Long-term azithromycin for Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease (Bronchiectasis Intervention Study) : a multicentre, double-blind, randomised controlled trial

Background Indigenous children in high-income countries have a heavy burden of bronchiectasis unrelated to cystic fibrosis. We aimed to establish whether long-term azithromycin reduced pulmonary exacerbations in Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease. Methods Between Nov 12, 2008, and Dec 23, 2010, we enrolled Indigenous Australian, Maori, and Pacific Island children aged 1—8 years with either bronchiectasis or chronic suppurative lung disease into a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial. Eligible children had had at least one pulmonary exacerbation in the previous 12 months. Children were randomised (1:1 ratio, by computer-generated sequence with permuted block design, stratified by study site and exacerbation frequency [1—2 vs ≥3 episodes in the preceding 12 months]) to receive either azithromycin (30 mg/kg) or placebo once a week for up to 24 months. Allocation concealment was achieved by double-sealed, opaque envelopes; participants, caregivers, and study personnel were masked to assignment until after data analysis. The primary outcome was exacerbation (respiratory episodes treated with antibiotics) rate. Analysis of the primary endpoint was by intention to treat. At enrolment and at their final clinic visits, children had deep nasal swabs collected, which we analysed for antibiotic-resistant bacteria. This study is registered with the Australian New Zealand Clinical Trials Registry; ACTRN12610000383066. Findings 45 children were assigned to azithromycin and 44 to placebo. The study was stopped early for feasibility reasons on Dec 31, 2011, thus children received the intervention for 12—24 months. The mean treatment duration was 20·7 months (SD 5·7), with a total of 902 child-months in the azithromycin group and 875 child-months in the placebo group. Compared with the placebo group, children receiving azithromycin had significantly lower exacerbation rates (incidence rate ratio 0·50; 95% CI 0·35—0·71; p<0·0001). However, children in the azithromycin group developed significantly higher carriage of azithromycin-resistant bacteria (19 of 41, 46%) than those receiving placebo (four of 37, 11%; p=0·002). The most common adverse events were non-pulmonary infections (71 of 112 events in the azithromycin group vs 132 of 209 events in the placebo group) and bronchiectasis-related events (episodes or investigations; 22 of 112 events in the azithromycin group vs 48 of 209 events in the placebo group); however, study drugs were well tolerated with no serious adverse events being attributed to the intervention. Interpretation Once-weekly azithromycin for up to 24 months decreased pulmonary exacerbations in Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease. However, this strategy was also accompanied by increased carriage of azithromycin-resistant bacteria, the clinical consequences of which are uncertain, and will need careful monitoring and further study.

Motivations and Intentions : A Case Study of Design-Led Activism

With a focus on intention and motivation, this paper describes a study involving three organisational communities and their collective effort to develop and provide more inclusive housing for people with disabilities and their families. While many studies, such as that by Rocha & Miles (2009), focus on commercial organisations, and sustainability from an economic perspective, this study involves a not-for-profit organisation (the accommodation and service provider) as well as a research organisation and a design action group volunteering their services free of charge. From this pro-bono context, the paper describes a case study that explores the nature of the collective as a basis for creative practice and political activism and the theoretical implications and wider application in terms of emerging research in the area of collaborative entrepreneurship and design activism.

Publishing

Publishing is no doubt one of the oldest and most diverse sectors in the creative economy. While publishing originally was associated with print and paper, the term is nowadays also commonly used to represent organizations that control, administer and license intellectual properties in other sectors of the creative economy such as videogames and music. While the title of this chapter is ‘Publishing’, we have no intention of covering all publishing related activities, but will focus on the economic consequences of digitization on two traditional and important print media sectors, namely books and magazines. Within these sectors we will specifically focus on consumer magazines and trade books, in other words books and magazines that are sold via commercial retailers to consumers. It is relevant to study these two publishing industries, since they share a number of very fundamental characteristics and have experienced similar economic consequences caused by the digitization of the creative economy. Both industries have undergone a gradual shift from print to digital and increasingly rely on revenues based on digital content carriers such as e- books, tablet magazine applications, special interest websites, blogs and so on.

Learning detectors quickly with stationary statistics

Computer vision is increasingly becoming interested in the rapid estimation of object detectors. The canonical strategy of using Hard Negative Mining to train a Support Vector Machine is slow, since the large negative set must be traversed at least once per detector. Recent work has demonstrated that, with an assumption of signal stationarity, Linear Discriminant Analysis is able to learn comparable detectors without ever revisiting the negative set. Even with this insight, the time to learn a detector can still be on the order of minutes. Correlation filters, on the other hand, can produce a detector in under a second. However, this involves the unnatural assumption that the statistics are periodic, and requires the negative set to be re-sampled per detector size. These two methods differ chie y in the structure which they impose on the co- variance matrix of all examples. This paper is a comparative study which develops techniques (i) to assume periodic statistics without needing to revisit the negative set and (ii) to accelerate the estimation of detectors with aperiodic statistics. It is experimentally verified that periodicity is detrimental.

Hidden credential retrieval from a reusable password

We revisit the venerable question of access credentials management, which concerns the techniques that we, humans with limited memory, must employ to safeguard our various access keys and tokens in a connected world. Although many existing solutions can be employed to protect a long secret using a short password, those solutions typically require certain assumptions on the distribution of the secret and/or the password, and are helpful against only a subset of the possible attackers. After briefly reviewing a variety of approaches, we propose a user-centric comprehensive model to capture the possible threats posed by online and offline attackers, from the outside and the inside, against the security of both the plaintext and the password. We then propose a few very simple protocols, adapted from the Ford-Kaliski server-assisted password generator and the Boldyreva unique blind signature in particular, that provide the best protection against all kinds of threats, for all distributions of secrets. We also quantify the concrete security of our approach in terms of online and offline password guesses made by outsiders and insiders, in the random-oracle model. The main contribution of this paper lies not in the technical novelty of the proposed solution, but in the identification of the problem and its model. Our results have an immediate and practical application for the real world: they show how to implement single-sign-on stateless roaming authentication for the internet, in a ad-hoc user-driven fashion that requires no change to protocols or infrastructure.

Back to the roots : mean-variance analysis of relevance estimations

Recently, mean-variance analysis has been proposed as a novel paradigm to model document ranking in Information Retrieval. The main merit of this approach is that it diversifies the ranking of retrieved documents. In its original formulation, the strategy considers both the mean of relevance estimates of retrieved documents and their variance. How- ever, when this strategy has been empirically instantiated, the concepts of mean and variance are discarded in favour of a point-wise estimation of relevance (to replace the mean) and of a parameter to be tuned or, alternatively, a quantity dependent upon the document length (to replace the variance). In this paper we revisit this ranking strategy by going back to its roots: mean and variance. For each retrieved document, we infer a relevance distribution from a series of point-wise relevance estimations provided by a number of different systems. This is used to compute the mean and the variance of document relevance estimates. On the TREC Clueweb collection, we show that this approach improves the retrieval performances. This development could lead to new strategies to address the fusion of relevance estimates provided by different systems.

Creative practices in the design studio culture : collaboration and communication

For the purpose of developing collaborative support in design studio environments, we have carried out ethnographic fieldwork in professional and academic product design studios. Our intention was to understand design practices beyond the productivity point of view and take into account the experiential, inspirational and aesthetical aspects of design practices. Using examples from our fieldwork, we develop our results around three broad themes by which design professionals support communication and collaboration: (1) use of artefacts, (2) use of space and (3) designerly practices. We use the results of our fieldwork for drawing implications for designing technologies for the design studio culture.

Experiential role of artefacts in cooperative design

The role of material artefacts in supporting distributed and co-located work practices has been well acknowledged within HCI and CSCW research. In this paper, we show that in addition to their ecological, coordinative and organizational support, artefacts also play an 'experiential' role. In this case, artefacts not only improve efficiency or have a purely functional role (e.g. allowing people to complete tasks quickly), but the materiality, use and manifestations of these artefacts bring quality and richness to people's performance and help them make better sense of their everyday lives. In a domain such as industrial design, such artefacts play an important role for supporting creativity and innovation. Based on our ethnographic fieldwork on understanding cooperative design practices of industrial design students and researchers, we describe several experiential practices that are supported by design-related artefacts such as sketches, drawings, physical models and explorative prototypes -- used and developed in designers' everyday work. Our main intention in carrying out this kind of research is to develop technologies to support designers' everyday practices. We believe that with the emergence of ubiquitous computing, there is a growing need to focus on the personal, social and creative side of people's everyday experiences. By focusing on the experiential practices of designers, we can provide a much broader view in the design of new interactive technologies.

Exploring mediated interactions : a design exercise

With the emergence of personal and ubiquitous computing systems in the last decade, interaction designers have started designing products by employing quality oriented aspects such as user experience, playfulness, enchantment and others. In order to explore novel forms of mediated interactions, designers need to focus beyond the basic user requirements and usability issues. We present a procedure and results of a design exercise that we carried out with students of a master's course on Visual Design. Our intention was to explore new forms of mediated interaction by using a specific design exercise. We provide the details of the resulted design concepts and discuss the usefulness of our design exercise.

Promoting active lifestyles in young children: investigating mothers’ decisions about their child’s physical activity and screen time behaviours

Objectives Given increasing trends of obesity being noted from early in life and that active lifestyles track across time, it is important that children at a very young age be active to combat a foundation of unhealthy behaviours forming. This study investigated, within a theory of planned behaviour (TPB) framework, factors which influence mothers’ decisions about their child’s 1) adequate physical activity (PA) and 2) limited screen time behaviours. Methods Mothers (N = 162) completed a main questionnaire, via on-line or paper-based administration, which comprised standard TPB items in addition to measures of planning and background demographic variables. One week later, consenting mothers completed a follow-up telephone questionnaire which assessed the decisions they had made regarding their child’s PA and screen time behaviours during the previous week. Results Hierarchical multiple regression analyses revealed support for the predictive model, explaining an overall 73% and 78% of the variance in mothers’ intention and 38% and 53% of the variance in mothers’ decisions to ensure their child engages in adequate PA and limited screen time, respectively. Attitude and subjective norms predicted intention in both target behaviours, as did intentions with behaviour. Contrary to predictions, perceived behavioural control (PBC) in PA behaviour and planning in screen time behaviour were not significant predictors of intention, neither was PBC a predictor of either behaviour. Conclusions The findings illustrate the various roles that psycho-social factors play in mothers’ decisions to ensure their child engages in active lifestyle behaviours which can help to inform future intervention programs aimed at combating very young children’s inactivity.

Sustaining social innovation enterprises through a design led innovation framework

Constant changes in the global economic environment require companies to revisit traditional assumptions about how businesses create and capture value (Teece, 2010). In recent years, management practice literature has focused largely on better understanding business models and business model innovation (Amit, Zott and Massa, 2010; Johnson, Christensen and Kagermann, 2008). Much has been written on the benefits of linking design and design thinking to organisational strategies and business transformation. However, very little has been researched and reported on regarding the impact of design led approaches to triple bottom-line opportunities such as, social innovation enterprise. In the context of this paper Design Led Innovation is defined as the tools and approaches which enable design thinking to be embedded as an element of cultural transformation within a business. Being Design Led requires a company to have a vision for top line growth founded on deep customer insights and expanded through customer and stakeholder engagements. The outcomes of this are then mapped to all aspects of the business, enabling the vision to be successfully implemented and achieved. It is the latter part of this definition where we believe Design Led Innovation has the greatest value in transforming social innovation enterprise into a sustainable business venture. However, we also acknowledge that enabling these firms to think strategically about their business model is difficult given the unique operational and funding challenges that often characterize many social enterprises. The purpose of this paper, therefore, is to pose the question, do sustainable innovation enterprise innovate their business model? And if so, how? It is the authors’ opinion that such enterprises only innovate at the product or system level without a complete understanding of the business model structure, which underpins the long term viability. However, in this paper we challenge this notion and explore if such firms can overcome their size and operational constraints to become sustainable enterprises using a design led approach. This is achieved through contextualizing business model innovation, briefly defining social innovation enterprise and profiling a new and emerging industry in Australia – Clean Technology. Future research challenges and opportunities are also presented.

Hybrid frequency–time domain models for dynamic response analysis of marine structures

Time-domain models of marine structures based on frequency domain data are usually built upon the Cummins equation. This type of model is a vector integro-differential equation which involves convolution terms. These convolution terms are not convenient for analysis and design of motion control systems. In addition, these models are not efficient with respect to simulation time, and ease of implementation in standard simulation packages. For these reasons, different methods have been proposed in the literature as approximate alternative representations of the convolutions. Because the convolution is a linear operation, different approaches can be followed to obtain an approximately equivalent linear system in the form of either transfer function or state-space models. This process involves the use of system identification, and several options are available depending on how the identification problem is posed. This raises the question whether one method is better than the others. This paper therefore has three objectives. The first objective is to revisit some of the methods for replacing the convolutions, which have been reported in different areas of analysis of marine systems: hydrodynamics, wave energy conversion, and motion control systems. The second objective is to compare the different methods in terms of complexity and performance. For this purpose, a model for the response in the vertical plane of a modern containership is considered. The third objective is to describe the implementation of the resulting model in the standard simulation environment Matlab/Simulink.

A 5- versus 3-day course of oral corticosteroids for children with asthma exacerbations who are not hospitalised : a randomised controlled trial

Objective To determine whether a 5-day course of oral prednisolone is superior to a 3-day course in reducing the 2-week morbidity of children with asthma exacerbations who are not hospitalised. Design, setting and participants Double-blind randomised controlled trial of asthma outcomes following a 5-day course of oral prednisolone (1 mg/kg) compared with a 3-day course of prednisolone plus placebo for 2 days. Participants were children aged 2–15 years who presented to the emergency departments of three Queensland hospitals between March 2004 and February 2007 with an acute exacerbation of asthma, but were not hospitalised. Sample size was defined a priori for a study power of 90%. Main outcome measures Difference in proportion of children who were symptom-free at Day 7, as measured by intention-to-treat (ITT) and per-protocol analysis; quality of life (QOL) on Days 7 and 14. Results 201 children were enrolled, and there was an 82% completion rate. There was no difference between groups in the proportion of children who were symptom-free (observed difference, 0.04 [95% CI, − 0.09 to 0.18] by ITT analysis; 0.04 [95% CI, − 0.17 to 0.09] by per-protocol analysis). There was also no difference between groups in QOL (P = 0.42). The difference between groups for the primary outcome was within the equivalence range calculated post priori. Conclusion A 5-day course of oral prednisolone confers no advantage over a 3-day course for children with asthma exacerbations who are not hospitalised.

Review: "Planning Asian cities : risks and resilience" edited by Stephen Hamnett and Dean Forbes, Planning, History and Environment Series, London, Routledge, 2011

Since the beginning of the agricultural revolution, cities have always been the cradle of civilisation, innovation and productivity, particularly as a result of the recent change factors affecting their (trans)formation, such as globalisation, the knowledge economy, technological advancements, climate change and so on. While in some parts of the world, cities are rapidly growing, in other parts, cities are shrinking, and their populations are aging. Even under the current pressure of constantly changing global conditions, the role of cities in influencing and partially shaping local, regional, national, supranational and even global level economy, society, environment and governance is undeniable. Global changes, while providing opportunities for cities and their administrations to reform and revisit existing planning and development processes and mechanisms, at the same time, challenge them by dealing with everincreasing risks and establishing resilience. At present, more than half of the world’s population...

A comprehensive analysis of parameter settings for novelty-biased cumulative gain

In the TREC Web Diversity track, novelty-biased cumulative gain (α-NDCG) is one of the official measures to assess retrieval performance of IR systems. The measure is characterised by a parameter, α, the effect of which has not been thoroughly investigated. We find that common settings of α, i.e. α=0.5, may prevent the measure from behaving as desired when evaluating result diversification. This is because it excessively penalises systems that cover many intents while it rewards those that redundantly cover only few intents. This issue is crucial since it highly influences systems at top ranks. We revisit our previously proposed threshold, suggesting α be set on a query-basis. The intuitiveness of the measure is then studied by examining actual rankings from TREC 09-10 Web track submissions. By varying α according to our query-based threshold, the discriminative power of α-NDCG is not harmed and in fact, our approach improves α-NDCG's robustness. Experimental results show that the threshold for α can turn the measure to be more intuitive than using its common settings.