Laparoscopic adjustable gastric banding in Australian adolescents: should it be done?

There are very few studies on laparoscopic adjustable gastric banding (LAGB) in obese adolescents with follow up for more than 36 months, let alone good prospective data beyond 24 months in Australian adolescents. We aimed to evaluate medium term (>36 months) safety and efficacy of LAGB in adolescents with severe obesity. This is a prospective cohort study (March 2009–December 2015) in one tertiary referral hospital including obese adolescents (14–18 years) with a body mass index (BMI) >40 (or ≥35 with comorbidities) who consented to have LAGB. Exclusion criteria were syndromal causes of obesity, depression and oesophageal motility disorders. Main outcome measures include change in weight and BMI at 6, 12, 24, 36 and 48 months post LAGB; postoperative complications; and admissions. Twenty-one adolescents (median [interquartile range (IQR)] 17.4 [16.5–17.7] years, 9 males, mean ± SD BMI 47.3 ± 8.4 kg/m2) had a median follow up of 45.5 [32–50] months post LAGB. Follow up data were available for 16 adolescents. Weight and BMI improved significantly at all follow up times (all p < 0.01). The median maximum BMI loss was 10 [7.1–14.7] kg/m2. There were four minor early complications. Seven bands were removed due to weight loss failure/regain (two had also obstructive symptoms). We have shown in the longest prospective LAGB postoperative follow up study of Australian adolescents that LAGB improves BMI in the majority of adolescents without significant comorbidities. LAGB is still a reasonable option to be considered as a temporary procedure to manage severe obesity during adolescence

Suffering in silence: the 10 most under-reported humanitarian crises of 2016

Aid organisation, CARE International, has issued a new report highlighting the top ten most underreported humanitarian crises of 2016. The report features food crises in Eritrea, Madagascar, North Korea and Papua New Guinea; conflicts in Burundi, Lake Chad Basin, Democratic Republic of Congo, Central African Republic, Sudan and last year’s monsoon floods in Bangladesh. Using the media monitoring services of Meltwater Group, CARE analysed those natural disasters or conflicts that received the least media attention in 2016. More than 250,000 global online sources were monitored in English, French and German. To filter according to scale, CARE chose countries in which at least one million people are affected by natural or man-made disasters. The result is a list of over thirty crises that we analysed and ranked by the number of articles mentioning each, starting with the one that received the fewest articles

Smart home control devices: summary and assessment of energy and lifestyle marketing claims

This content analysis of smart home control marketing materials indicates that the promoted benefits of these devices are not strongly aligned with energy policy objectives. Only one of 11 themes identified relates to energy and cost savings. Further, load shifting was not mentioned or promoted by any companies selling smart home control products. In contrast, several other themes identified in the analysis may undermine energy and cost savings for households (e.g. promoting higher levels of comfort, convenience and entertainment). Middle-class aspirational consumers, who represent the target market for these devices, are likely to be more interested in these ‘other’ benefits than energy savings. It is currently unclear whether these products will assist households in the current or future energy market. The subsequent empirical research being conducted as part of the Smart Home Control project will seek to understand how smart control devices are being integrated into everyday practices in households. The project will identify what benefits are realised for Australian households and how these devices may support or undermine the intended benefits of enabling technologies in the energy sector

From awareness to action - a cybersecurity agenda for the 45th President

CSIS began work in late 2014 with leading experts to develop recommendations on cybersecurity for the next presidential administration.  The CSIS Cyber Policy Task Force divided its work among two groups, one in Washington D.C. and the other in Silicon Valley.   Each group brought a unique and powerful perspective to the problems of cybersecurity, and their efforts form the basis of our recommendations on policies, organizational improvements, and resources needed for progress in this challenging area. Cybersecurity is no longer a “greenfield” for policy development. Much has been done since CSIS’s first report was published in 2008 and the next administration will inherit a work in progress. Despite an exponential increase in attention to cybersecurity over the last decade, we are still at risk and there is much for the next administration to do.  This risk exists because of our reliance on technologies that are inherently vulnerable and because the enforcement of laws in cyberspace is inherently difficult, with some countries refusing to cooperate in prosecuting cybercriminals. Nations are also unwilling to constrain cyber espionage or limit the perceived benefits of military cyber operations. The goals of our recommendations for the next administration’s cybersecurity efforts remain the same: to create a secure and stable digital environment that supports continued economic growth while protecting personal freedoms and national security. The requirements to achieve these goals also remain the same: central direction and leadership from the White House to create and implement a comprehensive and coordinated approach, since cybersecurity cuts across the mission of many different agencies

Nearly half of Australians support changes to 18C: IPA polling

Those who support watering down the anti-hate laws in the Racial Discriminaton Act have received a boost this morning. Polling commissioned by conservative think tank the Institute of Public Affairs shows that almost one in two people support removing the words \u27insult\u27 and \u27offend\u27 from section 18C of the Act, which also makes it an offence to humilate or intimidate a person based on their race. A parliamentary committee was established last year to look at changing the laws. The committee has already received more than 11,000 written submissions and is this week conducting hearings accross the country

Global kids online: tools for researchers

Global Kids Online is an international research project that aims to generate and sustain a rigorous cross-national evidence base around children’s use of the internet by creating a global network of researchers and experts. The project developed a global research toolkit that would enable academics, governments, civil society and other actors to carry out reliable and standardised national research with children and their parents on the opportunities, risks and protective factors of children’s internet use. The Global Kids Online research toolkit has been developed with country partners, experts, and international advisors. The Getting started guide introduces the research principles and resources. &nbsp

Caliphate in decline: an estimate of Islamic State’s financial fortunes

This report is based on a systematic review of open source information about the finances of Islamic State in its core territory in Syria and Iraq. Key findings Estimates vary widely. It remains impossible to say exactly how much money Islamic State has at its disposal. The group’s most significant sources of revenue are closely tied to its territory. They are: (1) taxes and fees; (2) oil; and (3) looting, confiscations, and fines. We have found no hard evidence that foreign donations continue to be significant. Similarly, revenues from the sale of antiquities and kidnap for ransom, while difficult to quantify, are unlikely to have been major sources of income. In the years since 2014, Islamic State’s annual revenue has more than halved: from up to $1.9b in 2014 to a maximum of$870m in 2016. There are no signs yet that the group has created significant new funding streams that would make up for recent losses. With current trends continuing, the Islamic State’s “business model” will soon fail. Assessment Evaluating Islamic State finances through traditional approaches towards “countering terrorist finance” leads to serious misconceptions. Islamic State is fundamentally different because of the large territory it controls and the unique opportunities this offers for generating income. Conversely, its reliance on population and territory helps to explain the group’s current financial troubles. According to figures provided by the Global Coalition, by November 2016 Islamic State had lost 62 per cent of its mid-2014 “peak” territory in Iraq, and 30 per cent in Syria. From a revenue perspective, this means fewer people and businesses to tax and less control over natural resources such as oil fields. Prospects There are good reasons to believe that Islamic State revenues will further decline. In particular, capturing Mosul, the Caliphate’s “commercial capital”, will have a significant detrimental effect on Islamic State finances Nevertheless, Islamic State, and its Al-Qaeda in Iraq (AQI) predecessor, have repeatedly demonstrated that financial and military setbacks can be overcome. Moreover, the decline in revenues may not have an immediate effect on the group’s ability to carry out terrorist attacks outside its territory. While hurting Islamic State finances puts pressure on the organization and its state-building project, wider efforts will continue to be necessary to ultimately defeat it

The impact of foreign military involvement on the development of northern Australia

Summary Globally, governments are under increasing pressure to allocate ever scarcer land resources while taking account of economic outcomes, environmental sustainability and social benefits. Food production, mineral resource extraction, tourism, industrial infrastructure and urban development are just some of the essential activities that compete for land. Similarly, airspace is becoming increasingly crowded as the demand for travel and trade increase. One less obvious, but also important use of land, sea and airspace, is military training. Australia, with its large area, relatively small population and its geographical positioning on the periphery of principle sea and air trade routes, is uniquely placed as it still has sufficient land and airspace available where it can adequately meet the demands detailed above and can still allocate land for large military training areas, particularly in the north. During World War Two, Australia provided training areas to the United States to support the conflict in the Pacific. The United States has continued to conduct military training on Australian soil and airspace to the present day. The United Kingdom conducted 12 major nuclear weapon’s tests in Australia between 1952 and 1957. More recently, regional neighbours have been provided permanent training facilities, particularly for pilot training. These arrangements provide both benefits and costs to Australia. They invest in infrastructure, provide employment to the local workforce and inject money into local economies. They can also be environmentally and culturally disruptive and can prevent land use for other purposes. The negative aspects of permanent, foreign military bases in Australia notwithstanding, they can be used strategically as a development tool for northern Australia. Key points Foreign forces have a history of land use for the military training extending back to World War II. Allowing foreign defence forces to access Australian military establishments and field training ranges is fundamental to maintaining regional security and long-standing strategic alliances. Expenditure by foreign forces visiting northern Australia has had significant impact on local economies, which will grow exponentially due to increasing numbers of personnel over extended periods. Environmental risks relating to land clearing, infrastructure development and military operations are mitigated through robust management and control systems. Social impacts of visiting foreign forces have been negligible where troops have been permitted to interact with local communities

We need a comprehensive housing approach to deal with heatwaves

Heatwaves across much of the country this summer have revealed a serious problem with our national housing stock. Wendy Miller looks at smarter design and construction, better rating systems and the role of government and industry to overcoming barriers to better housing design. Read the full article on The Conversation

Empty spaces: real parking needs at five TODs

The land near transit stations is a valuable commodity. Hundreds or thousands of people travel to and through these places each day, and decisions about what to do with this land have implications for local economies, transit ridership, residents’ access to opportunity, and overall quality of life for everyone in a community. Many communities choose to dedicate at least some of that land for parking. The question is, how much? Too little parking could discourage people from coming to the station, but too much parking is unnecessarily expensive and gets in the way of other uses like homes, shops, or offices. How much parking should transportation engineers build? To answer that question, many engineers and planners consult the Institute of Transportation Engineers’ (ITE) Trip Generation and Parking Generation guides. These publications represent data collected from mostly isolated suburban land uses—not walkable, urban places served by transit. There are few alternative guidelines for engineers building this other type of development, however, so despite these shortcomings many planners continue to use ITE’s publications. The goal of this study was to determine how much less parking is required at transitoriented developments (TODs) and how many fewer vehicle trips are generated than standard industry estimates. It is clear that TODs require less parking than development without transit, or transit without development. This study sought to gather information about how much parking is used at TOD to help developers and engineers make more-informed decisions in the future. To do that, Professor Reid Ewing and his research team at the University of Utah College of Architecture + Planning selected five TODs across the country, each with a slightly different approach to development and parking: Englewood, CO in the Denver region; Wilshire/Vermont station in Los Angeles, CA; Fruitvale Transit Village in Oakland, CA; the Redmond, WA station in the Seattle region; and Rhode Island Row in Washington, DC. The research team together with two transportation consulting firms, Fehr & Peers Associates and NelsonNygaard Consulting Associates, counted all persons entering and exiting the TOD buildings, and conducted brief intercept surveys of a sample of them. Researchers also conducted parking inventory and occupancy counts. Consistent with other research, this study found that the five TODs generated fewer vehicle trips than ITE publications estimate, and used less parking than many regulations require for similar land uses. And in one case, actual vehicle trips were just one third of what ITE guidelines estimate. The TODs included in this study also built less parking than recommended by ITE. Yet even this reduced amount of parking was not used to capacity: the ratio of demand to actual supply was between 58 and 84 percent. Fewer vehicle trips is one likely reason why parking occupancy rates were lower than expected. Another possible reason is that ITE’s data do not fully account for other travel modes that are available and actively encouraged at TODs. In each of the five TODs studied, at least 33 percent of trips were taken by modes other than driving. Additional reasons for low parking rates is that parking is shared between commercial and residential uses at two TODs, is shared between transit and park-and-ride uses at one TOD, is unbundled with apartment rents at two TODs, and is priced at market rates for commercial users at three TODs. These findings underscore the obvious need for developers, regulators, and practitioners to rethink how they use parking guidelines intended for suburban development not served by transit. Current engineering standards are not designed to accommodate this type of development but in time we hope studies like this can help change that. Better aligning industry standards with current needs can reduce the cost of development near transit, and make it easier to build more homes, shops, and offices in these high-demand locations