Prescribing practices of Australian dispensing doctors

Background: In response to health workforce shortages policymakers have considered expanding the roles that a health professional may perform. A more traditional combination of health professional roles is that of a dispensing doctor (DD) who routinely prescribes and dispenses pharmaceuticals. A systematic review conducted on mainly overseas DDs’ practices found that DDs tended to prescribe more items per patients, less often generically, and showed poorer adherence to best practice. Convenience for patients was cited by both patients and DDs as the main reason for dispensing. In Australia, rural doctors are allowed to dispense Pharmaceutical Benefit Scheme (PBS) subsidised pharmaceutical benefits if there is no reasonable pharmacy coverage. Little was known about the practices of these Australian DDs. Objectives: To examine the PBS prescribing patterns of dispensing with matched non-dispensing doctors and identify factors that influence prescribing behaviour. Method: A sequential explanatory (QUAN-->qual) mixed methodology was utilised. Firstly, rurality-matched DDs’ and non-DDs’ PBS data for fiscal years 2005-7 were analysed against criteria distilled from a systematic review and stakeholder consultations. Secondly, structured interviews were conducted with a purposive sample of DDs to examine the quantitative findings. Key findings: DDs prescribed significantly fewer PBS prescriptions per patients but used Regulation 24 significantly more than non-DDs. Regulation 24 biased the prescribing data. DDs prescribed proportionally more penicillin type antibiotics, adrenergic inhalants and non-steroidal anti-inflammatories as compared to non-DDs. Reasons offered by DD-respondents highlighted that prescribing was influenced by an awareness of cost to the patients, peer pressure and confidential prescriber feedback provided on a regular basis. Implications: This innovative census study does not support international data that DDs are less judicious in their prescribing. There is some evidence that DDs might reduce health inequity between rural and urban Australian, and that the DD health model is valuable to patients in isolated communities.

Collaborative design learning for traditional crafts industry

Traditional craft industries need assistance with being transformed into creative industries; as such a transformation will support them to face the future competitive global market. Assistance such as advisory programs should serve long-term benefit for crafts industries as well as optimize self-help potential. Advisory programs using participatory methods will enable craftspeople and stakeholders to reveal resources and potencies, such as socio-cultural value, tradition and other kind of heritages, to generate new innovative ideas of craft design in a sustainable way.

Privacy by Design : Does it matter for social networks?

Privacy is an important component of freedom and plays a key role in protecting fundamental human rights. It is becoming increasingly difficult to ignore the fact that without appropriate levels of privacy, a person’s rights are diminished. Users want to protect their privacy - particularly in “privacy invasive” areas such as social networks. However, Social Network users seldom know how protect their own privacy through online mechanisms. What is required is an emerging concept that provides users legitimate control over their own personal information, whilst preserving and maintaining the advantages of engaging with online services such as Social Networks. This paper reviews “Privacy by Design (PbD)” and shows how it applies to diverse privacy areas. Such an approach will move towards mitigating many of the privacy issues in online information systems and can be a potential pathway for protecting user’s personal information. The research has posed many questions in need of further investigation for different open source distributed Social Networks. Findings from this research will lead to a novel distributed architecture that provides more transparent and accountable privacy for the users of online information systems.

Water Sensitive Urban Design (WSUD) application auditing

Background WSUD implementation in the Gold Coast City Council area commenced more than a decade ago. As a result, Council is expected to be in possession of WSUD assets valued at over tens of million dollars. The Gold Coast City Council is responsible for the maintenance and long-term management of these WSUD assets. Any shortcoming in implementation of best WSUD practices can potentially result in substantial liabilities and ineffective expenditure for the Council in addition to reduced efficiencies and outcomes. This highlights the importance of periodic auditing of WSUD implementation. Project scope The overall study entailed the following tasks: * A state-of-the-art literature review of the conceptual hydraulic and water quality treatment principles, current state of knowledge in relation to industry standards, best practice and identification of knowledge gaps in relation to maintenance and management practices and potential barriers to the implementation of WSUD. * Council stakeholder interviews to understand current practical issues in relation to the implementation of WSUD and the process of WSUD application from development application approval to asset management. * Field auditing of selected WSUD systems for condition assessment and identification of possible strengths and weaknesses in implementation. * Review of the Land Development Guidelines in order to identify any gaps and to propose recommendations for improvement. Conclusions Given below is a consolidated summary of the findings of the study undertaken. State-of-the-art literature review Though the conceptual framework for WSUD implementation is well established, the underlying theoretical knowledge underpinning the treatment processes and maintenance regimes and life cycle costing are still not well understood. Essentially, these are the recurring themes in the literature, namely, the inadequate understanding of treatment processes and lack of guidance to ensure specificity of maintenance regimes and life cycle costing of WSUDs. The fundamental barriers to successful WSUD implementation are: * Lack of knowledge transfer – This essentially relates to the lack of appropriate dissemination of research outcomes and the common absence of protocols for knowledge transfer within the same organisation. * Cultural barriers – These relate to social and institutional factors, including institutional inertia and the lack of clear understanding of the benefits. * Fragmented responsibilities – This results from poor administrative integration within local councils in relation to WSUDs. * Technical barriers – These relate to lack of knowledge on operational and maintenance practices which is compounded by model limitations and the lack of long-term quantitative performance evaluation data. * Lack of engineering standards – Despite the availability of numerous guidelines which are non-enforceable and can sometimes be confusing, there is a need for stringent engineering standards. The knowledge gaps in relation to WSUDs are only closing very slowly. Some of the common knowledge gaps identified in recent publications have been recognised almost a decade ago. The key knowledge gaps identified in the published literature are: * lack of knowledge on operational and maintenance practices; * lack of reliable methodology for identifying life cycle issues including costs; * lack of technical knowledge on system performance; * lack of guidance on retrofitting in existing developments. Based on the review of barriers to WSUD implementation and current knowledge gaps, the following were identified as core areas for further investigation: * performance evaluation of WSUD devices to enhance model development and to assess their viability in the context of environmental, economic and social drivers; establishing realistic life cycle costs to strengthen maintenance and asset management practices; * development of guidelines specific to retrofitting in view of the unique challenges posed by existing urban precincts together with guidance to ensure site specificity; establishment of a process for knowledge translation for enhancing currently available best practice guidelines; * identification of drivers and overcoming of barriers in the areas of institutional fragmentation, knowledge gaps and awareness of WSUD practices. GCCC stakeholder interviews Fourteen staff members involved in WSUD systems management in the Gold Coast City Council, representing four Directorates were interviewed using a standard questionnaire. The primary issues identified by the stakeholders were: * standardisation of WSUD terminology; * clear protocols for safeguarding devices during the construction phase; * engagement of all council stakeholders in the WSUD process from the initial phase; * limitations in the Land Development Guidelines; * ensuring public safety through design; * system siting to avoid conflicts with environmental and public use of open space; * provision of adequate access for maintenance; * integration of social and ecosystem issues to ensure long-term viability of systems in relation to both, vandalism and visual recreation; * lack of performance monitoring and inadequacy of the maintenance budget; * lack of technical training for staff involved in WSUD design approvals and maintenance; incentives for developers for acting responsibly in stormwater management. Field auditing of WSUD systems A representative cross section of WSUD systems in the Gold Coast were audited in the field. The following strengths and weaknesses in WSUD implementation were noted: * The implementation of WSUD systems in the field is not consistent. * The concerns raised by the stakeholders during the interviews in relation to WSUD implementation was validated from the observations from the field auditing, particularly in relation to the following: * safeguarding of devices during the construction phase * public safety * accessibility for maintenance * lack of performance monitoring by Council to assess system performance * inadequate maintenance of existing systems to suit site specific requirements. * A treatment train approach is not being consistently adopted. * Most of the systems audited have satisfactorily catered for public safety. Accessibility for maintenance has been satisfactorily catered for in most of the systems that were audited. * Systems are being commissioned prior to construction activities being substantially completed. * The hydraulic design of most systems appears to be satisfactory. * The design intent of the systems is not always clear. Review of Land Development Guidelines The Land Development Guidelines (TDG) was extensively reviewed and the following primary issues were noted in relation to WSUD implementation: * the LDG appears to have been prepared primarily to provide guidance to developers. It is not clear to what extent the guidelines are applicable to Council staff involved in WSUD maintenance and management; * Section 13 is very voluminous and appears to be a compilation of a series of individual documents resulting in difficulties in locating specific information, a lack of integration and duplication of information; * the LDG has been developed with a primary focus on new urban precinct development and the retrofitting of systems in existing developments has not been specifically discussed; * WSUDs are discussed in two different sections in the LDG and it is not clear which section takes precedence as there are inconsistencies between the two sections; there is inconsistent terminology being used; * there is a need for consolidation of information provided in different sections in the LDG; * there are inconsistencies in the design criteria provided; * there is a need for regular updating of the LDG to ensure that the information provided encompasses the state-of-the-art; * there is limited guidance provided for the preparation of maintenance plans and life cycle costing to assist developers in asset handover and to assist Council staff in assessment. * Based on these observations, eleven recommendations have been provided which are discussed below. Additionally, the stakeholder provided the following specific comments during the interviews in relation to the LDG: * lack of flexibility to cover the different stages of the life cycle of the systems; * no differentiation in projects undertaken by developers and Council; * inadequate information with regards to safety issues such as maximum standing water depth, fencing and safety barriers and public access; * lack of detailed design criteria in relation to Crime Prevention through Environmental Design, safety, amenity, environment, surrounding uses and impacts on surroundings; * inadequate information regarding maintenance requirements specific to the assessment and compliance phases; * recommendations for plantings are based primarily on landscape requirements rather than pollutant uptake capability. Recommendations With regards to the Land Development Guidelines, the following specific recommendations are provided: 1. the relevant sections and their extent of applicability to Council should be clearly identified; 2. integration of the different subsections within Section 13 and re-formatting the document for easy reference; 3. the maintenance guidelines provided in Section 13 should be translated to a maintenance manual for guidance of Council staff; 4. should consider extending the Guidelines to specifically encompass retrofitting of WSUD systems to existing urban precincts; 5. Section 3 needs to be revised to be made consistent with Section 13, to ensure priority for WSUD practices in urban precincts and to move away from conventional stormwater drainage design such as kerb and channelling; 6. it would also be good to specify as to which Section takes predominance in relation to stormwater drainage. It is expected that Section 13 would take predominance over the other sections in the LDG; 7. terminology needs to be made consistent to avoid confusion among developers and Council staff. Water Sensitive Urban Design is the term commonly used in Australia for stormwater quality treatment, rather than Stormwater Quality Improvement Devices. This once again underlines the need for ensuring consistency between Section 3 and Section 13; 8. it would also be good if there is a glossary of commonly used terms in relation to WSUD for use by all stakeholders and which should also be reflected in the LDG; 9. consolidation of all WSUD information into one section should be considered together with appropriate indicators in other LDG Sections regarding the availability of WSUD information. Ensuring consistency in the information provided is implied; 10. Section 13 should be updated at regular intervals to ensure the incorporation of the latest in research outcomes and incorporating criteria and guidance based on the state-of-the-art knowledge. The updating could be undertaken, say, in five year cycles. This would help to overcome the current lack of knowledge transfer; 11. the Council should consider commissioning specialised studies to extend the current knowledge base in relation to WSUD maintenance and life cycle costing. Additionally, Recommendation 10 is also applicable in this instance. The following additional recommendations are made based on the state-of-the-art literature review, stakeholder interviews and field auditing of WSUD systems: 1. Performance monitoring of existing systems to assess improvements to water quality, identify modifications and enhancements to improve performance; 2. Appropriate and monitored maintenance during different phases of development of built assets over time is needed to investigate the most appropriate time/phase of development to commission the final WSUD asset. 3. Undertake focussed investigations in the areas of WSUD maintenance and asset management in order to establish more realistic life cycle costs of systems and maintenance schedules; 4. the engagement of all relevant Council stakeholders from the initial stage of concept planning through to asset handover, and ongoing monitoring. This close engagement of internal stakeholders will assist in building a greater understanding of responsibilities and contribute to overcoming constraints imposed by fragmented responsibilities; 5. the undertaking of a public education program to inform the community of the benefits and ecosystem functions of WSUD systems; 6. technical training to impart state-of-the-art knowledge to staff involved in the approval of designs and maintenance and management of WSUD projects; 7. during the construction phase, it is important to ensure that appropriate measures to safeguard WSUD devices are implemented; 8. risks associated with potential public access to open water zones should be minimised with the application of appropriate safety measures; 9. system siting should ensure that potential conflicts are avoided with respect to public and ecosystem needs; 10. integration of social and ecosystem issues to ensure long-term viability of systems; provide incentives to developers who are proactive and responsible in the area of stormwater management.

Improving the Walkability of Subtropical Urban Areas: a case study analysis for the development of a design process

This research develops a new framework to be used as a tool for analysing and designing walkable communities. The literature review recognises the work of other researchers combining their findings with the theory of activity nodes and considers how a framework may be used on a more global basis. The methodology develops a set of criteria through the analysis of noted successful case studies and this is then tested against an area with very low walking rates in Brisbane, Australia. Results of the study suggest that as well as the accepted criteria of connectivity, accessibility, safety, security, and path quality further criteria in the form or planning hierarchy, activity nodes and climate mitigation could be added to allow the framework to cover a broader context. Of particular note is the development of the nodal approach, which allows simple and effective analysis of existing conditions, and may also prove effective as a tool for planning and design of walkable communities.

The study of design elements and people’s behaviour in campus public space : how design shapes user’s behaviour

A growing body of researches provided evidence of the successful design in particular focus on design elements, ranging from colour, lighting, technology, landscape and spatial arrangement. However, no example or literature investigates the opportunities for linking these design elements in a practical base. Drawing upon existing architectural design theory, this paper investigates the relationship between design elements regards to public’s behavioural response to the public space. The aims of this paper are two-fold: first to examine whether there is a direct relationship between the two, and second to find out how the design elements could be coordinated together to influence not only the activities but also the environment, function and experience. To meet this objective, observation, behavioural mapping, interview and cognitive mapping methodologies are used. The present study involves two local case studies to find out the relationship between design elements in order to assist the design of a better public space for public activities. Correlation between the design elements shows that public activities is more likely to happen in relatively space with well balance of design. These finding provide a better understanding of public space design by gaining deeper perceptive between design and user’s behaviour, consequently improving social activities and interactions in public space. Moreover, it focuses on campus public areas which can be a vital aspect of university campus and play a valuable role in the overall success of public space design.

Design of LSF wall studs under fire conditions

Cold-formed steel lipped channels are commonly used in LSF wall construction as load bearing studs with plasterboards on both sides. Under fire conditions, cold-formed thin-walled steel sections heat up quickly resulting in fast reduction in their strength and stiffness. Usually the LSF wall panels are subjected to fire from one side which will cause thermal bowing, neutral axis shift and magnification effects due to the development of non-uniform temperature distributions across the stud. This will induce an additional bending moment in the stud and hence the studs in LSF wall panels should be designed as a beam column considering both the applied axial compression load and the additional bending moment. Traditionally the fire resistance rating of these wall panels is based on approximate prescriptive methods. Very often they are limited to standard wall configurations used by the industry. Therefore a detailed research study is needed to develop fire design rules to predict the failure load and hence the failure time of LSF wall panels subject to non-uniform temperature distributions. This paper presents the details of an investigation to develop suitable fire design rules for LSF wall studs under non-uniform elevated temperature distributions. Applications of the previously developed fire design rules based on AISI design manual and Eurocode 3 Parts 1.2 and 1.3 to LSF wall studs were investigated in detail and new simplified fire design rules based on AS/NZS 4600 and Eurocode 3 Part 1.3 were proposed in the current study with suitable allowances for the interaction effects of compression and bending actions. The accuracy of the proposed fire design rules was verified by using the results from full scale fire tests and extensive numerical studies.

Review of current fire design rules for cold-formed steel wall systems

Light gauge steel frame wall systems are commonly used in industrial and commercial buildings, and there is a need for simple fire design rules to predict their load capacities and fire resistance ratings. During fire events, the light gauge steel frame wall studs are subjected to non-uniform temperature distributions that cause thermal bowing, neutral axis shift and magnification effects and thus resulting in a combined axial compression and bending action on the studs. In this research, a series of full-scale fire tests was conducted first to evaluate the performance of light gauge steel frame wall systems with eight different wall configurations under standard fire conditions. Finite element models of light gauge steel frame walls were then developed, analysed under transient and steady-state conditions and validated using full-scale fire tests. Using the results from fire tests and finite element analyses, a detailed investigation was undertaken into the prediction of axial compression strength and failure times of light gauge steel frame wall studs in standard fires using the available fire design rules based on Australian, American and European standards. The results from both fire tests and finite element analyses were used to investigate the ability of these fire design rules to include the complex effects of non-uniform temperature distributions and their accuracy in predicting the axial compression strength of wall studs and the failure times. Suitable modifications were then proposed to the fire design rules. This article presents the details of this investigation on the fire design rules of light gauge steel frame walls and the results.

Development of improved fire design rules for cold-formed steel wall systems

Traditionally the fire resistance rating of LSF wall systems is based on approximate prescriptive methods developed using limited fire tests. Therefore a detailed research study into the performance of load bearing LSF wall systems under standard fire conditions was undertaken to develop improved fire design rules. It used the extensive fire performance results of eight different LSF wall systems from a series of full scale fire tests and numerical studies for this purpose. The use of previous fire design rules developed for LSF walls subjected to non-uniform elevated temperature distributions based on AISI design manual and Eurocode3 Parts 1.2 and 1.3 was investigated first. New simplified fire design rules based on AS/NZS 4600, North American Specification and Eurocode 3 Part 1.3 were then proposed in this study with suitable allowances for the interaction effects of compression and bending actions. The importance of considering thermal bowing, magnified thermal bowing and neutral axis shift in the fire design was also investigated. A spread sheet based design tool was developed based on the new design rules to predict the failure load ratio versus time and temperature curves for varying LSF wall configurations. The accuracy of the proposed design rules was verified using the test and FEA results for different wall configurations, steel grades, thicknesses and load ratios. This paper presents the details and results of this study including the improved fire design rules for predicting the load capacity of LSF wall studs and the failure times of LSF walls under standard fire conditions.

Development of a simplified design method to predict the fire rating of LSF walls

Recent fire research into the behaviour of light gauge steel frame (LSF) wall systems has devel-oped fire design rules based on Australian and European cold-formed steel design standards, AS/NZS 4600 and Eurocode 3 Part 1.3. However, these design rules are complex since the LSF wall studs are subjected to non-uniform elevated temperature distributions when the walls are exposed to fire from one side. Therefore this paper proposes an alternative design method for routine predictions of fire resistance rating of LSF walls. In this method, suitable equations are recommended first to predict the idealised stud time-temperature pro-files of eight different LSF wall configurations subject to standard fire conditions based on full scale fire test results. A new set of equations was then proposed to find the critical hot flange (failure) temperature for a giv-en load ratio for the same LSF wall configurations with varying steel grades and thickness. These equations were developed based on detailed finite element analyses that predicted the axial compression capacities and failure times of LSF wall studs subject to non-uniform temperature distributions with varying steel grades and thicknesses. This paper proposes a simple design method in which the two sets of equations developed for time-temperature profiles and critical hot flange temperatures are used to find the failure times of LSF walls. The proposed method was verified by comparing its predictions with the results from full scale fire tests and finite element analyses. This paper presents the details of this study including the finite element models of LSF wall studs, the results from relevant fire tests and finite element analyses, and the proposed equations.

Improved design rules for cold-formed steel columns

Current design rules for determining the member strength of cold-formed steel columns are based on the effective length of the member and a single column capacity curve for both pin-ended and fixed-ended columns. This research has reviewed the use of AS/NZS 4600 design rules for their accuracy in determining the member compression capacities of slender cold-formed steel columns using detailed numerical studies. It has shown that AS/NZS 4600 design rules accurately predicted the capacities of pinned and fixed ended columns undergoing flexural buckling. However, for fixed ended columns undergoing flexural-torsional buckling, it was found that current AS/NZS 4600 design rules did not include the beneficial effect of warping fixity. Therefore AS/NZS 4600 design rules were found to be excessively conservative and hence uneconomical in predicting the failure loads obtained from tests and finite element analyses of fixed-ended lipped channel columns. Based on this finding, suitable recommendations have been made to modify the current AS/NZS 4600 design rules to more accurately reflect the results obtained from the numerical and experimental studies conducted in this research. This paper presents the details of this research on cold-formed steel columns and the results.

Improved design rules for fixed ended cold-formed steel columns subject to flexural-torsional buckling

This paper has presented the details of an investigation into the flexural and flexuraltorsional buckling behaviour of cold-formed structural steel columns with pinned and fixed ends. Current design rules for the member capacities of cold-formed steel columns are based on the same non-dimensional strength curve for both fixed and pinned-ended columns. This research has reviewed the accuracy of the current design rules in AS/NZS 4600 and the North American Specification in determining the member capacities of cold-formed steel columns using the results from detailed finite element analyses and an experimental study of lipped channel columns. It was found that the current Australian and American design rules accurately predicted the member capacities of pin ended lipped channel columns undergoing flexural and flexural torsional buckling. However, for fixed ended columns with warping fixity undergoing flexural-torsional buckling, it was found that the current design rules significantly underestimated the column capacities as they disregard the beneficial effect of warping fixity. This paper has therefore proposed improved design rules and verified their accuracy using finite element analysis and test results of cold-formed lipped channel columns made of three cross-sections and five different steel grades and thicknesses.

Some practical issues in the design and analysis of computer experiments

Deterministic computer simulations of physical experiments are now common techniques in science and engineering. Often, physical experiments are too time consuming, expensive or impossible to conduct. Complex computer models or codes, rather than physical experiments lead to the study of computer experiments, which are used to investigate many scientific phenomena of this nature. A computer experiment consists of a number of runs of the computer code with different input choices. The Design and Analysis of Computer Experiments is a rapidly growing technique in statistical experimental design. This thesis investigates some practical issues in the design and analysis of computer experiments and attempts to answer some of the questions faced by experimenters using computer experiments. In particular, the question of the number of computer experiments and how they should be augmented is studied and attention is given to when the response is a function over time.

Digital soapboxes : towards an interaction design agenda for situated civic innovation

We argue that there are at least two significant issues for interaction designers to consider when creating the next generation of human interfaces for civic and urban engagement: (1) The disconnect between citizens participating in either digital or physical realms has resulted in a neglect of the hybrid role that public place and situated technology can play in contributing to civic innovation. (2) Under the veneer of many social media tools, hardly any meaningful strategies or approaches are found that go beyond awareness raising and allow citizens to do more than clicking a ‘Like’ button. We call for an agenda to design the next generation of ‘digital soapboxes’ that contributes towards a new form of polity helping citizens not only to have a voice but also to appropriate their city in order to take action for change.

The knock-on from the knock-off : recent shifts within Australian mass market fashion design practice

Australia's mass market fashion labels have traditionally benefitted from their peripheral location to the world's fashion centres. Operating a season behind, Australian mass market designers and buyers were well-placed to watch trends play out overseas before testing them in the Australian marketplace. For this reason, often a designer's role was to source and oversee the manufacture of 'knock-offs', or close copies of northern hemisphere mass market garments. Both Weller and Walsh have commented on this practice.12 The knock-on effect from this continues to be a cautious, derivative fashion sensibility within Australian mass market fashion design, where any new trend or product is first tested and proved overseas months earlier. However, there is evidence that this is changing. The rapid online dissemination of global fashion trends, coupled with the Australian consumer’s willingness to shop online, has meant that the ‘knock-off’ is less viable. For this reason, a number of mass market companies are moving away from the practice of direct sourcing and are developing product in-house under a northern hemisphere model. This shift is also witnessed in the trend for mass market companies to develop collections in partnership with independent Australian designers. This paper explores the current and potential effects of these shifts within Australian mass market design practice, and discusses how they may impact on both consumers and on the wider culture of Australian fashion.