerability for patients with chronic childhood diseases, particularly when patients shift from a pediatric to an adult care setting. An increasing number of patients with Kawasaki disease (KD) who develop medium and large coronary artery aneurysms (classified by the American Heart Association according to maximal internal coronary artery diameter Z‐scores ≥5 and ≥10, respectively) are becoming adults and thus undergoing an HCT. However, a poor transition to an adult provider represents a risk of loss to follow‐up, which can result in increasing morbidity and mortality. Methods and Results This scientific statement provides a summary of available literature and expert opinion pertaining to KD and HCT of children as they reach adulthood. The statement reviews the existing life‐long risks for patients with KD, explains current guidelines for long‐term care of patients with KD, and offers guidance on assessment and preparation of patients with KD for HCT. The key element to a successful HCT, enabling successful transition outcomes, is having a structured intervention that incorporates the components of planning, transfer, and integration into adult care. This structured intervention can be accomplished by using the Six Core Elements approach that is recommended by the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians. Conclusions Formal HCT programs for patients with KD who develop aneurysms should be established to ensure a smooth transition with uninterrupted medical care as these youths become adults.

Abstract:

Wraparound is a mental health services philosophy for children and adolescents. This philosophy includes a defined planning process that involves the child, adolescent, and family in making treatment decisions. As a result, it creates a unique set of individualized community services and natural supports to achieve multiple positive outcomes. This philosophy requires a work process that sometimes becomes uncomfortable for professionals in the mental health area since it takes us away from what we learned in the academy or what the agency we work expects us. This practice invites us to take off the hat of experts in our area of expertise. This article aims to present the Wraparound philosophy as an alternative for community mental health services at the tertiary prevention level for children and adolescents. Also, as an effective process in which communities learn to care for and protect their members by keeping them in the least restrictive environment.

Abstract:

This single and critical case study evaluated a faith-based natural family planning program's salient features using a framework on implementation fidelity. Multiple focus group discussions were conducted, with three groups of stakeholders (n=100), to gather qualitative data on their knowledge and experience of the program. Overall, the findings showed that the program primarily adhered to the essential elements of implementation fidelity, such as content, frequency, duration, and coverage prescribed by its designers. Three lessons were drawn to address some issues that have influenced the degree of fidelity in which the program was implemented. The first is the need to secure adequate and sustained human and financial resources. The second is the need to strengthen its partnership with government and non-government organizations that have provided them with much-needed assistance. Finally, there is also the need to provide extensive training, materials, and support to its service providers to preserve their morale and interest. Other faith-based organizations may hold this case as an indicator of how and why an NFP program works and the extent to which the need for family planning can be met adapted to their local conditions and needs. References Arbuckle, Gerald A. Refounding the Church: Dissent for Leadership. Quezon City: Claretian Publications. 1993. Arevalo, Marcos. "Expanding the Availability and improving the delivery of natural family planning services and fertility awareness education: providers' perspectives. Adv Contracept. Jun-Sep 1997; 13(2-3):275-81. Arévalo, Marcos, Victoria Jennings, and Irit Sinai. "Efficacy of a new method of family planning: the Standard Days Method." Contraception 65, no. 5 (2002): 333-338.Arévalo, Marcos, Irit Sinai, and Victoria Jennings. "A fixed formula to define the fertile window of the menstrual cycle as the basis of a simple method of natural family planning." Contraception 60, no. 6 (1999): 357-360. Atun, Jenna (2013). Religiosity and Contraceptive Use among Filipino Youth. Philippine Center for Population and Development. (2013) Accessed April 15, 2019, from http://www.pcpd.ph/.../religiosity-and-contraceptive-use- Authority, P. S. ICF Philippines national demographic and health survey 2017. Quezon City, Philippines, and Rockville, Maryland, USA: PSA and ICF, 2018. Authority, Philippine Statistics. "Philippine statistics authority." Accessed from Philippine Statistics Authority Web site: https://psa. gov. ph/vegetable-root-crops-main/tomato (2018). Authority, P. S. “Philippine statistics authority.” Accessed July 20, 2019, from Philippine Statistics Authority Web site: https://psa. gov. ph/vegetable-root-crops-main/tomato.(2016) Authority, P. S. “ICF Philippines national demographic and health survey.” Quezon City, Philippines, and Rockville, Maryland, USA: PSA and ICF, 2017. Bamber, John, Stella Owens, Heino Schonfeld, Deborah Ghate, and Deirdre Fullerton. "Effective Community Development Programmes: a review of the international evidence base." (2010). Barden-O'Fallon, Janine. "Availability of family planning services and quality of counseling by faith-based organizations: a three-country comparative analysis." Reproductive health, 14, no. 1 (2017): 57. Baskarada, Sasa. "Qualitative case study guidelines." The Qualitative Report 19, no. 40 (2014): 1-25. Accessed July 25, 2019, from http://www.nova.edu/ssss/QR/QR19/baskarada24.pdf Beaubien, Louis, and Daphne Rixon. "Key performance indicators in co-operatives: directions and principles." Journal of Co-operative Studies 45, no. 2 (2012): 5-15. Booker, Victoria K., June Grube Robinson, Bonnie J. Kay, Lourdes Gutierrez Najera, and Genevieve Stewart. "Changes in empowerment: Effects of participation in a lay health promotion program." Health Education & Behavior 24, no. 4 (1997): 452-464. Breitenstein, Susan M., Deborah Gross, Christine A. Garvey, Carri Hill, Louis Fogg, and Barbara Resnick. "Implementation fidelity in community‐based interventions." Research in nursing & health 33, no. 2 (2010): 164-173. Carroll, Christopher, Malcolm Patterson, Stephen Wood, Andrew Booth, Jo Rick, and Shashi Balain. "A conceptual framework for implementation fidelity." Implementation Science 2, no. 1 (2007): 40. Casterline, J.B., A.E. Perez & A.E. Biddlecom. “Factors Affecting Unmet Need for FP in the Philippines," “Studies in Family Planning, (1997). (3):173-191. Accessed November 02, 2019, from http://www.jstor.org/stable/2137886. Catholic Bishops' Conference of the Philippines. (2011). Guiding Principles of Population Control. Accessed September 27, 2019, from www.cbcponline.net/ Catholic Church. Bishops' Conference of the Philippines. (1992). Acts and Decrees of the Second Plenary Council of the Philippines. Catholic Bishops' Conference of the Philippines. Catholic Bishops' Conference of the Philippines. (1990). A Pastoral Letter on the Population Control Activities of the Philippine Government and Planned Parenthood Association. Accessed November 24, 2019, from cbcponline.net/v2/?p=324. Cleland, John, and Kazuyo Machiyama. "Unmet need for family planning: past achievements and remaining challenges." In Seminars in reproductive medicine, vol. 33, no. 01, pp. 011-016. Thieme Medical Publishers, 2015. Costello, Marilou P., and John B. Casterline. "Fertility decline in the Philippines: current status, prospects." asdf (2009): 479. Creel, Liz C., Justine V. Sass, and Nancy V. Yinger. "Overview of quality of care in reproductive health: definitions and measurements of quality." New Perspectives on Quality of Care 1 (2002): 1-8. Cronin Jr, J. Joseph, Michael K. Brady, and G. Tomas M. Hult. "Assessing the effects of quality, value, and customer satisfaction on consumer behavioral intentions in service environments." Journal of retailing 76, no. 2 (2000): 193-218. Crous, M. "Quality service delivery through customer satisfaction." (2006). D’Arcy, Catherine, Ann Taket, and Lisa Hanna. "Implementing empowerment-based Lay Health Worker programs: a preliminary study." Health promotion international 34, no. 4 (2019): 726-734. Dane, Andrew V., and Barry H. Schneider. "Program integrity in primary and early secondary prevention: are implementation effects out of control?" Clinical psychology review 18, no. 1 (1998): 23-45. David, Clarissa C., and Jenna Mae L. Atun. "Factors affecting fertility desires in the Philippines." Social Science Diliman 10, no. 2 (2014).Accessed August 12, 2019, from jounals.upd.edu.ph/index.php/socialsciencediliman/article/viewFile/4407/3999. Ewerling, F., Victora, C. G., Raj, A., Coll, C. V., Hellwig, F., & Barros, A. J. (2018). Demand for family planning satisfied with modern methods among sexually active women in low-and middle-income countries: who is lagging? Reproductive health, 15(1). (2018): 42. Francisco, J.M. “Letting the Texts of RH Speak for themselves: (Dis) continuity andCounterpoint in CBCP Statements.” Philippine Studies: Historical and Ethnographic Viewpoints, 223. (2015). Accessed October 17, 2019, from www.philippinestudies.net. Franta, Benjamin, Hilly Ann Roa-Quiaoit, Dexter Lo, and Gemma Narisma. "Climate Disasters in the Philippines." (2016). Fehring, Richard Jerome, Mary Schneider, and Kathleen Raviele. "Pilot evaluation of an Internet‐based natural family planning education and service program." Journal of Obstetric, Gynecologic & Neonatal Nursing 40, no. 3 (2011): 281-291. Glickman, Norman J., and Lisa J. Servon. "More than bricks and sticks: Five components of community development corporation capacity." Housing Policy Debate 9, no. 3 (1998): 497-539. Gomez, Fausto, B., OP. “The Role of Priests in Natural Family Planning." Boletin Ecclesiastico de Filipinas, LXXII, (1996): 163. Gribble, James N. "The standard days' method of family planning: a response to Cairo." International family planning perspectives 29, no. 4 (2003): 188-191. Guida, Maurizio, Giovanni A. Tommaselli, Massimiliano Pellicano, Stefano Palomba, and Carmine Nappi. "An overview on the effectiveness of natural family planning." Gynecological Endocrinology 11, no. 3 (1997): 203-219.Hasson, Henna. "Systematic evaluation of implementation fidelity of complex interventions in health and social care." Implementation Science 5, no. 1 (2010): 67. Infantado, R. B. "Main-streaming NFP into the Philippines' Department of Health: opportunities and challenges." Advances in Contraception 13, no. 2-3 (1997): 249-254. Institute for Reproductive Health. Faith-based organizations as partners in family planning: Working together to improve family well-being. Washington, DC: Georgetown University. (2011). Accessed February 11, 2019, from http://www.ccih.org/FBOs_as_Partners_in_FP_Report.pdf. Ledesma, Antonio. J. “All-NFP: A Way Forward.” Philippine Daily Inquirer (2012). Accessed August 04, 2019, from https://opinion.inquirer.net/35848/all-nfp-a-way-forward#ixzz5zAroo0oo Ledesma, Antonio. J. “Al-Natural Family Planning: Going beyond the RH Bill.” Accessed April 15, 2019, from https://archcdo.wordpress.com/ Lundgren, Rebecka, Jeannette Cachan, and Victoria Jennings. "Engaging men in family planning services delivery: experiences introducing the Standard Days Method® in four countries." World health & population 14, no. 1 (2012): 44. Lundgren, Rebecka I., Mihira V. Karra, and Eileen A. Yam. "The role of the Standard Days Method in modern family planning services in developing countries." The European Journal of Contraception & Reproductive Health Care 17, no. 4 (2012): 254-259.Mikolajczyk, Rafael T., Joseph B. Stanford, and Martina Rauchfuss. "Factors influencing the choice to use modern natural family planning." Contraception 67, no. 4 (2003): 253-258. Orbeta, Aniceto., Jr. “Poverty, Fertility Preferences, and Family Planning Practice in the Philippines.” Philippine Journal of Development, 129. (2006). Accessed October 25, 2019, from https://ideas.repec.org/p/phd/dpaper/dp_2005-22.html.July Orbeta, Aniceto Jr. “Poverty, vulnerability, and family size: evidence from the Philippines (No. 68). (2005). Asian Development Bank. Orbeta Jr, Aniceto, and Ernesto M. Pernia. Population Growth and Economic Development in the Philippines: What Has Been the Experience and What Must Be Done? No. 1999-22. PIDS Discussion Paper Series, 1999. Rufo, Aries. “The church pays lip service to natural family planning.” Rappler (2011). Accessed October 01, 2019, from https://news.abs-cbn.com/-depth/12/04/11/church-pays-lip-service-natural-family-planning. Schivone, Gillian B., and Paul D. Blumenthal. "Contraception in the developing world: special considerations." In Seminars in reproductive medicine, vol. 34, no. 03, pp. 168-174. Thieme Medical Publishers, 2016. Seidman, M. "Requirements for NFP service delivery: an overview." Advances in Contraception 13, no. 2-3 (1997): 241-247. Selak, Anne. “What the Church Owes Families.” La Croix International (2020) Accessed October 24, 2020, from https://www.commonwealmagazine.org/what-church-owes-families. Sinai, Irit, Rebecka Lundgren, Marcos Arévalo, and Victoria Jennings. "Fertility awareness-based methods of family planning: predictors of correct use." International family planning perspectives (2006): 94-100. Smoley, Brian A., and Christa M. Robinson. "Natural family planning." American family physician 86, no. 10 (2012): 924-928. Stanford, Joseph B., Janis C. Lemaire, and Poppy B. Thurman. "Women's interest in natural family planning." Journal of Family Practice 46 (1998): 65-72. Tommaselli, G. A., M. Guida, S. Palomba, M. Pellicano, and C. Nappi. "The importance of user compliance on the effectiveness of natural family planning programs." Gynecological endocrinology 14, no. 2 (2000): 81-89. Van de Vusse, Leona, Lisa Hanson, Richard J. Fehring, Amy Newman, and Jaime Fox. "Couples' views on the effects of natural family planning on marital dynamics." Journal of Nursing Scholarship 35, no. 2 (2003): 171-176. Vidal, Avis C. “Faith-based organizations in Community Development. (2001) Accessed January 28, 2020, from www.huduser.org/publications/pdf/faith-based.pdf. Walker, Christopher, and Mark Weinheimer. "The performance of community development systems: A report to the National Community Development Initiative." Washington, DC: Urban Institute (1996). Weldon, Elizabeth, Karen A. Jehn, and Priti Pradhan. "Processes that mediate the relationship between a group goal and improved group performance." Journal of personality and social psychology 61, no. 4 (1991): 555. World Health Organization, "Family Planning Contraception Methods," June 22, 2020. Accessed August 08, 2020, from https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception. World Health Organization. "Building from common foundations: the World Health Organization and faith-based organizations in primary healthcare." (2008). World Health Organization. “Health topics: family planning.” (1988). Accessed September 24, 2020, from http://www.who.int/topics/family_planning/en/. World Health Organization. (1988). Natural family planning: a guide to the provision of services. Accessed August 27, 2019, from https://apps.who.int/iris/handle/10665/39322.Yin, Robert K. "Case study research: Design and methods 4th edition." In the United States: Library of Congress Cataloguing-in-Publication Data. 2009.

Abstract:

Background: The majority of carotid imaging is performed on asymptomatic patients, those without stroke or transient ischemic attack, for whom the evidence for carotid revascularization is limited. In 2013, three Choosing Wisely campaigns identified carotid imaging for syncope (American Academy of Neurology), screening (American Academy of Family Physicians) and preoperatively before cardiac surgery (Society of Thoracic Surgeons) as low-value. The impact of these recommendations is unknown. Methods: We compared annual rates of carotid imaging in the VA Health System between 2007 and 2016. As administrative carotid imaging codes are non-specific, we used natural language processing to identify carotid imaging, including ultrasound, computed tomography angiography (CTA) and magnetic resonance angiography (MRA). We reviewed the study reason listed in radiology records to develop a lexicon of test indications for identifying imaging for syncope, preoperative testing and carotid bruits. We conducted an interrupted time series analysis to determine whether trends in overall and indication-specific asymptomatic carotid imaging changed, comparing imaging rates prior to the recommendations (2007-2012) and following their release (2014-2016). Results: We identified 773,044 carotid images for asymptomatic indications (mean age, 69.9 years; 96.5% men) including 720,961 ultrasounds, 28,979 CTAs, and 24,539 MRAs. From 2007 to 2016 the annual rate of asymptomatic imaging decreased from 10.79 to 10.35 images per 1,000 veterans (rate ratio 0.96; P<0.001). Annual rates of imaging for bruits also decreased while imaging for syncope and preoperative evaluation increased (rate ratios: 0.62, 1.08 and 1.59, all P<.0001) (Figure). Rates of asymptomatic imaging declined by 1.01% annually (95% CI -1.18% to -0.84%) prior to Choosing Wisely, with a change to a flat rate in the post-period (0.12%; 95% CI -0.37% to 0.62%). Trends in annual rates of imaging for syncope and preoperative evaluation increased following Choosing Wisely, while the rate of decrease of imaging for bruits diminished. Conclusions: The release of 3 Choosing Wisely guidelines targeting carotid imaging did not reduce overall or indication specific rates of asymptomatic carotid imaging in the VA Health System.

Abstract:

Objective This study sought to determine childbearing patterns and decision making among female otolaryngologists. Study Design Anonymous survey. Setting An anonymous survey was sent in 2020 to female otolaryngologists identified through their membership with the American Academy of Otolaryngology–Head and Neck Surgery. Methods Data were analyzed concerning individual fertility and childbearing history, reflections regarding decision making, perceptions of workplace support, and estimations of objective childbearing potential. Results There were 398 responses. The mean age at first pregnancy was 32.3 years. Almost one-third of respondents who attempted to conceive (30.4%) were diagnosed with infertility. Of those who had their first pregnancy during training, 55% reported having substantial workplace support, as opposed to 70% of those whose first pregnancies followed completion of training ( P = .01). When asked what they would do differently in retrospect, most women with infertility (65.0%) would have attempted conception earlier; 41 (41.0%) would have used cryopreservation to extend fertility; and 14 (14.0%) would have gone into a different specialty. Conclusion Female otolaryngologist respondents have children later in life than the general population, and a substantial proportion face infertility or have regrets about family planning decisions and career decision making. Increased awareness, further investigation, and targeted programs are needed to support the growing number of female otolaryngologists who desire both a career and a family.

Abstract:

In this paper presented a comprehensive inventory of the non-native vascular flora of Anaikatty hills. The survey was undertaken to document the invasive alien plant species in different ecosystems during September 2017 to October 2019 in Anaikatty hills, Coimbatore forest division, Western Ghats. A total of 98 invasive alien species under 81 genera and 40 families were recorded. Asteraceae is the most dominant family with 16 species followed by Amaranthaceae and Solanaceae (6 species each). and are the dominant genera (4 Cassia Ipomoeaspecies each) followed by and (3 species each). The life form analysis of the invasive alien flora showed that herbaceous Indigofera Solanum species constitute the major life form (73.47%) followed by shrubs (9.18 %), climbers (8.16 %), trees (5.10 %) and grasses (4.08 %). Phytogeographical regions analysis revealed that tropical American elements (57.14 %) are the most dominant. It is an immense need to control the infestations of such alien and naturalised weeds in the natural ecosystem. This can be eliminated by better planning, periodic monitoring and adopt suitable controlling measures.

Abstract:

All infants, children, and adolescent patients through age 21 years must have access to comprehensive health care benefits that will ensure their optimal health and well-being. The following services should be included in the health benefit plans offered by all private and public insurers. These services should be performed in a cost-effective manner that does not compromise the highest quality of care in a variety of appropriate settings. As these services are physician directed and medically necessary, they should not be limited and should include all of the following: 1. Medical care, including (a) health supervision with its preventive care and immunizations according to the "Recommendations for Preventive Pediatric Health Care"1 of the American Academy of Pediatrics, and, (b) diagnosis and treatment of acute and chronic illness, developmental disabilities, learning disorders, and behavioral problems. 2. Surgical care. 3. Mental health services including those appropriate for treatment of substance abuse and other psychosocial problems, as directed or prescribed by a physician. 4. Emergency and trauma care services. 5. Inpatient hospital services. 6. Specialty and pediatric subspecialty consultations occurring either in the inpatient or outpatient setting. 7. Family planning services. 8. Pregnancy services including: (a) genetic counseling and related services as needed; (b) prenatal care; (c) prenatal consultation with a pediatrician; (d) care of all complications; (e) counseling on all pregnancy options; (f) elective termination of pregnancy; (g) care for the pregnancy of a single dependent of the policy holder. 9. Care of all newborns and infants including: (a) Attendance and management at high-risk deliveries; (b) health supervision; (c) treatment of congenital anomalies and other illnesses on injuries.

Abstract:

Introduction: Congenitally corrected transposition of the great arteries (ccTGA) is rare with varied associated cardiac defects and rhythm abnormalities. We aimed to describe the natural history, associated anomalies and prenatal outcome in a cohort of prenatally diagnosed patients in which biventricular repair is anticipated. Methods: A retrospective cohort study was conducted via the Fetal Heart Society Research Collaborative. All fetuses with ccTGA encountered at 15 North American cardiac centers between 1/2004-7/2020 were identified. Fetuses with a hypoplastic ventricle precluding biventricular repair were excluded. Data is presented as median (interquartile range). Results: Inclusion criteria were met in 139 fetuses who were diagnosed with ccTGA at 24 (21-29) weeks. There was a family history of congenital heart disease in 12%. Maternal diabetes was present in 10%. Prenatal genetic testing in 50 pregnancies was normal. Excluding 14 fetuses with heterotaxy, extracardiac anomalies were observed in 9/125 (7.1%). Associated cardiac/extracardiac defects are detailed in table 1. Fetal atrioventricular block (AVB) was present in 17 fetuses (12%), diagnosed at a median of 26 (23-28), range 20-36 weeks. Two fetuses had SVT; 1 self-resolved and 1 during labor. Change occurred during follow-up in 34 fetuses, most commonly in severity of tricuspid regurgitation (6 improved, 4 worsened) and worsening of pulmonary stenosis (n=5). There were 112 live births, 17 terminations, 2 fetal deaths (FD) and 8 lost to follow-up. Both fetuses with FD had AVB, making the intrauterine mortality associated with fetal AVB 11.8% (2/17). Conclusions: This study represents the largest cohort to date of fetuses with ccTGA. Fetal ccTGA is associated with a spectrum of cardiac defects that may evolve, with extracardiac pathology occurring in 7.1%. AVB is found in 12% of fetuses and is a risk factor for FD. This data informs fetal counseling and can aid in delivery planning and perinatal care.

Abstract:

Photo by Christian Bowen on Unsplash ABSTRACT Assisted Reproductive Technology can be a beneficial tool for couples unable to reproduce independently; however, it has historically discriminated against the LGBTQ+ community members. Given the evolution and acceptance of LGBTQ rights in recent years, discrimination and barriers to access reproductive technology and health care should be readdressed as they still exist within this community. INTRODUCTION In recent years, the LGBTQ+ community has made great strides toward attaining equal rights. This fight dates back to 1970 when Michael Baker and McConnell applied for a marriage license in Minnesota.[1] After the county courthouse denied the couple's request, they appealed to the Minnesota Supreme Court. Baker and McConnell’s dispute reached the US Supreme Court. Baker v. Nelson[2] was the first time a same-sex couple attempted to pursue marriage through higher courts in the US.[3] Because the couple lost the case, Baker changed his name to a gender-neutral one, and McConnell adopted Baker, allowing Baker and McConnell to have legal protections like the ability to receive certain inheritances. Baker and McConnell received a marriage license from an unsuspecting clerk from Blue Earth County, where they wed on September 3, 1971.[4] BACKGROUND The Supreme Court’s decision left individual state legislatures the option to accommodate same-sex couples’ rights constitutionally. As a result, some states banned same-sex marriage, while others offered alternative options such as domestic partnerships. With many obstacles, such as the Defense of Marriage Act (DOMA) and President Bush’s efforts to limit marriage to heterosexual people, Massachusetts became the first state to legalize gay marriage in 2003.[5] Other states slowly followed. Finally, in 2015 the US Supreme Court made same-sex marriage legal in all 50 states in Obergefell v. Hodges,[6] marking an important milestone for the LGBTQ+ community’s fight toward marriage equality. The Obergefell v. Hodges decision emphasized that members of the homosexual community are “not to be condemned to live in loneliness, excluded from one of civilization's oldest institutions,” thus granting them the right to “equal dignity in the eyes of the law.”[7] This paper argues that in the aftermath of the wide acceptance of LGBTQ rights, discrimination and barriers to access reproductive technology and health care persist nationally. Procreation also faces discrimination. Research supports that children’s overall psychological and physical welfare with same-sex parents does not differ compared to children with heterosexual parents.[8] Some others worry about the children’s developmental health and argue that same-sex male couples’ inability to breastfeed their children may be harmful; however, such parents can obtain breast milk via surrogate donation.[9] Further concerns regarding confusion in gender identity in children raised by same-sex parents are not supported by research in the field indicating that there are “no negative developmental or psychological outcomes for a child, nor does it result in differing gender identity, gender role behavior or sexual partner preference compared to opposite-sex parents.”[10] ANALYSIS l. Desire to Procreate The American perception toward same-sex unions has evolved “from pathology to deviant lifestyle to identity.”[11] In 2001, only 35 percent of Americans favored same‐sex marriage, while 62 percent favored it in 2017.[12] The “Gay marriage generation”[13] has a positive attitude toward same-sex unions, arising from the “interaction among activists, celebrities, political and religious leaders, and ordinary people, who together reconfigured Americans’ social imagination of homosexuality in a way that made gay marriage seem normal, logical, and good.”[14] Same-sex couples’ right to build a biological family and ability to do so using modern reproductive technology is unclear. The data generated by the LGBTQ Family Building Survey revealed “dramatic differences in expectations around family building between LGBTQ millennials (aged 18-35) and older generations of LGBTQ people,”[15] which may be in part attributable to recent federal rulings in favor of same-sex couples. Three important results from this survey are that 63 percent of LGBTQ millennials are considering expanding their families throughout parenthood, 48 percent of LGBTQ millennials are actively planning to grow their families, compared to 55 percent of non-LGBTQ millennials; and 63 percent of those LGBTQ people interested in building a family expect to use assisted reproductive technology (ART), foster care, or adoption to become parents.[16] There are 15.9 million Americans who identify as LGBTQ+ (6.1 million of whom are 18 to 35 years old); thus, an estimated “3.8 million LGBTQ+ millennials are considering expanding their families in the coming years, and 2.9 million are actively planning to do so.”[17] Yet access and affordability to ART, especially in vitro fertilization (IVF) and surrogacy for same-sex couples, has not been consistent at a national level. The two primary problems accessing ART for the LGBTQ community are the lack of federal law and cost. A federal law that guaranteed coverage would address both problems. ll. ART for Same-Sex Couples All same-sex male (SSM) couples and same-sex female (SSF) couples must involve third parties, including surrogates or egg or sperm donors.[18] ART involves the legal status of “up to two women (surrogate and egg donor),” the intended parents, and the child for SSM couples.[19] While sometimes necessary for heterosexual couples using ART, an egg or sperm from someone other than the intended parents or a surrogate will always be necessary for the LGBTQ people seeking ART. ART, in particular IVF, is essential for infertile couples unable to conceive on their own. Unlike other industrialized countries (such as Canada, the United Kingdom, Sweden, Germany, and Australia), the US does not heavily oversee this multibillion-dollar industry.[20] The American Society for Reproductive Medicine does provide lengthy guidelines to fertility clinics and sperm banks; however, state lawmakers have been less active as they seem to avoid the controversy surrounding controversial topics like embryo creation and abortion.[21] As a result, states “do not regulate how many children may be conceived from one donor, what types of medical information or updates must be supplied by donors, what genetic tests may be performed on embryos, how many fertilized eggs may be placed in a woman or how old a donor can be.”[22] lll. A Flawed Definition of Infertility The WHO defines the medical definition of infertility as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after twelve months or more of regular unprotected sexual intercourse.”[23] This antiquated definition must be updated to include social infertility to integrate same-sex couples’ rights.[24] In the US, single individuals and LGBTQ couples interested in building a family by biological means are considered “socially infertile.”[25] If insurance coverage is allotted only to those with physical infertility, then it is exclusive to the heterosexual community. Although some states, such as New York, discussed below, have directly addressed this inequality by extending the definition of infertility and coverage of infertility treatments to include all residents regardless of sexual orientation, this is not yet the norm everywhere else. The outdated definition of infertility is one of the main issues affecting same-sex couples’ access to ART, as medical insurance companies hold on to the formal definition of infertility to deny coverage. lV. Insurance Coverage for IVF Insurance coverage varies per state and relies on the flawed definition of infertility. As of August 2020, 19 states have passed laws requiring insurance coverage for infertility, 13 of which include IVF coverage, as seen in Figure 1. Also, most states do not offer IVF coverage to low-income people through Medicaid.[26] In states that mandate IVF insurance coverage, the utilization rate was “277% of the rate when there was no coverage,”[27] which supports the likelihood that in other states, the cost is a primary barrier to access. When insurance does not cover ART, ART is reserved for wealthy individuals. One cycle of ART could cost, on average, “between $10,000 and $15,000.”[28] In addition, multiple cycles are often required as one IVF cycle only has “about a 25% to 30%” live birth success rate.[29] Altogether, the total cost of successful childbirth was estimated from $44,000 to $211,940 in 1992.[30] On February 11, 2021, New York Governor Andrew M. Cuomo “directed the Department of Financial Services to ensure that insurers begin covering fertility services immediately for same-sex couples who wish to start a family.”[31] New York had recently passed an IVF insurance law that required “large group insurance policies and contracts that provide medical, major medical, or similar comprehensive-type coverage and are delivered or issued for delivery in New York to cover three cycles of IVF used in the treatment of infertility.”[32] But the law fell short for same-sex couples, which were still required to “pay 6 or 12 months of out-of-pocket expenses for fertility treatments such as testing and therapeutic donor insemination procedures before qualifying for coverage.”[33] Cuomo’s subsequent order made up for gaps in the law, which defined infertility as “the inability to conceive after a certain period of unprotected intercourse or donor insemination.”[34] Cuomo’s order and the law combine to make New York an example other states can follow to broaden access to ART. V. Surrogacy Access to surrogacy also presents its own set of problems, although not exclusive to the LGBTQ community. Among states, there are differences in how and when parental rights are established. States in dark green in Figure 2 allow pre-birth orders, while the states in light green allow post-birth parentage orders. Pre-birth orders “are obtained prior to the child’s birth, and they order that the intended parent(s) will be recognized as the child’s only legal parent(s) and will be placed on the child’s birth certificate,” while post-birth parentage orders have the same intent but are obtained after the child’s birth. [35] For instance, states can require genetic testing post-birth, possibly causing a delay in establishing parentage.[36] Although preventable through the execution of a health care power of attorney, a surrogate mother could be the legal, medical decision-maker for the baby before the intended parents are legally recognized. On February 15, 2021, gestational surrogacy – the most popular type of surrogacy in which the surrogate has no biological link to the baby – was legalized in New York,[37] but it remains illegal in some states such as Nebraska, Louisiana, and Michigan.[38] In addition, the costs of surrogacy are rising, and it can cost $100,000 in the US.[39] Medicaid does not cover surrogacy costs,[40] and some health insurance policies provide supplemental surrogacy insurance with premiums of approximately $10,000 and deductibles starting at $15,000.[41] Thus, “surrogacy is really only available to those gay and lesbian couples who are upper class,”[42] leaving non-affluent couples out of options to start a family through biological means. Vl. A Right to Equality and Procreation Some argue that same-sex couples should have the right to procreate (or reproductive rights). Based on arguments stemming from equal rights and non-discrimination, same-sex couples who need to use ART to procreate should have access to it. The need to merge social infertility into the currently incomplete definition of fertility could help same-sex couples achieve access through insurance coverage. The human right of equality and non-discrimination guarantees “equal and effective protection against discrimination on any ground.”[43] The United Nations later clarified that “sexual orientation is a concept which is undoubtedly covered” [44] by this protection. The right to procreate is not overtly mentioned in the US Constitution; however, the Equal Protection Clause states that “No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States… without due process of law.”[45] In fact, some states have abridged the reproductive privileges of some US citizens by upholding prohibitive and intricate mechanisms that deter same-sex couples from enjoying the privileges other citizens have. The Supreme Court acknowledged procreation as a “fundamental”[46] personal right, in Skinner v. Oklahoma, mandating that the reproductive rights of individuals be upheld as the right to procreate is “one of the basic civil rights of man”[47] because “procreation [is] fundamental to the very existence and survival of the race.”[48] In Eisenstadt v. Baird, the courts also supported that “the decision whether to bear or beget a child” fundamentally affects a person.[49] I argue that this protection extends to same-sex couples seeking to procreate. Finally, Obergefell v. Hodges held that the Due Process and Equal Protection clauses ensure same-sex couples the right to marriage, as marriage “safeguards children and families, draw[ing] meaning from related rights of childrearing, procreation, and education.”[50] By implicit or explicit means, these cases align with the freedom to procreate that should not be unequally applied to different social or economic groups. Yet, the cases do not apply to accessing expensive tools to procreate. As heterosexuals and the LGBTQ community face trouble accessing expensive ART for vastly different reasons, especially IVF and surrogacy, the equal rights or discrimination argument is not as helpful. For now, it is relevant to adoption cases where religious groups can discriminate.[51] The insurance coverage level may be the best approach. While the social norms adapt and become more inclusive, the elimination of the infertility requirement or changing the definition of infertility could work. Several arguments could address the insurance coverage deficit. Under one argument, a biological or physical inability to conceive exists in the homosexual couple trying to achieve a pregnancy. Depending on the wording or a social definition, a caselaw could be developed arguing the medical definition of infertility applies to the LGBTQ community as those trying to procreate are physically unable to conceive as a couple planning to become parents. One counterargument to that approach is that it can be offensive to label people infertile (or disabled) only because of their status as part of a homosexual couple.[52] CONCLUSION In the last 50 years, there has been a notable shift in the social acceptance of homosexuality.[53] Marriage equality has opened the door for further social and legal equality, as evidenced by the increased number of same-sex couples seeking parenthood “via co-parenting, fostering, adoption or surrogacy” – colloquially referred to as the ‘Gayby Boom’.[54] However, some prejudice and disdain toward LGBTQ+ parenting remain. Equitable access to ART for all people may be attainable as new technology drives costs down, legislators face societal pressure to require broader insurance coverage, and social norms become more inclusive. [1] Eckholm, E. (2015, May 17). The same-sex couple who got a marriage license in 1971. Retrieved April 08, 2021, from https://www.nytimes.com/2015/05/17/us/the-same-sex-couple-who-got-a-marriage-license-in-1971.html [2] Eckholm, E. [3] A brief history of civil rights in the United States: A timeline of the legalization of same-sex marriage in the U.S. (2021, January 27). Retrieved April 08, 2021, from https://guides.ll.georgetown.edu/c.php?g=592919&p=4182201 [4] Eckholm, E. [5] A brief history of civil rights in the United States: A timeline of the legalization of same-sex marriage in the U.S. (2021, January 27). Retrieved April 08, 2021, from https://guides.ll.georgetown.edu/c.php?g=592919&p=4182201 [6] A brief history of civil rights in the United States [7] A brief history of civil rights in the United States [8] Lee, J., & Bolzendahl, C. (2019). Acceptance and Rejection: Patterns of opinion on homosexuality in the United States and the world. Sociological Forum, 34(4), 1026-1031. doi:10.1111/socf.12562 [9] Lee, J., et al. [10] Lee, J., et al. [11] Lee, J., et al. [12] Lee, et al. [13] Lee, et al. [14] Lee, et al. [15] LGBTQ family building survey. (2020, July 02). Retrieved April 08, 2021, from https://www.familyequality.org/resources/lgbtq-family-building-survey/ [16] LGBTQ family building survey. (2020, July 02). Retrieved April 08, 2021, from https://www.familyequality.org/resources/lgbtq-family-building-survey/ [17] LGBTQ family building survey. (2020, July 02). Retrieved April 08, 2021, from https://www.familyequality.org/resources/lgbtq-family-building-survey/ [18] Mackenzie, S. C., Wickins-Drazilova, D., & Wickins, J. (2020). The ethics of fertility treatment for same-sex male couples: Considerations for a modern fertility clinic. European Journal of Obstetrics & Gynecology and Reproductive Biology, 244, 71-75. doi:10.1016/j.ejogrb.2019.11.011 [19] Mackenzie, et al. [20] Ollove, M. (2015, March 18). States not eager to regulate fertility industry. Retrieved April 08, 2021, from https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/3/18/states-not-eager-to-regulate-fertility-industry [21] Ollove, M. [22] Ollove, M. [23] World Health Organization. (2020, September 14). Infertility. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/infertility [24] Leondires, M. P. (2020, March 19). Fertility insurance Mandates & same-sex couples. Retrieved April 08, 2021, from https://www.gayparentstobe.com/gay-parenting-blog/fertility-insurance-mandates-same-sex-couples/ [25] Lo, W., & Campo-Engelstein, L. (2018). Expanding the Clinical Definition of Infertility to Include Socially Infertile Individuals and Couples. Reproductive Ethics II, 71–83. https://doi.org/10.1007/978-3-319-89429-4_6 [26] Mohapatra, S. (2015). Assisted Reproduction Inequality and Marriage Equality. Chicago-Kent Law Review, 92(1). Retrieved April 08, 2021, from https://scholarship.kentlaw.iit.edu/cgi/viewcontent.cgi?article=4146&context=cklawreview [27] Mohapatra, S. [28] Mohapatra, S. [29] Mohapatra, S. [30] Mohapatra, S. [31] Governor Cuomo announces new actions to expand access to FERTILITY coverage for same sex couples as part of 2021 Women's Agenda. (n.d.). [32] Health Insurers FAQs: IVF and Fertility Preservation Law Q&A Guidance. (n.d.). Retrieved April 08, 2021, from https://www.dfs.ny.gov/apps_and_licensing/health_insurers/ivf_fertility_preservation_law_qa_guidance [33] Governor Cuomo announces new actions to expand access to FERTILITY coverage for same sex couples as part of 2021 Women's Agenda. (n.d.). Retrieved April 08, 2021, from https://www.governor.ny.gov/news/governor-cuomo-announces-new-actions-expand-access-fertility-coverage-same-sex-couples-part#:~:text=February%2011%2C%202021-,Governor%20Cuomo%20Announces%20New%20Actions%20to%20Expand%20Access%20to%20Fertility,Part%20of%202021%20Women's%20Agenda&text=Cuomo%20today%20directed%20the%20Department,wish%20to%20start%20a%20family. [34] Leondires, M. P. [35] Assisted reproduction parentage proceedings information: Academy of Adoption and Assistive Reproduction Attorneys (AAAA). (2019, March 14). Retrieved April 08, 2021, from https://adoptionart.org/assisted-reproduction/parentage-proceedings/ [36] Assisted reproduction parentage proceedings information. [37] Governor Cuomo reminds surrogates and parents of their new Insurance rights and protections During Gestational Surrogacy. (n.d.). Retrieved April 08, 2021, from https://www.governor.ny.gov/news/governor-cuomo-reminds-surrogates-and-parents-their-new-insurance-rights-and-protections-during [38] U.S. Surrogacy Map: Surrogacy laws by state. (2020, December 23). Retrieved April 08, 2021, from https://www.creativefamilyconnections.com/us-surrogacy-law-map/ [39] Mohapatra, S. [40] Beitsch, R. (2017, June 29). As surrogacy surges, new parents seek legal protections. Retrieved April 08, 2021, from https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2017/06/29/as-surrogacy-surges-new-parents-seek-legal-protections#:~:text=Medicaid%20does%20not%20cover%20surrogacy,and%20intended%20parents%20at%20risk. [41] Where to find surrogacy insurance? (2017, November 02). Retrieved April 08, 2021, from https://surrogate.com/intended-parents/surrogacy-laws-and-legal-information/where-can-i-find-surrogacy-insurance/ [42] Mohapatra, S. [43] International covenant on civil and political rights. (n.d.). Retrieved April 08, 2021, from https://www.ohchr.org/en/professionalinterest/pages/ccpr.aspx [44] United Nations. (2003). Human rights in the administration of justice: a manual on human rights for judges, prosecutors and lawyers. [45] U.S. Const. amend. XIV, § 1. [46] Skinner v. Oklahoma, Https://caselaw.findlaw.com/us-supreme-court/316/535.html (June 1, 1942). [47] Skinner v. Oklahoma [48] Skinner v. Oklahoma [49] Eisenstadt v. Baird, Https://www.lexisnexis.com/community/casebrief/p/casebrief-eisenstadt-v-baird (March 22, 1972). [50] Obergefell v. Hodges [51] Higgins, T. (2021, June 17). Supreme Court sides with Catholic adoption agency that refuses to work with LGBT couples. CNBC. https://www.cnbc.com/2021/06/17/supreme-court-sides-with-catholic-adoption-agency-that-refuses-to-work-with-lgbt-couples.html. [52] Bowerman, M., May, A., & Rossman, S. (2017, April 24). Should the definition of infertility be more inclusive? USA Today. https://www.usatoday.com/story/news/nation-now/2017/04/22/same-sex-couples-covered-infertility-insurance/100644092/. [53] Mackenzie, et al. [54] Mackenzie, et al.

Abstract:

Introduction Special occasion cookery has been a staple of the cookbook writing in the English speaking Western world for decades. This includes providing catering for personal milestones as well as religious and secular festivals. Yet, in an era when the culinary publishing sector is undergoing considerable expansion and market segmentation, narratives of foods marking of one of life’s central and inescapable rites—death—are extremely rare. This discussion investigates examples of food writing related to death and funeral rites in contemporary cookbooks. Funeral feasts held in honour of the dead date back beyond recorded history (Luby and Gruber), and religious, ceremonial and community group meals as a component of funeral rites are now ubiquitous around the world. In earlier times, the dead were believed to derive both pleasure and advantage from these offerings (LeClercq), and contemporary practice still reflects this to some extent, with foods favoured by the deceased sometimes included in such meals (see, for instance, Varidel). In the past, offering some sustenance as a component of a funeral was often necessary, as mourners might have travelled considerable distances to attend the ceremony, and eateries outside the home were not as commonplace or convenient to access as they are today. The abundance and/or lavishness of the foods provided may also have reflected the high esteem in which the dead was held, and offered as a mark of community respect (Smith and Bird). Following longstanding tradition, it is still common for Western funeral attendees to gather after the formal parts of the event—the funeral service and burial or cremation —in a more informal atmosphere to share memories of the deceased and refreshments (Simplicity Funerals 31). Thursby notes that these events, which are ostensibly about the dead, often develop into a celebration of the ties between living family members and friends, “times of reunions and renewed relationships” (94). Sharing food is central to this celebration as “foods affirm identity, strengthen kinship bonds, provide comfortable and familiar emotional support during periods of stress” (79), while familiar dishes evoke both memories and promising signals of the continued celebration of life” (94). While in the southern states and some other parts of the USA, it is customary to gather at the church premises after the funeral for a meal made up of items contributed by members of the congregation, and with leftovers sent home with the bereaved family (Siegfried), it is more common in Australasia and the UK to gather either in the home of the principal mourners, someone else’s home or a local hotel, club or restaurant (Jalland). Church halls are a less common option in Australasia, and an increasing trend is the utilisation of facilities attached to the funeral home and supplied as a component of a funeral package (Australian Heritage Funerals). The provision of this catering largely depends on the venue chosen, with the cookery either done by family and/or friends, the hotel, club, restaurant or professional catering companies, although this does not usually affect the style of the food, which in Australia and New Zealand is often based on a morning or afternoon tea style meal (Jalland). Despite widespread culinary innovation in other contexts, funeral catering bears little evidence of experimentation. Ash likens this to as being “fed by grandmothers”, and describes “scones, pastries, sandwiches, biscuits, lamingtons—food from a fifties afternoon party with the taste of Country Women’s Association about it”, noting that funerals “require humble food. A sandwich is not an affront to the dead” (online). Numerous other memoirists note this reliance on familiar foods. In “S is for Sad” in her An Alphabet for Gourmets (1949), food writer M.F.K. Fisher writes of mourners’s deep need for sustenance at this time as a “mysterious appetite that often surges in us when our hearts seem breaking and our lives too bleakly empty” (135). In line with Probyn’s argument that food foregrounds the viscerality of life (7), Fisher notes that “most bereaved souls crave nourishment more tangible than prayers: they want a steak. […] It is as if our bodies, wiser than we who wear them, call out for encouragement and strength and […] compel us […] to eat” (135, 136). Yet, while funerals are a recurring theme in food memoirs (see, for example, West, Consuming), only a small number of Western cookbooks address this form of special occasion food provision. Feast by Nigella Lawson Nigella Lawson’s Feast: Food that Celebrates Life (2004) is one of the very few popular contemporary cookbooks in English that includes an entire named section on cookery for funerals. Following twenty-one chapters that range from the expected (Christmas, Thanksgiving, Easter, and wedding) to more original (children’s and midnight) feasts, Lawson frames her discussion with an anthropological understanding of the meaning of special occasion eating. She notes that we use food “to mark occasions that are important to us in life” (vii) and how eating together “is the vital way we celebrate anything that matters […] how we mark the connections between us, how we celebrate life” (vii). Such meals embody both personal and group identities because both how and what is eaten “lies at the heart of who we are-as individuals, families, communities” (vii). This is consistent with her overall aims as a food writer—to explore foods’ meanings—as she states in the book’s introduction “the recipes matter […] but it is what the food says that really counts” (vii). She reiterates this near the end of the book, adding, almost as an afterthought, “and, of course, what it tastes like” (318). Lawson’s food writing also reveals considerable detail about herself. In common with many other celebrity chefs and food writers, Lawson continuously draws on, elaborates upon, and ultimately constructs her own life as a major theme of her works (Brien, Rutherford, and Williamson). In doing so, she, like these other chefs and food writers, draws upon revelations of her private life to lend authenticity to her cooking, to the point where her cookbooks could be described as “memoir-illustrated-with-recipes” (Brien and Williamson). The privileging of autobiographical information in Lawson’s work extends beyond the use of her own home and children in her television programs and books, to the revelation of personal details about her life, with the result that these have become well known. Her readers thus know that her mother, sister and first and much-loved husband all died of cancer in a relatively brief space of time, and how these tragedies affected her life. Her first book, How to Eat: The Pleasures and Principles of Good Food (1998), opened with the following dedication: “In memory of my mother, Vanessa (1936–1985) and my sister Thomasina (1961–1993)” (dedication page). Her husband, BBC broadcaster and The Times (London) journalist John Diamond, who died of throat cancer in 2001, furthered this public knowledge, writing about both his illness and at length about Lawson in his column and his book C: Because Cowards Get Cancer Too (1999). In Feast, Lawson discusses her personal tragedies in the introduction of the ‘Funeral Foods’ chapter, writing about a friend's kind act of leaving bags of shopping from the supermarket for her when she was grieving (451). Her first recipe in this section, for a potato topped fish pie, is highly personalised in that it is described as “what I made on the evening following my mother’s funeral” (451). Following this, she again uses her own personal experience when she notes that “I don’t think anyone wants to cook in the immediate shock of bereavement […] but a few days on cooking can be a calming act, and since the mind knows no rest and has no focus, the body may as well be busy” (451). Similarly, her recipe for the slowly hard-boiled, dark-stained Hamine Eggs are described as “sans bouche”, which she explains means “without mouths to express sorrow and anguish.” She adds, drawing on her own memories of feelings at such times, “I find that appropriate: there is nothing to be said, or nothing that helps” (455). Despite these examples of raw emotion, Lawson’s chapter is not all about grief. She also comments on both the aesthetics of dishes suitable for such times and their meanings, as well as the assistance that can be offered to others through the preparation and sharing of food. In her recipe for a lamb tagine that includes prunes, she notes, for example, that the dried plums are “traditionally part of the funeral fare of many cultures […] since their black colour is thought to be appropriate to the solemnity of the occasion” (452). Lawson then suggests this as a suitable dish to offer to someone in mourning, someone who needs to “be taken care of by you” (452). This is followed by a lentil soup, the lentils again “because of their dark colour … considered fitting food for funerals” (453), but also practical, as the dish is “both comforting and sustaining and, importantly, easy to transport and reheat” (453). Her next recipe for a meatloaf containing a line of hard-boiled eggs continues this rhetorical framing—as it is “always comfort food […] perfect for having sliced on a plate at a funeral tea or for sending round to someone’s house” (453). She adds the observation that there is “something hopeful and cheering about the golden yolk showing through in each slice” (453), noting that the egg “is a recurring feature in funeral food, symbolising as it does, the cycle of life, the end and the beginning in one” (453). The next recipe, Heavenly Potatoes, is Lawson’s version of the dish known as Mormon or Utah Funeral potatoes (Jensen), which are so iconic in Utah that they were featured on one of the Salt Lake City Olympic Games souvenir pins (Spackman). This tray of potatoes baked in milk and sour cream and then topped with crushed cornflakes are, she notes, although they sound exotic, quite familiar, and “perfect alongside the British traditional baked ham” (454), and reference given to an earlier ham recipe. These savoury recipes are followed by those for three substantial cakes: an orange cake marbled with chocolate-coffee swirls, a fruit tea loaf, and a rosemary flavoured butter cake, each to be served sliced to mourners. She suggests making the marble cake (which Lawson advises she includes in memory of the deceased mother of one of her friends) in a ring mould, “as the circle is always significant. There is a cycle that continues but—after all, the cake is sliced and the circle broken—another that has ended” (456). Of the fruitcake, she writes “I think you need a fruit cake for a funeral: there’s something both comforting and bolstering (and traditional) about it” (457). This tripartite concern—with comfort, sustenance and tradition—is common to much writing about funeral foods. Cookbooks from the American South Despite this English example, a large proportion of cookbook writing about funeral foods is in American publications, and especially those by southern American authors, reflecting the bountiful spreads regularly offered to mourners in these states. This is chronicled in novels, short stories, folk songs and food memoirs as well as some cookery books (Purvis). West’s memoir Consuming Passions: A Food Obsessed Life (2000) has a chapter devoted to funeral food, complete with recipes (132–44). West notes that it is traditional in southern small towns to bring covered dishes of food to the bereaved, and that these foods have a powerful, and singular, expressive mode: “Sometimes we say all the wrong things, but food […] says, ‘I know you are inconsolable. I know you are fragile right now. And I am so sorry for your loss’” (139). Suggesting that these foods are “concern and sympathy in a Pyrex bowl” (139), West includes recipes for Chess pie (a lemon tart), with the information that this is known in the South as “funeral pie” (135) and a lemon-flavoured slice that, with a cup of tea, will “revive the spirit” (136). Like Lawson, West finds significance in the colours of funeral foods, continuing that the sunny lemon in this slice “reminds us that life continues, that we must sustain and nourish it” (139). Gaydon Metcalf and Charlotte Hays’s Being Dead is No Excuse: The Official Southern Ladies Guide to Hosting the Perfect Funeral (2005), is one of the few volumes available dedicated to funeral planning and also offers a significant cookery-focused section on food to offer at, and take to, funeral events. Jessica Bemis Ward’s To Die For: A Book of Funeral Food, Tips, and Tales from the Old City Cemetery, Lynchburg, Virginia (2004) not only contains more than 100 recipes, but also information about funeral customs, practical advice in writing obituaries and condolence notes, and a series of very atmospheric photographs of this historic cemetery. The recipes in the book are explicitly noted to be traditional comfort foods from Central Virginia, as Ward agrees with the other writers identified that “simplicity is the by-word when talking about funeral food” (20). Unlike the other examples cited here, however, Ward also promotes purchasing commercially-prepared local specialties to supplement home-cooked items. There is certainly significantly more general recognition of the specialist nature of catering for funerals in the USA than in Australasia. American food is notable in stressing how different ethnic groups and regions have specific dishes that are associated with post-funeral meals. From this, readers learn that the Amish commonly prepare a funeral pie with raisins, and Chinese-American funerals include symbolic foods taken to the graveside as an offering—including piles of oranges for good luck and entire roast pigs. Jewish, Italian and Greek culinary customs in America also receive attention in both scholarly studies and popular American food writing (see, for example, Rogak, Purvis). This is beginning to be acknowledged in Australia with some recent investigation into the cultural importance of food in contemporary Chinese, Jewish, Greek, and Anglo-Australian funerals (Keys), but is yet to be translated into local mainstream cookery publication. Possible Publishing Futures As home funerals are a growing trend in the USA (Wilson 2009), green funerals increase in popularity in the UK (West, Natural Burial), and the multi-million dollar funeral industry is beginning to be questioned in Australia (FCDC), a more family or community-centered “response to death and after-death care” (NHFA) is beginning to re-emerge. This is a process whereby family and community members play a key role in various parts of the funeral, including in planning and carrying out after-death rituals or ceremonies, preparing the body, transporting it to the place of burial or cremation, and facilitating its final disposition in such activities as digging the grave (Gonzalez and Hereira, NHFA). Westrate, director of the documentary A Family Undertaking (2004), believes this challenges us to “re-examine our attitudes toward death […] it’s one of life’s most defining moments, yet it’s the one we typically prepare for least […] [and an indication of our] culture of denial” (PBS). With an emphasis on holding meaningful re-personalised after-disposal events as well as minimal, non-invasive and environmentally friendly treatment of the body (Harris), such developments would also seem to indicate that the catering involved in funeral occasions, and the cookbooks that focus on the provision of such food, may well become more prominent in the future. References [AHF] Australian Heritage Funerals. “After the Funeral.” Australian Heritage Funerals, 2013. 10 Mar. 2013 ‹http://www.ahfunerals.com.au/services.php?arid=31›. Ash, Romy. “The Taste of Sad: Funeral Feasts, Loss and Mourning.” Voracious: Best New Australian Food Writing. Ed. Paul McNally. Richmond, Vic.: Hardie Grant, 2011. 3 Apr. 2013 ‹http://www.romyash.com/non-fiction/the-taste-of-sad-funeral-feasts-loss-and-mourning›. Brien, Donna Lee, Leonie Rutherford, and Rosemary Williamson. "Hearth and Hotmail: The Domestic Sphere as Commodity and Community in Cyberspace." M/C Journal 10.4 (2007). 28 Apr. 2013 ‹http://journal.media-culture.org.au/0708/10-brien.php›. Brien, Donna Lee, and Rosemary Williamson. “‘Angels of the Home’ in Cyberspace: New Technologies and Biographies of Domestic Production”. Biography and New Technologies. Australian National University. Humanities Research Centre, Canberra, ACT. 12-14 Sep. 2006. Conference Presentation. Diamond, John. C: Because Cowards Get Cancer Too… . London: Vermilion, 1998. Fisher, M.F.K. “S is for Sad.” An Alphabet for Gourmets. New York, North Point P, 1989. 1st. pub. New York, Viking: 1949. Gonzalez, Faustino, and Mildreys Hereira. “Home-Based Viewing (El Velorio) After Death: A Cost-Effective Alternative for Some Families.” American Journal of Hospice & Pallative Medicine 25.5 (2008): 419–20. Harris, Mark. Grave Matters: A Journey Through the Modern Funeral Industry to a Natural Way of Burial. New York: Scribner, 2007. Jalland, Patricia. Australian Ways of Death: A Social and Cultural History 1840-1918. Melbourne: Oxford UP, 2002. Jensen, Julie Badger. The Essential Mormon Cookbook: Green Jell-O, Funeral Potatoes, and Other Secret Combinations. Salt Lake City: Deseret, 2004. Keys, Laura. “Undertaking a Jelly Feast in Williamstown.” Hobsons Bay Leader 28 Mar. 2011. 2 Apr. 2013 ‹http://hobsons-bay-leader.whereilive.com.au/news/story/undertaking-a-jelly-feast-in-williamstown›. Lawson, Nigella. How to Eat: The Pleasures and Principles of Good Food. London: Chatto & Windus, 1998. ---. Feast: Food that Celebrates Life. London: Chatto & Windus, 2004. LeClercq, H. “The Agape Feast.” The Catholic Encyclopedia I, New York: Robert Appleton, 1907. 3 Apr. 2013. ‹http://www.piney.com/AgapeCE.html›. Luby, Edward M., and Mark F. Gruber. “The Dead Must Be Fed: Symbolic Meanings of the Shellmounds of the San Francisco Bay Area.” Cambridge Archaeological Journal 9.1 (1999): 95–108. Metcalf, Gaydon, and Charlotte Hays. Being Dead Is No Excuse: The Official Southern Ladies Guide to Hosting the Perfect Funeral. New York: Miramax, 2005. [NHFA] National Home Funeral Alliance. “What is a Home Funeral?” National Home Funeral Alliance, 2012. 3 Apr. 2013. ‹http://homefuneralalliance.org›. PBS. “A Family Undertaking.” POV: Documentaries with a Point of View. PBS, 2004. 3 Apr. 2013 ‹http://www.pbs.org/pov/afamilyundertaking/film_description.php#.UYHI2PFquRY›. Probyn, Elspeth. Carnal Appetites: Food/Sex/Identities. London: Routledge, 2000. Purvis, Kathleen. “Funeral Food.” The Oxford Companion to American Food and Drink. Ed. Andrew F. Smith. New York: Oxford UP, 2007. 247–48. Rogak, Lisa. Death Warmed Over: Funeral Food, Rituals, and Customs from Around the World. Berkeley: Ten Speed P, 2004. Siegfried, Susie. Church Potluck Carry-Ins and Casseroles: Homestyle Recipes for Church Suppers, Gatherings, and Community Celebrations. Avon, MA.: Adams Media, 2006. Simplicity Funerals. Things You Need To Know About Funerals. Sydney: Simplicity Funerals, 1990. Smith, Eric Alden, and Rebecca L. Bliege Bird. “Turtle Hunting and Tombstone Opening: Public Generosity as Costly Signaling.” Evolution and Human Behavior 21.4 (2000): 245–61.Spackman, Christy. “Mormonism’s Jell-O Mold: Why Do We Associate the Religion With the Gelatin Dessert?” Slate Magazine 17 Aug. (2012). 3 Apr. 2013.Thursby, Jacqueline S. Funeral Festivals in America: Rituals for the Living. Lexington: UP of Kentucky, 2006. Varidel, Rebecca. “Bompas and Parr: Funerals and Food at Nelson Bros.” Inside Cuisine 12 Mar. (2011). 3 Apr. 2013 ‹http://insidecuisine.com/2011/03/12/bompas-and-parr-funerals-and-food-at-nelson-bros›. Ward, Jessica Bemis. Food To Die for: A Book of Funeral Food, Tips, and Tales from the Old City Cemetery, Lynchburg, Virginia. Lynchburg: Southern Memorial Association, 2004. West, Ken. A Guide to Natural Burial. Andover UK: Sweet & Maxwell, 2010. West, Michael Lee. Consuming Passions: A Food Obsessed Life. New York: Perennial, 2000. Wilson, M.T. “The Home Funeral as the Final Act of Caring: A Qualitative Study.” Master in Nursing thesis. Livonia, Michigan: Madonna University, 2009.

Abstract:

By most accounts, “resilience” is a pretty resilient concept. Or policy instrument. Or heuristic tool. It’s this last that really concerns us here: resilience not as a politics, but rather as a descriptive device for attempts in the humanities—particularly in rhetoric and cultural studies—to adequately describe a discursive event. Or rather, to adequately describe a class of discursive events: those that involve rhetorical resistance by victimised subjects. I’ve argued elsewhere (Munro, Descriptive; Reading) that Peircean semiosis, inflected by a rhetorical postulate of genre, equips us well to closely describe a discursive event. Here, I want briefly to suggest that resilience—“discursive” resilience, to coin a term—might usefully supplement these hypotheses, at least from time to time. To support this suggestion, I’ll signal some uses of resilience before turning briefly to a case study: a sensational Argentine homicide case, which occurred in October 2002, and came to be known as the caso Belsunce. At the time, Argentina was wracked by economic crises and political instability. The imposition of severe restrictions on cash withdrawals from bank deposits had provoked major civil unrest. Between 21 December 2001 and 2 January 2002, Argentines witnessed a succession of five presidents. “Resilient” is a term that readily comes to mind to describe many of those who endured this catastrophic period. To describe the caso Belsunce, however—to describe its constitution and import as a discursive event—we might appeal to some more disciplinary-specific understandings of resilience. Glossing Peircean semiosis as a teleological process, Short notes that “one and the same thing […] may be many different signs at once” (106). Any given sign, in other words, admits of multiple interpretants or uptakes. And so it is with resilience, which is both a keyword in academic disciplines ranging from psychology to ecology and political science, and a buzzword in several corporate domains and spheres of governmental activity. It’s particularly prevalent in the discourses of highly networked post-9/11 Anglophone societies. So what, pray tell, is resilience? To the American Psychological Association, resilience comprises “the process of adapting well in the face of adversity.” To the Resilience Solutions Group at Arizona State University, resilience is “the capacity to recover fully from acute stressors, to carry on in the face of chronic difficulties: to regain one’s balance after losing it.” To the Stockholm Resilience Centre, resilience amounts to the “capacity of a system to continually change and adapt yet remain within critical thresholds,” while to the Resilience Alliance, resilience is similarly “the capacity of a system to absorb disturbance and still retain its basic function and structure” (Walker and Salt xiii). The adjective “resilient” is thus predicated of those entities, individuals or collectivities, which exhibit “resilience”. A “resilient Australia,” for example, is one “where all Australians are better able to adapt to change, where we have reduced exposure to risks, and where we are all better able to bounce back from disaster” (Australian Government). It’s tempting here to synthesise these statements with a sense of “ordinary language” usage to derive a definitional distillate: “resilience” is a capacity attributed to an entity which recovers intact from major injury. This capacity is evidenced in a reaction or uptake: a “resilient” entity is one which suffers some insult or disturbance, but whose integrity is held to have been maintained, or even enhanced, by its resistive or adaptive response. A conjecturally “resilient” entity is thus one which would presumably evince resilience if faced with an unrealised aversive event. However, such abstractions ignore how definitional claims do rhetorical work. On any given occasion, how “resilience” and its cognates are construed and what they connote are a function, at least in part, of the purposes of rhetorical agents and the protocols and objects of the disciplines or genres in which these agents put these terms to work. In disciplines operating within the same form of life or sphere of activity—disciplines sharing general conventions and broad objects of inquiry, such as the capacious ecological sciences or the contiguous fields of study within the ambit of applied psychology—resilience acts, at least at times, as a something of a “boundary object” (Star and Griesemer). Correlatively, across more diverse and distant fields of inquiry, resilience can work in more seemingly exclusive or contradictory ways (see Handmer and Dovers). Rhetorical aims and disciplinary objects similarly determine the originary tales we are inclined to tell. In the social sciences, the advent of resilience is often attributed to applied psychology, indebted, in turn, to epidemiology (see Seery, Holman and Cohen Silver). In environmental science, by contrast, resilience is typically taken to be a theory born in ecology (indebted to engineering and to the physical sciences, in particular to complex systems theory [see Janssen, Schoon, Ke and Börner]). Having no foundational claim to stake and, moreover, having different purposes and taking different objects, some more recent uptakes of resilience, in, for instance, securitisation studies, allow for its multidisciplinary roots (see Bourbeau; Kaufmann). But if resilience is many things to many people, a couple of commonalities in its range of translations should be drawn out. First, irrespective of its discipline or sphere of activity, talk of resilience typically entails construing an object of inquiry qua system, be that system an individual, a community of circumstance, a state, a socio-ecological unit or some differently delimited entity. This bounded system suffers some insult with no resulting loss of structural, relational, functional or other integrity. Second, resilience is usually marshalled to promote a politics. Resilience talk often consorts with discourses of meliorative action and of readily quantifiable practical effects. When the environmental sciences take the “Earth system” and the dynamics of global change as their objects of inquiry, a postulate of resilience is key to the elaboration and implementation of natural resource management policy. Proponents of socio-ecological resilience see the resilience hypothesis as enabling a demonstrably more enlightened stewardship of the biosphere (see Folke et al.; Holling; Walker and Salt). When applied psychology takes the anomalous situation of disadvantaged, at-risk individuals triumphing over trauma as its declared object of inquiry, a postulate of resilience is key to the positing and identification of personal and environmental resources or protective factors which would enable the overcoming of adversity. Proponents of psychosocial resilience see this concept as enabling the elaboration and implementation of interventions to foster individual and collective wellbeing (see Goldstein and Brooks; Ungar). Similarly, when policy think-tanks and government departments and agencies take the apprehension of particular threats to the social fabric as their object of inquiry, a postulate of resilience—or of a lack thereof—is critical to the elaboration and implementation of urban infrastructure, emergency planning and disaster management policies (see Drury et al.; Handmer and Dovers). However, despite its often positive connotations, resilience is well understood as a “normatively open” (Bourbeau 11) concept. This openness is apparent in some theories and practices of resilience. In limnological modelling, for example, eutrophication can result in a lake’s being in an undesirable, albeit resilient, turbid-water state (see Carpenter et al.; Walker and Meyers). But perhaps the negative connotations or indeed perverse effects of resilience are most apparent in some of its political uptakes. Certainly, governmental operationalisations of resilience are coming under increased scrutiny. Chief among the criticisms levelled at the “muddled politics” (Grove 147) of and around resilience is that its mobilisation works to constitute a particular neoliberal subjectivity (see Joseph; Neocleous). By enabling a conservative focus on individual responsibility, preparedness and adaptability, the topos of resilience contributes critically to the development of neoliberal governmentality (Joseph). In a practical sense, this deployment of resilience silences resistance: “building resilient subjects,” observe Evans and Reid (85), “involves the deliberate disabling of political habits. […] Resilient subjects are subjects that have accepted the imperative not to resist or secure themselves from the difficulties they are faced with but instead adapt to their enabling conditions.” It’s this prospect of practical acquiescence that sees resistance at times opposed to resilience (Neocleous). “Good intentions not withstanding,” notes Grove (146), “the effect of resilience initiatives is often to defend and strengthen the political economic status quo.” There’s much to commend in these analyses of how neoliberal uses of resilience constitute citizens as highly accommodating of capital and the state. But such critiques pertain to the governmental mobilisation of resilience in the contemporary “advanced liberal” settings of “various Anglo-Saxon countries” (Joseph 47). There are, of course, other instances—other events in other times and places—in which resilience indisputably sorts with resistance. Such an event is the caso Belsunce, in which a rhetorically resilient journalistic community pushed back, resisting some of the excesses of a corrupt neoliberal Argentine regime. I’ll turn briefly to this infamous case to suggest that a notion of “discursive resilience” might afford us some purchase when it comes to describing discursive events. To be clear: we’re considering resilience here not as an anticipatory politics, but rather as an analytic device to supplement the descriptive tools of Peircean semiosis and a rhetorical postulate of genre. As such, it’s more an instrument than an answer: a program, perhaps, for ongoing work. Although drawing on different disciplinary construals of the term, this use of resilience would be particularly indebted to the resilience thinking developed in ecology (see Carpenter el al.; Folke et al.; Holling; Walker et al.; Walker and Salt). Things would, of course, be lost in translation (see Adger; Gallopín): in taking a discursive event, rather than the dynamics of a socio-ecological system, as our object of inquiry, we’d retain some topological analogies while dispensing with, for example, Holling’s four-phase adaptive cycle (see Carpenter et al.; Folke; Gunderson; Gunderson and Holling; Walker et al.). For our purposes, it’s unlikely that descriptions of ecosystem succession need to be carried across. However, the general postulates of ecological resilience thinking—that a system is a complex series of dynamic relations and functions located at any given time within a basin of attraction (or stability domain or system regime) delimited by thresholds; that it is subject to multiple attractors and follows trajectories describable over varying scales of time and space; that these trajectories are inflected by exogenous and endogenous perturbations to which the system is subject; that the system either proves itself resilient to these perturbations in its adaptive or resistive response, or transforms, flipping from one domain (or basin) to another may well prove useful to some descriptive projects in the humanities. Resilience is fundamentally a question of uptake or response. Hence, when examining resilience in socio-ecological systems, Gallopín notes that it’s useful to consider “not only the resilience of the system (maintenance within a basin) but also coping with impacts produced and taking advantage of opportunities” (300). Argentine society in the early-to-mid 2000s was one such socio-political system, and the caso Belsunce was both one such impact and one such opportunity. Well-connected in the world of finance, 57-year-old former stockbroker Carlos Alberto Carrascosa lived with his 50-year-old sociologist turned charity worker wife, María Marta García Belsunce, close to their relatives in the exclusive gated community of Carmel Country Club, Pilar, Provincia de Buenos Aires, Argentina. At 7:07 pm on Sunday 27 October 2002, Carrascosa called ambulance emergencies, claiming that his wife had slipped and knocked her head while drawing a bath alone that rainy Sunday afternoon. At the time of his call, it transpired, Carrascosa was at home in the presence of intimates. Blood was pooled on the bathroom floor and smeared and spattered on its walls and adjoining areas. María Marta lay lifeless, brain matter oozing from several holes in her left parietal and temporal lobes. This was the moment when Carrascosa, calm and coherent, called emergency services, but didn’t advert the police. Someone, he told the operator, had slipped in the bath and bumped her head. Carrascosa described María Marta as breathing, with a faint pulse, but somehow failed to mention the holes in her head. “A knock with a tap,” a police source told journalist Horacio Cecchi, “really doesn’t compare with the five shots to the head, the spillage of brain matter and the loss of about half a litre of blood suffered by the victim” (Cecchi and Kollmann). Rather than a bathroom tap, María Marta’s head had met with five bullets discharged from a .32-calibre revolver. In effect, reported Cecchi, María Marta had died twice. “While perhaps a common conceit in fiction,” notes Cecchi, “in reality, dying twice is, by definition, impossible. María Marta’s two obscure endings seem to unsettle this certainty.” Her cadaver was eventually subjected to an autopsy, and what had been a tale of clumsiness and happenstance was rewritten, reinscribed under the Argentine Penal Code. The autopsy was conducted 36 days after the burial of María Marta; nine days later, she was mentioned for the second time in the mainstream Argentine press. Her reappearance, however, was marked by a shift in rubrics: from a short death notice in La Nación, María Marta was translated to the crime section of Argentina’s dailies. Until his wife’s mediatic reapparition, Carroscosa and other relatives had persisted with their “accident” hypothesis. Indeed, they’d taken a range of measures to preclude the sorts of uptakes that might ordinarily be expected to flow, under functioning liberal democratic regimes, from the discovery of a corpse with five projectiles lodged in its head. Subsequently recited as part of Carrascosa’s indictment, these measures were extensively reiterated in media coverage of the case. One of the more notorious actions involved the disposal of the sixth bullet, which was found lying under María Marta. In the course of moving the body of his half-sister, John Hurtig retrieved a small metallic object. This discovery was discussed by a number of family members, including Carrascosa, who had received ballistics training during his four years of naval instruction at the Escuela Nacional de Náutica de la Armada. They determined that the object was a lug or connector rod (“pituto”) used in library shelving: nothing, in any case, to indicate a homicide. With this determination made, the “pituto” was duly wrapped in lavatory paper and flushed down the toilet. This episode occasioned a range of outraged articles in Argentine dailies examining the topoi of privilege, power, corruption and impunity. “Distinguished persons,” notes Viau pointedly, “are so disposed […] that in the midst of all that chaos, they can locate a small, hard, steely object, wrap it in lavatory paper and flush it down the toilet, for that must be how they usually dispose of […] all that rubbish that no longer fits under the carpet.” Most often, though, critical comment was conducted by translating the reporting of the case to the genres of crime fiction. In an article entitled Someone Call Agatha Christie, Quick!, H.A.T. writes that “[s]omething smells rotten in the Carmel Country; a whole pile of rubbish seems to have been swept under its plush carpets.” An exemplary intervention in this vein was the work of journalist and novelist Vicente Battista, for whom the case (María Marta) “synthesizes the best of both traditions of crime fiction: the murder mystery and the hard-boiled novels.” “The crime,” Battista (¿Hubo Otra Mujer?) has Rodolfo observe in the first of his speculative dialogues on the case, “seems to be lifted from an Agatha Christie novel, but the criminal turns out to be a copy of the savage killers that Jim Thompson usually depicts.” Later, in an interview in which he correctly predicted the verdict, Battista expanded on these remarks: This familiar plot brings together the English murder mystery and the American hard-boiled novels. The murder mystery because it has all the elements: the crime takes place in a sealed room. In this instance, sealed not only because it occurred in a house, but also in a country, a sealed place of privilege. The victim was a society lady. Burglary is not the motive. In classic murder mystery novels, it was a bit unseemly that one should kill in order to rob. One killed either for a juicy sum of money, or for revenge, or out of passion. In those novels there were neither corrupt judges nor fugitive lawyers. Once Sherlock Holmes […] or Hercule Poirot […] said ‘this is the murderer’, that was that. That’s to say, once fingered in the climactic living room scene, with everyone gathered around the hearth, the perpetrator wouldn’t resist at all. And everyone would be happy because the judges were thought to be upright persons, at least in fiction. […] The violence of the crime of María Marta is part of the hard-boiled novel, and the sealed location in which it takes place, part of the murder mystery (Alarcón). I’ve argued elsewhere (Munro, Belsunce) that the translation of the case to the genres of crime fiction and their metaanalysis was a means by which a victimised Argentine public, represented by a disempowered and marginalised fourth estate, sought some rhetorical recompense. The postulate of resilience, however, might help further to describe and contextualise this notorious discursive event. A disaffected Argentine press finds itself in a stability domain with multiple attractors: on the one hand, an acquiescence to ever-increasing politico-juridical corruption, malfeasance and elitist impunity; on the other, an attractor of increasing contestation, democratisation, accountability and transparency. A discursive event like the caso Belsunce further perturbs Argentine society, threatening to displace it from its democratising trajectory. Unable to enforce due process, Argentina’s fourth estate adapts, doing what, in the circumstances, amounts to the next best thing: it denounces the proceedings by translating the case to the genres of crime fiction. In so doing, it engages a venerable reception history in which the co-constitution of true crime fiction and investigative journalism is exemplified by the figure of Rodolfo Walsh, whose denunciatory works mark a “politicisation of crime” (see Amar Sánchez Juegos; El sueño). Put otherwise, a section of Argentina’s fourth estate bounced back: by making poetics do rhetorical work, it resisted the pull towards what ecology calls an undesirable basin of attraction. Through a show of discursive resilience, these journalists worked to keep Argentine society on a democratising track. References Adger, Neil W. “Social and Ecological Resilience: Are They Related?” Progress in Human Geography 24.3 (2000): 347-64. Alarcón, Cristina. “Lo Único Real Que Tenemos Es Un Cadáver.” 2007. 12 July 2007 ‹http://www.pagina12.com.ar/diario/elpais/subnotas/87986-28144-2007-07-12.html>. Amar Sánchez, Ana María. “El Sueño Eterno de Justicia.” Textos De Y Sobre Rodolfo Walsh. Ed. Jorge Raúl Lafforgue. Buenos Aires: Alianza, 2000. 205-18. ———. Juegos De Seducción Y Traición. Literatura Y Cultura De Masas. Rosario: Beatriz Viterbo, 2000. American Psychological Association. “What Is Resilience?” 2013. 9 Aug 2013 ‹http://www.apa.org/helpcenter/road-resilience.aspx>. Australian Government. “Critical Infrastructure Resilience Strategy.” 2009. 9 Aug 2013 ‹http://www.tisn.gov.au/Documents/Australian+Government+s+Critical+Infrastructure+Resilience+Strategy.pdf>. Battista, Vicente. “¿Hubo Otra Mujer?” Clarín 2003. 26 Jan. 2003 ‹http://old.clarin.com/diario/2003/01/26/s-03402.htm>. ———. “María Marta: El Relato Del Crimen.” Clarín 2003. 16 Jan. 2003 ‹http://old.clarin.com/diario/2003/01/16/o-01701.htm>. Bourbeau, Philippe. “Resiliencism: Premises and Promises in Securitisation Research.” Resilience: International Policies, Practices and Discourses 1.1 (2013): 3-17. Carpenter, Steve, et al. “From Metaphor to Measurement: Resilience of What to What?” Ecosystems 4 (2001): 765-81. Cecchi, Horacio. “Las Dos Muertes De María Marta.” Página 12 (2002). 12 Dec. 2002 ‹http://www.pagina12.com.ar/diario/sociedad/3-14095-2002-12-12.html>. Cecchi, Horacio, and Raúl Kollmann. “Un Escenario Sigilosamente Montado.” Página 12 (2002). 13 Dec. 2002 ‹http://www.pagina12.com.ar/diario/sociedad/3-14122-2002-12-13.html>. Drury, John, et al. “Representing Crowd Behaviour in Emergency Planning Guidance: ‘Mass Panic’ or Collective Resilience?” Resilience: International Policies, Practices and Discourses 1.1 (2013): 18-37. Evans, Brad, and Julian Reid. “Dangerously Exposed: The Life and Death of the Resilient Subject.” Resilience: Interational Policies, Practices and Discourses 1.2 (2013): 83-98. Folke, Carl. “Resilience: The Emergence of a Perspective for Social-Ecological Systems Analyses.” Global Environmental Change 16 (2006): 253-67. Folke, Carl, et al. “Resilience Thinking: Integrating Resilience, Adaptability and Transformability.” Ecology and Society 15.4 (2010). Gallopín, Gilberto C. “Linkages between Vulnerability, Resilience, and Adaptive Capacity.” Global Environmental Change 16 (2006): 293-303. Goldstein, Sam, and Robert B. Brooks, eds. Handbook of Resilience in Children. New York: Springer Science and Business Media, 2006. Grove, Kevin. “On Resilience Politics: From Transformation to Subversion.” Resilience: Interational Policies, Practices and Discourses 1.2 (2013): 146-53. Gunderson, Lance H. “Ecological Resilience - in Theory and Application.” Annual Review of Ecology and Systematics 31 (2000): 425-39. Gunderson, Lance H., and C. S. Holling, eds. Panarchy Understanding Transformations in Human and Natural Systems. Washington: Island, 2002. Handmer, John W., and Stephen R. Dovers. “A Typology of Resilience: Rethinking Institutions for Sustainable Development.” Organization & Environment 9.4 (1996): 482-511. H.A.T. “Urgente: Llamen a Agatha Christie.” El País (2003). 14 Jan. 2003 ‹http://historico.elpais.com.uy/03/01/14/pinter_26140.asp>. Holling, Crawford S. “Resilience and Stability of Ecological Systems.” Annual Review of Ecology and Systematics 4 (1973): 1-23. Janssen, Marco A., et al. “Scholarly Networks on Resilience, Vulnerability and Adaptation within the Human Dimensions of Global Environmental Change.” Global Environmental Change 16 (2006): 240-52. Joseph, Jonathan. “Resilience as Embedded Neoliberalism: A Governmentality Approach.” Resilience: International Policies, Practices and Discourses 1.1 (2013): 38-52. Kaufmann, Mareile. “Emergent Self-Organisation in Emergencies: Resilience Rationales in Interconnected Societies.” Resilience: Interational Policies, Practices and Discourses 1.1 (2013): 53-68. Munro, Andrew. “The Belsunce Case Judgement, Uptake, Genre.” Cultural Studies Review 13.2 (2007): 190-204. ———. “The Descriptive Purchase of Performativity.” Culture, Theory and Critique 53.1 (2012). ———. “Reading Austin Rhetorically.” Philosophy and Rhetoric 46.1 (2013): 22-43. Neocleous, Mark. “Resisting Resilience.” Radical Philosophy 178 March/April (2013): 2-7. Resilience Solutions Group, Arizona State U. “What Is Resilience?” 2013. 9 Aug. 2013 ‹http://resilience.asu.edu/what-is-resilience>. Seery, Mark D., E. Alison Holman, and Roxane Cohen Silver. “Whatever Does Not Kill Us: Cumulative Lifetime Adversity, Vulnerability, and Resilience.” Journal of Personality and Social Psychology 99.6 (2010): 1025-41. Short, Thomas L. “What They Said in Amsterdam: Peirce's Semiotic Today.” Semiotica 60.1-2 (1986): 103-28. Star, Susan Leigh, and James R. Griesemer. “Institutional Ecology, ‘Translations’ and Boundary Objects: Amateurs and Professionals in Berkeley's Museum of Vertebrate Zoology, 1907-39.” Social Studies of Science 19.3 (1989): 387-420. Stockholm Resilience Centre. “What Is Resilience?” 2007. 9 Aug. 2013 ‹http://www.stockholmresilience.org/21/research/what-is-resilience.html>. Ungar, Michael ed. Handbook for Working with Children and Youth Pathways to Resilience across Cultures and Contexts. Thousand Oaks: Sage, 2005. Viau, Susana. “Carmel.” Página 12 (2002). 27 Dec. 2002 ‹http://www.pagina12.com.ar/diario/contratapa/13-14651-2002-12-27.html>. Walker, Brian, et al. “Resilience, Adaptability and Transformability in Social-Ecological Systems.” Ecology and Society 9.2 (2004). Walker, Brian, and Jacqueline A. Meyers. “Thresholds in Ecological and Social-Ecological Systems: A Developing Database.” Ecology and Society 9.2 (2004). Walker, Brian, and David Salt. Resilience Thinking Sustaining Ecosystems and People in a Changing World. Washington: Island, 2006.

Abstract:

Introduction It is now commonplace for babies to begin their lives inhabiting media environments characterised by the presence, distribution, and mobility of digital devices and screens. Such arrangements can be traced, in part, to the birth of a new regime of mobile and touchscreen media beginning with the release of the iPhone in 2007 and the iPad in 2010, which stimulated a surge in household media consumption, underpinned by broadband and wireless Internet infrastructures. Research into these conditions of ambient mediation at the beginnings of life, however, is currently dominated by medical and educational literature, largely removed from media studies approaches that seek to understand the everyday contexts of babies using media. Putting aside discourses of promise or peril familiar to researchers of children’s media (Buckingham; Postman), this paper draws on ongoing research in both domestic and social media settings exploring infants’ everyday encounters and entanglements with mobile media and communication technologies. The paper identifies the ways infants’ mobile communication is assembled and distributed through touchscreen interfaces, proxy parent users, and commercial software sorting. It argues that within these interfacial, intermediary, and interactive contexts, we can conceptualise infants’ communicative agency through an emerging repertoire of techniques: accidental, assisted and automated. This assemblage of infant communication recognises that children no longer live with but in media (Deuze), which underscores the impossibility of a path of media resistance found in medical discourses of ‘exposure’ and restriction, and instead points to the need for critical and ethical responses to these immanent conditions of infant media life. Background and Approach Infants, understandably, have largely been excluded from analyses of mobile mediality given their historically limited engagement with or capacity to use mobile media. Yet, this situation is undergoing change as mobile devices become increasingly prominent in children’s homes (OfCom; Rideout), and as touchscreen interfaces lower thresholds of usability (Buckleitner; Hourcade et al.). The dominant frameworks within research addressing infants and media continue to resonate with long running and widely circulated debates in the study of children and mass media (Wartella and Robb), responding in contradictory ways to what is seen as an ever-increasing ‘technologization of childhood’ (McPake, Plowman and Stephen). Education research centres on digital literacy, emphasising the potential of mobile computing for these future digital learners, labourers, and citizens (McPake, Plowman and Stephen). Alternatively, health research largely positions mobile media within the rubric of ‘screen time’ inherited from older broadcast models, with paediatric groups continuing to caution parents about the dangers of infants’ ‘exposure’ to electronic screens (Strasburger and Hogan), without differentiating between screen types or activities. In turn, a range of digital media channels seek to propel or profit from infant media culture, with a number of review sites, YouTube channels and tech blogs promoting or surveying the latest gadgets and apps for babies. Within media studies, research is beginning to analyse the practices, conceptions and implications of digital interfaces and content for younger children. Studies are, for example, quantifying the devices, activities, and time spent by young children with mobile devices (Ofcom; Rideout), reviewing the design and marketing of children’s mobile application software products (e.g. Shuler), analysing digital content shared about babies on social media platforms (Kumar & Schoenebeck; Morris), and exploring emerging interactive spaces and technologies shaping young children’s ‘postdigital’ play (Giddings; Jayemanne, Nansen and Apperley). This paper extends this growing area of research by focusing specifically on infants’ early encounters, contexts, and configurations of mobile mediality, offering some preliminary analysis of an emerging repertoire of mobile communication techniques: accidental, assisted, and automated. That is, through infants playing with devices and accidentally activating them; through others such as parents assisting use; and through software features in applications that help to automate interaction. This analysis draws from an ongoing research project exploring young children’s mobile and interactive media use in domestic settings, which is employing ethnographic techniques including household technology tours and interviews, as well as participant observation and demonstrations of infant media interaction. To date 19 families, with 31 children aged between 0 and 5, located in Melbourne, Australia have participated. These participating families are largely homogeneous and privileged; though are a sample of relatively early and heavy adopters that reveal emerging qualities about young children’s changing media environments and encounters. This approach builds on established traditions of media and ethnographic research on technology consumption and use within domestic spaces (e.g. Mackay and Ivey; Silverstone and Hirsch), but turns to the digital media encountered by infants, the geographies and routines of these encounters, and how families mediate these encounters within the contexts of home life. This paper offers some preliminary findings from this research, drawing mostly from discussions with parents about their babies’ use of digital, mobile, and touchscreen media. In this larger project, the domestic and family research is accompanied by the collection of online data focused on the cultural context of, and content shared about, infants’ mobile media use. In this paper I report on social media analysis of publicly shared images tagged with #babyselfie queried from Instagram’s API. I viewed all publicly shared images on Instagram tagged with #babyselfie, and collected the associated captions, comments, hashtags, and metadata, over a period of 48 hours in October 2014, resulting in a dataset of 324 posts. Clearly, using this data for research purposes raises ethical issues about privacy and consent given the posts are being used in an unintended context from which they were originally shared; something that is further complicated by the research focus on young children. These issues, in which the ease of extracting online data using digital methods research (Rogers), needs to be both minimised and balanced against the value of the research aims and outcomes (Highfield and Leaver). To minimise risks, captions and comments cited in this paper have been de-identified; whist the value of this data lies in complementing and contextualising the more ethnographically informed research, despite perceptions of incompatibility, through analysis of the wider cultural and mediated networks in which babies’ digital lives are now shared and represented. This field of cultural production also includes analysis of examples of children’s software products from mobile app stores that support baby image capture and sharing, and in particular in this paper discussion of the My Baby Selfie app from the iTunes App Store and the Baby Selfie app from the Google Play store. The rationale for drawing on these multiple sources of data within the larger project is to locate young children’s digital entanglements within the diverse places, platforms and politics in which they unfold. This research scope is limited by the constraints of this short paper, however different sources of data are drawn upon here in order to identify, compare, and contextualise the emerging themes of accidental, assisted, and automated. Accidental Media Use The domestication and aggregation of mobile media in the home, principally laptops, mobile phones and tablet computers has established polymediated environments in which infants are increasingly surrounded by mobile media; in which they often observe their parents using mobile devices; and in which the flashing of screens unsurprisingly draws their attention. Living within these ambient media environments, then, infants often observe, find and reach for mobile devices: on the iPad or whatever, then what's actually happening in front of them, then naturally they'll gravitate towards it. These media encounters are animated by touchscreens interfaces that are responsive to the gestural actions of infants. Conversely, touchscreen interfaces drive attempts to swipe legacy media screens. Underscoring the nomenclature of ‘natural user interfaces’ within the design and manufacturer communities, screens lighting up through touch prompts interest, interaction, and even habituation through gestural interaction, especially swiping: It's funny because when she was younger she would go up the T.V. and she would try swiping to turn the channel.They can grab it and start playing with it. It just shows that it's so much part of their world … to swipe something. Despite demonstrable capacities of infants to interact with mobile screens, discussions with parents revealed that accidental forms of media engagement were a more regular consequence of these ambient contexts, interfacial affordances and early encounters with mobile media. It was not uncommon for infants to accidentally swipe and activate applications, to temporarily lock the screen, or even to dial contacts: He didn't know the password, and he just kept locking it … find it disabled for 15 minutes.If I've got that on YouTube, they can quite quickly get on to some you know [video] … by pressing … and they don't do it on purpose, they're just pushing random buttons.He does Skype calls! I think he recognizes their image, the icon. Then just taps it and … Similarly, in the analysis of publicly shared images on Instagram tagged with #babyselfie, there were instances in which it appeared infants had accidentally taken photos with the cameraphone based on the image content, photo framing or descriptions in the caption. Many of these photos showed a baby with an arm in view reaching towards the phone in a classic trope of a selfie image; others were poorly framed shots showing parts of baby faces too close to the camera lens suggesting they accidentally took the photograph; whilst most definitive was many instances in which the caption of the image posted by parents directly attributed the photographic production to an infant: Isabella's first #babyselfie She actually pushed the button herself! My little man loves taking selfies lol Whilst, then, the research identified many instances in which infants accidentally engaged in mobile media use, sometimes managing to communicate with an unsuspecting interlocutor, it is important to acknowledge such encounters could not have emerged without the enabling infrastructure of ambient media contexts and touchscreen interfaces, nor observed without studying this infrastructure utilising materially-oriented ethnographic perspectives (Star). Significantly, too, was the intermediary role played by parents. With parents acting as intermediaries in household environments or as proxy users in posting content on their behalf, multiple forms of assisted infant communication were identified. Assisted Media Use Assisted communication emerged from discussions with parents about the ways, routines, and rationale for making mobile media available to their children. These sometimes revolved around keeping their child engaged whilst they were travelling as a family – part of what has been described as the pass-back effect – but were more frequently discussed in terms of sharing and showing digital content, especially family photographs, and in facilitating infant mediated communication with relatives abroad: they love scrolling through my photos on my iPhone …We quite often just have them [on Skype] … have the computers in there while we're having dinner … the laptop will be there, opened up at one end of the table with the family here and there will be my sister having breakfast with her family in Ireland … These forms of parental mediated communication did not, however, simply situate or construct infants as passive recipients of their parents’ desires to make media content available or their efforts to establish communication with extended family members. Instead, the research revealed that infants were often active participants in these processes, pushing for access to devices, digital content, and mediated communication. These distributed relations of agency were expressed through infants verbal requests and gestural urging; through the ways parents initiated use by, for example, unlocking a device, preparing software, or loading an application, but then handed them over to infants to play, explore or communicate; and through wider networks of relations in which others including siblings, acted as proxies or had a say in the kinds of media infants used: she can do it, once I've unlocked … even, even with iView, once I'm on iView she can pick her own show and then go to the channel she wants to go to.We had my son’s birthday and there were some photos, some footage of us singing happy birthday and the little one just wants to watch it over and over again. She thinks it's fantastic watching herself.He [sibling] becomes like a proxy user … with the second one … they don't even need the agency because of their sibling. Similarly, the assisted communication emerging from the analysis of #babyselfie images on Instagram revealed that parents were not simply determining infant media use, but often acting as proxies on their behalf. #Selfie obsessed baby. Seriously though. He won't stop. Insists on pressing the button and everything. He sees my phone and points and says "Pic? Pic?" I've created a monster lol. In sharing this digital content on social networks, parents were acting as intermediaries in the communication of their children’s digital images. Clearly they were determining the platforms and networks where these images were published online, yet the production of these images was more uncertain, with accidental self-portraits taken by infants suggesting they played a key role in the circuits of digital photography distribution (van Dijck). Automated Media Use The production, archiving, circulation and reception of these images speaks to larger assemblages of media in which software protocols and algorithms are increasingly embedded in and help to configure everyday life (e.g. Chun; Gillespie), including young children’s media lives (Ito). Here, software automates process of sorting and shaping information, and in doing so both empowers and governs forms of infant media conduct. The final theme emerging from the research, then, is the identification of automated forms of infant mobile media use enabled through software applications and algorithmic operations. Automated techniques of interaction emerged as part of the repertoire of infant mobile mediality and communication through observations and discussions during the family research, and through surveying commercial software applications. Within family discussions, parents spoke about the ways digital databases and applications facilitated infant exploration and navigation. These included photo galleries stored on mobile devices, as well as children’s Internet television services such as the Australian Broadcasting Corporation’s catch-up online TV service, iView, which are visually organised and easily scrollable. In addition, algorithmic functions for sorting, recommending and autoplay on the video-sharing platform YouTube meant that infants were often automatically delivered an ongoing stream of content: They just keep watching it [YouTube]. So it leads on form the other thing. Which is pretty amazing, that's pretty interactive.Yeah, but the kids like, like if they've watched a YouTube clip now, they'll know to look down the next column to see what they want to play next … you get suggestions there so. Forms of automated communication specifically addressing infants was also located in examples of children’s software products from mobile app stores: the My Baby Selfie app from the iTunes App Store and the Baby Selfie app from the Google Play store. These applications are designed to support baby image capture and sharing, promising to “allow your baby to take a photo of him himself [sic]” (Giudicelli), based on automated software features that use sounds and images to capture a babies attention and touch sensors to activate image capture and storage. In one sense, these applications may appear to empower infants to participate in the production of digital content, namely selfies, yet they also clearly distribute this agency with and through mobile media and digital software. Moreover, they imply forms of conduct, expectations and imperatives around the possibilities of infant presence in a participatory digital culture. Immanent Ethic and Critique Digital participation typically assumes a degree of individual agency in deciding what to share, post, or communicate that is not typically available to infants. The emerging communicative practices of infants detailed above suggests that infants are increasingly connecting, however this communicative agency is distributed amongst a network of ambient devices, user-friendly interfaces, proxy users, and software sorting. Such distributions reflect conditions Deuze has noted, that we do not live with but in media. He argues this ubiquity, habituation, and embodiment of media and communication technologies pervade and constitute our lives becoming effectively invisible, negating the possibility of an outside from which resistance can be mounted. Whilst, resistance remains a solution promoted in medical discourses and paediatric advice proposing no ‘screen time’ for children aged below two (Strasburger and Hogan), Deuze’s thesis suggests this is ontologically futile and instead we should strive for a more immanent relation that seeks to modulate choices and actions from within our media life: finding “creative ways to wield the awesome communication power of media both ethically and aesthetically” ("Unseen" 367). An immanent ethics and a critical aesthetics of infant mediated life can be located in examples of cultural production and everyday parental practice addressing the arrangements of infant mobile media and communication discussed above. For example, an article in the Guardian, ‘Toddlers pose a serious risk to smartphones and tablets’ parodies moral panics around children’s exposure to media by noting that media devices are at greater risk of physical damage from children handling them, whilst a design project from the Eindhoven Academy – called New Born Fame – built from soft toys shaped like social media logos, motion and touch sensors that activate image capture (much like babyselfie apps), but with automated social media sharing, critically interrogates the ways infants are increasingly bound-up with the networked and algorithmic regimes of our computational culture. Finally, parents in this research revealed that they carefully considered the ethics of media in their children’s lives by organising everyday media practices that balanced dwelling with new, old, and non media forms, and by curating their digitally mediated interactions and archives with an awareness they were custodians of their children’s digital memories (Garde-Hansen et al.). I suggest these examples work from an immanent ethical and critical position in order to make visible and operate from within the conditions of infant media life. Rather than seeking to deny or avoid the diversity of encounters infants have with and through mobile media in their everyday lives, this analysis has explored the ways infants are increasingly configured as users of mobile media and communication technologies, identifying an emerging repertoire of infant mobile communication techniques. The emerging practices of infant mobile communication outlined here are intertwined with contemporary household media environments, and assembled through accidental, assisted, and automated relations of living with mobile media. Moreover, such entanglements of use are both represented and discursively reconfigured through multiple channels, contexts, and networks of public mediation. Together, these diverse contexts and forms of conduct have implications for both studying and understanding the ways babies are emerging as active participants and interpellated subjects within a continually expanding digital culture. Acknowledgments This research was supported with funding from the Australian Research Council (ARC) Discovery Early Career Researcher Award (DE130100735). I would like to express my appreciation to the children and families involved in this study for their generous contribution of time and experiences. References Buckingham, David. After the Death of Childhood: Growing Up in the Age of Electronic Media. Polity Press: Oxford, 2000. Buckleitner, Warren. “A Taxonomy of Multi-Touch Interaction Styles, by Stage.” Children's Technology Review 18.11 (2011): 10-11. Chun, Wendy. Programmed Visions: Software and Memory. Cambridge: MIT Press, 2011. Deuze, Mark. “Media Life.” Media, Culture and Society 33.1 (2011): 137-148. Deuze, Mark. “The Unseen Disappearance of Invisible Media: A Response to Sebastian Kubitschko and Daniel Knapp.” Media, Culture and Society 34.3 (2012): 365-368. Garde-Hansen, Joanne, Andrew Hoskins and Anna Reading. Save as … Digital Memories. Hampshire: Palgrave Macmillan, 2009. Giddings, Seth. Gameworlds: Virtual Media and Children’s Everyday Play. New York: Bloomsbury, 2014. Gillespie, Tarleton. “The Relevance of Algorithms.” Media Technologies: Essays on Communication, Materiality, and Society. Eds. Tarelton Gillespie, Pablo Boczkowski and Kirsten Foot. Cambridge: MIT Press, 2014. Giudicelli, Patrick. "My Baby Selfie." iTunes App Store. Apple Inc., 2015. Highfield, Tim, and Tama Leaver. “A Methodology for Mapping Instagram Hashtags.” First Monday 20.1 (2015). Hourcade, Juan Pablo, Sarah Mascher, David Wu, and Luiza Pantoja. “Look, My Baby Is Using an iPad! An Analysis of Youtube Videos of Infants and Toddlers Using Tablets.” Proceedings of CHI 15. New York: ACM Press, 2015. 1915–1924. Ito, Mizuko. Engineering Play: A Cultural History of Children’s Software. Cambridge: MIT Press, 2009. Jayemanne, Darshana, Bjorn Nansen and Thomas Apperley. “Post-Digital Play and the Aesthetics of Recruitment.” Proceedings of Digital Games Research Association (DiGRA) 2015. Lüneburg, 14-17 May 2015. Kumar, Priya, and Sarita Schoenebeck. “The Modern Day Baby Book: Enacting Good Mothering and Stewarding Privacy on Facebook.” Proceedings of CSCW 2015. Vancouver, 14-18 March 2015. Mackay, Hugh, and Darren Ivey. Modern Media in the Home: An Ethnographic Study. Rome: John Libbey, 2004. Morris, Meredith. “Social Networking Site Use by Mothers of Young Children.” Proceedings of CSCW 2014. 1272-1282. OfCom. Children and Parents: Media Use and Attitudes Report. London: OfCom, 2013. McPake, Joanna, Lydia Plowman and Christine Stephen. "The Technologisation of Childhood? Young Children and Technology in The Home.” Children and Society 24.1 (2010): 63–74. Postman, Neil. Technopoly: The Surrender of Culture to Technology. New York: Vintage, 1993. Rideout, Victoria. Zero to Eight: Children’s Media Use in America 2013. Common Sense Media, 2013. Rogers, Richard. Digital Methods. Boston. MIT Press, 2013. Silverstone, Roger, and Eric Hirsch (eds). Consuming Technologies: Media and Information in Domestic Spaces. London: Routledge, 1992. Shuler, Carly. iLearn: A Content Analysis of the iTunes App Store’s Education Section. New York: The Joan Ganz Cooney Center at Sesame Workshop, 2009. Star, Susan Leigh. “The Ethnography of Infrastructure.” American Behavioral Scientist 43.3 (1999): 377–391. Strasburger, Victor, and Marjorie Hogan. “Policy Statement from the American Academy of Pediatrics: Children, Adolescents, and the Media.” Pediatrics 132 (2013): 958-961. Van Dijck, José. “Digital Photography: Digital Photography: Communication, Identity, Memory.” Visual Communication 7.1 (2008): 57-76. Wartella, Ellen, and Michael Robb. “Historical and Recurring Concerns about Children’s Use of the Mass Media.” The Handbook of Children, Media, and Development. Eds. Sandra Calvert and Barbara Wilson. Malden: Blackwell, 2008.

Abstract:

Introduction The aim of this paper is to examine whether recent catastrophic tsunamis have driven a cultural shift in the awareness of Australians to the danger associated with this natural hazard and whether the media have contributed to the emergence of “tsunami” as a new Australian catastrophe. Prior to the devastating 2004 Indian Ocean Tsunami disaster (2004 IOT), tsunamis as a type of hazard capable of generating widespread catastrophe were not well known by the general public and had barely registered within the wider scientific community. As a university based lecturer who specialises in natural disasters, I always started my public talks or student lectures with an attempt at a detailed description of what a tsunami is. With little high quality visual and media imagery to use, this was not easy. The Australian geologist Ted Bryant was right when he named his 2001 book Tsunami: The Underrated Hazard. That changed on 26 December 2004 when the third largest earthquake ever recorded occurred northwest of Sumatra, Indonesia, triggering the most catastrophic tsunami ever experienced. The 2004 IOT claimed at least 220,000 lives—probably more—injured tens of thousands, destroyed widespread coastal infrastructure and left millions homeless. Beyond the catastrophic impacts, this tsunami was conspicuous because, for the first time, such a devastating tsunami was widely captured on video and other forms of moving and still imagery. This occurred for two reasons. Firstly, the tsunami took place during daylight hours in good weather conditions—factors conducive to capturing high quality visual images. Secondly, many people—both local residents and westerners who were on beachside holidays and at the coast at multiple locations impacted by the tsunami—were able to capture images of the tsunami on their cameras, videos, and smart phones. The extensive media coverage—including horrifying television, video, and still imagery that raced around the globe in the hours and days after the tsunami, filling our television screens, homes, and lives regardless of where we lived—had a dramatic effect. This single event drove a quantum shift in the wider cultural awareness of this type of catastrophe and acted as a catalyst for improved individual and societal understanding of the nature and effects of disaster landscapes. Since this event, there have been several notable tsunamis, including the March 2011 Japan catastrophe. Once again, this event occurred during daylight hours and was widely captured by multiple forms of media. These events have resulted in a cascade of media coverage across television, radio, movie, and documentary channels, in the print media, online, and in the popular press and on social media—very little of which was available prior to 2004. Much of this has been documentary and informative in style, but there have also been numerous television dramas and movies. For example, an episode of the popular American television series CSI Miami entitled Crime Wave (Season 3, Episode 7) featured a tsunami, triggered by a volcanic eruption in the Atlantic and impacting Miami, as the backdrop to a standard crime-filled episode ("CSI," IMDb; Wikipedia). In 2010, Warner Bros Studios released the supernatural drama fantasy film Hereafter directed by Clint Eastwood. In the movie, a television journalist survives a near-death experience during the 2004 IOT in what might be the most dramatic, and probably accurate, cinematic portrayal of a tsunami ("Hereafter," IMDb; Wikipedia). Thus, these creative and entertaining forms of media, influenced by the catastrophic nature of tsunamis, are impetuses for creativity that also contribute to a transformation of cultural knowledge of catastrophe. The transformative potential of creative media, together with national and intergovernmental disaster risk reduction activity such as community education, awareness campaigns, community evacuation planning and drills, may be indirectly inferred from rapid and positive community behavioural responses. By this I mean many people in coastal communities who experience strong earthquakes are starting a process of self-evacuation, even if regional tsunami warning centres have not issued an alert or warning. For example, when people in coastal locations in Samoa felt a large earthquake on 29 September 2009, many self-evacuated to higher ground or sought information and instruction from relevant authorities because they expected a tsunami to occur. When interviewed, survivors stated that the memory of television and media coverage of the 2004 IOT acted as a catalyst for their affirmative behavioural response (Dominey-Howes and Thaman 1). Thus, individual and community cultural understandings of the nature and effects of tsunami catastrophes are incredibly important for shaping resilience and reducing vulnerability. However, this cultural shift is not playing out evenly.Are Australia and Its People at Risk from Tsunamis?Prior to the 2004 IOT, there was little discussion about, research in to, or awareness about tsunamis and Australia. Ted Bryant from the University of Wollongong had controversially proposed that Australia had been affected by tsunamis much bigger than the 2004 IOT six to eight times during the last 10,000 years and that it was only a matter of when, not if, such an event repeated itself (Bryant, "Second Edition"). Whilst his claims had received some media attention, his ideas did not achieve widespread scientific, cultural, or community acceptance. Not-with-standing this, Australia has been affected by more than 60 small tsunamis since European colonisation (Dominey-Howes 239). Indeed, the 2004 IOT and 2006 Java tsunami caused significant flooding of parts of the Northern Territory and Western Australia (Prendergast and Brown 69). However, the affected areas were sparsely populated and experienced very little in the way of damage or loss. Thus they did not cross any sort of critical threshold of “catastrophe” and failed to achieve meaningful community consciousness—they were not agents of cultural transformation.Regardless of the risk faced by Australia’s coastline, Australians travel to, and holiday in, places that experience tsunamis. In fact, 26 Australians were killed during the 2004 IOT (DFAT) and five were killed by the September 2009 South Pacific tsunami (Caldwell et al. 26). What Role Do the Media Play in Preparing for and Responding to Catastrophe?Regardless of the type of hazard/disaster/catastrophe, the key functions the media play include (but are not limited to): pre-event community education, awareness raising, and planning and preparations; during-event preparation and action, including status updates, evacuation warnings and notices, and recommendations for affirmative behaviours; and post-event responses and recovery actions to follow, including where to gain aid and support. Further, the media also play a role in providing a forum for debate and post-event analysis and reflection, as a mechanism to hold decision makers to account. From time to time, the media also provide a platform for examining who, if anyone, might be to blame for losses sustained during catastrophes and can act as a powerful conduit for driving socio-cultural, behavioural, and policy change. Many of these functions are elegantly described and a series of best practices outlined by The Caribbean Disaster Emergency Management Agency in a tsunami specific publication freely available online (CDEMA 1). What Has Been the Media Coverage in Australia about Tsunamis and Their Effects on Australians?A manifest contents analysis of media material covering tsunamis over the last decade using the framework of Cox et al. reveals that coverage falls into distinctive and repetitive forms or themes. After tsunamis, I have collected articles (more than 130 to date) published in key Australian national broadsheets (e.g., The Australian and Sydney Morning Herald) and tabloid (e.g., The Telegraph) newspapers and have watched on television and monitored on social media, such as YouTube and Facebook, the types of coverage given to tsunamis either affecting Australia, or Australians domestically and overseas. In all cases, I continued to monitor and collect these stories and accounts for a fixed period of four weeks after each event, commencing on the day of the tsunami. The themes raised in the coverage include: the nature of the event. For example, where, when, why did it occur, how big was it, and what were the effects; what emergency response and recovery actions are being undertaken by the emergency services and how these are being provided; exploration of how the event was made worse or better by poor/good planning and prior knowledge, action or inaction, confusion and misunderstanding; the attribution of blame and responsibility; the good news story—often the discovery and rescue of an “iconic victim/survivor”—usually a child days to weeks later; and follow-up reporting weeks to months later and on anniversaries. This coverage generally focuses on how things are improving and is often juxtaposed with the ongoing suffering of victims. I select the word “victims” purposefully for the media frequently prefer this over the more affirmative “survivor.”The media seldom carry reports of “behind the scenes” disaster preparatory work such as community education programs, the development and installation of warning and monitoring systems, and ongoing training and policy work by response agencies and governments since such stories tend to be less glamorous in terms of the disaster gore factor and less newsworthy (Cox et al. 469; Miles and Morse 365; Ploughman 308).With regard to Australians specifically, the manifest contents analysis reveals that coverage can be described as follows. First, it focuses on those Australians killed and injured. Such coverage provides elements of a biography of the victims, telling their stories, personalising these individuals so we build empathy for their suffering and the suffering of their families. The Australian victims are not unknown strangers—they are named and pictures of their smiling faces are printed or broadcast. Second, the media describe and catalogue the loss and ongoing suffering of the victims (survivors). Third, the media use phrases to describe Australians such as “innocent victims in the wrong place at the wrong time.” This narrative establishes the sense that these “innocents” have been somehow wronged and transgressed and that suffering should not be experienced by them. The fourth theme addresses the difficulties Australians have in accessing Consular support and in acquiring replacement passports in order to return home. It usually goes on to describe how they have difficulty in gaining access to accommodation, clothing, food, and water and any necessary medicines and the challenges associated with booking travel home and the complexities of communicating with family and friends. The last theme focuses on how Australians were often (usually?) not given relevant safety information by “responsible people” or “those in the know” in the place where they were at the time of the tsunami. This establishes a sense that Australians were left out and not considered by the relevant authorities. This narrative pays little attention to the wide scale impact upon and suffering of resident local populations who lack the capacity to escape the landscape of catastrophe.How Does Australian Media Coverage of (Tsunami) Catastrophe Compare with Elsewhere?A review of the available literature suggests media coverage of catastrophes involving domestic citizens is similar globally. For example, Olofsson (557) in an analysis of newspaper articles in Sweden about the 2004 IOT showed that the tsunami was framed as a Swedish disaster heavily focused on Sweden, Swedish victims, and Thailand, and that there was a division between “us” (Swedes) and “them” (others or non-Swedes). Olofsson (557) described two types of “us” and “them.” At the international level Sweden, i.e. “us,” was glorified and contrasted with “inferior” countries such as Thailand, “them.” Olofsson (557) concluded that mediated frames of catastrophe are influenced by stereotypes and nationalistic values.Such nationalistic approaches preface one type of suffering in catastrophe over others and delegitimises the experiences of some survivors. Thus, catastrophes are not evenly experienced. Importantly, Olofsson although not explicitly using the term, explains that the underlying reason for this construction of “them” and “us” is a form of imperialism and colonialism. Sharp refers to “historically rooted power hierarchies between countries and regions of the world” (304)—this is especially so of western news media reporting on catastrophes within and affecting “other” (non-western) countries. Sharp goes much further in relation to western representations and imaginations of the “war on terror” (arguably a global catastrophe) by explicitly noting the near universal western-centric dominance of this representation and the construction of the “west” as good and all “non-west” as not (299). Like it or not, the western media, including elements of the mainstream Australian media, adhere to this imperialistic representation. Studies of tsunami and other catastrophes drawing upon different types of media (still images, video, film, camera, and social media such as Facebook, Twitter, and the like) and from different national settings have explored the multiple functions of media. These functions include: providing information, questioning the authorities, and offering a chance for transformative learning. Further, they alleviate pain and suffering, providing new virtual communities of shared experience and hearing that facilitate resilience and recovery from catastrophe. Lastly, they contribute to a cultural transformation of catastrophe—both positive and negative (Hjorth and Kyoung-hwa "The Mourning"; "Good Grief"; McCargo and Hyon-Suk 236; Brown and Minty 9; Lau et al. 675; Morgan and de Goyet 33; Piotrowski and Armstrong 341; Sood et al. 27).Has Extensive Media Coverage Resulted in an Improved Awareness of the Catastrophic Potential of Tsunami for Australians?In playing devil’s advocate, my simple response is NO! This because I have been interviewing Australians about their perceptions and knowledge of tsunamis as a catastrophe, after events have occurred. These events have triggered alerts and warnings by the Australian Tsunami Warning System (ATWS) for selected coastal regions of Australia. Consequently, I have visited coastal suburbs and interviewed people about tsunamis generally and those events specifically. Formal interviews (surveys) and informal conversations have revolved around what people perceived about the hazard, the likely consequences, what they knew about the warning, where they got their information from, how they behaved and why, and so forth. I have undertaken this work after the 2007 Solomon Islands, 2009 New Zealand, 2009 South Pacific, the February 2010 Chile, and March 2011 Japan tsunamis. I have now spoken to more than 800 people. Detailed research results will be presented elsewhere, but of relevance here, I have discovered that, to begin with, Australians have a reasonable and shared cultural knowledge of the potential catastrophic effects that tsunamis can have. They use terms such as “devastating; death; damage; loss; frightening; economic impact; societal loss; horrific; overwhelming and catastrophic.” Secondly, when I ask Australians about their sources of information about tsunamis, they describe the television (80%); Internet (85%); radio (25%); newspaper (35%); and social media including YouTube (65%). This tells me that the media are critical to underpinning knowledge of catastrophe and are a powerful transformative medium for the acquisition of knowledge. Thirdly, when asked about where people get information about live warning messages and alerts, Australians stated the “television (95%); Internet (70%); family and friends (65%).” Fourthly and significantly, when individuals were asked what they thought being caught in a tsunami would be like, responses included “fun (50%); awesome (75%); like in a movie (40%).” Fifthly, when people were asked about what they would do (i.e., their “stated behaviour”) during a real tsunami arriving at the coast, responses included “go down to the beach to swim/surf the tsunami (40%); go to the sea to watch (85%); video the tsunami and sell to the news media people (40%).”An independent and powerful representation of the disjunct between Australians’ knowledge of the catastrophic potential of tsunamis and their “negative” behavioral response can be found in viewing live television news coverage broadcast from Sydney beaches on the morning of Sunday 28 February 2010. The Chilean tsunami had taken more than 14 hours to travel from Chile to the eastern seaboard of Australia and the ATWS had issued an accurate warning and had correctly forecast the arrival time of the tsunami (approximately 08.30 am). The television and radio media had dutifully broadcast the warning issued by the State Emergency Services. The message was simple: “Stay out of the water, evacuate the beaches and move to higher ground.” As the tsunami arrived, those news broadcasts showed volunteer State Emergency Service personnel and Surf Life Saving Australia lifeguards “begging” with literally hundreds (probably thousands up and down the eastern seaboard of Australia) of members of the public to stop swimming in the incoming tsunami and to evacuate the beaches. On that occasion, Australians were lucky and the tsunami was inconsequential. What do these responses mean? Clearly Australians recognise and can describe the consequences of a tsunami. However, they are not associating the catastrophic nature of tsunami with their own lives or experience. They are avoiding or disallowing the reality; they normalise and dramaticise the event. Thus in Australia, to date, a cultural transformation about the catastrophic nature of tsunami has not occurred for reasons that are not entirely clear but are the subject of ongoing study.The Emergence of Tsunami as a “New Australian Catastrophe”?As a natural disaster expert with nearly two decades experience, in my mind tsunami has emerged as a “new Australian catastrophe.” I believe this has occurred for a number of reasons. Firstly, the 2004 IOT was devastating and did impact northwestern Australia, raising the flag on this hitherto, unknown threat. Australia is now known to be vulnerable to the tsunami catastrophe. The media have played a critical role here. Secondly, in the 2004 IOT and other tsunamis since, Australians have died and their deaths have been widely reported in the Australian media. Thirdly, the emergence of various forms of social media has facilitated an explosion in information and material that can be consumed, digested, reimagined, and normalised by Australians hungry for the gore of catastrophe—it feeds our desire for catastrophic death and destruction. Fourthly, catastrophe has been creatively imagined and retold for a story-hungry viewing public. Whether through regular television shows easily consumed from a comfy chair at home, or whilst eating popcorn at a cinema, tsunami catastrophe is being fed to us in a way that reaffirms its naturalness. Juxtaposed against this idea though is that, despite all the graphic imagery of tsunami catastrophe, especially images of dead children in other countries, Australian media do not and culturally cannot, display images of dead Australian children. Such images are widely considered too gruesome but are well known to drive changes in cultural behaviour because of the iconic significance of the child within our society. As such, a cultural shift has not yet occurred and so the potential of catastrophe remains waiting to strike. Fifthly and significantly, given the fact that large numbers of Australians have not died during recent tsunamis means that again, the catastrophic potential of tsunamis is not yet realised and has not resulted in cultural changes to more affirmative behaviour. Lastly, Australians are probably more aware of “regular or common” catastrophes such as floods and bush fires that are normal to the Australian climate system and which are endlessly experienced individually and culturally and covered by the media in all forms. The Australian summer of 2012–13 has again been dominated by floods and fires. If this idea is accepted, the media construct a uniquely Australian imaginary of catastrophe and cultural discourse of disaster. The familiarity with these common climate catastrophes makes us “culturally blind” to the catastrophe that is tsunami.The consequences of a major tsunami affecting Australia some point in the future are likely to be of a scale not yet comprehensible. References Australian Broadcasting Corporation (ABC). "ABC Net Splash." 20 Mar. 2013 ‹http://splash.abc.net.au/media?id=31077›. Brown, Philip, and Jessica Minty. “Media Coverage and Charitable Giving after the 2004 Tsunami.” Southern Economic Journal 75 (2008): 9–25. Bryant, Edward. Tsunami: The Underrated Hazard. First Edition, Cambridge: Cambridge UP, 2001. ———. Tsunami: The Underrated Hazard. Second Edition, Sydney: Springer-Praxis, 2008. Caldwell, Anna, Natalie Gregg, Fiona Hudson, Patrick Lion, Janelle Miles, Bart Sinclair, and John Wright. “Samoa Tsunami Claims Five Aussies as Death Toll Rises.” The Courier Mail 1 Oct. 2009. 20 Mar. 2013 ‹http://www.couriermail.com.au/news/samoa-tsunami-claims-five-aussies-as-death-toll-rises/story-e6freon6-1225781357413›. CDEMA. "The Caribbean Disaster Emergency Management Agency. Tsunami SMART Media Web Site." 18 Dec. 2012. 20 Mar. 2013 ‹http://weready.org/tsunami/index.php?Itemid=40&id=40&option=com_content&view=article›. Cox, Robin, Bonita Long, and Megan Jones. “Sequestering of Suffering – Critical Discourse Analysis of Natural Disaster Media Coverage.” Journal of Health Psychology 13 (2008): 469–80. “CSI: Miami (Season 3, Episode 7).” International Movie Database (IMDb). ‹http://www.imdb.com/title/tt0534784/›. 9 Jan. 2013. "CSI: Miami (Season 3)." Wikipedia. ‹http://en.wikipedia.org/wiki/CSI:_Miami_(season_3)#Episodes›. 21 Mar. 2013. DFAT. "Department of Foreign Affairs and Trade Annual Report 2004–2005." 8 Jan. 2013 ‹http://www.dfat.gov.au/dept/annual_reports/04_05/downloads/2_Outcome2.pdf›. Dominey-Howes, Dale. “Geological and Historical Records of Australian Tsunami.” Marine Geology 239 (2007): 99–123. Dominey-Howes, Dale, and Randy Thaman. “UNESCO-IOC International Tsunami Survey Team Samoa Interim Report of Field Survey 14–21 October 2009.” No. 2. Australian Tsunami Research Centre. University of New South Wales, Sydney. "Hereafter." International Movie Database (IMDb). ‹http://www.imdb.com/title/tt1212419/›. 9 Jan. 2013."Hereafter." Wikipedia. ‹http://en.wikipedia.org/wiki/Hereafter (film)›. 21 Mar. 2013. Hjorth, Larissa, and Yonnie Kyoung-hwa. “The Mourning After: A Case Study of Social Media in the 3.11 Earthquake Disaster in Japan.” Television and News Media 12 (2011): 552–59. ———, and Yonnie Kyoung-hwa. “Good Grief: The Role of Mobile Social Media in the 3.11 Earthquake Disaster in Japan.” Digital Creativity 22 (2011): 187–99. Lau, Joseph, Mason Lau, and Jean Kim. “Impacts of Media Coverage on the Community Stress Level in Hong Kong after the Tsunami on 26 December 2004.” Journal of Epidemiology and Community Health 60 (2006): 675–82. McCargo, Duncan, and Lee Hyon-Suk. “Japan’s Political Tsunami: What’s Media Got to Do with It?” International Journal of Press-Politics 15 (2010): 236–45. Miles, Brian, and Stephanie Morse. “The Role of News Media in Natural Disaster Risk and Recovery.” Ecological Economics 63 (2007): 365–73. Morgan, Olive, and Charles de Goyet. “Dispelling Disaster Myths about Dead Bodies and Disease: The Role of Scientific Evidence and the Media.” Revista Panamericana de Salud Publica-Pan American Journal of Public Health 18 (2005): 33–6. Olofsson, Anna. “The Indian Ocean Tsunami in Swedish Newspapers: Nationalism after Catastrophe.” Disaster Prevention and Management 20 (2011): 557–69. Piotrowski, Chris, and Terry Armstrong. “Mass Media Preferences in Disaster: A Study of Hurricane Danny.” Social Behavior and Personality 26 (1998): 341–45. Ploughman, Penelope. “The American Print News Media Construction of Five Natural Disasters.” Disasters 19 (1995): 308–26. Prendergast, Amy, and Nick Brown. “Far Field Impact and Coastal Sedimentation Associated with the 2006 Java Tsunami in West Australia: Post-Tsunami Survey at Steep Point, West Australia.” Natural Hazards 60 (2012): 69–79. Sharp, Joanne. “A Subaltern Critical Geopolitics of The War on Terror: Postcolonial Security in Tanzania.” Geoforum 42 (2011): 297–305. Sood, Rahul, Stockdale, Geoffrey, and Everett Rogers. “How the News Media Operate in Natural Disasters.” Journal of Communication 37 (1987): 27–41.

Abstract:

Introduction: Artist Villages in Beijing Many of the most renowned sites of Beijing are found in the inner-city districts of Dongcheng and Xicheng: for instance, the Forbidden City, Tiananmen Square, the Lama Temple, the National Theatre, the Central Opera Academy, the Bell Tower, the Drum Tower, the Imperial College, and the Confucius Temple. However, in the past decade a new attraction has been added to the visitor “must-see” list in Beijing. The 798 Art District originated as an artist village within abandoned factory buildings at Dashanzi, right between the city’s Central Business District and the open outer rural space on Beijing’s north-east. It is arguably the most striking symbol of China’s contemporary art scene. The history of the 798 Art District is by now well known (Keane), so this paper will provide a short summary of its evolution. Of more concern is the relationship between the urban fringe and what Howard Becker has called “art worlds.” By art worlds, Becker refers to the multitude of agents that contribute to a final work of art: for instance, people who provide canvasses, frames, and art supplies; critics and intermediaries; and the people who run exhibition services. To the art-world list in Beijing we need to add government officials and developers. To date there are more than 100 artist communities or villages in Beijing; almost all are located in the city’s outskirts. In particular, a high-powered art centre outside the city of Beijing has recently established a global reputation. Songzhuang is situated in outer Tongzhou District, some 30 kilometres east of Tiananmen Square. The Beijing Municipal Government officially classifies Songzhuang as the Capital Art District (CAD) or “the Songzhuang Original Art Cluster.” The important difference between 798 and Songzhuang is that, whereas the former has become a centre for retail and art galleries, Songzhuang operates as an arts production centre for experimental art, with less focus on commercial art. The destiny of the artistic communities is closely related to urban planning policies that either try to shut them down or protect them. In this paper I will take a close look at three artist villages: Yuanmingyuan, 798, and Songzhuang. In tracing the evolution of the three artist villages, I will shed some light on artists’ lives in city fringes. I argue that these outer districts provide creative industries with a new opportunity for development. This is counter to the conventional wisdom that central urban areas are the ideal locality for creative industries. Accordingly, this argument needs to be qualified: some types of creative work are more suitable to rural and undeveloped areas. The visual art “industry” is one of these. Inner and Outer Worlds Urban historians contend that innovation is more likely to happen in inner urban areas because of intensive interactions between people (Jacobs). City life has been associated with the development of creative industries and economic benefits brought about by the interaction of creative classes. In short, the argument is that cities, or, more specifically, urban areas are primary economic entities (Montgomery) whereas outer suburbs are uncreative and dull (Florida, "Cities"). The conventional wisdom is that talented creative people are attracted to the creative milieu in cities: universities, book shops, cafes, museums, theatres etc. These are both the hard and the soft infrastructure of modern cities. They illustrate diversified built forms, lifestyles and experiences (Lorenzen and Frederiksen; Florida, Rise; Landry; Montgomery; Leadbeater and Oakley). The assumption that inner-city density is the cradle of creative industries has encountered critique. Empirical studies in Australia have shown that creative occupations are found in relatively high densities in urban fringes. The point made in several studies is that suburbia has been neglected by scholars and policy makers and may have potential for future development (Gibson and Brennan-Horley; Commission; Collis, Felton, and Graham). Moreover, some have argued that the practice of constructing inner city enclaves may be leading to homogenized and prescriptive geographies (Collis, Felton, and Graham; Kotkin). As Jane Jacobs has indicated, it is not only density of interactions but diversity that attracts and accommodates economic growth in cities. However, the spatiality of creative industries varies across different sectors. For example, media companies and advertising agencies are more likely to be found in the inner city, whereas most visual artists prefer working in the comparatively quiet and loosely-structured outskirts. Nevertheless, the logic embodied in thinking around the distinctions between “urbanism” and “suburbanism” pays little attention to this issue, although both schools acknowledge the causal relationship between locality and creativity. According to Drake, empirical evidence shows that the function of locality is not only about encouraging interactions between SMEs (small to medium enterprises) within clusters which can generate creativity, but also a catalyst for individual creativity (Drake). Therefore for policy makers in China, the question here is how to plan or prepare a better space to accommodate creative professionals’ needs in different sectors while making the master plan. This question is particularly urgent to the Chinese government, which is undertaking a massive urbanization transition throughout the country. In placing a lens on Beijing, it is important to note the distinctive features of its politics, forms of social structure, and climate. As Zhu has described it, Beijing has spread in a symmetrical structure. The reasons have much to do with ancient history. According to Zhu, the city which was planned in the era of Genghis Khan was constituted by four layers or enclosures, with the emperor at the centre, surrounded by the gentry and other populations distributed outwards according to wealth, status, and occupation. The outer layer accommodated many lower social classes, including itinerant artists, musicians, and merchants. This ”outer city” combined with open rural space. The system of enclosures is carried on in today’s city planning of Beijing. Nowadays Beijing is most commonly described by its ring roads (Mars and Hornsby). However, despite the existing structure, new approaches to urban policy have resulted in a great deal of flux. The emergence of new landscapes such as semi-urbanized villages, rural urban syndicates (chengxiang jiehebu), and villages-within-cities (Mars and Hornsby 290) illustrate this flux. These new types of landscapes, which don’t correspond to the suburban concept that we find in the US or Australia, serve to represent and mediate the urban-rural relationship in China. The outer villages also reflect an old tradition of “recluse” (yin shi), which since the Wei and Jin Dynasties allowed intellectuals to withdraw themselves from the temporal world of the city and live freely in the mountains. The Lost Artistic Utopia: Yuanmingyuan Artist Village Yuanmingyuan, also known as the Ming Dynasty summer palace, is located in Haidian District in the north-west of Beijing. Haidian has transformed from an outer district of Beijing into one of its flourishing urban districts since the mid-1980s. Haidian’s success is largely due to the electronics industry which developed from spin-offs from Peking University, Tsinghua University and the Chinese Academy of Sciences in the 1980s. This led to the rapid emergence of Zhongguancun, sometimes referred to as China’s Silicon Valley. However there is another side of Haidian’s transformation. As the first graduates came out of Chinese Academies of the Arts following the Cultural Revolution (1966–1976), creative lifestyles became available. Some people quit jobs at state-owned institutions and chose to go freelance, which was unimaginable in China under the former regime of Mao Zedong. By 1990, the earliest “artist village” emerged around the Yuanmingyuan accommodating artists from around China. The first site was Fuyuanmen village. Artists living and working there proudly called their village “West Village” in China, comparing it to the Greenwich Village in New York. At that time they were labelled as “vagabonds” (mangliu) since they had no family in Beijing, and no stable job or income. Despite financial difficulties, the Yuanmingyuan artist village was a haven for artists. They were able to enjoy a liberating and vigorous environment by being close to the top universities in Beijing[1]. Access to ideas was limited in China at that time so this proximity was a key ingredient. According to an interview by He Lu, the Yuanmingyuan artist village gave artists a sense of belonging which went far beyond geographic identification as a marginal group unwelcomed by conservative urban society. Many issues arose along with the growth of the artist village. The non-traditional lifestyle and look of these artists were deemed abnormal by many of the general public; the way of their expression and behaviour was too extreme to be accepted by the mainstream in what was ultimately a political district; they were a headache for local police who saw them as troublemakers; moreover, their contact with the western world was a sensitive issue for the government at that time. Suddenly, the village was closed by the government in 1993. Although the Yuanmingyuan artist village existed for only a few years, it is of significance in China’s contemporary art history. It is the birth place of the cynical realism movement as well as the genesis of Fang Lijun, Zhang Xiaogang and Yue Mingjun, now among the most successful Chinese contemporary artists in global art market. The Starting Point of Art Industry: 798 and Songzhuang After the Yuanmingyuan artist village was shut down in 1993, artists moved to two locations in the east of Beijing to escape from the government and embrace the free space they longed for. One was 798, an abandoned electronic switching factory in Beijing’s north-east urban fringe area; the other was Songzhuang in Tongzhou District, a further twenty kilometres east. Both of these sites would be included in the first ten official creative clusters by Beijing municipal government in 2006. But instead of simply being substitutes for the Yuanmingyuan artist village, both have developed their own cultures, functioning and influencing artists’ lives in different ways. Songzhuang is located in Tongzhou which is an outer district in Beijing’s east. Songzhuang was initially a rural location; its livelihood was agriculture and industry. Just before the closing down of the Yuanmingyuan village, several artists including Fang Lijun moved to this remote quiet village. Through word of mouth, more artists followed their steps. There are about four thousand registered artists currently living in Songzhuang now; it is already the biggest visual art community in Beijing. An artistic milieu and a local sense of place have grown with the increasing number of artists. The local district government invests in building impressive exhibition spaces and promoting art in order to bring in more tourists, investors and artists. Compared with Songzhuang, 798 enjoys a favourable location along the airport expressway, between the capital airport and the CBD of Beijing. The unused electronics plant was initially rented as classrooms by the China Central Academy of Fine Arts in the 1990s. Then several artists moved their studios and workshops to the area upon eviction from the Yuanmingyuan village. Until 2002 the site was just a space to rent cheap work space, a factor that has stimulated many art districts globally (Zukin). From that time the resident artists began to plan how to establish a contemporary art district in China. Led by Huang Rui, a leading visual artist, the “798 collective” launched arts events and festivals, notably a “rebuilding 798” project of 2003. More galleries, cafés, bars, and restaurants began to set up, culminating in a management takeover by the Chaoyang District government with the Seven Stars Group[2] prior to the Beijing Olympics. The area now provides massive tax revenue to the local and national government. Nonetheless, both 798 and Songzhuang face problems which reflect the conflict between artists’ attachment to fringe areas and the government’s urbanization approach. 798 can hardly be called an artist production village now due to the local government’s determination to exploit cultural tourism. Over 50 percent of enterprises and people working in 798 now identify 798 as a tourism area rather than an art or “creative” cluster (Liu). Heavy commercialization has greatly disappointed many leading artists. The price for renting space has gone beyond the affordability of artists, and many have chosen to leave. In Songzhuang, the story is similar. In addition to rising prices, a legal dispute between artists and local residents regarding land property rights in 2008 drove some artists out of Songzhuang because they didn’t feel it was stable anymore (Smith). The district’s future as a centre of original art runs up against the aspirations of local officials for more tax revenue and tourist dollars. In the Songzhuang Cultural Creative Industries Cluster Design Plan (cited in Yang), which was developed by J.A.O Design International Architects and Planners Limited and sponsored by the Songzhuang local government in 2007, Songzhuang is designed as an “arts capital incorporated with culture, commerce and tourism.” The down side of this aspiration is that more museums, galleries, shopping centres, hotels, and recreation infrastructure will inevitably be developed in order to capitalise on Songzhuang’s global reputation. Concluding Reflections In reflecting on the recent history of artist villages in Beijing, we might conclude that rural locations are not only a cheap place for artists to live but also a space to showcase their works. More importantly, the relation of artists and outlying district has evolved into a symbiotic relationship. They interact and grow together. The existence of artists transforms the locale and the locale in turn reinforces the identity of artists. In Yuanmingyuan the artists appreciated the old “recluse” tradition and therefore sought spiritual liberation after decades of suppression. The outlying location symbolized freedom to them and provided distance from the world of noisy interaction. But isolation of artists from the local community and the associated constant conflict with local villagers deepened estrangement; these events brought about the end of the dream. In contrast, at 798 and Songzhuang, artists not only regarded the place as their worksite but also engaged with the local community. They communicated with local people and co-developed projects to transform the local landscape. Local communities changed; they started to learn about the artistic world while gaining economic benefits in many ways, such as house renting, running small grocery stores, providing art supplies and even modelling. Their participation into the “art worlds” (Becker) contributed to a changing cultural environment, in turn strengthening the brand of these artist villages. In many regards there were positive externalities for both artists and the district, although as I mentioned in relation to Songzhuang, tensions about land use have never completely been resolved. Today, the fine arts in China have gone far beyond the traditional modes of classics, aesthetics, liberation or rebellion. Art is also a business which requires the access to the material world in order to produce incomes and make profits. It appears that many contemporary artists are not part of a movement of rebellion (except several artists, such as Ai Weiwei), adopting the pure spirit of art as their life-time mission, as in the Yuanmingyuan artist village. They still long for recognition, but they are also concerned with success and producing a livelihood. The boundary between inner urban and outer urban areas is not as significant to them as it once was for artists from a former period. While many artists enjoy the quiet and space of the fringe and rural areas to work; they also require urban space to exhibit their works and earn money. This factor explains the recent emergence of Caochangdi and other artist villages in the neighbouring area around the 798. These latest artist villages in the urban fringe still have open and peaceful spaces and can be accessed easily due to convenient transportation. Unfortunately, the coalition of business and government leads to rapid commercialization of place which is not aligned with the basic need of artists, which is not only a free or affordable place but also a space for creativity. As mentioned above, 798 is now so commercialized that it is too crowded and expensive for artists due to the government’s overdevelopment; whereas the government’s original intention was to facilitate the development of 798. Furthermore, although artists are a key stakeholder in the government’s agenda for visual art industry, it is always the government’s call when artists’ attachment to rural space comes into conflict with Beijing government’s urbanization plan. Hence the government decides which artist villages should be sacrificed to give way to urban development and which direction the reserved artist villages or art clusters should be developed. The logic of government policy causes an absolute distinction between cities and outlying districts. And the government’s enthusiasm for “urbanization” leads to urbanized artist villages, such as the 798. A vicious circle is formed: the government continuously attempts to have selected artist villages commercialized and transformed into urbanized or quasi-urbanized area and closes other artist villages. One of the outcomes of this policy is that in the government created creative clusters, many artists do not stay, and move away into rural and outlying areas because they prefer to work in non-urban spaces. To resolve this dilemma, greater attention is required to understand artists needs and ways to combine urban convenience and rural tranquillity into their development plans. This may be a bridge too far, however. Reference Becker, Howard Saul. Art Worlds. 25th anniversary, updated and expanded ed. Berkeley, CA: U of California P, 2008. Collis, Christy, Emma Felton, and Phil Graham. "Beyond the Inner City: Real and Imagined Places in Creative Place Policy and Practice." The Information Society: An International Journal 26.2 (2010): 104–12. Commission, Outer London. The Mayor's Outer London Commission: Report. London: Great London Authority, 2010. Drake, Graham. "'This Place Gives Me Space': Place and Creativity in the Creative Industries." Geoforum 34.4 (2003): 511–24. Florida, Richard. "Cities and the Creative Class." The Urban Sociology Reader. Eds. Jan Lin and Christopher Mele. London: Routledge, 2005. 290–301. ———. The Rise of the Creative Class. New York: Basic Books, 2002. Gibson, Chris, and Chris Brennan-Horley. "Goodbye Pram City: Beyond Inner/Outer Zone Binaries in Creative City Research." Urban Policy and Research 24.4 (2006): 455–71. Jacobs, Jane. The Economy of Cities. New York: Random House, 1969. Keane, Michael. "The Capital Complex: Beijing's New Creative Clusters." Creative Economies, Creative Cities: Asian-European Perspectives. Ed. Lily Kong and Justin O'Connor. London: Springer, 2009. 77–95. Kotkin, Joel. "The Protean Future of American Cities." New Geographer 7 Mar. 2011. 27 Mar. 2011 ‹http://blogs.forbes.com/joelkotkin/2011/03/07/the-protean-future-of-american-cities/›. Landry, Charles. The Creative City: A Toolkit for Urban Innovators. London: Earthscan Publications, 2000. Leadbeater, Charles, and Kate Oakley. The Independents: Britain's New Cultural Entrepreneurs. London: Demos, 1999. Liu, Mingliang. "Beijing 798 Art Zone: Field Study and Follow-Up Study in the Context of Market." Chinese National Academy of Arts, 2010. Lorenzen, Mark, and Lars Frederiksen. "Why Do Cultural Industries Cluster? Localization, Urbanization, Products and Projects." Creative Cities, Cultural Clusters and Local Economic Development. Ed. Philip Cooke and Luciana Lazzeretti. Cheltenham, UK: Edward Elgar, 2008. 155-79. Mars, Neville, and Adrian Hornsby. The Chinese Dream: A Society under Construction. Rotterdam: 010 Publishers, 2008. Montgomery, John. The New Wealth of Cities: City Dynamics and the Fifth Wave. Aldershot: Ashgate, 2007. Smith, Karen. "Heart of the Art." Beijing: Portrait of a City. Ed. Alexandra Pearson and Lucy Cavender. Hong Kong: The Middle Kingdom Bookworm, 2008. 106–19. Yang, Wei, ed. Songzhuang Arts 2006. Beijing: Hunan Fine Arts Press, 2007. Zhu, Jianfei. Chinese Spatial Strategies Imperial Beijing, 1420-1911. Routledge Curzon, 2004. Zukin, Sharon. The Cultures of Cities. Cambridge, MA: Blackwell, 1995. [1] Most prestigious Chinese universities are located in the Haidian District of Beijing, such as Peking University, Tsinghua University, etc. [2] Seven Star Group is the landholder of the area where 798 is based.

Abstract:

Photo by Jo-Anne McArthur on Unsplash ABSTRACT The UK-based campaign group Scrap Factory Farming has launched a legal challenge against industrial animal agriculture; the challenge is in the process of judicial review. While a fringe movement, Scrap Factory Farming has already accrued some serious backers, including the legal team of Michael Mansfield QC. The premise is that factory farming is a danger not just to animals or the environment but also to human health. According to its stated goals, governments should be given until 2025 to phase out industrialized “concentrated animal feeding organizations” (CAFOs) in favor of more sustainable and safer agriculture. This paper will discuss the bioethical issues involved in Scrap Factory Farming’s legal challenge and argue that an overhaul of factory farming is long overdue. INTRODUCTION A CAFO is a subset of animal feeding operations that has a highly concentrated animal population. CAFOs house at least 1000 beef cows, 2500 pigs, or 125,000 chickens for at least 45 days a year. The animals are often confined in pens or cages to use minimal energy, allowing them to put on as much weight as possible in as short a time. The animals are killed early relative to their total lifespans because the return on investment (the amount of meat produced compared to animal feed) is a curve of diminishing returns. CAFOs’ primary goal is efficiency: fifty billion animals are “processed” in CAFOs every year. The bioethical questions raised by CAFOs include whether it is acceptable to kill the animals, and if so, under what circumstances, whether the animals have rights, and what animal welfare standards should apply. While there are laws and standards in place, they tend to reflect the farm lobby and fail to consider broader animal ethics. Another critical issue applicable to industrial animal agriculture is the problem of the just distribution of scarce resources. There is a finite amount of food that the world can produce, which is, for the moment, approximately enough to go around.[1] The issue is how it goes around. Despite there being enough calories and nutrients on the planet to give all a comfortable life, these calories and nutrients are distributed such that there is excess and waste in much of the global North and rampant starvation and malnutrition in the global South. The problem of distribution can be solved in two ways: either by efficient and just distribution or by increasing net production (either increase productivity or decrease waste) so that even an inefficient and unjust distribution system will probably meet the minimum nutritional standards for all humans. This essay explores four bioethical fields (animal ethics, climate ethics, workers’ rights, and just distribution) as they relate to current industrial agriculture and CAFOs. l. Animal Ethics Two central paradigms characterize animal ethics: welfarism and animal rights. These roughly correspond to the classical frameworks of utilitarianism and deontology. Welfarists[2] hold the common-sense position that animals must be treated well and respected as individuals but do not have inalienable rights in the same ways as humans. A typical welfare position might be, “I believe that animals should be given the best life possible, but there is no inherent evil in using animals for food, so long as they are handled and killed humanely.” Animal rights theorists and activists, on the other hand, would say, “I believe non-human animals should be given the best lives possible, but we should also respect certain rights of theirs analogous to human rights: they should never be killed for food, experimented upon, etc.” Jeremy Bentham famously gave an early exposition of the animal rights case: “The question is not Can they reason?, nor Can they talk?, but Can they suffer? Why should the law refuse its protection to any sensitive being?” Those who take an animal welfare stance have grounds to oppose the treatment of animals in CAFOs as opposed to more traditional grass-fed animal agriculture. CAFOs cannot respect the natural behaviors or needs of animals who evolved socially for millions of years in open plains. If more space was allowed per animal or more time for socialization and other positive experiences in the animal’s life, the yield of the farm would drop. This is not commercially viable in a competitive industry like animal agriculture; thus, there is very little incentive for CAFOs to treat animals well. Rampant abuse is documented.[3] Acts of cruelty are routine: pigs often have teeth pulled and tails docked because they often go mad in their conditions and attempt to cannibalize each other; chickens have their beaks clipped to avoid them pecking at each other, causing immense pain; cows and bulls have their horns burned off to avoid them damaging others (as this damages the final meat product, too); male chicks that hatch in the egg industry are ground up in a macerator, un-anaesthetized, in the first 24 hours of their life as they will not go on to lay eggs. These practices vary widely among factory farms and among jurisdictions. Yet, arguably, the welfare of animals cannot be properly respected because all CAFOs fundamentally see animals as mere products-in-the-making instead of the complex, sentient, and emotional individuals science has repeatedly shown them to be.[4] ll. Climate Ethics The climate impact of farming animals is increasingly evident. Around 15-20 percent of human-made emissions come from animal agriculture.[5] and deforestation to create space for livestock grazing or growing crops to feed farm animals. An average quarter-pound hamburger uses up to six kilograms of feed, causes 66 square feet of deforestation, and uses up to 65 liters of water, with around 4kg of carbon emissions to boot – a majority of which come from the cattle themselves (as opposed to food processing or food miles).[6] According to environmentalist George Monbiot, “Even if you shipped bananas six times around the planet, their impact would be lower than local beef and lamb.”[7] The disparity between the impact of animal and plant-based produce is stark. Not all animal products are created equally. Broadly, there are two ways to farm animals: extensive or intensive farming. Extensive animal farming might be considered a “traditional” way of farming: keeping animals in large fields, as naturally as possible, often rotating them between different areas to not overgraze any one pasture. However, its efficiency is much lower than intensive farming – the style CAFOs use. Intensive animal farming is arguably more environmentally efficient. That is, CAFOs produce more output per unit of natural resource input than extensive systems do. However, environmental efficiency is relative rather than absolute, as the level of intensive animal agriculture leads to large-scale deforestation to produce crops for factory-farmed animals. CAFOs are also point-sources of pollution from the massive quantities of animal waste produced – around 1,000,000 tons per day in the US alone, triple the amount of all human waste produced per day – which has significant negative impacts on human health in the surrounding areas.[8] The environmental impacts of CAFOs must be given serious ethical consideration using new frameworks in climate ethics and bioethics. One example of a land ethic to guide thinking in this area is that “[it] is right when it tends to preserve the integrity, stability, and beauty of the biotic community. It is wrong when it tends otherwise.”[9] It remains to be seen whether CAFOs can operate in a way that respects and preserves “integrity, stability, and beauty” of their local ecosystem, given the facts above. The pollution CAFOs emit affects the surrounding areas. Hog CAFOs are built disproportionately around predominantly minority communities in North Carolina where poverty rates are high.[10] Animal waste carries heavy metals, infectious diseases, and antibiotic-resistant pathogens into nearby water sources and houses. lll. Workers’ Rights The poor treatment of slaughterhouse workers has been documented in the US during the COVID-19 pandemic, where, despite outbreaks of coronavirus among workers, the White House ordered that they remain open to maintain the supply of meat. The staff of slaughterhouses in the US is almost exclusively people with low socioeconomic status, ethnic minorities, and migrants.[11] Almost half of frontline slaughterhouse workers are Hispanic, and a quarter is Black. Additionally, half are immigrants, and a quarter comes from families with limited English proficiency. An eighth live in poverty, with around 45 percent below 200 percent of the poverty line. Only one-in-forty has a college degree or more, while one-in-six lacks health insurance. Employee turnover rates are around 200 percent per year.[12] Injuries are very common in the fast-moving conveyor belt environment with sharp knives, machinery, and a crowd of workers. OSHA found 17 cases of hospitalizations, two body part amputations per week, and loss of an eye every month in the American industrial meat industry. This is three times the workplace accident rate of the average American worker across all industries. Beef and pork workers are likely to suffer repetitive strain at seven times the rate of the rest of the population. One worker told the US Department of Agriculture (USDA) that “every co-worker I know has been injured at some point… I can attest that the line speeds are already too fast to keep up with. Please, I am asking you not to increase them anymore.”[13] Slaughterhouses pose a major risk to public health from zoonotic disease transmission. 20 percent of slaughterhouse workers interviewed in Kenya admit to slaughtering sick animals, which greatly increases the risk of transmitting disease either to a worker further down the production line or a consumer at the supermarket.[14] Moreover, due to poor hygienic conditions and high population density, animals in CAFOs are overfed with antibiotics. Over two-thirds of all antibiotics globally are given to animals in agriculture, predicted to increase by 66 percent by 2030.[15] The majority of these animals do not require antibiotics; their overuse creates a strong and consistent selection pressure on any present bacterial pathogens that leads to antibiotic resistance that could create devastating cross-species disease affecting even humans. The World Health Organization predicts that around 10 million humans per year could die of antibiotic-resistant diseases by 2050.[16] Many of these antibiotics are also necessary for human medical interventions, so antibiotics in animals have a tremendous opportunity cost. The final concern is that of zoonosis itself. A zoonotic disease is any disease that crosses the species boundary from animals to humans. According to the United Nations, 60 percent of all known infections and 75 percent of all emerging infections are zoonotic.[17] Many potential zoonoses are harbored in wild animals (particularly when wild animals are hunted and sold in wet markets) because of the natural biodiversity. However, around a third of zoonoses originate in domesticated animals, which is a huge proportion given the relative lack of diversity of the animals we choose to eat. Q fever, or “query fever,” is an example of a slaughterhouse-borne disease. Q fever has a high fatality rate when untreated that decreases to “just” 2 percent with appropriate treatment.[18] H1N1 (swine flu) and H5N1 (bird flu) are perhaps the most famous examples of zoonoses associated with factory farming. lV. Unjust Distribution The global distribution of food can cause suffering. According to research commissioned by the BBC, the average Ethiopian eats around seven kilograms of meat per year, and the average Rwandan eats eight.[19] This is a factor of ten smaller than the average European, while the average American clocks in at around 115 kilograms of meat per year. In terms of calories, Eritreans average around 1600kcal per day while most Europeans ingest double that. Despite enough calories on the planet to sustain its population, 25,000 people worldwide starve to death each day, 40 percent of whom are children. There are two ways to address the unjust distribution: efficient redistribution and greater net production, which are not mutually exclusive. Some argue that redistribution will lead to lower net productivity because it disincentivizes labor;[20] others argue that redistribution is necessary to respect human rights of survival and equality.[21] Instead of arguing this point, I will focus on people’s food choices and their effect on both the efficiency and total yield of global agriculture, as these are usually less discussed. Regardless of the metric used, animals always produce far fewer calories and nutrients (protein, iron, zinc, and all the others) than we feed them. This is true because of the conservation of mass. They cannot feasibly produce more, as they burn off and excrete much of what they ingest. The exact measurement of the loss varies based on the metric used. When compared to live weight, cows consume somewhere around ten times their weight. When it comes to actual edible weight, they consume up to 25 times more than we can get out of them. Cows are only around one percent efficient in terms of calorific production and four percent efficient in protein production. Poultry is more efficient, but we still lose half of all crops we put into them by weight and get out only a fifth of the protein and a tenth of the calories fed to them.[22] Most other animals lie somewhere in the middle of these two in terms of efficiency, but no animal is ever as efficient as eating plants before they are filtered through animals in terms of the nutritional value available to the world. Due to this inefficiency, it takes over 100 square meters to produce 1000 calories of beef or lamb compared to just 1.3 square meters to produce the same calories from tofu.[23] The food choices in the Western world, where we eat so much more meat than people eat elsewhere, are directly related to a reduction in the amount of food and nutrition in the rest of the world. The most influential theory of justice in recent times is John Rawls’ Original Position wherein stakeholders in an idealized future society meet behind a “veil of ignorance” to negotiate policy, not knowing the role they will play in that society. There is an equal chance of each policymaker ending up poverty-stricken or incredibly privileged; therefore, each should negotiate to maximize the outcome of all citizens, especially those worst-off in society, known as the “maximin” strategy. In this hypothetical scenario, resource distribution would be devised to be as just as possible and should therefore sway away from animal consumption. CONCLUSION Evidence is growing that animals of all sorts, including fish and certain invertebrates, feel pain in ways that people are increasingly inclined to respect, though still, climate science is more developed and often inspires more public passion than animal rights do. Workers’ rights and welfare in slaughterhouses have become mainstream topics of conversation because of the outbreaks of COVID-19 in such settings. Environmentalists note overconsumption in high-income countries, also shining a light on the starvation of much of the low-income population of the world. At the intersection of these bioethical issues lies the modern CAFO, significantly contributing to animal suffering, climate change, poor working conditions conducive to disease, and unjust distribution of finite global resources (physical space and crops). It is certainly time to move away from the CAFO model of agriculture to at least a healthy mixture of extensive agriculture and alternative (non-animal) proteins. - [1] Berners-Lee M, Kennelly C, Watson R, Hewitt CN; Current global food production is sufficient to meet human nutritional needs in 2050 provided there is radical societal adaptation. Elementa: Science of the Anthropocene. 6:52, 2018. DOI: https://doi.org/10.1525/elementa.310 [2] : Lund TB, Kondrup SV, Sandøe P. A multidimensional measure of animal ethics orientation – Developed and applied to a representative sample of the Danish public. PLoS ONE 14(2): e0211656. 2019. DOI: https://doi.org/10.1371/ journal.pone.0211656 [3] Fiber-Ostrow P & Lovell JS. Behind a veil of secrecy: animal abuse, factory farms, and Ag-Gag legislation, Contemporary Justice Review, 19:2, p230-249. 2016. DOI: 10.1080/10282580.2016.1168257 [4] Jones RC. Science, sentience, and animal welfare. Biol Philos 28, p1–30 2013. DOI: https://doi.org/10.1007/s10539-012-9351-1 [5] Twine R. Emissions from Animal Agriculture—16.5% Is the New Minimum Figure. Sustainability, 13, 6276. 2021. DOI: https://doi.org/ 10.3390/su13116276 [6] Capper JL. "Is the Grass Always Greener? Comparing the Environmental Impact of Conventional, Natural and Grass-Fed Beef Production Systems" Animals 2, no. 2: 127-143. 2012. DOI: https://doi.org/10.3390/ani2020127 [7] Monbiot, George. “In Trying to Reduce the Impact of Our Diets, … Their Impact Would Be Lower than Local Beef and Lamb.” Twitter, Twitter, 24 Jan. 2020, twitter.com/GeorgeMonbiot/status/1220691168012460032. [8] Copeland C. Resources, Science, and Industry Division. "Animal waste and water quality: EPA regulation of concentrated animal feeding operations (CAFOs)." Congressional Research Service, the Library of Congress, 2006. [9] Leopold A. A Sand County Almanac, and Sketches Here and There. 1949. [10] Nicole W. “CAFOs and environmental justice: the case of North Carolina.” Environmental health perspectives vol. 121:6. 2013: A182-9. DOI: 10.1289/ehp.121-a182 [11] Fremstad S, Brown H, Rho HJ. CEPR’s Analysis of American Community Survey, 2014-2018 5-Year Estimates. 2020. Accessed 08/06/21 at https://cepr.net/meatpacking-workers-are-a-diverse-group-who-need-better-protections [12] Broadway, MJ. "Planning for change in small towns or trying to avoid the slaughterhouse blues." Journal of Rural Studies 16:1. P37-46. 2000. [13] Wasley A. The Guardian. 2018. Accessed 08/06/2021 at https://www.theguardian.com/environment/2018/jul/05/amputations-serious-injuries-us-meat-industry-plant [14] Cook EA, de Glanville WA, Thomas LF, Kariuki S, Bronsvoort BM, Fèvre EM. Working conditions and public health risks in slaughterhouses in western Kenya. BMC Public Health. 17(1):14. 2017. DOI: 10.1186/s12889-016-3923-y. [15] Global trends in antimicrobial use in food animals. Van Boeckel TP, Brower C, Gilbert M, Grenfell BT, Levin SA, Robinson TP, Teillant A, Laxminarayan R. Proceedings of the National Academy of Sciences May 2015, 112 (18) 5649-5654; DOI: 10.1073/pnas.1503141112 [16] Resistance, IICGoA. "No Time to Wait: Securing the future from drug-resistant infections." Report to the Secretary-General of the United Nations: p1-36. 2019. [17] Espinosa R, Tago D, Treich N. Infectious Diseases and Meat Production. Environ Resource Econ 76, p1019–1044. 2020. https://doi.org/10.1007/s10640-020-00484-3 [18] “Q Fever Fact Sheet.” Pennsylvania Department of Health, 4 Jan. 2003. https://www.health.pa.gov/topics/Documents/Diseases%20and%20Conditions/Q%20Fever%20.pdf [19] Ritchie, Hannah. “Which Countries Eat the Most Meat?” BBC News, BBC, 4 Feb. 2019, www.bbc.co.uk/news/health-47057341. [20] Reynolds, Alan. “The Fundamental Fallacy of Redistribution.” Cato.org, 11 Feb. 2016, 1:22 pm, www.cato.org/blog/fundamental-fallacy-redistribution. [21] Patricia Justino Professor and Senior Research Fellow. “Welfare Works: Redistribution Is the Way to Create Less Violent, Less Unequal Societies.” The Conversation, 20 Aug. 2021, theconversation.com/welfare-works-redistribution-is-the-way-to-create-less-violent-less-unequal-societies-128807. [22] Cassidy E, et al, “Redefining Agricultural Yields: From Tonnes to People Nourished Per Hectare.” Environmental Research Letters, V. 8(3), p2-3. IOPScience. 2013, http://iopscience.iop.org/1748-9326/8/3/034015 [23] Poore J, Nemecek T. Reducing food’s environmental impacts through producers and consumers. Science, 360(6392), p987-992. 2018.

Abstract:

Introduction‘Dream’ has been researched across numerous fields in its multiplicity within both a physical and emotional capacity. For Pagel et al., there is no fixed definition of what ‘dream’ is or are. However, in an advertising context, ’dream’ is the idealised version of our desires, re-visualised in real life (Coombes and Batchelor 103). It could be said that for countless consumers, advertising imagery has elicited dreams of living the perfect life and procuring material pleasures (Manca et al.; Hood). Goodis asserts, “advertising doesn’t always mirror how people are acting but how they are dreaming, in a sense what we are doing is wrapping up your emotions and selling them back to you” (qtd. in Back and Quaade 65). One component of this notion of ‘dream’ in advertising is captured by wishful images of the face and body in their ‘perfect form’ presented in a field of other beauty ideals. For our purposes, ‘dream’ is a “philosophical concept” (Pagel et al. 14) by which dreams are a series of aspirations and desires that consumers internalise, while at the same time, find difficult to achieve. ‘Dream’, then, will be used to critically explore how the beauty and advertising industries collectively employ ethnic ambiguity in addition to other tactics and strategies to sell us dream-like visions of idealised beauty. Forever Dreaming: The Introduction of Ethnic AmbiguityWe can link dreams to beauty as both areas of analysis contain many cultural interpretations and can be deconstructed to reveal different meanings (Sontag). In many ways, beauty is another dream and Sontag notes that the concept of beauty is often linked to certain physical traits that an individual possesses. These physical traits are capitalised upon by product marketing by which Hood claims, aims to enhance one, or even more, of them. For example, lipstick is not marketed as simply as a mixture of wax and pigment but rather a way to “obtain beauty, find romance or gain confidence” (7). As a result, global beauty brands can find long term marketing success through meaningful product marketing. This long-term marketing success relies on influencing human behaviour and perceptions. As a result of meaningful marketing, consumers may find themselves driven to purchase implicit qualities in products advertised to reflect their dreams (Hood).Following the 1980s, this version of meaningful marketing has become a driving purpose for advertising agencies around the globe (Steel). Advertising agencies rely on deeper human insights, identifying latent desires to create a brief that must ultimately sell a dream (Steel). The ideal strategy needs to define something that will build brand loyalty and encourage consumers to have a symbiotic relationship connecting their dreams with the product being sold. As Hood argues, “advertising consists of selling not just things but also dreams”. While this concept is one that “some see as inherently damning”, it is also inherently necessary (7). We understand that people are emotional beings, investing in the artefacts they build, obtain or use with significance “beyond merely utilitarian” (7). For these reasons, beauty advertisers act as the purveyors of dreams in the form of physical perfection as an articulation of consumer’s own aspirations of beauty.These aspirations of dream beauty are a direct representation of our thoughts and feelings. As such, it should be noted that we as consumers are often encouraged to draw inspiration from imagery that is often times seen as ethnically ambiguous. “Ethnic ambiguity” is the absence of any one prominent ethnic or racial feature that is easily discernible to one specific group (Garcia 234; Harrison et al.). An example of this ethnic ambiguity can be seen in marketing campaigns by high end makeup artist and her eponymous range of cosmetics, Charlotte Tilbury. Most notably, in a 2015 launch for her “Makeup Wardrobe”, Tilbury’s makeup palettes boasted 10 aspirational ‘looks’ and personas that could be achieved simply through purchase. The images of women featured on a figurative ‘wheel of fortune’ digital display used to market products online. This digital ‘wheel of fortune’ comprised of ethnically ambiguous models against descriptive persona’s such as “The Dolce Vita” and “The Glamour Muse”. These kinds of digital marketing tools required consumers to make a decision based on what their dream ‘look’ is through an ethnically ambiguous lens and from here are guided to purchase their desired aesthetic. Like Charlotte Tilbury, the beauty industry has seen a growing body of cosmetic brands that employ ethnic ambiguity to sell dreams of homogenised beauty. We will see the ways in which modern day beauty brands, such as Kylie Jenner Cosmetics and Fenty Beauty have come to adopt ethnic ambiguity or embrace entire ethnic and racial groups in order to expand their consumer influence.Aspirational Ambiguity: Dreams of DisempowermentSince the early 2000s, beauty advertising has seen a prominent rise in the use of ethnically ambiguous models. Some see this as an effort to answer the global desire for diversity and inclusion. However, the notion that beauty standards transcend racial boundaries and is inclusive, is simply another form of appropriating and fetishising ethnicity (R. Sengupta). In many ways, these manufactured dream-like versions of beauty have evolved to reach wider markets, in the hope that consumers will be emboldened to both embrace their racial heritage, and at the same time conform to homogenised standards of beauty (Frith et al.; Harrison et al.).In this bid to diversify and extend consumer reach, there are three prominent reasons why ethnically ambiguous models are more likely to be featured over models whose African, Indigenous, and/or Asian heritage is more prominent. Firstly, ethnically ambiguous models do not seem to conform to a particular notion of what is considered beautiful. For many decades, popular culture has been saturated with images of thin, of young, of narrow noses and hips, of blonde, blue eyes, and Caucasian hair textures (Harrison et al.; Hunter; Saraswati). These Westernised beauty ideals have been historically shaped through years of colonial influence, grounded in an imbalance of power and imposed to create a culture of dominance and oppression (Saraswati). Secondly, ethnic models are featured to convey “the sense of the ‘exotic’, and their ‘otherness’ acts to normalise and entrench the dominant ideal of white beauty” (qtd. in Redmond 175). ‘Otherness’ can be defined as the opposite of the majority, in Westernised society this ‘other’ can mean “people who are other than white, male, able bodied, heterosexual” (qtd. in Graycar 74). This ‘otherness’ showcased by ethnically ambiguous models draws viewers in. Physical features that were possessed by one specific ethnic group such as African, Asian, Latinx or Indigenous peoples have now become blended and are no longer confined to one race. Additionally, ethnically ambiguous models enable white consumers to dream about an exotic local or lifestyle, while at the same time providing ethnic audiences a way to see themselves.Finally, it is undeniable that ethnically ambiguous and mixed-race models have become desirable due to a historical preference for light skin (Saraswati). The visual references of light-skinned beauty epitomise a colonial dream and this standardisation has been transferred to indigenous peoples, or ethnic minorities in Western countries. According to Harrison et al, “marketers use mixed-race representations as cultural currency by mythologising mixed-race bodies as the new beauty standard” to represent a racial bridge, “tailored to ameliorate perceived racial divides” (503). Therefore, ethnically ambiguous models have an assumed advantage over their racially dominant counterparts, because they appear to straddle various racial boundaries. They are constructed to embody whomever, from wherever and whenever, fetishising their roleplay for the industry, when it pleases. This further exoticises multi-racial beauty models and renders them a commodified fantasy for many consumers alike. The continued commodification of ethnic ambiguity is problematic as it exploits models with distinctly mixed-race heritage to continue to sell images of white-washed beauty (Solomon et al.). An argument could be made that scarcity contributes to mixed-race models’ value, and therefore the total number of advertising opportunities that are offered to mixed-race models remains limited. To date, numerous studies highlight a limited use of racially diverse models within the beauty industry and does not reflect the growing global body of diverse consumers with purchasing power (Wasylkiw et al.; Redmond; Johnson; Jung and Lee; Frith et al.). In fact, prior to globalisation, Yan and Bissell claim that “each culture had a unique standard of attractiveness, derived from traditional views about beauty as well as the physical features of the people” (197) and over time the construction of dream beauty is characterised using Western features combined with exoticised traits of indigenous ethnic groups. Akinro and Mbunyuza-Memani claim that this “trend of normalising white or 'western' feminine looks as the standard of beauty” has pervaded a number of these indigenous cultures, eventually disseminated through the media as the ultimate goal (308). It can also be argued that the “growing inclusion of mixed-race models in ads is driven less by the motivation to portray diversity and driven more by pragmatism,” and in a more practical sense has implications for the “financial future of the advertised brands and the advertising industry as a whole” (Harrison et al. 513). As a result, uses of mixed-race models “are rather understood as palatable responses within dominant white culture to racial and ethnic minority populations growing in … cultural prominence” (513) in a tokenistic bid to sell a dream of unified beauty.The Dream Girl: Normalisation of Mixed-RaceIn 2017, an article in CNN’s Style section highlighted the growing number of mixed-race models in Japan’s fashion and beauty industry as a modern-day phenomenon from Japan’s interlocking history with the United States (Chung and Ogura). These beauty and fashion influencers refer to themselves as hafu, an exclusionary term that historically represented an “othered” minority of mixed-race heritage in Japanese society signalling complex and troubled interactions with majority Japanese (Oshima). The complications once associated with the term ‘hafu’ are now being reclaimed by bi-racial beauty and fashion models and as such, these models are beginning to defy categorisation and, in some ways, national identity because of their chameleon-like qualities. However, while there is an increasing use of mixed-race Japanese models, everyday mixed-race women are regularly excluded within general society; which highlights the incongruent nature of ‘half’ identity. And yet there is an increasing preference and demand from fashion and beauty outlets to feature them in Japanese and Western popular culture (Harrison et al.; Chung and Ogura). Numéro Tokyo’s editorial director Sayumi Gunji, estimated that almost 30-40 per cent of runway models in present day Japan, identify as either bi-racial mixed-race or multi-racial (Chung and Ogura).Gunji claims:"Almost all top models in the their 20s are hafu, especially the top models of popular fashion magazines ... . [In] the Japanese media and market, a foreigner's flawless looks aren't as readily accepted -- they feel a little distant. But biracial models, who are taller, have bigger eyes, higher noses [and] Barbie-doll-like looks, are admired because they are dreamy looking but not totally different from the Japanese. That's the key to their popularity," she adds. (Qtd. in Chung and Ogura)The "dreamy look" that Gunji describes is attributed to a historical preference toward light skin and a kind of willingness and sensuality, that once, only white models could be seen to tout (Frith et al. 58). Frith et al. and O’Barr discuss that beauty in Japanese advertising mirrors “the way women are portrayed in advertising in the West” (qtd. in Frith et al. 58). The emergence of hafu in Japanese beauty advertising sees these two worlds, a mixture of doll-like and sensual beauty, converging to create a dream-like standard for Japanese consumers. The growing presence of Japanese-American models such as Kiko Mizuhara and Jun Hasegawa are both a direct example of the unattainable ‘dreamy look’ that pervades the Japanese beauty industry. Given this ongoing trend of mixed-race models in beauty advertising, a recent article on Refinery29 talks about the significance of how mixed-race models are disassembling their once marginalised status.A. Sengupta writes:In contrast to passing, in which mixedness was marginalized and hidden, visibly multiracial models now feature prominently in affirmative sites of social norms. Multiracial looks are normalized, and, by extension, mixed identity is validated. There’s no cohesive social movement behind it, but it’s a quiet sea change that’s come with broadened beauty standards and the slow dismantling of social hierarchies.Another example of the normalisation in multi-racial identity is Adwoa Aboah, a mixed-race British model and feminist activist who has been featured on the covers of numerous fashion publications and on runways worldwide. In British Vogue’s December 2017 issue, titled “Great BRITAIN”, Adwoa Aboah achieved front cover status, alongside her image featured other politically powerful names, perhaps suggesting that Aboah represents not only the changing face of a historically white publication but as an embodiment of an increasingly diverse consumer landscape. Not only is she seen as both as a voice for those disenfranchised by the industry, by which she is employed, but as a symbol of new dreams. To conclude this section, it seems the evolution of advertising’s inclusion of multi-racial models reveals a progressive step change for the beauty industry. However, relying simply on the faces of ethnically ambiguous talent has become a covert way to fulfil consumer’s desire for diversity without wholly dismantling the destructive hierarchies of white dominance. Over this time however, new beauty creations have entered the market and with it two modern day icons.Architecting Black Beauty through the American DreamAccording to Kiick, the conception of the ‘American Dream’ is born out of a desire to “seek out a more advantageous existence than the current situation” (qtd. in Manca et al. 84). As a result of diligent hard work, Americans were rewarded with an opportunity for a better life (Manca et al.). Kylie Jenner’s entry into the beauty space seemed like a natural move for the then eighteen-year-old; it was a new-age representation of the ‘American Dream’ (Robehmed 2018). In less than five years, Jenner has created Kylie Cosmetics, a beauty empire that has since amassed a global consumer base, helping her earn billionaire status. A more critical investigation into Jenner’s performance however illustrates that her eponymous range of beauty products sells dreams which have been appropriated from black culture (Phelps). The term cultural appropriation refers to the way dominant cultures “adopt and adapt certain aspects of another’s culture and make it their own” (qtd. in Han 9). In Jenner’s case, her connection to ethnic Armenian roots through her sisters Kourtney, Kim, and Khloe Kardashian have significantly influenced her expression of ‘othered’ culture and moreover ethnic beauty ideals such as curvier body shapes and textured hair. Jenner’s beauty advertisements have epitomised what it means to be black in America, cherry picking racialised features of black women (namely their lips, hips/buttocks and afro-braided hairstyles) and rearticulated them through a white lens. The omission of the ‘black experience’ in her promotion of product is problematic for three reasons. Firstly, representing groups or people without invitation enables room for systemic stereotyping (Han). Secondly, this stereotyping can lead to continued marginalisation of minority cultures (Kulchyski). And finally, the over exaggeration of physical attributes, such as Jenner’s lips, hips and buttocks, reinforces her complicity in exoticising and fetishising the “other”. As a result, consumers of social media beauty advertising may pay less attention to cultural appropriation if they are already unaware that the beauty imagery they consume is based on the exploitation of black culture.Another perspective on Jenner’s use of black culture is in large part due to her cultural appreciation of black beauty. This meaning behind Jenner’s cultural appreciation can be attributed to the inherent value placed on another person’s culture, in the recognition of the positive qualities and the celebration of all aspects of that culture (Han). This is evidenced by her recent addition of cosmetic products for darker complexions (Brown). However, Jenner’s supposed fascination with black culture may be in large part due to the environment in which she was nurtured (Phelps). As Phelps reveals, “consider the cultural significance of the Kardashian family, and the various ways in which the Kardashian women, who are tremendously wealthy and present as white, have integrated elements of black culture as seemingly “natural” in their public bodily performances” (9). Although the Kardashian-Jenner family have faced public backlash for their collective appropriation they have acquired a tremendous “capital gain in terms of celebrity staying power and hyper-visibility” (Phelps 9). Despite the negative attention, Kylie Jenner’s expression of black culture has resurfaced the very issues that had once been historically deemed insignificant. In spite of Jenner’s cultural appropriation of black beauty, her promotion through Kylie Cosmetics continues to sell dreams of idealised beauty through the white lens.In comparison, Rihanna Fenty’s cosmetic empire has been touted as a celebration of diversity and inclusion for modern-age beauty. Unlike Kylie Cosmetics, Fenty’s eponymous brand has become popular for its broader message of inclusivity across both skin tone, body shape and gender. Upon her product release, Fenty Beauty acknowledged a growing body of diverse consumers and as a direct response to feature models of diverse skin tones, cultural background and racial heritage. Perhaps more importantly, Fenty Beauty’s challenge to the ongoing debate around diversity and inclusion has been in stark contrast to Kylie Jenner’s ongoing appropriation of black culture. Images featured at the first brand and product launch of Fenty Beauty and in present day advertising, show South Sudanese model Duckie Thot and hijab-wearing model Halima Aden as central characters within the Fenty narrative, illustrating that inclusion need not remain ambiguous and diversity need not be appropriated. Fenty’s initial product line up included ninety products, but most notably, the Pro Filt’r foundation caused the most publicity. Since its introduction in 2017, the foundation collection contained range of 40 (now 50) inclusive foundation shades, 13 of these shades were designed to cater for much darker complexions, an industry first (Walters). As a result of the brand’s inclusion of diverse product shades and models, Fenty Beauty has been shown to push boundaries within the beauty industry and the social media landscape (Walters). Capitalising on all races and expanding beauty ideals, Fenty’s showcase of beauty subscribes to the notion that for women everywhere in the world, their dreams can and do come true. In conclusion, Fenty Beauty has played a critical role in re-educating global consumers about diversity in beauty (Walters) but perhaps more importantly Rihanna, by definition, has become a true embodiment of the ‘American Dream’.Conclusion: Future Dreams in BeautyIt is undeniable that beauty advertising has remained complicit in selling unattainable dreams to consumers. In the context of ‘dream’ as a philosophical concept, it is more important than ever to ensure our dreams are mirrored, not as an ambiguous body of consumers, but as diverse and unique individuals. Changemakers in the industry such as Fenty Beauty are challenging this status quo and beauty advertising in general will have to evolve their strategy in a bid to answer to an increasingly globalised market. It must be reinforced however, that while “beauty companies and advertisers work effectively to reach a growingly multicultural market, scholars have a responsibility to assess the ramifications that accompany such change,” (Harrison et al. 518). If advertising’s role is to mirror consumers’ dreams then, our roles as dreamers have never been so important. ReferencesAkinro, Ngozi, and Lindani Mbunyuza-Memani. "Black Is Not Beautiful: Persistent Messages and the Globalization of 'White' Beauty in African Women’s Magazines." Journal of International and Intercultural Communication 12.4 (2019): 308–324.Back, Les, and Vibeke Quaade. “Dream Utopias, Nightmare Realities: Imaging Race and Culture within the World of Benetton Advertising.” Third Text 7.22 (1993): 65–80. DOI: 10.1080/09528829308576402.Barry, Ben. “Selling Whose Dream? A Taxonomy of Aspiration in Fashion Imagery.” Fashion, Style & Popular Culture 1.2 (2014). 22 Jan. 2020 <http://www.ingentaconnect.com/content/intellect/fspc/2014/00000001/00000002/art00004>.Brown, Ann. “Kylie Jenner’s Going after Black Beauty Consumers Now with New Lip Shade for Darker-Skinned Women.” Madame Noire 9 Sep. 2016. 1 Feb. 2020 <https://madamenoire.com/716586/kylie-jenner-going-black-beauty-consumer-new-lip-shade-women-darker-hues/>.Cho, Hannah. “Advertising in the Beauty Industry: Digital Media and Conceptions of Beauty.” Senior Capstone Projects 820 (2018). 1 Mar. 2020 <https://digitalwindow.vassar.edu/senior_capstone/820>.Chung, Stephy, and Junko Ogura. “What It Means to Be a Mixed-Race Model in Japan.” CNN, 26 Oct. 2018. 29 Jan. 2020 <https://www.cnn.com/style/article/rina-fukushi-japanese-hafu-models/index.html>.Coombs, Danielle Sarver, and Bob Batchelor. We Are What We Sell: How Advertising Shapes American Life ... and Always Has. California: ABC-CLIO, 2014.Crawford, Robert. “‘Truth in Advertising’: The Impossible Dream?” Media International Australia Incorporating Culture and Policy 119.1 (2006): 124–137.Engeln-Maddox, R. “Buying a Beauty Standard or Dreaming of a New Life? Expectations Associated with Media Ideals.” Psychology of Women Quarterly 30.3 (2006): 258–266.Frith, Katherine, Ping Shaw, and Hong Cheng. “The Construction of Beauty: A Cross-Cultural Analysis of Women’s Magazine Advertising.” Journal of Communication 55.1 (2005): 56–70.García, Justin D. “‘You Don’t Look Mexican!’ My Life in Ethnic Ambiguity and What It Says about the Construction of Race in America.” Multicultural Perspectives 15.4 (2013): 234–238.Graycar, Reg. “Gender, Race, Bias and Perspective: OR, How Otherness Colours Your Judgment.” International Journal of the Legal Profession 15.1-2 (2008): 73–86. DOI: 10.1080/09695950802439734."Great Britain." British Vogue, 2017: 240-310. 28 Jan. 2020 <https://www.zinio.com/gb/british-vogue/december-2017-i392997>.Han, Hsiao-Cheng (Sandrine). “Moving from Cultural Appropriation to Cultural Appreciation.” Art Education 72.2 (2019): 8–13.Harrison, Robert L., Kevin D. Thomas, and Samantha N.N. Cross. “Restricted Visions of Multiracial Identity in Advertising.” Journal of Advertising 46.4 (2017): 503–520.Hood, John McDonald. Selling the Dream: Why Advertising Is Good Business. Westport: Praeger, 2005.Hunter, Margaret L. ““If You’re Light, You’re Alright”: Light Skin Color as Social Capital for Women of Color.” Gender & Society 16.2 (2002): 175–193.Johnson, Melissa A. "How Ethnic Are U.S. Ethnic Media: The Case of Latina Magazines." Mass Communication and Society 3.2–3 (2000): 229–248.Jung, Jaehee, and Yoon-Jung Lee. “Cross-Cultural Examination of Women’s Fashion and Beauty Magazine Advertisements in the United States and South Korea.” Clothing and Textiles Research Journal 27.4 (2009): 274–286.Manca, Luigi, Alessandra Manca, and Gail W. Pieper. Utopian Images and Narratives in Advertising: Dreams for Sale. Maryland: Lexington Books, 2012.Ohmann, Richard. "Review of Culture and the Ad: Exploring Otherness in the World of Advertising." Contemporary Sociology 24.6 (1995): 821–823.Oshima, Kimmie. "Perception of Hafu or Mixed-Race People in Japan: Group-Session Studies among Hafu Students at a Japanese University." Intercultural Communication Studies 23.3 (2014): 22-34.Pagel, J.F., et al. “Definitions of Dream: A Paradigm for Comparing Field Descriptive Specific Studies of Dream.” Dreaming 11 (2001). DOI: 10.1023/A:1012240307661.Peter Kulchyski. “From Appropriation to Subversion: Aboriginal Cultural Production in the Age of Postmodernism.” American Indian Quarterly 21.4 (1997): 605.Phelps, Katherine. “Lil’ Gangstas and Good Girls: Tween Girls’ Racial Performances Online.” Conference Papers -- American Sociological Association. (2019): 1–29.Redmond, Sean. “Thin White Women in Advertising: Deathly Corporeality.” Journal of Consumer Culture 3.2 (2003): 170–190.Robehmed, Natalie. “How 20-Year-Old Kylie Jenner Built a $900 Million Fortune in Less than 3 Years.” Forbes Magazine, 11 July 2018. 29 Jan. 2020 <https://www.forbes.com/sites/forbesdigitalcovers/2018/07/11/how-20-year-old-kylie-jenner-built-a-900-million-fortune-in-less-than-3-years/#33e64869aa62>.Saraswati, L. Ayu. “Cosmopolitan Whiteness: The Effects and Affects of Skin-Whitening Advertisements in a Transnational Women’s Magazine in Indonesia.” Meridians: Feminism, Race, Transnationalism 10.2 (2010): 15–41.Sengupta, Anita. “Is Fashion’s Newfound ‘Inclusivity’ Only Skin Deep?” Refinery29, 8 May 2018. 27 Jan. 2020 <https://www.refinery29.com/en-us/multiracial-women-fetishized-in-fashion-industry-controversy>.Sengupta, Rhea. “Reading Representations of Black, East Asian, and White Women in Magazines for Adolescent Girls.” Sex Roles 54.11 (2006): 799–808.Solomon, Michael R., Richard D. Ashmore, and Laura C. Longo. “The Beauty Match-Up Hypothesis: Congruence between Types of Beauty and Product Images in Advertising.” Journal of Advertising 21.4 (1992): 23–34.Sontag, Susan. “An Argument about Beauty.” Daedalus 134.4 (2005): 208–213.Steel, Jon. Truth, Lies, and Advertising: The Art of Account Planning. New Jersey: Wiley, 1998.Walters, Jenna. “‘FINALLY SOME DIVERSITY’: An Exploration into the Public’s Perceptions of the ‘Fenty Beauty’ Campaign in Relation to How It Challenges the Lack of Diversity in the Mainstream Westernized Beauty Industry.” Hons. diss. Cardiff: Cardiff Metropolitan University, 2018. 27 Jan. 2020 <https://repository.cardiffmet.ac.uk/handle/10369/9985>.Wasylkiw, L., et al. “Are All Models Created Equal? A Content Analysis of Women in Advertisements of Fitness versus Fashion Magazines.” Body Image 6.2 (2009): 137–140.Yan, Yan, and Kim Bissell. “The Globalization of Beauty: How Is Ideal Beauty Influenced by Globally Published Fashion and Beauty Magazines?” Journal of Intercultural Communication Research 43.3 (2014): 194–214.

Abstract:

Introduction Within wellness circles, there has been growing concern over an increasing focus on Alternative Right (or Alt-right) conspiracy (see Aubry; Bloom and Moskalenko). Greene, referring to a definition provided by the Anti-Defamation League, defines the Alt-right as a loose political network characterised by its rejection of mainstream conservatism, embrace of white nationalism, and use of online platforms (33). The “wellness revolution”, on the other hand, which marked a split from the health care sector in which “thought leaders” replaced medical experts as authorities on health (Pilzer, qtd. in Kickbusch and Payne 275), combines New Age practices with ideological movements that emphasise the “interdependence of body, mind and spirit” (Voigt and Laing 32). It has been noted that there is overlap between the circulation of conspiracy theory and New Age mysticism (see Ward and Voas; Parmigiani). Influencers following the Paleo diet, or Palaeolithic diet, such as Australian celebrity chef and Paleo diet guru Pete Evans, have also come under fire for sharing conspiracy theories and pseudoscience (see Brennan). Johnson notes that the origins of the Paleo diet can be traced back to 1975, with the publication of Dr Walter Voegtlin’s book The Stone Age Diet. This text, however, has been largely disavowed by Paleo leaders due to Voegtlin’s “white supremacist, eugenicist, and generally unpalatable politics”. Nevertheless, it is interesting to consider how white nationalism and conspiracy theory may overlap within the wellness space. A specific example occurred in 2020, when Pete Evans shared an Alt-right conspiracy meme to his Facebook account. The ‘butterfly-caterpillar meme’ contained the image of a black sun, a symbol equated with the swastika (Goodrick-Clarke 3). Though Evans later commented that the sharing of the hate symbol was unintentional, and that he misunderstood the symbol, this case raised questions about the ability of wellness influencers to amplify white nationalist messaging. This essay is concerned with the question: what makes the wellness industry a target for the spreading of white nationalist ideas? It argues that the wellness industry and far-right ideology possess a pre-occupation with bodily purity which makes it more likely that white nationalist material carrying this message will be spread via wellness networks. Through a critical examination of the media surrounding Evans’s sharing of the butterfly-caterpillar meme, this case study will examine the ideological aspects of the Paleo diet and how they appeal to a white nationalist agenda. Focussing on the Australian context, this essay will theorise the spreadability of memes in relation to white nationalist symbolism. It contends that the Paleo diet positions foods that are not organic as impure, and holds a preference for positive messaging. Alt-right propaganda packaged in a positive and New Age frame poses a danger in that it can operate as a kind of contagion for high-profile networks, exponentially increasing its spreadability. This is of particular concern when it is considered that diet can have an impact on people’s actions outside of the online space: it impacts what people consume and do with their bodies, as evidenced by calls for eating disorders created by algorithmic repetition to be considered a ‘cyber-pathy’. This creates the conditions for the wellness industry to be targeted using memes as recruitment material for white nationalist groups. The Paleo Diet and the Sharing of a Neo-Nazi Meme Pete Evans is a famous Australian TV Chef from the hit series My Kitchen Rules, a show that ran from 2010-2020. The show followed pairs from different households as they cooked for Evans and his co-host Manu Feildel. During the show’s run, Evans also became known for spruiking the Paleo diet, producing several cookbooks and a documentary on the topic. According to Catie Gressier, who conducted a study of Paleo dieters in Melbourne, Paleo’s aim is “to eat only those foods available prior to the agricultural revolution: meat, fish, vegetables, nuts, seeds and a small amount of fruit” and that this framed as a more “authentic” diet (3). This is seen as an ideological diet as opposed to others which may consist of rules or eating restrictions. The Paleo diet stresses “real foods” or “organic foods as close to their real state as possible” (Ramachandran et al.). Studies find that the paleo diet can be very nutritious (Cambeses-Franco et al. 2021). However, it is important to note that the presence of multiple influencers and thought leaders in the field means that there can be several variations in the diet. This article will limit its examination to that of the diet promoted by Evans. A common rationale is that the human body is incompatible with certain mass-produced foods (like grains, pulses, and dairy products, sugar, salt, and modification practices (like food processing), and that these are the cause of many modern conditions (Cambeses-Franco et al. 2021). While growing concerns over unnatural additives in foods are warranted, it can be observed that in Evans’s case, the promotion of the Paleo diet increasingly blurred the line between pseudoscience and conspiracy. In his Paleo diet book for toddlers, Evans emphasised the importance of the ideological diet and suggested that parents feed their toddlers bone broth instead of breast milk, prompting a federal investigation by the health department (Brennan). This escalated in 2020 during the global pandemic. In January, Evans promoted the work of a prominent anti-vaccine advocate (Molloy). In April, his Biocharger device, which he claimed could cure coronavirus, earned him a hefty fine from the Therapeutic Goods Administration (White). In November, several months after My Kitchen Rules was cancelled, Evans posted an Alt-right political cartoon with the image of a black sun, a symbol equated with the swastika (Goodrick-Clarke 3), to his Facebook account (Gillespie). In later news reports, it was also pointed out that the black sun symbol was emblazoned on the backpack of the Christchurch shooter (see Sutton and Molloy) who had targeted two mosques in Christchurch, New Zealand, killing 51 people and injuring 40. Initially, when a user on Facebook pointed out that the meme contained a black sun, Evans responded “I was waiting for someone to see that” (Evans, qtd. in Gillespie). Evans eventually recanted the image, writing: sincere apologies to anyone who misinterpreted a previous post of a caterpillar and a butterfly having a chat over a drink and perceived that I was promoting hatred. I look forward to studying every symbol that have ever existed and research them thoroughly before posting. Hopefully this symbol ❤️ resonates deeply into the hearts of ALL! (Evans, qtd. in Gillespie). The post was later deleted. In December of 2020, Evans’s Facebook page of around 1.5 million followers was removed due to its sharing of conspiracy theories and misinformation about the coronavirus (Gillespie). However, it should be noted that the sharing of the caterpillar-butterfly meme was different from the previous instances of conspiracy sharing, in that Evans stated that it was unintentional, and it included imagery associated with neo-Nazi ideology (the black sun). Evans’s response implies that, while the values of the Paleo diet are framed in terms of positivity, the symbols in the butterfly-caterpillar meme are associated with “promoting hatred”. In this way, Evans frames racism as merely and simplistically an act of hatred, rather than engaging in the ways in which it reinforces a racial hierarchy and racially motivated violence. According to Hartzell (10), white nationalists tend to position themselves as superior to other races and see themselves as protectors of the “white race”. “White” in this context is of European descent (Geary, Schofield and Sutton). There are conspiracy theories associated with this belief, one of which is that their race is under threat of extinction because of immigration from ‘undesirable’ countries of origin. This can also be observed in the Alt-right, which is a white nationalist movement that was created and organised online. According to Berger, this movement “seeks to unify the activities of several different extremist movements or ideologies”. This is characterised by anti-immigrant sentiment, conspiracy theories, and support for former US President Donald Trump. It can be argued, in this case, that the symbol links to a larger conspiracy theory in which whiteness must be defended against some perceived threat. The meme implies that there is an ‘us’ versus ‘them’, or ‘good’ versus ‘evil’, and that some people are ‘in the know’ while others are not. Spreadable Memes An important aspect of this case study is that this instance of far-right recruitment used the form of a meme. Memes are highly spreadable, and they have very complex mechanisms for disseminating ideas and ideology. This can have a dramatic impact if that ideology is a harmful one, such a white supremacist symbol. While the digital meme, an image with a small amount of text, is common today, Richard Dawkins originally used the term meme to describe the ways in which units of culture can be spread from person to person (qtd. in Shifman 9). These can be anything from the lyrics of a song to a political idea. Jeff Hemsley and Robert Mason (qtd. in Shifman) see virality as a “process wherein a message is actively forwarded from one person to other, within and between multiple weakly linked personal networks, resulting in a rapid increase in the number of people who are exposed to the message” (55). This also links to Jenkins, Ford, and Green’s notions of spreadability (3-11), a natural selection process by which media content continues to exist through networked sharing, or disappears once it stops being shared. Evans’s response indicates that he merely shared the image. Despite the black sun imagery, a Make America Great Again (MAGA) hat is clearly present. A political presence, and one that is associated with white nationalism, is present despite Evans’s attempts to frame the meme in the language of innocence and positivity. This is not to say Evans is extremist or supports a white nationalist agenda. However, in much the same way that sharing of imagery may not necessarily indicate agreement with its ideological messaging, this framing creates a way in which wellness influencers may avoid criticism (Ma 1). Furthermore, the act of sharing the meme, regardless of intention, amplifies its message exponentially. The Paleo Diet, the Far Right and Purity This overlap between wellness and white nationalist ideology is not new. In Jules Evans’s exploration of why QAnon is popular with New Age and far-right followers, she points to the fact that many Nazi leaders – Hitler, Hess, Himmler – “were into alternative medicine, organic and vegetarian diets, homeopathy, anti-vaxxing, and natural healing”. Similarly, Bernhard Forchtner and Ana Tominc argue that a natural diet which focussed on food purity was favoured by the Nazis (421). In their examination of the German neo-Nazi YouTube channel Balaclava Küche they argue add that “present-day extreme right views on environment and diet are often close to positions found in contemporary Green movements and foodie magazines” (422). Like neo-Nazi preoccupations with food, the Paleo diet’s ideology has its basis in the concept of purity. Gressier found that the Paleo diet contains an “embedded moralism” that “filters into constructions of food as either pure or polluting” (1). This is supported by Ramachandran et al.’s study, which found that the diet “promoted ‘real food’ – or the shift to consuming organic whole foods that are as close to their natural state as possible, with an avoidance of processed foods”. This framing of the food as real creates a binary – if one is real, the other must not be. Another example can be seen in Pete Evans’s Webpage, which lists about 33 Paleo recipes. The Butter Chicken recipe states: the paleo way of life is not meant to be restrictive, as you can see from this lovely butter chicken recipe. All the nasties have been replaced with good-quality ingredients that make it as good, if not better, than the original. I prefer chicken thighs for their superior flavour and tenderness. The term “nasties” here can be seen to create a dichotomy between real and fake, the west and the east. We see these foods are associated with impurity, the foods that are not “real foods” are positioned as a threat. It can be seen as an orientalist approach, othering those not associated with the west. As can be observed in this Butter Chicken recipe that is “getting rid of the nasties”, it appropriates and ‘sanitises’ ingredients. In her article on the campaign to boycott Halal, Shakira Hussein points out that “ethnic food” presents as multiculturalism in the context of white chefs and homecooks, but the opposite is true if the roles are switched (91). Later in her essay “Halal Chops and Fascist Cupcakes”, she discusses the “weaponisation of food” and how specific white nationalist groups express disgust at the thought of consuming Muslim food. This ethnocentric framing of butter chicken projects a western superiority, replacing traditional ingredients with ‘familiar’ ingredients, making it more palatable to nationalistic tastes. Spreading Consumption I have established that the Paleo diet, with its emphasis on ‘real foods’, is deeply embedded with nationalist ideology. I have also discussed how this is highly spreadable in the form of a meme, particularly when it is framed in the language of positivity. Furthermore, I have argued that this is an attempt to escape criticism for promoting white nationalist values. I would like to turn now to how this spreadability through diet can have an impact on the physical actions of its followers through its digital communication. The Paleo diet, and how to go about following it as described by celebrity influencers, has an impact on what people do with their bodies. Hanganu-Bresch discusses the concept of orthorexia, a fixation with eating proper foods that operates as a cyber-pathy, a digitally propagated condition targeting media users. Like the ‘viral’ and ‘spreadable’ meme, this puritanical obsession with eating can also be considered both a spreadable condition and ideology. According to Hanganu-Bresch, orthorexia sees this diet as a way to overcome an illness or to improve general health, but this also begins to feel righteous and even holy or spiritual. This operates within the context of neoliberalism. Brice and Thorpe talk about women’s activewear worn in everyday settings, or ‘athleisure’, as a neoliberal uniform that says, ‘I’m taking control of my body and health’. To take this idea a step further, this uniform could be extended out into digital spaces as well in terms of what people post on their profiles and social media. This ideological aspect operates as not only a highly spreadable message, but one that is targeted at the overall health of its followers. It encourages not only the spreading of ideology, in this case, white nationalist ideology, but also the modification of food consumption. If this were then to be used as a vehicle to spread messages that encourage white nationalist ideology, it can be seen to be not only a kind of contagion but a powerful one at that. White nationalist iconography that is clearly associated with white supremacist propaganda has the potential to spread extremism. However, neoliberal principles of discipline and bodywork operate through “messages of empowerment, choice, and self-care” (Lavrence and Lozanski, qtd. in Brice and Thorpe). While racist extremism does not necessarily equate to neoliberal and ethnocentric values, a frame of growth, purity, and positivity create an overlap that allow extremist messaging to spread more easily through these networks. Conclusion The case of Pete Evans’s sharing of the butterfly-caterpillar meme exemplifies a concerning overlap between white nationalist discourse and wellness. Ideologically based diets that emphasise real foods, such as the Paleo diet, have a preoccupation with purity and consumption that appeals to white nationalism. They also share a tolerance for the promotion of conspiracy theory and tendency to create an ‘us’ versus ‘them’ dichotomy. Noting these points can provide insight into a potential targeting of the wellness industry to spread racist ideology. As research into spreadability shows, memes are extremely shareable, even if the user does not grasp the meaning behind the symbolism. This article has also extended the idea of the cyberpathy further, noting a weaponisation of the properties of the meme, for the purposes of radicalisation, and how these are accelerated by celebrity influence. This is more potent within the wellness industry when the message is packaged as a form of growth and positivity, which serve to deflect accusations of racism. Furthermore, when diet is combined with white nationalist ideology, it may operate like a contagion, creating the conditions for racism. Those exposed may not have the intention of sharing or spreading racist ideology, but its amplification contributes to the promotion of a racist agenda nevertheless. As such, further investigation into the far-right infiltration of the wellness industry would be beneficial as it could provide more insight into how wellness groups are targeted. Acknowledgements A previous version of this article was presented with Dr Shakira Hussein and Scheherazade Bloul at the Just Food Conference at New York University in June 2021. This article would not have been possible without their input and advice. Dr Shakira Hussein can be contacted at shussein@unimelb.edu.au and Scheherazade Bloul can be contacted at scherrybloul@gmail.com. References Aubry, Sophie. “‘Playing with Fire’: The Curious Marriage of Qanon and Wellness.” Sydney Morning Herald 27 Sep. 2020. 29 July 2020 <https://www.smh.com.au/lifestyle/health-and-wellness/playing-with-fire-the- curious-marriage-of-qanon-and-wellness-20200924-p55yu7.html>. Berger, J.M. “Trump Is the Glue That Binds the Far Right.” The Atlantic 29 Oct. 2018. 20 July 2021 <https://www.theatlantic.com/ideas/archive/2018/10/trump-alt-right-twitter/574219/>. Bloom, Mia, and Sophia Moskalenko. Pastels and Pedophiles: Inside the Mind of QAnon. Stanford University Press, 2021. Brennan, Imogen. “Pete Evans’ Co-Authored Paleo Diet Cookbook for Babies under Investigation.” ABC News 12 Mar. 2015. 13 Nov. 2021 <https://www.abc.net.au/news/2015-03-12/paleo-diet-cookbook-for-babies-under-investigation-pete-evans/6309452>. Brice, Julie, and Holly Thorpe. “Chapter 1: Activewear: The Uniform of the Neoliberal Female Citizen.” Sportswomen’s Apparel around the World: Uniformly Dressed (New Femininities in Digital, Physical and Sporting Cultures). Ed. Linda K. Fuller. Cham: Palgrave Macmillan, 2021. 19-35. Cambeses-Franco, Cristina, Sara González-García, Gumersindo Feijoo, and María Teresa Moreira. “Is the Paleo Diet Safe for Health and the Environment?” Science of the Total Environment 781 (2021). <https://www.sciencedirect.com/science/article/pii/S004896972101785X>. Evans, Pete. “Butter Chicken.” Peteevans.com. 8 Mar. 2022 <https://peteevans.com/recipes/butter-chicken/>. Forchtner, Bernhard, and Ana Tominc. “Kalashnikov and Cooking-Spoon: Neo-Nazism, Veganism and a Lifestyle Cooking Show on Youtube.” Food, Culture & Society 20.3 (2017): 415-441. Geary, Daniel, Camilla Schofield, and Jennifer Sutton. “Introduction: Toward a Global History of White Nationalism.” Global White Nationalism: From Apartheid to Trump. Eds. Daniel Geary, Camilla Schofield, and Jennifer Sutton. 1st ed. Manchester: Manchester UP, 2020. 1–28. Gillespie, Eden. “‘Misinterpreted’: Pete Evans Apologises for Sharing Cartoon with Supposed Neo-Nazi Symbol and Is Dropped by Publisher.” SBS The Feed 16 Nov. 2020. 13 Nov. 2021 <https://www.sbs.com.au/news/the-feed/misinterpreted-pete-evans-apologises-for-sharing-cartoon-with-supposed-neo-nazi-symbol-and-is-dropped-by-publisher>. Goodrick-Clarke, Nicholas. Black Sun: Aryan Cults, Esoteric Nazism, and the Politics of Identity. New York: New York UP, 2001. Greene, Viveca S. “‘Deplorable’ Satire: Alt-Right Memes, White Genocide Tweets, and Redpilling Normies.” Studies in American Humor 5.1 (2019): 31-69. Gressier, Catie. “Food as Faith: Suffering, Salvation and the Paleo Diet in Australia.” Food Culture & Society (2021): 1-13. Hanganu-Bresch, Cristina. “Orthorexia: Eating Right in the Context of Healthism.” Medical Humanities 46.3 (2020): 311-322. Hartzell, Stephanie L. “Alt-White: Conceptualizing the Alt-Right as a Rhetorical Bridge between White Nationalism and Mainstream Public Discourse.” Journal of Contemporary Rhetoric 8 (2018). Hussein, Shakira. “Not Eating the Muslim Other: Halal Certification, Scaremongering, and the Racialisation of Muslim Identity.” International Journal for Crime, Justice and Social Democracy 4.3 (2015): 85-96. Hussein, Shakira. “Halal Chops and Fascist Cupcakes: On Diversity and the Weaponisation of Food.” Meanjin 76.1 (2017). <https://meanjin.com.au/essays/halal-chops-and-fascist-cupcakes/>. Jenkins, Henry, Sam Ford, and Joshua Green. Spreadable Media: Creating Value and Meaning in a Networked Culture. New York: New York UP, 2013. Johnson, Adrienne Rose. “The Paleo Diet and the American Weight Loss Utopia, 1975–2014.” Utopian Studies 26.1 (2015): 101-124. Kickbusch, Ilona, and Lea Payne. “Twenty-First Century Health Promotion: The Public Health Revolution Meets the Wellness Revolution.” Health Promotion International 18.4 (2003): 275-278. Ma, Cindy. “What Is the ‘Lite’ in ‘Alt-Lite?’ The Discourse of White Vulnerability and Dominance among Youtube’s Reactionaries.” Social Media + Society 7.3 (2021). Molloy, Shannon. “Celebrity Chef Pete Evans Sparks Fury for ‘Dangerous’ Selfie with Anti-Vaccination Voice.” News.com.au 13 Jan. 2020. 13 Nov. 2021 <https://www.abc.net.au/news/2015-03-12/paleo-diet-cookbook-for-babies-under-investigation-pete-evans/6309452>. Morgan, Jonathon. “These Charts Show Exactly How Racist and Radical the Alt-Right Has Gotten This Year.” The Washington Post 26 Sep. 2016. 20 July 2021 <https://www.washingtonpost.com/news/the-intersect/wp/2016/09/26/these-charts-show-exactly-how-racist-and-radical-the-alt-right-has-gotten-this-year/>. Parmigiani, Giovanna. “Magic and Politics: Conspirituality and COVID-19.” Journal of the American Academy of Religion 89.2 (2021): 506–529. Ramachandran, Divya, James Kite, Amy Jo Vassallo, Josephine Y. Chau, Stephanie Partridge, Becky Freeman, and Timothy Gill. “Food Trends and Popular Nutrition Advice Online – Implications for Public Health.” Online Journal of Public Health Informatics 10.2 (2018). Shifman, Limor. Memes in Digital Culture. MIT Press, 2014. Sutton, Candace, Shannon Molloy, and staff writers. “Gunman’s Family in Australia Called Police after News of Christchurch Massacre.” News.com.au 16 Mar. 2019. 14 Nov 2021 <https://www.news.com.au/world/pacific/gunman-who-opened-fire-on-christchurch-mosque-addresses-attack-in-manifesto/news-story/70372a39f720697813607a9ec426a734>. Voigt, Cornelia, and Jennifer H. Laing. “A Way through the Maze: Exploring Differences and Overlaps between Wellness and Medical Tourism Providers.” Medical Tourism and Transnational Health Care (2013): 30-47. Ward, Charlotte, and David Voas. “The Emergence of Conspirituality.” Journal of Contemporary Religion 26.1 (2011): 103–121. White, Daniella. “Celebrity Chef Pete Evans Fined $80,000, Ordered to Stop Making Wellness Claims.” Sydney Morning Herald 25 Mar. 2020. 13 Nov. 2021 <https://www.smh.com.au/national/celebrity-chef-pete-evans-fined-80-000-ordered-to-stop-making-wellness-claims-20210525-p57v40.html>. Zhou, Naaman. “Pete Evans’ Documentary Should be Cut from Netflix, Doctors Group Says”. The Guardian 2 June 2018. 3 Jan. 2022 <https://www.theguardian.com/australia-news/2018/jun/03/pete-evans-documentary-should-be-cut-from-netflix-doctors-group-says>.

Abstract:

Introduction The first “Aquarius Festival” came together in Canberra, at the Australian National University, in the autumn of 1971 and was reprised in 1973 in the small rural town of Nimbin, in northern New South Wales. Both events reflected the Zeitgeist in what was, in some ways, an inchoate expression of the so-called “counterculture” (Roszak). Rather than attempting to analyse the counterculture as a discrete movement with a definable history, I enlist the theory of cultural memes to read the counter culture as a Dawkinsian cluster meme, with this paper offered as “testimonio”, a form of quasi-political memoir that views shifts in the culture through the lens of personal experience (Zimmerman, Yúdice). I track an evolving personal, “internal” topography and map its points of intersection with the radical social, political and cultural changes spawned by the “consciousness revolution” that was an integral part of the counterculture emerging in the 1970s. I focus particularly on the notion of “consciousness raising”, as a Dawkinsian memetic replicator, in the context of the idealistic notions of the much-heralded “New Age” of Aquarius, and propose that this meme has been a persistent feature of the evolution of the “meme cluster” known as the counterculture. Mimesis and the Counterculture Since evolutionary biologist Richard Dawkins floated the notion of cultural memes as a template to account for the evolution of ideas within political cultures, a literature of commentary and criticism has emerged that debates the strengths and weaknesses of his proposed model and its application across a number of fields. I borrow the notion to trace the influence of a set of memes that clustered around the emergence of what writer Marilyn Ferguson called The Aquarian Conspiracy, in her 1980 book of that name. Ferguson’s text, subtitled Personal and Social Transformation in Our Time, was a controversial attempt to account for what was known as the “New Age” movement, with its late millennial focus on social and personal transformation. That focus leads me to approach the counterculture (a term first floated by Theodore Roszak) less as a definable historical movement and more as a cluster of aspirational tropes expressing a range of aspects or concerns, from the overt political activism through to experimental technologies for the transformation of consciousness, and all characterised by a critical interrogation of, and resistance to, conventional social norms (Ferguson’s “personal and social transformation”). With its more overtly “spiritual” focus, I read the “New Age” meme, then, as a sub-set of this “cluster meme”, the counterculture. In my reading, “New Age” and “counterculture” overlap, sharing persistent concerns and a broad enough tent to accommodate the serious—the combative political action of Students for a Democratic Society (SDS), say, (see Elbaum)—to the light-hearted—the sport of frisbee for example (Stancil). The interrogation of conventional social and political norms inherited from previous generations was a prominent strategy across both movements. Rather than offering a sociological analysis or history of the ragbag counterculture, per se, my discussion here focuses in on the particular meme of “consciousness raising” within that broader set of cultural shifts, some of which were sustained in their own right, some dropping away, and many absorbed into the dominant mainstream culture. Dawkins use of the term “meme” was rooted in the Greek mimesis, to emphasise the replication of an idea by imitation, or copying. He likened the way ideas survive and change in human culture to the natural selection of genes in biological evolution. While the transmission of memes does not depend on a physical medium, such as the DNA of biology, they replicate with a greater or lesser degree of success by harnessing human social media in a kind of “infectivity”, it is argued, through “contagious” repetition among human populations. Dawkins proposed that just as biological organisms could be said to act as “hosts” for replicating genes, in the same way people and groups of people act as hosts for replicating memes. Even before Dawkins floated his term, French biologist Jacques Monod wrote that ideas have retained some of the properties of organisms. Like them, they tend to perpetuate their structure and to breed; they too can fuse, recombine, segregate their content; indeed they too can evolve, and in this evolution selection must surely play an important role. (165, emphasis mine) Ideas have power, in Monod’s analysis: “They interact with each other and with other mental forces in the same brain, in neighbouring brains, and thanks to global communication, in far distant, foreign brains” (Monod, cited in Gleick). Emblematic of the counterculture were various “New Age” phenomena such as psychedelic drugs, art and music, with the latter contributing the “Aquarius” meme, whose theme song came from the stage musical (and later, film) Hair, and particularly the lyric that runs: “This is the dawning of the Age of Aquarius”. The Australian Aquarius Festivals of 1971 and 1973 explicitly invoked this meme in the way identified by Monod and the “Aquarius” meme resonated even in Australia. Problematising “Aquarius” As for the astrological accuracy of the “Age of Aquarius meme”, professional astrologers argue about its dating, and the qualities that supposedly characterise it. When I consulted with two prominent workers in this field for the preparation of this article, I was astonished to find their respective dating of the putative Age of Aquarius were centuries apart! What memes were being “hosted” here? According to the lyrics: When the moon is in the seventh house And Jupiter aligns with Mars Then peace will guide the planets And love will steer the stars. (Hair) My astrologer informants assert that the moon is actually in the seventh house twice every year, and that Jupiter aligns with Mars every two years. Yet we are still waiting for the outbreak of peace promised according to these astrological conditions. I am also informed that there’s no “real” astrological underpinning for the aspirations of the song’s lyrics, for an astrological “Age” is not determined by any planet but by constellations rising, they tell me. Most important, contrary to the aspirations embodied in the lyrics, peace was not guiding the planets and love was not about to “steer the stars”. For Mars is not the planet of love, apparently, but of war and conflict and, empowered with the expansiveness of Jupiter, it was the forceful aggression of a militaristic mind-set that actually prevailed as the “New Age” supposedly dawned. For the hippified summer of love had taken a nosedive with the tragic events at the Altamont speedway, near San Francisco in 1969, when biker gangs, enlisted to provide security for a concert performance by The Rolling Stones allegedly provoked violence, marring the event and contributing to a dawning disillusionment (for a useful coverage of the event and its historical context see Dalton). There was a lot of far-fetched poetic licence involved in this dreaming, then, but memes, according to Nikos Salingaros, are “greatly simplified versions of patterns”. “The simpler they are, the faster they can proliferate”, he writes, and the most successful memes “come with a great psychological appeal” (243, 260; emphasis mine). What could be retrieved from this inchoate idealism? Harmony and understanding Sympathy and trust abounding No more falsehoods or derisions Golden living dreams of visions Mystic crystal revelation And the mind’s true liberation Aquarius, Aquarius. (Hair) In what follows I want to focus on this notion: “mind’s true liberation” by tracing the evolution of this project of “liberating” the mind, reflected in my personal journey. Nimbin and Aquarius I had attended the first Aquarius Festival, which came together in Canberra, at the Australian National University, in the autumn of 1971. I travelled there from Perth, overland, in a Ford Transit van, among a raggedy band of tie-dyed hippie actors, styled as The Campus Guerilla Theatre Troupe, re-joining our long-lost sisters and brothers as visionary pioneers of the New Age of Aquarius. Our visions were fueled with a suitcase full of potent Sumatran “buddha sticks” and, contrary to Biblical prophesies, we tended to see—not “through a glass darkly” but—in psychedelic, pop-, and op-art explosions of colour. We could see energy, man! Two years later, I found myself at the next Aquarius event in Nimbin, too, but by that time I inhabited a totally different mind-zone, albeit one characterised by the familiar, intense idealism. In the interim, I had been arrested in 1971 while “tripping out” in Sydney on potent “acid”, or LSD (Lysergic acid diethylamide); had tried out political engagement at the Pram Factory Theatre in Melbourne; had camped out in protest at the flooding of Lake Pedder in the Tasmanian wilderness; met a young guru, started meditating, and joined “the ashram”—part of the movement known as the Divine Light Mission, which originated in India and was carried to the “West” (including Australia) by an enthusiastic and evangelical following of drug-toking drop-outs who had been swarming through India intent on escaping the dominant culture of the military-industrial complex and the horrors of the Vietnam War. Thus, by the time of the 1973 event in Nimbin, while other festival participants were foraging for “gold top” magic mushrooms in farmers’ fields, we devotees had put aside such chemical interventions in conscious awareness to dig latrines (our “service” project for the event) and we invited everyone to join us for “satsang” in the yellow, canvas-covered, geodesic dome, to attend to the message of peace. The liberation meme had shifted through a mutation that involved lifestyle-changing choices that were less about alternative approaches to sustainable agriculture and more about engaging directly with “mind’s true liberation”. Raising Consciousness What comes into focus here is the meme of “consciousness raising”, which became the persistent project within which I lived and worked and had my being for many years. Triggered initially by the ingestion of those psychedelic substances that led to my shocking encounter with the police, the project was carried forward into the more disciplined environs of my guru’s ashrams. However, before my encounter with sustained spiritual practice I had tried to work the shift within the parameters of an ostensibly political framework. “Consciousness raising” was a form of political activism borrowed from the political sphere. Originally generated by Mao Zedong in China during the revolutionary struggle to overthrow the vested colonial interests that were choking Chinese nationalism in the 1940s, to our “distant, foreign brains” (Monod), as Western revolutionary romantics, Chairman Mao and his Little Red Book were taken up, in a kind of international counterculture solidarity with revolutionaries everywhere. It must be admitted, this solidarity was a fairly superficial gesture. Back in China it might be construed as part of a crude totalitarian campaign to inculcate Marxist-Leninist political ideas among the peasant classes (see Compestine for a fictionalised account of traumatic times; Han Suyin’s long-form autobiography—an early example of testimonio as personal and political history—offers an unapologetic account of a struggle not usually construed as sympathetically by Western commentators). But the meme (and the processes) of consciousness raising were picked up by feminists in the United States in the late 1960s and into the 1970s (Brownmiller 21) and it was in this form I encountered it as an actor with the politically engaged theatre troupe, The Australian Performing Group, at Carlton’s Pram Factory Theatre in late 1971. The Performance Group I performed as a core member of the Group in 1971-72. Decisions as to which direction the Group should take were to be made as a collective, and the group veered towards anarchy. Most of the women were getting together outside of the confines of the Pram Factory to raise their consciousness within the Carlton Women’s Liberation Cell Group. While happy that the sexual revolution was reducing women’s sexual inhibitions, some of the men at the Factory were grumbling into their beer, disturbed that intimate details of their private lives—and their sexual performance—might be disclosed and raked over by a bunch of radical feminists. As they began to demand equal rights to orgasm in the bedroom, the women started to seek equal access within the performance group, too. They requested rehearsal time to stage the first production by the Women’s Theatre Group, newly formed under the umbrella of the wider collective. As all of the acknowledged writers in the Group so far were men—some of whom had not kept pace in consciousness raising—scripts tended to be viewed as part of a patriarchal plot, so Betty Can Jump was an improvised piece, with the performance material developed entirely by the cast in workshop-style rehearsals, under the direction of Kerry Dwyer (see Blundell, Zuber-Skerritt 21, plus various contributors at www.pramfactory.com/memoirsfolder/). I was the only male in the collective included in the cast. Several women would have been more comfortable if no mere male were involved at all. My gendered attitudes would scarcely have withstood a critical interrogation but, as my partner was active in launching the Women’s Electoral Lobby, I was given the benefit of the doubt. Director Kerry Dwyer liked my physicalised approach to performance (we were both inspired by the “poor theatre” of Jerzy Grotowski and the earlier surrealistic theories of Antonin Artaud), and I was cast to play all the male parts, whatever they would be. Memorable material came up in improvisation, much of which made it into the performances, but my personal favorite didn’t make the cut. It was a sprawling movement piece where I was “born” out of a symbolic mass of writhing female bodies. It was an arduous process and, after much heaving and huffing, I emerged from the birth canal stammering “SSSS … SSSS … SSMMMO-THER”! The radical reversioning of culturally authorised roles for women has inevitably, if more slowly, led to a re-thinking of the culturally approved and reinforced models of masculinity, too, once widely accepted as entirely biologically ordained rather than culturally constructed. But the possibility of a queer re-versioning of gender would be recognised only slowly. Liberation Meanwhile, Dennis Altman was emerging as an early spokesman for gay, or homosexual, liberation and he was invited to address the collective. Altman’s stirring book, Homosexual: Oppression and Liberation, had recently been published, but none of us had read it. Radical or not, the Group had shown little evidence of sensitivity to gender-queer issues. My own sexuality was very much “oppressed” rather than liberated and I would have been loath to use “queer” to describe myself. The term “homosexual” was fraught with pejorative, quasi-medical associations and, in a collective so divided across strict and sometimes hostile gender boundaries, deviant affiliations got short shrift. Dennis was unsure of his reception before this bunch of apparent “heteros”. Sitting at the rear of the meeting, I admired his courage. It took more self-acceptance than I could muster to confront the Group on this issue at the time. Somewhere in the back of my mind, “homosexuality” was still something I was supposed to “get over”, so I failed to respond to Altman’s implicit invitation to come out and join the party. The others saw me in relationship with a woman and whatever doubts they might have carried about the nature of my sexuality were tactfully suspended. Looking back, I am struck by the number of simultaneous poses I was trying to maintain: as an actor; as a practitioner of an Artaudian “theatre of cruelty”; as a politically committed activist; and as a “hetero”-sexual. My identity was an assemblage of entities posing as “I”; it was as if I were performing a self. Little gay boys are encouraged from an early age to hide their real impulses, not only from others—in the very closest circle, the family; at school; among one’s peers—but from themselves, too. The coercive effects of shaming usually fix the denial into place in our psyches before we have any intellectual (or political) resources to consider other options. Growing up trying to please, I hid my feelings. In my experience, it could be downright dangerous to resist the subtle and gross coercions that applied around gender normativity. The psychoanalyst D. W. Winnicott, of the British object-relations school, argues that when the environment does not support the developing personality and requires the person to sacrifice his or her own spontaneous needs to adapt to environmental demands, there is not even a resting-place for individual experience and the result is a failure in the primary narcissistic state to evolve an individual. The “individual” then develops as an extension of the shell rather than that of the core [...] What there is left of a core is hidden away and is difficult to find even in the most far-reaching analysis. The individual then exists by not being found. The true self is hidden, and what we have to deal with clinically is the complex false self whose function is to keep this true self hidden. (212) How to connect to that hidden core, then? “Mind’s true liberation...” Alienated from the performative version of selfhood, but still inspired by the promise of liberation, even in the “fuzzy” form for which my inchoate hunger yearned (sexual liberation? political liberation? mystical liberation?), I was left to seek out a more authentic basis for selfhood, one that didn’t send me spinning along the roller-coaster of psychedelic drugs, or lie to me with the nostrums of a toxic, most forms of which would deny me, as a sexual, moral and legal pariah, the comforts of those “anchorage points to the social matrix” identified by Soddy (cited in Mol 58). My spiritual inquiry was “counter” to these institutionalised models of religious culture. So, I began to read my way through a myriad of books on comparative religion. And to my surprise, rather than taking up with the religions of antique cultures, instead I encountered a very young guru, initially as presented in a simply drawn poster in the window of Melbourne’s only vegetarian restaurant (Shakahari, in Carlton). “Are you hungry and tired of reading recipe books?” asked the figure in the poster. I had little sense of where that hunger would lead me, but it seemed to promise a fulfilment in ways that the fractious politics of the APG offered little nourishment. So, while many of my peers in the cities chose to pursue direct political action, and others experimented with cooperative living in rural communes, I chose the communal lifestyle of the ashram. In these different forms, then, the conscious raising meme persisted when other challenges raised by the counterculture either faded or were absorbed in the mainstream. I finally came to realise that the intense disillusionment process I had been through (“dis-illusionment” as the stripping away of illusions) was the beginning of awakening, in effect a “spiritual initiation” into a new way of seeing myself and my “place” in the world. Buddhist teachers might encourage this very kind of stripping away of false notions as part of their teaching, so the aspiration towards the “true liberation” of the mind expressed in the Aquarian visioning might be—and in my case, actually has been and continues to be—fulfilled to a very real extent. Gurus and the entire turn towards Eastern mysticism were part of the New Age meme cluster prevailing during the early 1970s, but I was fortunate to connect with an enduring set of empirical practices that haven’t faded with the fashions of the counterculture. A good guitarist would never want to play in public without first tuning her instrument. In a similar way, it is now possible for me to tune my mind back to a deeper, more original source of being than the socially constructed sense of self, which had been so fraught with conflicts for me. I have discovered that before gender, and before sexuality, in fact, pulsing away behind the thicket of everyday associations, there is an original, unconditioned state of beingness, the awareness of which can be reclaimed through focused meditation practices, tested in a wide variety of “real world” settings. For quite a significant period of time I worked as an instructor in the method on behalf of my guru, or mentor, travelling through a dozen or so countries, and it was through this exposure that I was able to observe that the practices worked independently of culture and that “mind’s true liberation” was in many ways a de-programming of cultural indoctrinations (see Marsh, 2014, 2013, 2011 and 2007 for testimony of this process). In Japan, Zen roshi might challenge their students with the koan: “Show me your original face, before you were born!” While that might seem to be an absurd proposal, I am finding that there is a potential, if unexpected, liberation in following through such an inquiry. As “hokey” as the Aquarian meme-set might have been, it was a reflection of the idealistic hope that characterised the cluster of memes that aggregated within the counterculture, a yearning for healthier life choices than those offered by the toxicity of the military-industrial complex, the grossly exploitative effects of rampant Capitalism and a politics of cynicism and domination. The meme of the “true liberation” of the mind, then, promised by the heady lyrics of a 1970s hippie musical, has continued to bear fruit in ways that I could not have imagined. References Altman, Dennis. Homosexual Oppression and Liberation. Sydney: Angus & Robertson, 1972. Blundell, Graeme. The Naked Truth: A Life in Parts. Sydney: Hachette, 2011. Brownmiller, Susan. In Our Time: Memoir of a Revolution. New York: The Dial Press, 1999. Compestine, Ying Chang. Revolution Is Not a Dinner Party. New York: Square Fish, 2009. Dalton, David. “Altamont: End of the Sixties, Or Big Mix-Up in the Middle of Nowhere?” Gadfly Nov/Dec 1999. April 2014 ‹http://www.gadflyonline.com/archive/NovDec99/archive-altamont.html›. Dawkins, Richard. The Selfish Gene. Oxford: Oxford UP, 1976. Elbaum, Max. Revolution in the Air: Sixties Radicals Turn to Lenin, Mao and Che. London and New York: Verso, 2002. Ferguson, Marilyn. The Aquarian Conspiracy. Los Angeles: Tarcher Putnam, 1980. Gleick, James. “What Defines a Meme?” Smithsonian Magazine 2011. April 2014 ‹http://www.smithsonianmag.com/arts-culture/What-Defines-a Meme.html›. Hair, The American Tribal Love Rock Musical. Prod. Michael Butler. Book by Gerome Ragni and James Rado; Lyrics by Gerome Ragni and James Rado; Music by Galt MacDermot; Musical Director: Galt MacDermot. 1968. Han, Suyin. The Crippled Tree. 1965. Reprinted. Chicago: Academy Chicago P, 1985. ---. A Mortal Flower. 1966. Reprinted. Chicago: Academy Chicago P, 1985. ---. Birdless Summer. 1968. Reprinted. Chicago: Academy Chicago P, 1985. ---. The Morning Deluge: Mao TseTung and the Chinese Revolution 1893-1954. Boston: Little Brown, 1972. ---. My House Has Two Doors. New York: Putnam, 1980. Marsh, Victor. The Boy in the Yellow Dress. Melbourne: Clouds of Magellan Press, 2014. ---. “A Touch of Silk: A (Post)modern Faerie Tale.” Griffith Review 42: Once Upon a Time in Oz (Oct. 2013): 159-69. ---. “Bent Kid, Straight World: Life Writing and the Reconfiguration of ‘Queer’.” TEXT: Journal of Writing and Writing Courses 15.1 (April 2011). ‹http://www.textjournal.com.au/april11/marsh.htm›. ---. “The Boy in the Yellow Dress: Re-framing Subjectivity in Narrativisations of the Queer Self.“ Life Writing 4.2 (Oct. 2007): 263-286. Mol, Hans. Identity and the Sacred: A Sketch for a New Social-Scientific Theory of Religion. Oxford: Blackwell, 1976. Monod, Jacques. Chance and Necessity: An Essay on the Natural Philosophy of Modern Biology. New York: Alfred A. Knopf, 1970. Roszak, Theodore. The Making of a Counter Culture: Reflections on the Technocratic Society and Its Youthful Opposition. New York: Doubleday, 1968. Salingaros, Nikos. Theory of Architecture. Solingen: Umbau-Verlag, 2006. Stancil, E.D., and M.D. Johnson. Frisbee: A Practitioner’s Manual and Definitive Treatise. New York: Workman, 1975 Winnicott, D.W. Through Paediatrics to Psycho-Analysis: Collected Papers. 1958. London: Hogarth Press, 1975. Yúdice, George. “Testimonio and Postmodernism.” Latin American Perspectives 18.3 (1991): 15-31. Zimmerman, Marc. “Testimonio.” The Sage Encyclopedia of Social Science Research Methods. Eds. Michael S. Lewis-Beck, Alan Bryman and Tim Futing Liao. London: Sage Publications, 2003. Zuber-Skerritt, Ortrun, ed. Australian Playwrights: David Williamson. Amsterdam: Rodolpi, 1988.