A prospective observational study of patient positioning in a Saudi intensive care unit

Aim: To describe the positioning of patients managed in an intensive care unit (ICU); assess how frequently these patients were repositioned; and determine if any specific factors influenced how, why or when patients were repositioned in the ICU. Background: Alterations in body position of ICU patients are important for patient comfort and are believed to prevent and/or treat pressure ulcers, improve respiratory function and combat the adverse effects of immobility. There is a paucity of research on the positioning of critically ill patients in Saudi Arabian ICUs. Design and Methods: A prospective observational study was undertaken. Participant demographic data were collected as were clinical factors (i.e. ventilation status, primary diagnosis, co-morbidities and Ramsay sedation score) and organizational factors (i.e. time of day, type of mattress or beds used, nurse/patient ratio and the patient's position). Clinical and some organization data were recorded over a continuous 48 hour period. Result: Twenty-eight participants were recruited to the study. No participant was managed in either a flat or prone position. Obese participants were most likely to be managed in a supine position. The mean time between turns was two hours. There was no significant association between the mean time between turns and the recorded variables related to patients' demographic and organizational considerations. Conclusion: Results indicate that patient positioning in the ICU was a direct result of unit policy - it appeared that patients were not repositioned based upon evaluation of their clinical condition but rather according to a two-hour ICU timetable

Evolutionary genetics and human assisted movement of a globally invasive pest (Russian wheat aphid : Diuraphis noxia)

This PhD study has examined the population genetics of the Russian wheat aphid (RWA, Diuraphis noxia), one of the world’s most invasive agricultural pests, throughout its native and introduced global range. Firstly, this study investigated the geographic distribution of genetic diversity within and among RWA populations in western China. Analysis of mitochondrial data from 18 sites provided evidence for the long-term existence and expansion of RWAs in western China. The results refute the hypothesis that RWA is an exotic species only present in China since 1975. The estimated date of RWA expansion throughout western China coincides with the debut of wheat domestication and cultivation practices in western Asia in the Holocene. It is concluded that western China represents the limit of the far eastern native range of this species. Analysis of microsatellite data indicated high contemporary gene flow among northern populations in western China, while clear geographic isolation between northern and southern populations was identified across the Tianshan mountain range and extensive desert regions. Secondly, this study analyzed the worldwide pathway of invasion using both microsatellite and endosymbiont genetic data. Individual RWAs were obtained from native populations in Central Asia and the Middle East and invasive populations in Africa and the Americas. Results indicated two pathways of RWA invasion from 1) Syria in the Middle East to North Africa and 2) Turkey to South Africa, Mexico and then North and South America. Very little clone diversity was identified among invasive populations suggesting that a limited founder event occurred together with predominantly asexual reproduction and rapid population expansion. The most likely explanation for the rapid spread (within two years) from South Africa to the New World is by human movement, probably as a result of the transfer of wheat breeding material. Furthermore, the mitochondrial data revealed the presence of a universal haplotype and it is proposed that this haplotype is representative of a wheat associated super-clone that has gained dominance worldwide as a result of the widespread planting of domesticated wheat. Finally, this study examined salivary gland gene diversity to determine whether a functional basis for RWA invasiveness could be identified. Peroxidase DNA sequence data were obtained for a selection of worldwide RWA samples. Results demonstrated that most native populations were polymorphic while invasive populations were monomorphic, supporting previous conclusions relating to demographic founder effects in invasive populations. Purifying selection most likely explains the existence of a universal allele present in Middle Eastern populations, while balancing selection was evident in East Asian populations. Selection acting on the peroxidase gene may provide an allele-dependent advantage linked to the successful establishment of RWAs on wheat, and ultimately their invasion potential. In conclusion, this study is the most comprehensive molecular genetic investigation of RWA population genetics undertaken to date and provides significant insights into the source and pathway of global invasion and the potential existence of a wheat-adapted genotype that has colonised major wheat growing countries worldwide except for Australia. This research has major biosecurity implications for Australia’s grain industry.

Integration of Saudi Arabia’s conservative Islamic culture in sustainable housing design

The cities of Saudi Arabia have perhaps the largest growth rates of cities in the Middle East, such that it has become a cause in shortage of housing for mid and low-income families, as is the case in other developing countries. Even when housing is found, it is not sustainable nor is it providing the cultural needs of those families. The aim of this paper is to integrate the unique conservative Islamic Saudi culture into the design of sustainable housing. This paper is part of a preliminary study of an on-going PhD thesis, which utilises a semistructured interview of a panel of nine experts in collecting the data. The interviews consisted of ten questions ranging from general questions such as stating their expertise and work position to more specific question such as listing the critical success factors and/or barriers for applying sustainability to housing in Saudi Arabia. Since the participants were selected according to their experience, the answers to the interview questions were satisfactory where the generation of the survey questions for the second stage in the PhD thesis took place after analysing the participant’s answers to the interview questions. This paper recommends design requirements for accommodating the conservative Islamic Saudi Culture in low cost sustainable houses. Such requirements include achieving privacy through the use of various types of traditional Saudi architectural elements, such as the method of decorative screening of windows, called Mashrabiya, and having an inner courtyard where the house looks inward rather than outward. Other requirements include educating firms on how to design sustainable housing, educating the public on the advantages of sustainable housing and implementing new laws that enforce the utilisation of sustainable methods to housing construction. This paper contributes towards the body of knowledge by proposing initial findings on how to integrate the conservative Islamic culture of Saudi Arabia into the design of a sustainable house specifically for mid and low-income families. This contribution can be implemented on developing countries in the region that are faced with housing shortage for mid and low-income families.

Chronic kidney disease in Saudi Arabia : a nursing perspective

Chronic kidney disease (CKD) is a major health problem in Saudi Arabia. The number of people requiring kidney replacement therapy in Saudi Arabia is growing, which poses challenges for health professionals and increases the burden on the health care system. However, there is a paucity of nursing literature about CKD in the Middle Eastern region, including Saudi Arabia. The purpose of this review is to describe the epidemiology, risk factors, treatment modalities and the implications for nursing practice of CKD in Saudi Arabia. Improving nurses’ knowledge and awareness about CKD and the risk factors in Saudi Arabia will help them to determine high risk groups and provide early management to delay progression of the disease.

Shifting Powers : Protection of Refugees and Displaced Persons in the Asia Pacific Region

The United Nations High Commissioner for Refugees' (UNHCR) 2011 statistics on refugee populations residing by region are a stark reminder of the challenge facing states and civil society in the Asia Pacific. In 2011, Africa hosted 2,149,000 refugees; the Americas, Europe, and Middle East and North Africa hosted 513 ,500, 1,605,500 and 1,889,900 respectively, while the Asia Pacific hosted a staggering 3,793,900. The fact that 35 per cent of the world's refugees reside in the Asia Pacific, coupled with the fact that 84 per cent of refugees displaced in Asia remain in the region,raises the questions why so few countries in the region are signatories to the Convention relating to the Status of Refugees ('Refugee Convention') or cognate rights instruments and why no formally binding regional agreement exists for the equitable sharing of responsibilities for refugees...

International contact lens prescribing in 2009

This is the eighth consecutive year that we have presented data from a survey of international contact lens prescribing in Contact Lens Spectrum. In this article we report on an assessment of 25,801 fits across 28 contact lens markets located in North America, Europe, the Middle East, Asia, and Africa. As in previous years, we opted for a prospective approach to this work. Up to 1,000 survey forms were randomly disseminated in each market to contact lens practitioners (ophthalmologists, optometrists, and/or opticians depending on the market), and information about the first 10 patients prescribed with lenses after receipt of paper or electronic survey forms was anonymously recorded.

Food security in Australia in an era of neoliberalism, productivism and climate change

For over 150 years Australia has exported bulk, undifferentiated, commodities such as wool, wheat, meat and sugar to the UK and more recently to Japan, Korea, and the Middle East. It is estimated that, each year, Australia's farming system feeds a domestic population of some 22 million people, while exporting enough food to feed another 40 million. With the Australian population expected to double in the next 40 years, and with the anticipated growth in the world's population to reach a level of some 9 billion (from its present level of 7 billion) in the same period, there are strong incentives for an expansion of food production in Australia. Neoliberal settings are encouraging this expansion at the same time as they are facilitating importation of foods, higher levels of foreign direct investment and the commoditisation of resources (such as water). Yet, expansion in food production – and in an era of climate change – will continue to compromise the environment. After discussing Australia's neoliberal framework and its relation to farming, this paper outlines how Australia is attempting to address the issue of food security. It argues that productivist farming approaches that are favoured by both industry and government are proving incapable of bringing about long-term production outcomes that will guarantee national food security.

Journalism Across Cultures : An Introduction

In today's global digital world, journalists are required to be cognizant of ethical and cultural issues beyond usual national boundaries. Drawing on global examples, this text examines international journalism through the authors' wide variety of cultural, educational, teaching and learning backgrounds, including their professional and practical experiences. While existing books tend to be more focused on specific regions or specific aspects of journalism, this book addresses in a comprehensive way journalism across cultures from a truly global (and holistic) perspective. It analyzes media systems in Africa, Latin America, the Arab world and the Middle East, China, as well as North America and Western Europe. This text is truly interdisciplinary in theoretical and practical approaches because it draws on other fields such as media and cultural studies, anthropology, sociology, linguistics, as well as politics and international relations. It will provide an introduction to cross-cultural journalism and equip students with the skills and understanding they need today.

Equal access to the opportunities available? Equity and diversity laws and policies in Australia

Australia has been populated for more than 40,000 years with Indigenous Australians joined by European settlers only 230 years ago. The first settlers consisted of convicts from more than 28 countries and members of the British army who arrived in 1788 to establish a British penal colony. Mass migration in the nineteenth century with one and a half million immigrants from Europe, principally from the United Kingdom and Ireland (Haines and Shlomowitz, 1992), established the continent as an Anglo society in the Pacific. In the twentieth century immigrants came from many European countries and in the latter decades from many parts of Asia and the Middle East (Collins, 1991, pp.10-13). In the 21st century Australia has an ethnically and culturally diverse population. The original Indigenous population of Australia accounts for approximately 460,000 or 2.5 per cent of the total population (ABS, 2006a). Estimates are that around 4.5m. persons in the population (close to 20 per cent), were born outside Australia with the majority of these arriving from Europe, principally the United Kingdom, and New Zealand (ABS, 2006b). Like many other countries, Australia has a legacy of discrimination and inequality in employment. Propelled by racist ideologies and the male breadwinner ideology, Indigenous Australians, and non-European immigrants, and women were barred from certain jobs and paid less for their work than any white male counterpart. These conditions were legally sanctioned through the industrial relations system and other laws in the nineteenth and first half of the twentieth century. Since the 1960s a dramatic change has occurred in social policy and national legislation and Australia today has an extensive array of laws which forbid employment discrimination on race, ethnicity, gender and many other characteristics, and other approaches which promote proactive organizational plans and actions to achieve equity in employment. This chapter outlines these developments.

A multi-genome analysis approach enables tracking of the invasion of a single Russian wheat aphid (Diuraphis noxia) clone throughout the New World

This study investigated the population genetics, demographic history and pathway of invasion of the Russian wheat aphid (RWA) from its native range in Central Asia, the Middle East and Europe to South Africa and the Americas. We screened microsatellite markers, mitochondrial DNA and endosymbiont genes in 504 RWA clones from nineteen populations worldwide. Following pathway analyses of microsatellite and endosymbiont data, we postulate that Turkey and Syria were the most likely sources of invasion to Kenya and South Africa, respectively. Furthermore, we found that one clone transferred between South Africa and the Americas was most likely responsible for the New World invasion. Finally, endosymbiont DNA was found to be a high resolution population genetic marker, extremely useful for studies of invasion over a relatively short evolutionary history time frame. This study has provided valuable insights into the factors that may have facilitated the recent global invasion by this damaging pest.

The ventral striatum of the Syrian hamster

The Syrian hamster, Mesocricetus auratus, was first used in laboratory experiments some fifty years ago in the Middle East, from animals captured in the wild. 1 Since then the Syrian hamster has been domesticated and used extensively in laboratory studies of motivation, includuing reproduction, feeding, aggression and circadian behaviors. 2 In comparison to the rat, the male Syrian hamster is a solitary animal known for its territorial aggression, photoperiodic mating and hoarding behaviors. Many neural circuits controlling reproductive behaviors are now known. 3 While these motivated behaviors have been demonstrated to be regulated by endocrine status there is increasing evidence that dopamine within the nucleus accumbens conveys the rewarding tone of sexual motivation

Braving a New World : Design Interventions for Changing Climates. Papers from the Subtropical Cities 2013 Fall Conference of the Association of Collegiate Schools of Architecture (ACSA)

We no longer have the luxury of time as the effects of climate change are being felt, according to the latest Intergovernmental Panel on Climate Change report, on every continent and in every ocean. More than 50% of the population of the United States and 85% of Australians live in coastal regions. The number of people living in the world’s coastal regions is expected to increase along with the need to improve capacity to mitigate hazards , and manage the multiple risks that have been identified by the scientific community. Under the auspices of the Association of Collegiate Schools of Architecture (ACSA) design academics and practitioners from the Americas, Asia, and Australia met in Fort Lauderdale, Florida for the fourth Subtropical Cities international conference to share outcomes of research and new pedagogies to address the critical transformation of the physical environments and infrastructures of the world’s vulnerable coastal communities. The theme of Subtropical Cities, adopted by the ACSA for its Fall 2014 Conference, is not confined entirely to a latitudinal or climatic frame of reference. The paper and project presentations addressed a range of theoretical, practice-led, and education-oriented research topics in architecture and urban design related to the subtropics, with emphasis on urban and coastal regions. More than half the papers originate from universities and practices in coastal regions. Threads emerged from a tapestry of localized investigations to reveal a more global understanding about possible futures we are designing for current and future generations. The one hundred-plus conference delegates and presenters represented 33 universities and institutions from across the United States, Mexico, Canada, Australia, the Middle East, Peru and China. Case studies from India, Morocco, Tahiti, Indonesia, Jordan, and Cambodia were also presented, expanding the global knowledge base. Co-authored submissions presented new directions for architecture and design, with a resounding theme of collaboration across diverse disciplines. The ability to deal with abstraction and complexity, and the capacity to develop synthesis and frameworks for defining problem boundaries can be considered key attributes of architectural thinking. Such a unique set of abilities can forge collaboration with different professional disciplines to achieve extraordinary outcomes. As the broad range of papers presented at this conference suggest, existing architectural and urban typologies and practices are increasingly considered part of the cause and not the solution to adapting to climate change and sea level rise. Design responses and the actions needed to generate new and unfamiliar forms of urbanism and infrastructure for defense, adaptation, and retreat in subtropical urban regions are being actively explored in academic design studios and research projects around the world. Many presentations propose provocative and experimental strategies as global climate moves beyond our “comfort zone”. The ideas presented at the Subtropical Cities conference are timely as options for low-energy passive climatic design are becoming increasingly limited in the context of changing climate. At the same time, ways of reducing or obsoleting energy intensive mechanical systems in densely populated urban centres present additional challenges for designers and communities as a whole. The conference was marked by a common theme of trans-disciplinary research, where design integration with emerging technologies resonate with a reaffirmation of the centrality of design thinking, expanding the scope of the traditional architecture studio pedagogy to integrate knowledge from other disciplines and the participation of diverse communities.

The 1989 Comprehensive Plan of Action (CPA) and refugee policy in Southeast Asia : twenty years forward what has changed?

In 2012, the only South East Asian countries that have ratified the 1951 Convention relating to the Status of Refugees and the 1967 Protocol Relating to the Status of Refugees (hereafter referred to as the 1951 Convention and 1967 Protocol) is Philippines (signed 1954), Cambodia (signed 1995) and Timor Leste (signed 2001). Countries such as Indonesia, Malaysia and Thailand have annual asylum seeking populations from Myanmar, South Asia and Middle East, that are estimated to be at 15 000-20 000 per country (UNHCR 2012). The lack of a permanent and formal asylum processing process in these countries means that that asylum-seeking populations in the region are reliant on the local offices of the United Nations High Commission for Refugees based in the region to process their claims. These offices rely upon the good will of these governments to have a presence near detection camps and in capital cities to process claims of those who manage to reach the UNHCR representative office. The only burden sharing mechanism within the region primarily exists under the Bali Process on People Smuggling, Trafficking in Persons and Related Transnational Crime (the Bali Process), introduced in 2002. The Bali Process refers to an informal cooperative agreement amongst the states from the Asia-Pacific region, with Australia and Indonesia as the co-chairs, which discusses its namesake: primarily anti-people smuggling activities and migration protocols. There is no provision within this process to discuss the development of national asylum seeking legislation, processes for domestic processing of asylum claims or burden sharing in contrast to other regions such as Africa and South America (i.e. 2009 African Union Convention for the Protection and Assistance of the Internally Displaced, 1969 African Union Convention Governing the Specific Aspects of Refugee Problems in Africa and 1984 Cartagena Declaration on Refugees [Americas]) (PEF 2010: 19).