Overweight children have a greater proportion of fat mass relative to muscle mass in the upper limbs than in the lower limbs : implications for bone strength at the distal forearm

Background: The influence of adiposity on upper-limb bone strength has rarely been studied in children, despite the high incidence of forearm fractures in this population.

Objective: The objective was to compare the influence of muscle and fat tissues on bone strength between the upper and lower limbs in prepubertal children.

Design: Bone mineral content, total bone cross-sectional area, cortical bone area (CoA), cortical thickness (CoTh) at the radius and tibia (4% and 66%, respectively), trabecular density (TrD), bone strength index (4% sites), cortical density (CoD), stress-strain index, and muscle and fat areas (66% sites) were measured by using peripheral quantitative computed tomography in 427 children (206 boys) aged 7–10 y.

Results: Overweight children (n = 93) had greater values for bone variables (0.3–1.3 SD; P < 0.0001) than did their normal-weight peers, except for CoD 66% and CoTh 4%. The between-group differences were 21–87% greater at the tibia than at the radius. After adjustment for muscle cross-sectional area, TrD 4%, bone mineral content, CoA, and CoTh 66% at the tibia remained greater in overweight children, whereas at the distal radius total bone cross-sectional area and CoTh were smaller in overweight children (P < 0.05). Overweight children had a greater fat-muscle ratio than did normal-weight children, particularly in the forearm (92 ± 28% compared with 57 ± 17%). Fat-muscle ratio correlated negatively with all bone variables, except for TrD and CoD, after adjustment for body weight (r = −0.17 to −0.54; P < 0.0001).

Conclusions: Overweight children had stronger bones than did their normal-weight peers, largely because of greater muscle size. However, the overweight children had a high proportion of fat relative to muscle in the forearm, which is associated with reduced bone strength.

Evaluating health promotion in schools: a case study of design, implementation and results from the Hong Kong Healthy Schools Award Scheme

Health promoting schools (HPS) and Healthy Schools Award Schemes from a number of countries have demonstrated positive changes in children’s health behaviours and the culture and organisation of the school. The Hong Kong Healthy Schools Award Scheme (HKHSA) aims to promote staff development, parental education, involvement of the whole school community, and linkage with different stakeholders to improve the health and well-being of the pupils, parents and staff, and the broader community, supported by a system to monitor the achievement. This concept is very much in line with the research literature on school effectiveness and improvement. The indicators examined to evaluate the success of the HKHSA reflect outcomes related to both health and education and are not limited to changes in population health status. The early results demonstrated significant improvements in various aspects of student health and also improvement in school culture and organisation. The evaluation framework described in this paper and data collected to assess how schools perform in the HKHSA scheme, provides insight into how HPSs could lead to better outcomes for both education and health.

The language of design resolution in a digital building information model

Information in construction industry is delivered and interpreted in a language specific to the industry in which large complex objects are only partially described and with much information being implicit in the language used. Successful communication therefore relies on participants in the industry leaming how to interpret the language through many years of education, training and experience. With the introduction of computer technology, and in particular the detailed digital building information model (DB 1M), the accepted language currently in use is no longer a valid method of describing the building. At all stages in the paper based design and documentation process it is generally readily apparent which parts of the design require further completion and which are fully resolved. This is able to be achieved through the complex graphical language currently in use. In the DBIM, all information appears at the same level of resolution making difficult the interpretation of implicit information embedded in the model. This compromises the collaborative design environment which is being described as a fundamental characteristic of the future construction industry. This paper focuses on two areas. The first analyses design resolution and the role uncertain information plays in the design process. It then discusses the manner in which designers and the industry in general deal with incomplete or unresolved information. The second describes a theoretical model in which a design resolution (DR) environment incorporates the level of design resolution as an operable element in a collaborative DBIM. The development and implementation of this model will allow designers to better share, understand and interpret design knowledge from the shared information during the various stages of digital design and before full resolution is achieved.

Procurement of construction facilities: a case study of design management within a design and construct organisation

Presents a case study of design management within an Australian design-construct organization on a large residential apartment project, with the purpose of identifying and analysing issues associated with the organization, responsibilities and stages of development in a typical design-construct project. Discusses the nature of introspection in the Australian construction industry, the shift in procurement methods, the design and build approach, whole life issues, the need for a design manager, and the role of the facilities manager. Profiles the case study organization and its contracts and procurement methods, before focusing on weaknesses in the company, the role of the project design development manager in leading the design team, managing the design consultants, and interacting and advising the developer in relation to design decisions. Suggests from the exercise that: the project manager should remain the overall project leader, manager and interface between design, cost, programme, buildability, construction and user requirements; the design manager should be responsible for issuing all documentation; and the design cost manager should be responsible for verifying that the design developed accords with project budgets, project brief and quality requirements in conjunction with the design manager.

Developing business community portals for SMEs-Issues of design, development and sustainability

Governments worldwide are using funding initiatives to encourage small businesses to adopt e-commerce technology. In Australia both State and Federal Governments have encouraged e-commerce uptake through the funding of Internet portal developments that have a specific community or business focus. The success of such portals, as with many Web developments, has been mixed and there is little evidence of any evaluation of the effectiveness of such investments. This paper reports on research into an Australian B2B business community portal from launch to closure. A survey and in-depth interviews with portal participants were undertaken. The research sought to understand how the portal had been developed, and what factors may have contributed to its demise. The findings identified a number of factors, not discussed in the literature, that are important in portal development. These include: how the development process is undertaken; technological readiness of the small business owners; meeting business expectations; and understanding the business community stakeholders. The results from this study suggest that portal projects such as this are problematic and funding bodies such as governments need to understand the factors that contribute to success before funds are committed.

The social role of design representation

Design representation is a crucial part of all design activity. Representations provide a vehicle through which design ideas and decisions are explored, communicated and recorded. Since representation is so fundamental to design, it follows that a deep understanding of the nature and use of representation has the potential to improve current design practice. While there is recognition in the IS literature of the importance of representation, previous IS research has focused almost entirely on the functional aspects of representation, in particular modelling to support various methodologies or particular aspects of design such as database, object-oriented or process modelling. Since the development of an information system is a socio-technical process, this paper argues that we need to understand how representations can facilitate both the specification of the artefact, and the social aspects of design. This paper explores the use of design representation by real-world practitioners. It identifies two hitherto neglected social purposes of representation employed by designers when interacting with clients or users: selective focus, and promotion. The paper concludes by noting that as IS faces increasingly complex design challenges it is timely to examine our understanding of all aspects of design representation including its role in facilitating the social aspects of design.

The value of design : a discussion paper

Although there is often a difference between the architectural understanding of forms and their social and value-related perception (Malhis, 2008), elements of architectural value are often divided into economic or cultural concerns. Architecture’s true value, however, may be found at the resolution of this dichotomy although it can be argued it is not straightforward to isolate
and measure the true value of architecture. This discussion paper suggests that whilst many of the concerns highlighted appear in conflict, they are in fact reciprocal in nature with both causes being advanced through the efficiencies of architectural design. One viewpoint is that economic value perhaps should not be a topic of infrequent discussion, but rather it should be raised from time to time within the context of the broader market within which architecture is positioned. Even this viewpoint is subject to conjecture
for some. This discussion paper places the focus on the importance and relevance of value from an architectural perspective, which often is a concept rarely discussed in design circles. It is meant to encourage discourse and discussion about the different forms of value and how it is perceived in an architectural sense. As there are numerous classifications and perceptions of value in our society which are in a constant state of change, it is imperative that we regularly re-evaluate the relevance of these ever-changing values to design.

Effects of design parameters on sensitivity of microcantilever biosensors

Microcantilever biosensors produce cantilever bending due to differential surface stress between upper and lower surfaces of the cantilever. The bending is associated with concentration of ligands and adsorbed ligand-receptor intermolecular forces. Sample volume sizes in clinical diagnostic applications are usually very minute requiring a highly sensitive microcantilever for disease detection. This paper investigates a number of parameters that influence the sensitivity of microcantilever biosensors. The parameters include length, thickness, shape, and material of the cantilever beam. Biosensors of varying parameters are modeled and simulated. The results show that increasing the length of the cantilever beam enhances its sensitivity. However, increasing the thickness of the cantilever beam reduces its sensitivity. In static analysis, the shape of the cantilever beam does not notably impact upon its sensitivity. Also, using materials with lower Young’s modulus improves the sensitivity.

Web 2.0 VDS : social networking as a facilitator of design education

In 2009, Deakin University and the Chinese University of Hong Kong trailed the use of Web 2.0 technologies to enhance learning outcomes in a third year architectural design studio that was modelled on the Virtual Design Studios (VDS) of past decades. The studio developed the VDS further by integrating a social learning environment into the blended learning experience. The Web 2.0 VDS utilised the social networking sites Ning.com, YouTube and Skype; various 3D modelling and video- and/or image-processing software; plus chat-software. These were used in combination to deliver lectures, communicate learning goals, disseminate learning resources, submit work, and provide feedback and comments on various design works in assessing students’ outcomes. This paper centres on issues of learning and teaching associated with the development of a Social Network VDS (SNVDS).

Web 2.0 virtual design studio : social networking as facilitator of design education

In 2009, Deakin University and the Chinese University of Hong Kong trailed the use of Web 2.0 technologies to enhance learning outcomes in a third-year architectural design studio that was modelled on the virtual design studios (VDSs) of the past decades. The studio developed the VDS further by integrating a social learning environment into the blended learning experience. The Web 2.0 VDS utilized the social networking site Ning.com, YouTube, Skype and various three-dimensional modelling, video and image processing, and chat software to deliver lectures, communicate learning goals, disseminate learning resources, submitting, providing feedback and comments to various design works, and assessing of students’ outcomes. This research centres on issues of learning and teaching associated with the development of a social network VDS.

Developing a placebo-controlled trial in surgery : issues of design, acceptability and feasibility

Background: Surgical placebos are controversial. This in-depth study explored the design, acceptability, and feasibility issues relevant to designing a surgical placebo-controlled trial for the evaluation of the clinical and cost effectiveness of arthroscopic lavage for the management of people with osteoarthritis of the knee in the UK.
Methods: Two surgeon focus groups at a UK national meeting for orthopaedic surgeons and one regional surgeon focus group (41 surgeons); plenary discussion at a UK national meeting for orthopaedic anaesthetists (130 anaesthetists); three focus groups with anaesthetists (one national, two regional; 58 anaesthetists); two focus groups with members of the patient organisation Arthritis Care (7 participants); telephone interviews with people on consultant waiting lists from two UK regional centres (15 participants); interviews with Chairs of UK ethics committees (6 individuals); postal surveys of members of the British Association of Surgeons of the Knee (382 surgeons) and members of the British Society of Orthopaedic Anaesthetists (398 anaesthetists); two centre pilot (49 patients assessed).
Results: There was widespread acceptance that evaluation of arthroscopic lavage had to be conducted with a placebo control if scientific rigour was not to be compromised. The choice of placebo surgical procedure (three small incisions) proved easier than the method of anaesthesia (general anaesthesia). General anaesthesia, while an excellent mimic, was more intrusive and raised concerns among some stakeholders and caused extensive discussion with local decision-makers when seeking formal approval for the pilot. Patients were willing to participate in a pilot with a placebo arm; although some patients when allocated to surgery became apprehensive about the possibility of receiving placebo, and withdrew. Placebo surgery was undertaken successfully.
Conclusions: Our study illustrated the opposing and often strongly held opinions about surgical placebos, the ethical issues underpinning this controversy, and the challenges that exist even when ethics committee approval has been granted. It showed that a placebo-controlled trial could be conducted in principle, albeit with difficulty. It also highlighted that not only does a placebo-controlled trial in surgery have to be ethically and scientifically acceptable but that it also must be a feasible course of action. The place of placebo-controlled surgical trials more generally is likely to be limited and require specific circumstances to be met. Suggested criteria are presented.