Global burden of disease attributable to mental and substance use disorders : findings from the Global Burden of Disease Study 2010

Background We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) to estimate the burden of disease attributable to mental and substance use disorders in terms of disability-adjusted life years (DALYs), years of life lost to premature mortality (YLLs), and years lived with disability (YLDs). Methods For each of the 20 mental and substance use disorders included in GBD 2010, we systematically reviewed epidemiological data and used a Bayesian meta-regression tool, DisMod-MR, to model prevalence by age, sex, country, region, and year. We obtained disability weights from representative community surveys and an internet-based survey to calculate YLDs. We calculated premature mortality as YLLs from cause of death estimates for 1980–2010 for 20 age groups, both sexes, and 187 countries. We derived DALYs from the sum of YLDs and YLLs. We adjusted burden estimates for comorbidity and present them with 95% uncertainty intervals. Findings In 2010, mental and substance use disorders accounted for 183·9 million DALYs (95% UI 153·5 million–216·7 million), or 7·4% (6·2–8·6) of all DALYs worldwide. Such disorders accounted for 8·6 million YLLs (6·5 million–12·1 million; 0·5% [0·4–0·7] of all YLLs) and 175·3 million YLDs (144·5 million–207·8 million; 22·9% [18·6–27·2] of all YLDs). Mental and substance use disorders were the leading cause of YLDs worldwide. Depressive disorders accounted for 40·5% (31·7–49·2) of DALYs caused by mental and substance use disorders, with anxiety disorders accounting for 14·6% (11·2–18·4), illicit drug use disorders for 10·9% (8·9–13·2), alcohol use disorders for 9·6% (7·7–11·8), schizophrenia for 7·4% (5·0–9·8), bipolar disorder for 7·0% (4·4–10·3), pervasive developmental disorders for 4·2% (3·2–5·3), childhood behavioural disorders for 3·4% (2·2–4·7), and eating disorders for 1·2% (0·9–1·5). DALYs varied by age and sex, with the highest proportion of total DALYs occurring in people aged 10–29 years. The burden of mental and substance use disorders increased by 37·6% between 1990 and 2010, which for most disorders was driven by population growth and ageing. Interpretation Despite the apparently small contribution of YLLs—with deaths in people with mental disorders coded to the physical cause of death and suicide coded to the category of injuries under self-harm—our findings show the striking and growing challenge that these disorders pose for health systems in developed and developing regions. In view of the magnitude of their contribution, improvement in population health is only possible if countries make the prevention and treatment of mental and substance use disorders a public health priority.

Mitochondrial membrane potential in a small subset of artemisinin-induced dormant plasmodium falciparum parasites in vitro

Artemisinin induced dormancy is a proposed mechanism for failures of mono-therapy and is linked with artemisinin resistance in Plasmodium falciparum. The biological characterization and dynamics of dormant parasites are not well understood. Here we report that following dihydroartemisinin (DHA) treatment in vitro, a small subset of morphologically dormant parasites was stained with rhodamine 123 (RH), a mitochondrial membrane potential (MMP) marker, and persisted to recovery. FACS sorted RH-positive parasites resumed growth at 10,000/well while RH-negative parasites failed to recover at 5 million/well. Furthermore, transcriptional activity for mitochondrial enzymes was only detected in RH-positive dormant parasites. Importantly, after treating dormant parasites with different concentrations of atovaquone, a mitochondrial inhibitor, the recovery of dormant parasites was delayed or stopped. This demonstrates that mitochondrial activity is critical for survival and regrowth of dormant parasites and that RH staining provides a means of identifying these parasites. These findings provide novel paths for studying and eradicating this dormant stage.

Reshaping housing : the role of prefabricated systems

Prefabricated housing innovations have the potential to reduce the environmental impact of construction through improving efficiency and quality. The current paper systematically summarises the published evidence since 1990 that describes the barriers and drivers affecting the uptake of prefabricated housing innovations. These are discussed in relation to a ‘Project-Based Product Framework’ which considers multiple stakeholders including builders and other intermediaries, suppliers, end-users, the broader policy context and technical issues. The framework facilitated identification of central issues such as the prevalent business and cultural resistance associated with process changes; the potential for efficiency and quality improvements and cost savings; the simultaneous risks and benefits of close supplier-builder relationships, and negative user perceptions towards prefabricated houses. Though there is a lack of evidence regarding the effects of regulations and government policies on prefabrication uptake, there are indications of the positive potential of financial and social incentives. Directions for further research include understanding how to: manage the industry’s transition to prefabricated houses; appropriately compare prefabricated housing to traditional housing on cost, efficiency and quality measures; reconcile the differing perspectives of various stakeholders; quantify and identify the perspectives of the potential end-user population, and manage the interface between the emerging industry and information technology improvements.

Profiling the nature and context of the Australian prefabricated housing industry

The current state of the prefabricated housing market in Australia is systematically profiled, guided by a theoretical systems model. Particular focus is given to two original data collections. The first identifies manufacturers and builders using prefabrication innovations, and the second compares the context for prefabricated housing in Australia with that of key international jurisdictions. The results indicate a small but growing market for prefabricated housing in Australia, often building upon expertise developed through non-residential building applications. The international comparison highlighted the complexity of the interactions between macro policy decisions and historical influences and the uptake of prefabricated housing. The data suggest factors such as the small scale of the Australian market, and a lack of investment in research, development and training have not encouraged prefabrication. A lack of clear regulatory policy surrounding prefabricated housing is common both in Australia and internationally, with local effects in regards to home warranties and housing finance highlighted. Future research should target the continuing lack of consideration of prefabrication from within the housing construction industry, and build upon the research reported in this paper to further quantify the potential end user market and the continuing development of the industry.

What’s driving the uptake of prefabricated housing in Australia?

Prefabrication has been promoted as a means to improve the efficiency of the Australian house building industry. Issues affecting the uptake of prefabrication were identified through interviews with small and medium sized building companies. Prefabrication’s specific impact on housing construction and smaller organisations has not been frequently investigated. Similar past research has been conducted without the use of a clear theoretical grounding guiding the identification of relevant issues. The current study is guided by a combination of the Theory of Planned Behaviour (TPB) and the Technology Acceptance Model (TAM). This allowed the identification of a broad range of issues across attitudinal, normative, behavioural control and technology adaptation domains. Results revealed improved quality was often offset against practical cost implications. While a high quality of prefabricated products was reported, key technical challenges included coordinating the transporting of modules, and balancing standardisation and product flexibility. Resistance from traditional industry stakeholders regarding build methods, financing, and openness to encouraging prefabrication was commonly reported. The key role of government decision making in facilitating greater demand and competitiveness of prefabricated businesses in the consumer marketplace was also highlighted. Further research is currently being undertaken by the authors, which builds on the exploratory results of the current study through confirmatory, quantitative surveying.

Predicting Australian builders’ intentions to use prefabrication

This study presents the results of the first large scale survey of Australian builders’ beliefs about prefabrication, drawing on 454 surveys completed by representatives of building companies in Queensland and Western Australia. Previous literature has identified a number of broad themes affecting the uptake of prefabrication. The current study builds on this work by using a structured theoretical model based on the Theory of Planned Behaviour (TPB) and the Technology Acceptance Model (TAM), to further explore the specific factors influencing builders’ intentions to increase their use of prefabrication. Information was gathered concerning the characteristics of respondents in addition to three aims. The aims were: (1) To identify the relative importance of a number of key factors which may affect builders’ use of prefabrication, (2) To compare the characteristics of builders using various levels of prefabrication (including none), and; (3) To determine if a model based on the TPB, TAM, and other control variables can explain builders’ intentions to adopt prefabrication on their housing projects.

Can we get along better?

Queensland University of Technology, together with the Royal Melbourne Institute of Technology, the Alliancing Association of Australia, and the Australian Research Council, have recently commenced a 3 year research project which aims to explore the ways in which value for money can be optimised using collaborative contracting during delivery of Australian infrastructure projects.

Green urbanism and diffusion issues

This paper addresses the research question, ‘What are the diffusion determinants for green urbanism innovations in Australia?’ This is a significant topic given the global movement towards green urbanism. The study reported here is based on desktop research that provides new insights through (1) synthesis of the latest research findings on green urbanism innovations and (2) interpretation of diffusion issues through our innovation system model. Although innovation determinants have been studied extensively overseas and in Australia, there is presently a gap in the literature when it comes to these determinants for green urbanism in Australia. The current paper fills this gap. Using a conceptual framework drawn from the innovation systems literature, this paper synthesises and interprets the literature to map the current state of green urbanism innovations in Australia and to analyse the drivers for, and obstacles to, their optimal diffusion. The results point to the importance of collaboration between project-based actors in the implementation of green urbanism. Education, training and regulation across the product system is also required to improve the cultural and technical context for implementation. The results are limited by their exploratory nature and future research is planned to quantify barriers to green urbanism.

Social and cultural drivers of incentive effectiveness in infrastructure projects

Formal incentives systems aim to encourage improved performance by offering a reward for the achievement of project-specific goals. Despite argued benefits of incentive systems on project delivery outcomes, there remains debate over how incentive systems can be designed to encourage the formation of strong project relationships within a complex social system such as an infrastructure project. This challenge is compounded by the increasing emphasis in construction management research on the important mediating influence of technical and organisational context on project performance. In light of this challenge, the research presented in this paper focuses on the design of incentive systems in four infrastructure projects: two road reconstructions in the Netherlands and two building constructions in Australia. Based on a motivational theory frame, a cross case analysis is conducted to examine differences and similarities across social and cultural drivers impacting on the effectiveness of the incentive systems in light of infrastructure project context. Despite significant differences in case project characteristics, results indicate the projects’ experience similar social drivers impacting on incentive effectiveness. Significant value across the projects was placed on: varied performance goals and multiple opportunities to across the project team to pursue incentive rewards; fair risk allocation across contract parties; value-driven tender selection; improved design-build integration; and promotion of future work opportunities. However, differences across the contexts were identified. Results suggest future work opportunities were a more powerful social driver in upholding reputation and establishing strong project relationships in the Australian context. On the other hand, the relationship initiatives in the Dutch context seemed to be more broadly embraced resulting in a greater willingness to collaboratively manage project risk. Although there are limitations with this research in drawing generalizations across two sets of case projects, the results provide a strong base to explore the social and cultural influences on incentive effectiveness across different geographical and contextual boundaries in future research.

Digital literacies: Understanding the literate practices of refugee kids in an Afterschool Media Club

Since the 2000s, teachers in an increasing number of Australian schools have been learning how to support students with refugee backgrounds. For some of these students, entry into the Australian school system is not easy. English literacy is integral to some of the challenges confronting the students. In response, educators have been developing and researching ways of engaging with the students’ language and literacy learning. Much of the focus has been on traditional print-based school literacies. In contrast, I look here at student engagement in digital literacies in an after-school media club. Several concepts from the theory of French sociologist, Pierre Bourdieu are useful for understanding the position of students of refugee background in the Australian school system. Like other conflict theories, Bourdieusian theory has sometimes been criticised as ‘pessimistic’, that is, for suggesting that schools necessarily reproduce social disadvantage. However, others have used Bourdieusian theory to analyse and critique the reproductive work of schooling for groups of students who experience educational disadvantage. I align myself with this latter tradition. Specifically, I use Bourdieu’s triad of concepts to explain aspects of the literacy education experiences of some young people of refugee background: field, capital and habitus. In particular, I look at questions of the legitimation of students’ competences as capital in literate fields within and beyond the school context. Data are drawn from an Australian Research Council-funded project, Digital Learning and Print Literacy: A design experiment for the reform of low socio-economic, culturally diverse schools (2009-14). The data analysed in this chapter include interviews and observations relating to the participation of two Congolese girls in an after school media club. Implications are drawn for teachers of literacy in culturally and linguistically diverse contexts. Consideration is made of early childhood, primary and secondary settings.