Antibiotics overuse in children with upper respiratory tract infections in Saudi Arabia : risk factors and potential interventions

Background: Antibiotics misuse is currently one of the major public health issues worldwide. This misuse can lead to the development of bacterial resistance, increasing the burden of chronic diseases, rising costs of health services, and the development of side effects. Several factors may influence this pattern of overuse. Objectives:This article will review the pertinent factors contributing to the overuse of antibiotics worldwide, and to assess the intervention strategies to limit this overuse. Methods: studies about antibiotics use in children were reviewed from several electronic databases, such as MEDLINE and Pubmed. Results: Factors contributing to the overuse of antibiotics could include psychosocial factors, such as behaviors and attitudes (e.g. self-medication, over-the-counter medication, or patients/parents pressure), and demographic factors, such as socio-economic status and education level. Several intervention strategies were reported to be effective in reducing the overuse of antibiotics, such as health education, doctor-patient communication, and policies change. Multifaceted interventions were found to be the most effective in reducing the antibiotics overuse.

Beyond demand management : the value of sharing electricity information

Technologies such as smart meters and electricity feedback are becoming an increasingly compelling focus for HCI researchers in light of rising power prices and peak demand. We argue, however, that a pre-occupation with the goal of demand management has limited the scope of design for these technologies. In this paper we present our work-in-progress investigating the potential value of socially sharing electricity information as a means of broadening the scope of design for these devices. This paper outlines some preliminary findings gathered from a design workshop and a series of qualitative interviews with householders in Brisbane, Australia, regarding their attitudes towards electricity feedback and sharing consumption information. Preliminary findings suggest that; (1) the social sharing of electricity feedback information has the potential to be of value in better informing consumption decisions, however; (2) the potential for sharing may be constrained by attitudes towards privacy, trust and the possibility of misinformation being shared. We conclude by outlining ideas for our future research on this topic and invite comments on these ideas.

The impacts of power outages on the residents of contemporary multistorey apartment buildings in subtropical environments

With significant population growth experienced in South East Queensland over the past two decades and a high rate of growth expected to continue in coming decades, the Queensland Government is promoting urban consolidation planning policies to manage growth sustainably. Multi-residential buildings will play an important role in facilitating the increased densities which urban consolidation policies imply. However, a major flood event in January 2011 has brought to light the vulnerability of certain types of multi-residential typologies to power outages. The crisis conditions exposed how contemporary building design and construction practices, coupled with regulatory and planning issues, appear to have compromised the resilience and habitability of multi-storey residential buildings. In the greater urban area of Brisbane, Queensland, the debilitating dependence that certain types of apartment buildings have on mains electricity was highlighted by residents’ experiences of the Brisbane River flood disaster, before, during and after the event. This research examined high density residential buildings in West End, Brisbane, an inner city suburb which was severely affected by the flood and is earmarked for significant urban densification under the Brisbane City Plan. Medium-to-high-density residential buildings in the suburb were mapped in flooded and non-flooded locations and a database containing information about the buildings was created. Parameters included date of construction, number of storeys, systems of access and circulation, and potential for access to natural light and ventilation for habitable areas. A series of semi-structured interviews were conducted with residents involved in the owners’ management committees of several buildings to verify information the mapping could not provide. The interviews identified a number of critical systems failures due to power outage which had a significant impact on residents’ wellbeing, comfort and safety. Building services such as lifts, running water, fire alarms, security systems and air-conditioning ceased to operate when power was disconnected to neighbourhoods and buildings in anticipation of rising flood waters. Lack of access to buildings and dwellings, lack of safety, lack of building security, and lack of thermal comfort affected many residents whether or not their buildings were actually subjected to inundation, with some buildings rendered uninhabitable for a prolonged period. The extent of the impact on residents was dramatically influenced by the scale and type of building inhabited, with those dwelling in buildings under a 25m height limit, with a single lift, found to be most affected. The energy-dependency and strong trend of increasing power demands of high-rise buildings is well-documented. Extended electricity outages such as the one brought about by the 2011 flood in Queensland are likely to happen more frequently than the 50-year average of the flood event itself. Electricity blackouts can result from a number of man-made or natural causes, including shortages caused by demand exceeding supply. This paper highlights the vulnerability of energy-dependent buildings to power outages and investigates options for energy security for occupants of multi-storey buildings and makes recommendations to increase resilience and general liveability in multi-residential buildings in the subtropics through design modifications.

Living through extreme weather events and natural disasters: How resilient are our high-rise high-density typologies?

The inner city Brisbane suburbs of the West End peninsula are poised for redevelopment. Located within walking distance to CBD workplaces, home to Queensland’s highest value cultural precinct, and high quality riverside parklands, there is currently a once-in-a-lifetime opportunity to redevelop parts of the suburb to create a truly urban neighbourhood. According to a local community association, local residents agree and embrace the concept of high-density living, but are opposed to the high-rise urban form (12 storeys) advocated by the City’s planning authority (BCC, 2011) and would prefer to see medium-rise (5-8 storeys) medium-density built form. Brisbane experienced a major flood event which inundated the peninsula suburbs of West End in summer January 2011. The vulnerability of taller buildings to the vagaries of climate and more extreme weather events and their reliance on main electricity was exposed when power outages immediately before, during and after the flood disaster seriously limited occupants’ access and egress when elevators were disabled. Not all buildings were flooded but dwellings quickly became unliveable due to disabled air-conditioning. Some tall buildings remained uninhabitable for several weeks after the event. This paper describes an innovative design research method applied to the complex problem of resilient, sustainable neighbourhood form in subtropical cities, in which a thorough comparative analysis of a range of multiple-dwelling types has revealed the impact that government policy regarding design of the physical environment has on a community’s resilience. The outcomes advocate the role of climate-responsive design in averting the rising human capital and financial costs of natural disasters and climate change.

A case-control study of ambient heat exposure and urolithiasis among outdoor workers in a shipbuilding company, Guangzhou, China

Higher ambient temperatures will increase heat stress on workers, leading to impacts upon their individual health and productivity. In particular, research has indicated that higher ambient temperatures can increase the prevalence of urolithiasis. This thesis examines the relationship between ambient heat exposure and urolithiasis among outdoor workers in a shipbuilding company in Guangzhou, China, and makes recommendations for minimising the possible impacts of high ambient temperatures on urolithiasis. A retrospective 1:4 matched case-control study was performed to investigate the association between ambient heat exposure and urolithiasis. Ambient heat exposure was characterised by total exposure time, type of work, department and length of service. The data were obtained from the affiliated hospital of the shipbuilding company under study for the period 2003 to 2010. A conditional logistic regression model was used to estimate the association between heat exposure and urolithiasis. This study found that the odds ratio (OR) of urolithiasis for total exposure time was 1.5 (95% confidence interval (CI): 1.2–1.8). Eight types of work in the shipbuilding company were investigated, including welder, assembler, production security and quality inspector, planing machine operator, spray painter, gas-cutting worker and indoor employee. Five out of eight types of work had significantly higher risks for urolithiasis, and four of the five mainly consisted of outdoors work with ORs of 4.4 (95% CI: 1.7–11.4) for spray painter, 3.8 (95% CI: 1.9–7.2) for welder, 2.7 (95% CI: 1.4–5.0) for production security and quality inspector, and 2.2 (95% CI: 1.1–4.3) for assembler, compared to the reference group (indoor employee). Workers with abnormal blood pressure (hypertension) were more likely to have urolithiasis with an OR of 1.6 (95% CI: 1.0–2.5) compared to those without hypertension. This study contributes to the understanding of the association between ambient heat exposure and urolithiasis among outdoor workers in China. In the context of global climate change, this is particularly important because rising temperatures are expected to increase the prevalence of urolithiasis among outdoor workers, putting greater pressure on productivity, occupational health management and health care systems. The results of this study have clear implications for public health policy and planning, as they indicate that more attention is required to protect outdoor workers from heat-related urolithiasis.

Potential dietary consquences of food insecurity among Australian adults residing in urbanised disadvantaged areas

Introduction: Food insecurity is the limited/uncertain availability, access to or ability to acquire nutritionally-adequate, culturallyrelevant and safe foods. Adults suffering from food insecurity are at risk of inadequate nutrient intakes or, paradoxically, overweight/ obesity and the development of chronic disease. Despite the global financial crisis and rising costs of living, there are few studies investigating the potential dietary consequences of food insecurity among the Australian population. This study examined whether food insecurity was associated with weight status and poorer intakes of fruits, vegetable and takeaway foods among adults residing in socioeconomically-disadvantaged urbanised areas. Methods: In this cross-sectional study, a random sample of residents (n=1000) were selected from the most disadvantaged suburbs of Brisbane city (response rate 51%). Data were collected by postal questionnaire which ascertained information on sociodemographic information, household food security status, height, weight, fruit and vegetable intakes and takeaway consumption. Data were analysed using chi-square and logistic regression. Results: The overall prevalence of food insecurity was 31%. Food insecurity was not associated with weight status among men or women. Associations between food security status and potential dietary consequences differed for men and women. Among women, food security was not associated with intakes of fruit, vegetable or takeaway consumption. Contrastingly, among men food security was associated with vegetable intakes and consumption of takeaway food: men reporting food insecurity had lower intakes of vegetables and were more likely to consume takeaway foods compared to those that were food secure. Conclusion: Food security is an important public health issue in Australia and has potential dietary consequences that may adversely affect the health of food-insecure groups, most notably men residing in food-insecure households.

Potential health and dietary consequences of food insecurity among Australian adults residing in urbanised disadvantaged areas

Purpose: Food insecurity is the limited/uncertain availability or ability to acquire nutritionally-adequate, culturally-relevant and safe foods. Adults suffering from food insecurity are at risk of inadequate nutrient intakes or, paradoxically, overweight/obesity and the development of chronic disease. Despite the global financial crisis and rising costs of living, few studies have investigated the potential dietary and health consequences of food insecurity among the Australian population. This study examined whether food insecurity was associated with health behaviours and dietary intakes among adults residing in socioeconomically-disadvantaged urbanised areas. Methods: In this cross-sectional study, a random sample of residents (n = 1000) were selected from the most disadvantaged suburbs of Brisbane city (response rate 51%). Data were collected by postal questionnaire which ascertained information on socio-demographic information, household food security, height, weight, frequency of healthcare utilisation, presence of chronic disease and intakes of fruit, vegetables and take-away. Data were analysed using logistic regression. Results/Findings: The prevalence of food insecurity was 25%. Those reporting food insecurity were two-to-three times more likely to have seen a general practitioner or been hospitalised within the previous 6 months. Furthermore, food insecurity was associated with a three-to-six-fold increase in the likelihood of experiencing depression. Food insecurity was associated with higher intakes of some take-away foods, however was not significantly associated with weight status or intakes of fruits or vegetables among this disadvantaged sample. Conclusion: Food insecurity has potential adverse health consequences that may result in significant health burdens among the population, and this may be concentrated in socioeconomically-disadvantaged suburbs.

BabelFuse data fusion unit with precision wireless clock synchronisation

A significant issue encountered when fusing data received from multiple sensors is the accuracy of the timestamp associated with each piece of data. This is particularly important in applications such as Simultaneous Localisation and Mapping (SLAM) where vehicle velocity forms an important part of the mapping algorithms; on fastmoving vehicles, even millisecond inconsistencies in data timestamping can produce errors which need to be compensated for. The timestamping problem is compounded in a robot swarm environment due to the use of non-deterministic readily-available hardware (such as 802.11-based wireless) and inaccurate clock synchronisation protocols (such as Network Time Protocol (NTP)). As a result, the synchronisation of the clocks between robots can be out by tens-to-hundreds of milliseconds making correlation of data difficult and preventing the possibility of the units performing synchronised actions such as triggering cameras or intricate swarm manoeuvres. In this thesis, a complete data fusion unit is designed, implemented and tested. The unit, named BabelFuse, is able to accept sensor data from a number of low-speed communication buses (such as RS232, RS485 and CAN Bus) and also timestamp events that occur on General Purpose Input/Output (GPIO) pins referencing a submillisecondaccurate wirelessly-distributed "global" clock signal. In addition to its timestamping capabilities, it can also be used to trigger an attached camera at a predefined start time and frame rate. This functionality enables the creation of a wirelessly-synchronised distributed image acquisition system over a large geographic area; a real world application for this functionality is the creation of a platform to facilitate wirelessly-distributed 3D stereoscopic vision. A ‘best-practice’ design methodology is adopted within the project to ensure the final system operates according to its requirements. Initially, requirements are generated from which a high-level architecture is distilled. This architecture is then converted into a hardware specification and low-level design, which is then manufactured. The manufactured hardware is then verified to ensure it operates as designed and firmware and Linux Operating System (OS) drivers are written to provide the features and connectivity required of the system. Finally, integration testing is performed to ensure the unit functions as per its requirements. The BabelFuse System comprises of a single Grand Master unit which is responsible for maintaining the absolute value of the "global" clock. Slave nodes then determine their local clock o.set from that of the Grand Master via synchronisation events which occur multiple times per-second. The mechanism used for synchronising the clocks between the boards wirelessly makes use of specific hardware and a firmware protocol based on elements of the IEEE-1588 Precision Time Protocol (PTP). With the key requirement of the system being submillisecond-accurate clock synchronisation (as a basis for timestamping and camera triggering), automated testing is carried out to monitor the o.sets between each Slave and the Grand Master over time. A common strobe pulse is also sent to each unit for timestamping; the correlation between the timestamps of the di.erent units is used to validate the clock o.set results. Analysis of the automated test results show that the BabelFuse units are almost threemagnitudes more accurate than their requirement; clocks of the Slave and Grand Master units do not di.er by more than three microseconds over a running time of six hours and the mean clock o.set of Slaves to the Grand Master is less-than one microsecond. The common strobe pulse used to verify the clock o.set data yields a positive result with a maximum variation between units of less-than two microseconds and a mean value of less-than one microsecond. The camera triggering functionality is verified by connecting the trigger pulse output of each board to a four-channel digital oscilloscope and setting each unit to output a 100Hz periodic pulse with a common start time. The resulting waveform shows a maximum variation between the rising-edges of the pulses of approximately 39¥ìs, well below its target of 1ms.

Investigating knowledge transfer through transnational programs between Indonesian and Australian universities : A conceptual framework

Globalization stimulated demand for transnational higher education. However, little is known about how transnational programs can facilitate knowledge transfer between the partner universities—something that is often implied in the partnership arrangement. For the purpose of this paper transnational programs will be limited to dual degree programs between Indonesian and Australian universities, which, in recent years have been rising. Nevertheless, the discussion and synthesis may have value to other transnational programs. Situating the knowledge transfer in the wider context of globalization of higher education and the current reforms in Indonesian education, the paper acknowledges the tension between the need to generate revenue and the ideals of facilitating knowledge transfer and capacity development for Indonesian universities. Drawing on a detailed review of research findings in the business and education sector literature, this paper presents a conceptual framework that may be used to analyze knowledge transfer between Indonesian and Australian universities. Such investigations delineate the significant drivers underlying transnational programs for supporting knowledge transfer. The proposed framework incorporates the types of knowledge, knowledge transfer mechanisms, and the processes. It also considers how the inter-university antecedents may affect the potential for knowledge transfer between the universities. A discussion of how the framework may be used to implemented knowledge transfer concludes this paper.

Occupant comfort, the housing industry and electricity infrastructure : understanding the synergies

Despite increasingly stringent energy performance regulations for new homes, southeast Queensland has a high and growing penetration of, and reliance on, air conditioners to provide thermal comfort to housing inhabitants. This reliance impacts on electricity infrastructure investment which is the key driving force behind rising electricity prices. This paper reports initial findings of a research project that seeks to better understand three key issues: (i) how families manage their thermal comfort in summer and how well their homes limit overheating; (ii) the extent to which the homes have been constructed according to the building approval documentation; and (iii) the impact that these issues have on urban design, especially in relation to electricity infrastructure in urban developments.

A Delphi study into the audit challenges of IT governance in the Australian public sector

Information technology (IT) has been playing a powerful role in creating a competitive advantage for organisations over the past decades. This role has become proportionally greater over time as expectations for IT investments to drive business opportunities keep on rising. However, this reliance on IT has also raised concerns about regulatory compliance, governance and security. IT governance (ITG) audit leverages the skills of IS/IT auditors to ensure that IT initiatives are in line with the business strategies. ITG audit emerged as part of performance audit to provide an assessment of the effective implementation of ITG. This research attempts to empirically examine the ITG audit challenges in the public sector. Based on literature and Delphi research, this paper provides insights regarding the impact of, and required effort to address these challenges. The authors also present the ten major ITG audit challenges facing Australian public sector organisations today.

Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010 : a systematic analysis for the Global Burden of Disease Study 2010

Background Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs). Methods Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis. Findings Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350 000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient −0·37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa. Interpretation Rates of YLDs per 100 000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Effective and affordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world. Funding Bill & Melinda Gates Foundation.

Shifting global powers and international law : challenges and opportunities [Challenges of Globalisation series]

This book examines the influence of emerging economies on international legal rules, institutions and processes. It describes recent and predicted changes in economic, political and cultural powers, flowing from the growth of emerging economies such as China, India, Brazil, South Africa and Russia, and analyses the influence of these changes on various legal frameworks and norms. Its contributors come from a variety of fields of expertise, including international law, politics, environmental law, human rights, economics and finance. The book begins by providing a broad analysis of the nature of the shifting global dynamic in its historical and contemporary contexts, including analysis of the rise of China as a major economic and political power and the end of the period of United States domination in international affairs. It illustrates the impact of these changes on states’ domestic policies and priorities, as they adapt to a new international dynamic. The authors then offer a range of perspectives on the impact of these changes as they relate to specific regimes and issues, including climate change regulation, collective security, indigenous rights, the rights of women and girls, environmental protection and foreign aid and development. The book provides a fresh and comprehensive analysis of an issue with extensive implications for international law and politics.

Seriously playful : the uses of networked spoof videos in China

This thesis examines online spoof videos in China. It shows the relationship between user-created content and change and how such videos are impacting on social memory. In the West, we are witnessing two outstanding trends in media. On the one hand, media are turning more "demotic" (Turner, 2006) and "participatory" (Jenkins, 2006), whereby lay audiences use popular media for identity formation, representation and association, reconfiguring the media and cultural landscape, and rendering invalid the old paradigm based on the dichotomy of audience and author, creator and consumer, expert and amateur. On the other hand, in both mainstream media and user-creation online there is a trend towards "silly citizenship", with comedy, send-ups and spoofs that used to reside in the margin propelled to the central stage in both pleasure and politics (Hartley, 2010), as is shown in the rising popularity of the Daily Show, Colbert Report, and spoof videos in elections ,e.g. the 2008 presidential election in US (Gray, Jones, & Thompson, 2009; Tryon, 2008). User generated content—and spoof subcultures—is now much a debated phenomenon in China. However, with different political (one party rule and censorship) and cultural (media regarded mainly as instrument for education and social stabilization instead of a critical fourth estate) configurations, will the social and cultural impacts of the two trends in the West be as the same in China? If not, what will be the specificities in the China context? The project starts with a historical review of popular culture and user-created content in China, before turning to spoof videos and looking at how they are produced and shared, travel and diffused on the Internet, and how the communities and sub-cultures forming and emerging around spoof videos are changing the overall cultural landscape in China. By acting as a participant observer in online video sharing sites and conducting face-to face as well as online interviews, I identify lead users and creators of spoof videos and the social networks emerging around them. I call these lead users "skill hubs" and their networks "liquid communities", foregrounding the fact that their appeal doesn’t come from their amicable personality, but rather from their creative skills; and that the networks surrounding them are in a permanent flux, with members coming and going as they see fit. I argue that the "liquidness" (Bauman, 2000) of these communities is what makes them constantly creative and appealing. Textual analysis of online videos, their comments and derivatives are conducted to tease out the uses that that can be made of spoof videos, namely as phatic communication, as alternative memory and as political engagement. Through these analyses I show that spoof videos constitute not only a space where young generations can engage with each other, communicate their anger and dissatisfaction, fun and hope, and where they participate in socio-cultural and political debates, but also create a space where they can experiment with their new skills, new ideas, and new citizenship. The rise of spoof videos heralds the beginning of a trend in popular culture in contemporary China towards the "canonization of the jester" and the dethroning of the establishment. I also argue that a historical perspective is needed to understand the current surge of use creativity and user activism in China, and that many forms of popular media we experience today have their antecedents in various stages of Chinese history. The entrenched "control-resistance" binary is inadequate in interpreting the rich, flux and multilayered Internet space in China.

A framework of promoting stakeholder mutual benefits for sustainable housing implementation

Strong regulatory pressure and rising public awareness on environmental issues will continue to influence the market demand for sustainable housing for years to come. Despite this potential, the voluntary uptake rate of sustainable practices is not as high as expected within the new built housing industry. This is in contrast to the influx of emerging building technologies, new materials and innovative designs as showcased in office buildings and exemplar homes worldwide. One of the possible reasons for this under-performance is that key stakeholders such as developers, builders and consumers do not fully understand and appreciate the related challenges, risks and opportunities of pursuing sustainability. Therefore, in their professional and business activities, they may not be able to see the tangible and mutual benefits that sustainable housing may bring. This research investigates the multiple challenges to achieving benefits (CABs) from sustainable housing development, and links these factors to the characteristics of key stakeholders in the housing supply chain. It begins with a comparative survey study among seven stakeholder groups in the Australian housing industry, in order to examine the importance and interrelationships of CABs. In-depth interviews then further explore the survey findings with a focus on stakeholder diversity, which leads to the identification of 12 critical mutual-benefit factors and their interrelationship. Based on such a platform, a mutual-benefit framework is developed with the aid of Interpretive Structure Modelling, to identify the patterns of stakeholder benefit materialisation, suggest the priority of critical factors and provide related stakeholder-specific action guidelines for sustainable housing implementation. The study concludes with a case study of two real-life housing projects to test the application of the mutual-benefit framework for improvement. This framework will lead to a shared value of sustainability among stakeholders and improved stakeholder collaboration, which in turn help to break the "circle of blame" for the current under-performance of sustainable housing implementation.